Patients were recruited from the Ambulatory Care Clinic at Bellevue Hospital in New York City via flyers, face-to-face recruitment, and physician referral. Emergency food security interventions are evolving. The 2 hypertension self-management interventions resulted in modest, nonsignificant BP reductions in this sample of urban, minority, low-income patients. children, MethodsA group of 28 men and women with type 2 diabetes and uncontrolled hypertension were randomized to either 1) home blood pressure telemonitoring alone or 2) home blood pressure telemonitoring plus telephone-based nurse case management. Analyses were performed with SPSS version 20 (IBM Corp). Food insecurity is associated with chronic disease among low-income NHANES participants. Have a coupon or promotional code? Seligman HK, Davis TC, Schillinger D, Wolf MS. Food insecurity is associated with hypoglycemia and poor diabetes self-management in a low-income sample with diabetes. Exclusion criteria were screening BP 180/110 mm Hg or higher, cognitive dysfunction or psychiatric comorbidity, pregnancy, concurrent participation in another clinical trial, or being deemed unable to comply with study protocol (ie, unwilling or unable to follow the home BP monitoring protocol or participate in telephone sessions). Diabetes Care 2012;35(2):233–8. Food Insecurity × Time interaction effect on systolic blood pressure (SBP) among 28 patients with uncontrolled hypertension and diabetes receiving telemonitoring interventions for BP reduction, New York City, 2012–2013. Poverty and obesity: the role of energy density and energy costs. Overall, the estimated drop in SBP over the course of the intervention (adjusting for the set of covariates) among food-secure participants was 9.2 mm Hg, whereas SBP increased by 3.1 mm Hg among food-insecure participants (Figure). During scheduled telephone sessions, HouseCalls nurse case managers provide self-management education and medication and appointment reminders, and they facilitate patient–provider communication. Responses of “often” or “sometimes”; “yes”; and “almost every month” or “some months but not every month” were coded as affirmative, and the sum of affirmative responses yielded the scale score (0–6). Alexandria (VA): US Department of Agriculture, Food and Nutrition Service; March 2000. Abbreviations: BP, blood pressure; GED, general educational development certificate; SD, standard deviation. Accessed January 6, 2014. Prev Chronic Dis 2015;12:140368. ConclusionScreening for food insecurity may help identify patients in need of tailored disease management interventions. They were instructed to take BP readings in the morning and evening at least 3 days per week during the 6-month intervention. Participants completed the 6-item USDA food security short form at baseline (17,18). Vermont has strong programs and partnerships that combat hunger and food insecurity, including major federal programs, free and reduced-price school meal programs, and local charitable food efforts. January/March 2017, Volume :6 Number 1 , page 7 - 10 [Buy], Join NursingCenter to get uninterrupted access to this Article. For health care providers, assessing for food insecurity reveals more about a family's struggles than about the availability of food in their home; it is a window into a broader view of the family's strengths and challenges. Coleman-Jensen A, Nord M, Singh A. In addition to the lack of data concerning possible explanatory factors, the small sample size is a limitation that precludes generalizations. Fermentation, freeze drying, dehydration, water bath canning, and pressure canning are all excellent options for preserving food. Seligman HK, Laraia BA, Kushel MB. Rose D, Oliveira V. Nutrient intakes of individuals from food-insufficient households in the United States. Multiple regression: testing and interpreting interactions. Nutritionally poor foods are often less expensive than healthful foods (2,3), and food insecurity is associated with poor diet quality (4–6) and diet-sensitive diseases, including diabetes, hypertension, and hyperlipidemia (7–12). Some old approaches remain relevant, but are sometimes not well understood. Although food insecurity exists in every county in the US, some regions and types of communities experience higher rates than others. Prev Chronic Dis 2014;11:130334. Maslow, It provides... Read more » Food insecurity is a dynamic, complex issue associated with health, educational, and economic factors. Food insecurity and glycemic control among low-income patients with type 2 diabetes. the average level of food insecurity and at whether that food insecurity is widely experienced or concentrated in certain groups (Reenock, Bernhard and Sobek, 2007; Østby, 2008). The US Department of Agriculture (USDA) definition of food insecurity is “having limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways” (1). Ethn Dis 2011;21(3):328–34. These findings contribute to the growing literature demonstrating poorer health outcomes in food-insecure versus food-secure individuals (7–14). (14) Seligman HK, Jacobs EA, Lopez A, TschannJ, Fernandez A. Malnutrition results from deficiencies, excesses or imbalances in the consumption of macro- and/or micro-nutrients. The intervention tested in this study was the HouseCalls telehealth program, which is integrated into the New York City Health and Hospitals Corporation (HHC) system as part of its home care program. N Engl J Med 2010;363(1):6–9. Morisky DE, Ang A, Krousel-Wood M, Ward HJ. We also did not collect data on health literacy (21), a potentially relevant factor in this patient sample, or on psychological stress, which affects BP and is part of a proposed model of the cycle of food insecurity and chronic disease (9,22–24). DOI: http://dx.doi.org/10.5888/pcd12.140368external icon. a Adjusted models control for intervention arm, age, sex, race/ethnicity, total family income adjusted for household size, education, body mass index, and antihypertensive medication use. Newbury Park (CA): Sage, 1991. Seligman HK, Bindman AB, Vittinghoff E, Kanaya AM, Kushel MB. Dixon LB, Winkleby MA, Radimer KL. Increased rural to urban migration, climate change, changes in lifestyle and diet patterns put considerable pressure on the declining freshwater resources and biodiversity, loss of fertile land. The intervention is delivered by HHC nurses who have real-time access to patients’ EHRs and are in communication with their providers. Food insecurity affects 14.9% of American households, and rates are approaching 25% among black and Hispanic households (1). Diabetes Care 2009;32(12):2218–24. The charitable food sector, including institutions like food banks, food pantries, soup kitchens, and feeding programs, is working together to address food insecurity while promoting health. Sample items are “The food that (I/we) bought just didn’t