Improving food access and nutrition among food-insecure patients with cancer: A quality improvement pilot.
JCO Oncology Practice
Background: Malnutrition and food insecurity are prevalent among people with cancer, impacting treatment outcomes and quality of life. Interventions to address these challenges in oncology are needed. We evaluated a quality improvement pilot, Comfort Cuisine, designed to improve food access and nutrition through medically tailored meals, education, and resources.
Methods: This pilot was conducted across Michigan Oncology Quality Consortium (MOQC) practices. Adults undergoing cancer treatment with low-income and/or food insecurity received 14 medically tailored meals per week for four weeks. Cancer-specific education materials and resources, including meal-time aids and materials designed to enhance comfort and engagement during eating, were also provided. Surveys conducted at baseline and post-program collected demographics, food security (2-item screening tool), mental health (PHQ-2 and PRO-CTCAE), and perceived impact on health and well-being. Descriptive statistics were calculated for all measures and change in mental health status was assessed using Wilcoxon signed-rank tests.
Results: Fifty patients were enrolled (mean age 61 years, 73% white). At baseline, 92% worried about food running out, 86% reported insufficient food due to financial constraints. Post-program survey respondents (n=18, 36% response rate) reported meal delivery improved well-being (83%) and ability to manage treatment and related side effects (94%). All patients reported meals met nutritional needs (78% significantly, 22% somewhat). Anxiety scores significantly improved from baseline to follow-up (4.1 to 2.9; p=0.04) while depressive symptoms showed a similar improvement although the change was not statistically significant (3.8 to 2.9; p=0.22). Program satisfaction was high, with 89% reporting satisfaction with meal variety and 78% rating meal quality as good or excellent.
Conclusions: This pilot demonstrates feasibility and acceptability of a short-term intervention combining medically tailored meals, nutrition education, and supportive resources for people with cancer and food insecurity. Participants reported high program satisfaction including improvements in well-being, ability to manage treatment and side effects, and decreased anxiety. Results support further evaluation and potential integration of nutrition-focused supportive care interventions in oncology practice.ncology practice.
