FOOD (Food to Overcome Outcomes Disparities)

食物（克服结果差异的食物）

• 批准号: 10413066
• 负责人: FRANCESCA M GANY
• 金额: $ 66.26万
• 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/10413066
• 关键词: Address; Appointment; Area; Black race; 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; Hispanic; Home; Hospitals; Household; Immigrant; Immigrant community; 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; Persons; Policies; Prevalence; Process; Proteins; Quality of life; Radiation; Randomized Controlled Trials; Reporting; Risk; Saints; Seminal; Services; Supportive care; Surveys; Time; Treatment Protocols; United States Department of Agriculture; 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; 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.

项目摘要 世界卫生组织将粮食安全定义为获得足够，安全，营养的食物 保持健康而活跃的生活。粮食安全包括物理和经济获取食品 满足人们的饮食需求和偏好。 18个项目，12个月的美国家庭食品 安全调查模块（USDA）将个人归类为具有高粮食安全，边际粮食安全， 粮食安全性低或粮食安全非常低。在美国，粮食不安全正在增长，总体流行率 12.7％（粮食安全较低和非常低的粮食安全）。移民和少数族裔粮食不安全的普遍性 社区超过全国平均水平。粮食不安全与治疗的不遵守有关。 食品不安全的患者更有可能推迟护理，并且通常无法负担开处方药。 食品不安全的患者的营养风险，抑郁，财务压力和较低 生活质量。营养干预导致生活质量提高。癌症患者特别是 由于治疗方案的强度和疾病 处理本身。纽约市一系列服务不足的癌症患者的研究表明，有56％为 粮食不安全，其中38％的队列粮食安全。治疗依从性很重要 癌症患者生存的决定因素。但是，在少数民族癌症患者中 社会经济和支持性护理需求与患者报告的错过的辐射有关，和/或 化学疗法预约。粮食不安全可能充当中介因素，作为功能，社会和 随着粮食不安全的增加，情绪健康会大大减少。在我们工作之前， 只有一项研究检查癌症患者的粮食不安全。迄今为止没有证据基础 解决粮食不安全的干预措施及其改善癌症和其他慢性疾病的潜力 治疗完成差异。克服结局差异的食物（食物）解决了这一差距 同类研究的首次大型研究是检查脆弱人群中的食物干预及其对乳房的影响 癌症治疗完成。结果有可能指导计划和政策更改。食物将利用 一项三臂随机对照试验，以评估基于医院的医学量身定制食品储藏室的影响 （食品储藏室）与食品凭证计划（代金券）与家庭杂货店交付计划（交付） 癌症治疗完成。食物是纪念斯隆·肯特林癌症中心之间的伙伴关系 （MSK）移民健康与癌症差异（IHCD）服务，纽约市食品银行，新的 约克市议会，纽约市卫生和医院，我们送出的上帝的爱以及圣巴纳巴斯 医院。这项研究基于开创性的飞行员可行性随机对照试验的基础， 它检查了可扩展的基于诊所的食品储藏室，食品凭证计划和家庭杂货店的交付。