Evaluating Covered California's Grocery Support Program

Measured by 2-item Hunger Vital Sign, a validated tool to assess food insecurity. Responses that indicate that food sometimes or often did not last or ran out before the end of the month indicate food insecurity

Measured using the one-item response allowing calculation of the proportion of participants that report difficulty getting and eating healthy foods.

Measured using the self-reported number of servings of vegetables or number of days where higher fat foods were consumed during the past 7 days, by study arm

Proportion of participants that used the emergency department (ED) or had a treat and release ED or observation room visit and number of visits by study arm

Proportion of participants who were hospitalized at least once and count of total hospitalizations from baseline to 12 months by study arm

Proportion of participants who were re-hospitalized within 30-days of the index hospitalization by study arm

Number of primary care provider, specialist, mental health, and addiction medicine visits across the 12 month study period by study arm

Measured as the change in self-rated overall, physical, and mental health reported on a 0 to 5-response (excellent to poor) scale by study arm. Higher score corresponds to better self-rated health

Measured as the change in the proportion of participants with low food security. Low food security will be defined as one or more item answered with "Often true" in the Hunger Vital Sign. Change in proportion of participants with low food security, from baseline to 12 months

Measured using the 14-response options providing reasons why respondents have difficulty eating or not eating healthy foods

Measured based on the change in self-reported hospitalizations, doctors visits, and ED visits within the past 12 months measured as continuous outcome between 0 and 100 or more

Measured using the change in severity or presence of other social risks assessed using validated survey items for housing insecurity, transportation barriers, and financial strain

Measured using the proportion of participants who report sometimes or often making trade offs between paying for food and paying for medications or medical care, utilities, rent or mortgage, transportation, and education

Measured using the validated 10-item measure (PROMIS-10) to assess self-rated health, quality of life, mental and physical health, social satisfaction, ability to carry out roles, ability to carry out everyday physical activities, experiences of fatigue, frequency of emotional problems, and average pain. Analysis will assess change in overall measure by study arm

Measured using a 5-response question (never to often) to delays to medical care because of cost where often is a worse outcome.

Measured using changes in self-report based on a validated, 4-item perceived stress scale (PSS-4); scores range from 0-16 and higher scores correspond to higher perceived stress

Measured using changes in participant responses across the 10-item validated self-efficacy scale; scores range from 10-40 with higher scores corresponding to higher perceived general self-efficacy

Measured using changes in participant responses across the validated, two-item chronic disease self-efficacy scale; scores range from 1 to 10 with higher scores relating to higher chronic disease self-efficacy

Measured using claims data to analyze utilization characteristics e.g., length of stay (total days, average number of days per stay), and days until next admit across the 12-month study period

Measured as an affirmative response to cost-based medication nonadherence; change measured as a negative to affirmative or vice-versa response from baseline by study arm

Measured using medical claims data and calculated based on daily supply

Measured in the medical claims as the total number of medications that the participant had at baseline and across the 12-month study period

Change in self-reported HbA1c from baseline by study arm

Total cost of utilization across study period for inpatient and outpatient utilization

The change in a single-item question asking patients how many days (out of 7) they missed taking one of their medications. Changes in the number of days reported from baseline by study arm. More days corresponds to higher medication nonadherence