FOOD (Food to Overcome Outcomes Disparities)

食物（克服结果差异的食物）

• 批准号: 10229364
• 负责人: FRANCESCA M GANY
• 金额: $ 82.41万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-06-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10229364
• 关键词: Address; Appointment; Area; Breast Cancer Patient; Breast Cancer Treatment; Cancer Patient; Caring; Chronic Disease; Clinic; Depression screen; Dietary Intervention; Disease; Drug Prescriptions; Economics; Emergency Situation; Financial Hardship; Food; Foundations; Health; Hispanics; Home; Hospitals; Household; Immigrant; Individual; Intake; Interruption; Intervention; Kentucky; Life; Love; Malignant Neoplasms; Mediating; Medical; Memorial Sloan-Kettering Cancer Center; Mental Depression; Minority; New York City; Not Hispanic or Latino; Nutritional; Oncology; Outcome; Patients; Policies; Prevalence; Process; Proteins; Quality of life; Radiation; Randomized Controlled Trials; Reporting; Risk; Saints; Seminal; Services; Supportive care; Surveys; Time; Treatment Protocols; Vulnerable Populations; Weight; Well in self; Work; World Health Organization; active method; arm; base; cancer health disparity; cancer therapy; chemotherapy; cohort; cost; depressive symptoms; dietary; ethnic minority population; evidence base; food insecurity; food resource; food security; fruits and vegetables; health disparity; improved; intervention cost; medically underserved population; metropolitan; minority communities; patient population; preference; programs; social; socioeconomics; symptomatic improvement; treatment adherence; treatment arm; voucher

Project Summary The World Health Organization defines food security as having access to sufficient, safe, nutritious food to maintain a healthy and active life. Food security includes both physical and economic access to food that meets people's dietary needs and preferences. The 18-item, 12-month time-referenced U.S. Household Food Security Survey Module (USDA) categorizes individuals as having high food security, marginal food security, low food security, or very low food security. Food insecurity is growing in the U.S., with an overall prevalence of 12.7% (low and very low food security). The prevalence of food insecurity among immigrant and minority communities exceeds the national average. Food insecurity is associated with non-adherence to treatment. Food-insecure patients are more likely to postpone care and often cannot afford prescribed medication(s). Food-insecure patients have significantly higher levels of nutritional risk, depression, financial strain, and lower quality of life. Nutrition interventions result in enhanced quality of life. Cancer patients are particularly vulnerable to both food insecurity and its impact, due to the intensity of treatment protocols and the disease process itself. A study among a cohort of underserved cancer patients in New York City showed that 56% were food insecure, with 38% of the cohort with very low food security. Treatment adherence is an important determinant of survival among cancer patients. However, among ethnic minority cancer patients, unmet socioeconomic and supportive care needs are associated with patient-reported missed radiation, and/or chemotherapy appointments. Food insecurity potentially acts as a mediating factor, as functional, social, and emotional well-being decrease significantly with increasing food insecurity. Prior to our work, there had been only one study examining food insecurity in cancer patients. There is to date no evidence base on interventions to address food insecurity, and their potential to ameliorate cancer and other chronic disease treatment completion disparities. Food to Overcome Outcomes Disparities (FOOD) addresses this gap as the first large study of its kind to examine food interventions in vulnerable populations and their impact on breast cancer treatment completion. Results have the potential to guide program and policy change. FOOD will utilize a three arm randomized controlled trial to assess the impact of a hospital-based medically tailored food pantry (Pantry) versus a food voucher program (Voucher) versus a home grocery delivery program (Delivery) on cancer treatment completion. FOOD is a partnership between the Memorial Sloan Kettering Cancer Center (MSK) Immigrant Health and Cancer Disparities (IHCD) Service, the Food Bank for New York City, the New York City Council, the New York City Health and Hospitals, God's Love We Deliver, and Saint Barnabas Hospital. This study builds upon the foundation laid by a seminal pilot feasibility randomized controlled trial, which examined a scalable, clinic-based food pantry, a food voucher program, and home grocery delivery.

项目总结