Electronic Theses and Dissertations

Date of Award

1-1-2023

Document Type

Dissertation

Degree Name

Ph.D. in Pharmaceutical Sciences

First Advisor

Meagen Rosenthal

Second Advisor

John Bentley

Third Advisor

Anne Cafer

School

University of Mississippi

Relational Format

dissertation/thesis

Abstract

Background: Initial research on food as medicine programs has shown encouraging evidence, but more evidence is needed to identify the most effective models, services, delivery methods, and funding mechanisms. Previously studied programs were designed by the researchers, providers, and public health advocates without input from patients on their preferences. Patient engagement is essential to develop successful programs.

Study Aims: 1) To explore the presence latent classes among individuals with diet-related chronic diseases likely to participate in food as medicine programs; 2) To explore preferences for attributes of food as medicine programs among individuals with diet-related chronic diseases likely to participate; 3) To explore willingness to pay for food as medicine programs among individuals with diet-related chronic diseases likely to participate.

Methods: A cross-sectional study was conducted to collect data from a sample of U.S. adults. A latent profile and discrete choice analyses was conducted to determine latent classes and preferences for program attributes, respectively. A partially de-biased approach was utilized to determine willingness to pay for three common food as medicine programs.

Results: The first study demonstrated four socio-ecologically different groups of individuals interested in food as medicine programs exist – the Socially-Limited Capable, High Propensity Capable, Disengage Capable, Low Propensity Vulnerable. The second study found cost per month was the most important attribute when choosing programs followed by the number of meals supplemented, enrollment and eligibility requirements, and program model. All four groups preferred the lower cost levels and supplementation of more than one meal per day. Among the program models, the voucher program was the least preferred by all four groups. Cooking demonstrations were the most preferred additional service. The final study indicated respondents were willing to pay in some capacity for participation in food as medicine programs and valued the medically tailored meal program the most.

Conclusion: This dissertation highlighted the heterogeneity of individuals likely to participate and their preferences for the design of food as medicine programs. The results allow the design and implementation of future programs to be customized for the needs of specific patient populations.

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