Through funding from the Community Engaged Research Initiative (CERI), CTSI supported new research published in Healthcare about the potential of medically tailored grocery deliveries to improve food security and hypertension in underserved communities.
Root Causes — an organization led by Duke medical, graduate, and undergraduate students who want to improve community health through service, advocacy, education and research — conducted the pilot randomized control trial using a Population Health Improvement Award from CERI.
"We are excited to partner with Root Causes, El Centro Hispano, North Carolina Central University, and our colleagues at Duke to drive impactful research on food insecurity," said Cindy Haynes, MSA-PA, assistant director for CERI. "This critical issue is directly linked to higher rates of chronic diseases and adverse health outcomes, and together, we are committed to making a difference."
The partnership exemplifies CERI’s commitment to fostering meaningful and equitable collaborations between the community and academic investigators, Haynes said. Community-engaged research ensures that research is not only impactful but also relevant to the communities where studies are conducted, she added.
The study by the Root Causes Fresh Produce Program student team found that Black and Hispanic patients experiencing hypertension and food insecurity who received medically tailored groceries and nutrition education following the Dietary Approach to Stop Hypertension (DASH) diet saw improvements in both blood pressure and food security scores over three months.
Food as Medicine
The team took novel steps to address patients’ co-existing health-related social needs by providing home deliveries, transportation to study visits, and home visits. The team found that these elements of the study design were viewed positively by participants and enhanced retention. The authors concluded that partnerships between student-run organizations and community-based organizations are logistically feasible and may be acceptable avenues for organizing community-engaged trials that enhance access and explore the potential of food as medicine.
“What still compels me about the meaning of this study comes from when we hosted a community celebration at the end of the study,” said Duke graduate Elaijah Lapay, a community health worker for El Centro Hispano and the study’s first author. “We shared our raw data in English and Spanish directly to participants who were able to attend the event. I still remember participants pointing at lines on graphs we generated and saying, ‘I think that’s me there.’
“Members of the Durham community who felt that they and their experiences hadn’t before been sought out or valued in research studies were now being shown what research can look like for and with them in it. My sincere hope is that future research on something so personal — how communities, families, and individuals feed and nourish themselves — continues to foster those intentional moments of personal connection to the research.”
Research Team
The research team was led by Lapay; Scott Brummel, assistant director for food and nutrition security with Duke’s Office of Community Health; undergraduate students Elliot Yoon, Kishen Mitra, and Elena Suarez; and medical students Trevor Sytsma, Haley Hutchinson and Linda Tang. Support came from Patrick Hemming, MD, with Duke Internal General Medicine and Ryan Kane, MD, with the Duke National Clinician Scholars Program within CTSI.
Lisa Best, MD, and Rubi Morales were lead coordinators with the community partners, North Carolina Central University (NCCU) Dietetic Internship Program and El Centro Hispano Community Health Department.
“We are so grateful for the contributions of several people who had a large impact on the study, though they are not authors,” Hemming said. “Medical students Willis Wong and Natalie Wickenheisser, now graduated, partnered with nutrition graduate student Hannah Malian to draft our grant proposal, determine our budget for the project, hire our wonderful clinical research coordinator Maralis Mercado Emerson, and design our survey instruments and recruitment strategy.”
Root Causes provides opportunities for Duke health professions and undergraduate students to interact with social drivers of health and create a network across disciplines to find solutions to community health needs. Learn more about the group from the School of Medicine, and contact or donate to the organization.