last, and (I/we) didn’t have money to get more”; (“I/we) couldn’t afford to eat balanced meals”; and “Were you ever hungry but didn’t eat because there wasn’t enough money for food?” Items were rated for the previous 12 months using several response scales. J Gen Intern Med 2007;22(7):1018–23. Interventions that cultivate sustainable food systems to promote health, prevent obesity, and improve food security have the potential for many large-scale and long-lasting benefits including improvements in social, environmental, health, and economic outcomes. Participants assigned to home telemonitoring received publicly available educational materials regarding management of hypertension and diabetes and were encouraged to follow the clinical guidelines described in the materials. CDC twenty four seven. Following this analysis, we tested the hypothesis that food insecurity would be associated with smaller reductions in BP (Food Insecurity × Time interaction). Funding for this study was provided by K24HL111315 (Ogedegbe). © 2021 Wolters Kluwer Health, Inc. and/or its subsidiaries. After performing an unadjusted analysis, we also examined the association between food insecurity and SBP change after adjusting for a set of relevant covariates (age, sex, race/ethnicity, total family income adjusted for household size, education, body mass index, and antihypertensive medication use). However, detailed dietary data were not collected in this pilot study, so these hypotheses could not be tested. Most of the types of political violence addressed here are more prevalent in societies with higher levels of chronic food insecurity. Food insecurity of any severity impacts families and communities in multiple ways. Diabetes Care 2014;37(9):2587–92. Values depict unadjusted SBP estimates at each time point. Helen Clark, former UNDP Administrator – on food insecurity in Africa and possible solutions. Diabetes risk and obesity in food-insecure households in rural Appalachian Ohio. On the basis of these findings, we propose that food-insecure patients may be less likely to benefit from behavioral interventions designed to improve chronic disease outcomes, but to our knowledge this relationship has not been tested. Calls are 15 to 45 minutes long depending on the needs of the patient. Join NursingCenter on Social Media to find out the latest news and special offers. 1. Another limitation is the 1-time assessment of food insecurity, given that food security status varies over time, both within a month and over longer periods of time (25). and 2) what are its dietary consequences? – Terms & Conditions – Privacy Policy – Disclaimer -- v7.7.7, Changes to Lippincott Professional Development Program, Calming the COVID-19 Storm - Q&A Podcast Series, Improving Health through Board Leadership, Profiles in Nursing Leadership: Pathways to Board Membership, Trust and Spheres of Influence: An Interview with Karen Cox, PhD, RN, FACHE, FAAN, Uniting Technology & Clinicians: An Interview with Molly McCarthy, MBA, RN-BC, Where are our N95s? The Food Security Solution. They also completed a single 30-minute telephone session with a nurse case manager within 2 weeks of randomization and delivery of the blood pressure telemonitoring device to their home. The nurse case manager had access to the patients’ home BP data via a secure website, where the readings are displayed in easy-to-read charts and figures that highlight the control rate for each week. Jan 13 2021 (IPS) - The COVID-19 pandemic has exacerbated food insecurity and disrupted food systems and food supply chains in developed and developing countries alike. To evaluate the impact of food insecurity on blood pressure reduction in a pilot clinical trial, we tested the effectiveness of 2 behavioral interventions for hypertension in people with and without food security. The intent-to-treat analysis showed a nonsignificant reduction in SBP of 2.7 mm Hg from baseline to 6 months across both intervention arms (main effect of Time). Teach a man to fish and you feed him for a lifetime." The duration and pattern of exposure to food insecurity may be a predictor of the associated health consequences. Am J Clin Nutr 2004;79(1):6–16. Our study examined the impact of food insecurity on blood pressure (BP) reduction in a pilot study examining the comparative effectiveness of 2 hypertension self-management strategies in an urban sample of low-income black and Hispanic patients. Abstract: Food insecurity is a threat to the physical and mental health of children and their families. you'll get access to the ePub version, a downloadable PDF, and the ability to print the full article. The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors’ affiliated institutions. In this article, food insecurity prevalence, definitions, and related concepts will be reviewed. Structural inequalities and discrimination against people of color, LGBTQ people, immigrants, people with disabilities, and women drives disparities in food insecurity. They also create individually tailored goals in collaboration with each participant. The primary reasons for dropout were family or housing issues and leaving the area. To evaluate the impact of food insecurity on blood pressure reduction in a pilot clinical trial, we tested the effectiveness of 2 behavioral interventions for hypertension in people with and without food security. Berkowitz SA, Baggett TP, Wexler DJ, Huskey KW, Wee CC. Sample characteristics show that this sample was racially/ethnically diverse, with low socioeconomic position ( Table 1). Rural areas have higher rates of food insecurity overall. Am J Public Health 1988;78(10):1298–301. In each of the analyses, results were not substantially different in magnitude or significance after adjustment for intervention arm, age, sex, race/ethnicity, family income, education, body mass index, and antihypertensive medication use ( Table 2). Understanding dietary correlates of food insecurity also assists in focusing our interventions, be they food assistance or nutrition education, and … Introduction Food insecurity is associated with diet-sensitive diseases and may be a barrier to successful chronic disease self-management. Some of the most common, yet complex, effects of food insecurity include: serious health complications, especially when people facing hunger are forced to choose between spending money on food … We did conduct exploratory analyses of several potential factors that might help to explain the observed differences in BP change over time between patients with and without food security. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Patients who were interested and eligible provided written informed consent and completed baseline assessments, including self-report questionnaires and measurement of height, weight, and BP. 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