The Delaware Food Farmacy: Integrating Medically Tailored Groceries and Community Health Workers into Chronic Disease Management.

Abstract

Objective: This study evaluates whether a medically tailored grocery intervention supported by community health workers improves clinical, behavioral, and social outcomes among patients with diet-related chronic conditions. The Delaware Food Farmacy (DFF), a six-month program implemented by ChristianaCare, targeted adults with diabetes, hypertension, or heart failure.

Methods: This retrospective pre-post quasi-experimental study analyzed intake and six-month data for 185 participants enrolled between 2021 and 2024. Participants received weekly home deliveries of groceries aligned with the DASH diet, cooking tools, and ongoing support from community health workers (CHWs). Outcomes included food security, depression (PHQ-9), anxiety (GAD-7), BMI, blood pressure, and HbA1c.

Results: Results indicated significant improvements in food security (p = 0.008), depression (-2.19 points, p < 0.001), anxiety (-1.76 points, p = 0.001), BMI (-1.44 kg/m², p = 0.020), and HbA1c (-0.52%, p = 0.027). Goal completion averaged 84%, and satisfaction exceeded 90% across all program components.

Conclusions: Findings demonstrate that medically tailored grocery programs supported by community health workers can produce measurable improvements in health and social outcomes among medically complex, low-income adults, offering a scalable, equity-oriented model to address chronic disease and inform value-based reimbursement pathways.