The Effect of Grocery Support Dose on Food Insecurity and Disease Control Among Covered California Members With Diabetes or Hypertension

Measured by 2-item Hunger Vital Sign, a validated tool to assess food insecurity. Higher scores indicate greater food insecurity.

Change in self-reported HbA1c from baseline by study arm.

Measured using the change in self-reported frequency per week that a participant experiences hypoglycemia.

Change in self-reported systolic and diastolic blood pressure from baseline by study arm.

The change is measured using an adapted 10-item version of the validated 17-item Diabetes and Hypertension Distress Scale, where each item ranges from 1-5, mean score ranges from 1-5, and total score is 10-50 with higher scores indicating greater diabetes- and hypertension-related distress.

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 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 an affirmative response to cost-based medication nonadherence and 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.

Measured using medical claims data and calculated based on daily supply.

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

Measured using a 5-response question (never to often) to delays to medical care because of cost and a binary (yes/no) response to a question about cost-related medication nonadherence.

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 changes in self-report based on a validated, 10-item perceived stress scale.

Measured using changes in participant responses across the 9-item validated self-efficacy scale.

Measured using changes in participant responses across the validated, two-item chronic disease self-efficacy scale.

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