Fresh Food and Fresh Moves: Enhancement of a Food is Medicine Program With Exercise to Optimize Diabetes Self-Management

Abstract

“Food is Medicine” (FIM) interventions address nutrition, however, few address other mediators of health like physical activity (PA). This study examined the acceptability and impact of PA support and resources integrated in the Fresh Start produce Rx (FSPRx) intervention on diabetes self-management. The FSPRx intervention included 9 group education classes, telephone-based health coaching, provision of resistance bands, and a PRx with medically underserved, rural adults with type 2 diabetes (n = 150). Data collection included surveys, retrospective chart review, and audio-recorded interviews (n = 25). Data were analyzed utilizing descriptive and bivariate analysis, and transcripts and open-ended survey questions analyzed via content analysis for themes. Self-efficacy in engaging in PA improved (P = 0.02), frequency of PA increased by 1.2 days per week (P < .001), and minutes of weekly PA increased but was not significant (P = 0.07). Frequency and self-efficacy of PA were not predictive of diabetes self-management improvements. Interview themes revealed reduced pain and context of PA behavior changes, confidence and skills. Integration of PA into a FIM framework was well received by participants, however, was not linked to diabetes self-efficacy. Further research is warranted to investigate efficacious and efficient approaches to align food and exercise as medicine interventions as well as enhanced emphasis on PA benefits.