Adherence Patterns in a Randomized Controlled Trial of a Client-Choice Pantry-Based Food is Medicine Program
In brief
Food pantry trial retained 81% of participants, with nutrition improving across groups
In this pilot trial, 210 of 330 eligible patients enrolled, and 81% of participants completed the study. Over four months, food selections became more nutritious in all three groups, including those receiving usual pantry services, so the findings do not show that medically tailored groceries or coaching drove the change. Longer-term effects remain unknown.
- Journal
- The American journal of clinical nutrition (Q1)
- Published
- 1 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Tammy Leonard, Jaclyn L Albin, Connor Russell, Sandi L Pruitt, Michael E Bowen, Milette Siler, et al.
- PMID
- 42822833
- DOI
- 10.1016/j.ajcnut.2026.101550
Why clinicians should know about it
- Picked for Internal Medicine (top studies of the week, 4 October 2026): RCT of food‑medicine program, impacts chronic disease management
Abstract
BACKGROUND: Food is Medicine (FIM) interventions, including medically tailored groceries (MTG), are increasingly being investigated as an approach to improving chronic disease management in populations with lower income. To deliver on the potential benefits of FIM for ameliorating disparities in chronic disease outcomes, interventions need to be effective, pragmatic and desirable to patients. OBJECTIVES: We sought to examine socio-economic and demographic correlates of enrollment, retention, adherence, and participation. Additionally, we assessed how the nutritional quality of food selected at a client choice food pantry varied across the duration of the study and by study arm. METHODS: We implemented a 3-arm pilot randomized controlled trial (RCT) including 3 groups: usual pantry services, MTG only, and MTG + food resource coaching. Chi-squared tests, t-tests and ANOVA were used to compare participants versus eligible non-participants, completers versus those who did not, and among participants across study arms. Differences in the nutritional quality of foods selected between each study group were assessed using multiple variable regression models. RESULTS: Among 586 individuals screened, 330 completed the screener and met eligibility criteria; 210 (64% of eligible participants) enrolled. Individuals meeting inclusion criteria whose preferred language was Spanish were more likely to enroll in the study (60% of Spanish speakers enrolled versus 44% of English speakers, p=0.004). Among 210 participants, there were no statistically significant differences in characteristics between completers (81.4%) versus non-completers (18.6%). Over 4 months, food selections for all groups became more nutritious. CONCLUSION: This FIM intervention achieved a high level of enrollment, retention, adherence, and participation among safety-net healthcare system patients that typically experience a high burden of chronic disease and poorer chronic disease outcomes. TRIAL REGISTRATION: The randomized controlled trial from which the cost estimates are reported is registered at ClinicalTrials.gov, ID number NCT06242808: https://clinicaltrials.gov/study/NCT06242808. Registration date: 02/05/2024.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.