Financial Gift, Nutrition, Healthy, Pregnancy Related
Conditions
Keywords
gift card, nutrition education, nutrition consultation, food purchase, recipe, telephone, medicaid, health claims
Brief summary
With funding from the Episcopal Health Foundation, the researchers will conduct a secondary data analysis to evaluate the impact of Driscoll Health Plan's Nurture program for pregnant members using claims data.
Detailed description
This record describes a quality improvement program (called Nurture) piloted by Driscoll Health Plan, which included nutrition education and food purchase support offered to a subset of pregnant women aged 30 years and above and covered by the Medicaid Managed Care Organization (MCO) plan in their STAR and CHIP programs during October 2022 and July 2023. Factor Health lab at Dell Medical School at the University of Texas at Austin will do a secondary data analysis to evaluate the impact of DHP's program. Driscoll Health Plan (DHP) is a non-profit, community-based health insurance plan that provides coverage to South Texas and the Rio Grande Valley communities. Their insurance products include STAR Medicaid, STAR Kids, CHIP, and CHIP Perinatal. With input from Factor Health lab at Dell Medical School, DHP introduced the Nurture program for its members as a quality improvement initiative, designed to expand members' access to nutrition education and food purchase support to improve health and pregnancy outcomes. Nurture included up to 8 packages mailed every four weeks until the member reaches the end of pregnancy. Each package included USD $40 in the form of gift cards to a large-chain grocery store, a healthy eating information sheet selected from Brighter Bites (https://brighterbites.org/), a set of three recipes, and nutrition-related Frequently Asked Questions during pregnancy (in four out of the eight packages). Members also received two 30-minute nutritional consultations over the phone. Members had the flexibility to opt out of the program at any time and discontinue receiving packages. Consultations were optional. If they opted out, they continued to receive the DHP benefits as part of their regular coverage.
Interventions
BEHAVIORALNurture program
1. Nurture Monthly Packages: Sent every four weeks until the member reaches the end of pregnancy (delivery or other reasons, e.g., miscarriage), with a maximum of eight packages. Each package includes: * A US$40 gift card (2 x $20 each) to a grocery store. * A healthy eating information sheet selected from Brighter Bites project (https://brighterbites.org/). * A set of three recipes. * Nutrition-related Frequently Asked Questions (included in four out of the eight packages). 2. Two 30-Minute Nutritional Consultations over the phone: Designed by a Registered Dietitian Nutritionist (RDN) who trained a bilingual nutrition specialist to deliver the consultations. Topics revolved around healthy eating during pregnancy, such as food choices, portion sizes, budget-friendly shopping, food safety, and food preparation. No nutrition therapy advice to manage diseases was provided.
OTHERRegular benefits
Includes regular healthcare services offered as part of the health plan coverage with Medicaid/CHIP.
Sponsors
Driscoll Health Plan
University of Texas at Austin
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
From the eligible population, DHP randomly selected a subset of approximately 500 women during the pilot period, from which approximately 200 were in the program, the exposed group. The women who were covered during the same period but were not selected were not exposed to the program and will compose the comparison group.
Eligibility
Sex/Gender
FEMALE
Age
30 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Member of Driscoll Health Plan * Pregnant * Aged 30 or older
Exclusion criteria
* Not a member of Driscoll Health Plan * Not pregnant * Younger than 30 years of age
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Composite outcome 1: Adverse health events during pregnancy | At pregnancy delivery | Composite includes health claims (paid or non-paid) with codes related to: * Gestational Diabetes Mellitus * Excessive weight gain during pregnancy * Pregnancy-associated hypertension |
| Composite outcome 2: Adverse health events at birth and newborn-related | At pregnancy delivery | Composite includes health claims (paid or non-paid) with codes related to: * Pre-term birth (\<37 weeks) * Neonatal Intensive Care Unit (NICU) * Small for gestational age * Large for gestational age * Stillbirths |
Other
| Measure | Time frame | Description |
|---|---|---|
| Cost (inpatient) | At pregnancy delivery | Cost of inpatient services (e.g., delivery) as available in paid health claims. |
| Cost (pharmacy/medication) | At pregnancy delivery | Cost of medication as available in paid health claims. |
| Cost (total) | At pregnancy delivery | Total cost of care as available in paid health claims. |
| Delivery mode (vaginal, C-section) | At pregnancy delivery | Health claims with codes related to mode of delivery. |
| Emergency Department visits | At pregnancy delivery | Health claims with codes related to visits to emergency department. |
| Prenatal visits | At pregnancy delivery | Number of prenatal visits during study pregnancy |
| Gift card usage | 30 days after inactive from program | Binary response was gift card fully used |
| Nutritional consults attended | At pregnancy delivery | Categorical description of nutritional consults attended, both/one/none |
| Birthweight | At pregnancy delivery | Requested from hospital's electronic health records (as available) |
| Cost (outpatient) | At pregnancy delivery | Cost of outpatient services (e.g., primary care visits, screening) as available in paid health claims. |
Countries
United States
Outcome results
None listed