Status:
UNKNOWN
Enrollment in and Utilization of the Flex Nutrition Program
Lead Sponsor:
Massachusetts General Hospital
Conditions:
Food Insecurity
Vulnerable Populations
Eligibility:
All Genders
3-64 years
Phase:
NA
Brief Summary
The goal of this clinical trial is to learn about the impact of proactive outreach on enrollment into and utilization of the Flexible Services Nutrition Program. The Flexible Services Nutrition Progra...
Detailed Description
The Medicaid ACO Flexible Services Program is a pilot that allocates state funding to address certain health-related social needs, in the domains of food and housing, with the goal of improving health...
Eligibility Criteria
Inclusion
- Has Medicaid ACO as primary health insurance, confirmed food insecurity (defined as a positive screen on the Hunger Vital Sign, which is conducted in routine care within primary care) AND one of the following:
- a Complex Physical Health Need
- a Behavioral Health Need
- a High Risk Pregnancy or
- Repeated ED use.
- A Complex Physical Health Need is defined as having a diagnosis of one or more of the following:
- Obesity (adults with BMI \> 30, pediatrics with weight in 95-99 percentiles)
- Diabetes
- Hypertension
- Chronic kidney disease or end stage renal disease
- Chronic heart failure
- Adult or pediatric cancer diagnosis
- Malnutrition
- Failure to thrive
- Gastrointestinal disease (e.g. inflammatory bowel disease such as Crohn's or Ulcerative Colitis)
- Asthma and two or more uncontrolled exacerbations per year
- COPD and two or more exacerbations per year High cholesterol
- HIV / AIDs
- Vitamin D deficiency or receiving Vitamin D supplements
- A Behavioral Health Need is defined as one or more of the following:
- Major depressive disorder
- Generalized anxiety disorder
- Bipolar disorder
- Schizophrenia
- Mood disorder (pediatric)
- Developmental disorders (e.g. autism)
- Substance use disorders or
- (for adults) an individual with PHQ-9 score or GAD-7 score of 10 or greater.
- High Risk Pregnancy is defined as:
- High risk pregnant individual with a diagnosis of:
- hypertensive disorders of pregnancy
- pregestational or gestational diabetes
- a referral to or care with a Maternal Fetal Medicine specialist or
- other high-risk, high-acuity diagnoses that can benefit from meeting an unmet social need
- Repeated ED Use is defined as:
- 2+ ED visits in last 6 months or 4+ ED visits in last 12 months
Exclusion
- Language other than English, Arabic, Spanish, or Creole.
- Language unknown
- Age\> 64.5 years (patients age out of the Medicaid ACO at 65, and this is a 6 month intervention)
- Previous referral (already in database whether or not enrolled)
- Invalid address (e.g. exclude address="NPA")
- No phone number
- Same address as another patient in report (randomly select 1 to retain)
Key Trial Info
Start Date :
August 1 2023
Trial Type :
INTERVENTIONAL
Allocation :
ESTIMATED
End Date :
February 1 2025
Estimated Enrollment :
255 Patients enrolled
Trial Details
Trial ID
NCT05972421
Start Date
August 1 2023
End Date
February 1 2025
Last Update
August 2 2023
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