A mixed-methods investigation of patient food and dietary preferences

The socioeconomic and cultural factors that influence what people eat can cause inequities that are detrimental to health, especially in underserved communities. The Food is Medicine movement strives to reduce these disparities by enhancing access to nutritious food, providing education, and encouraging behavioral changes.

To support patients with medical needs, researchers at Boston Medical Center (BMC) are collaborating with a local grocer, Nubian Markets, to develop a labeling system that identifies prepared meals medically tailored for health conditions like diabetes.

The findings were published in HealthCare: The Journal of Delivery Science and Innovation on August 6, 2024.

“We aim to provide resources that people can relate to, with the goal of reducing health disparities. Through our quality improvement research, we seek to really understand what patients want and need and how they should receive those resources,” says Olivia Thomas, a registered dietitian at BMC and lead author on the study.

The research team partnered with the patient community to codesign their Food is Medicine educational materials and programs to be more culturally inclusive. They found that actively engaging BMC’s diverse patient population in reimagining their programs enables the creation of generalizable, relatable resources that could help reduce disparities in health outcomes related to diet.

The researchers conducted surveys in six different languages between January and May 2023 in adult primary care settings about eating behaviors, food choices, and nutrition education preferences. To obtain feedback on disease-specific resources, they held a virtual focus group with patients who have type 2 diabetes.

Thomas and colleagues found that patients wanted educational materials available in different languages and modalities (in person vs. virtual), and access to support through nutrition counseling, hands-on cooking classes, and peer groups. To address these needs, the team is working to develop multilingual cooking classes in Spanish, Portuguese, Haitian-Creole, and Vietnamese.

The researchers also found that 76% of patients ate meals prepared outside of their homes because of scheduling constraints but didn’t feel like they had enough guidance on nutrition when ordering out.

Patients with medical needs like type 2 diabetes wanted practical, empowering guidance to find medically tailored meals and figure out how to portion foods.

The labeling system at Nubian Markets will enable clinicians to provide unrestricted grocery vouchers rather than prescriptions for specific foods, a unique aspect of BMC’s Food is Medicine program.

“Food insecurity is not just a matter of access; it profoundly impacts health and well-being, particularly within communities of color. At BMC, we recognize that addressing food insecurity is essential to achieving health equity. This study is a crucial extension of our commitment to prioritize food as medicine, and ultimately improve the health outcomes of our patient populations,” says Thea James, co-Executive Director of the Health Equity Accelerator and Vice President of Mission and Associate Chief Medical Officer at BMC.