Kristin L Rising1, Mackenzie Kemp2, Patricia Davidson3, Judd E Hollander2, Serge Jabbour4, Eric Jutkowitz5, Benjamin E Leiby6, Cheryl Marco4, Ian McElwee7, Geoffrey Mills8, Laura Pizzi9, Rhea E Powell10, Anna Marie Chang2. 1. Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut Street, Suite 300, Philadelphia, PA 19107, USA; Center for Connected Care, Sidney Kimmel Medical College, Thomas Jefferson University, 1015 Walnut St, Suite 704, Philadelphia, PA 19107, USA; College of Nursing, Thomas Jefferson University, 901 Walnut Street, Philadelphia, PA 19107, USA. Electronic address: Kristin.rising@jefferson.edu. 2. Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut Street, Suite 300, Philadelphia, PA 19107, USA; Center for Connected Care, Sidney Kimmel Medical College, Thomas Jefferson University, 1015 Walnut St, Suite 704, Philadelphia, PA 19107, USA. 3. College of Health Sciences, Nutrition Department, West Chester University, 855 South New Street, West Chester, PA 19383, USA. 4. Department of Endocrinology, Sidney Kimmel Medical College, Thomas Jefferson University, 211 S 9(th) St, Unit 600, Philadelphia, PA 19107, USA. 5. Department of Health Services, Policy & Practice, Brown University School of Public Health, 121 South Main Street, Providence, RI 02912, USA; Providence Veterans Affairs (VA) Medical Center, Center of Innovation in Long Term Services and Supports, 830 Chalkstone Avenue, Providence, RI 02908, USA. 6. Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College, Thomas Jefferson University, 1015 Chestnut Street, Suite 401, Philadelphia, PA 19107, USA. 7. Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut Street, Suite 300, Philadelphia, PA 19107, USA. 8. Department of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, 1015 Walnut Street, Suite 401, Philadelphia, PA 19107, USA. 9. Center for Health Outcomes, Policy, & Economics, Rutgers University, 160 Frelinghuysen Road, Piscataway, NJ 08854, USA. 10. Division of Internal Medicine, Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, 833 Chestnut Street, Suite 701, Philadelphia, PA 19107, USA; Mathematica, 600 Alexander Park, Suite 100, Princeton, NJ 08543, USA.
Abstract
BACKGROUND: Research has shown that among people with type 2 diabetes mellitus, reduction in hemoglobin A1c (HbA1c) prevents long term complications. Medically tailored meals (MTM) and telehealth-delivered medical nutrition therapy (tele-MNT) are promising strategies for patient-centered diabetes care. OBJECTIVES: Project MiNT will determine whether provision of MTM with and without the addition of telehealth-delivered medical nutrition therapy improves HbA1c and is cost effective for patients with type 2 diabetes mellitus. METHODS: Patients with poorly controlled type 2 diabetes mellitus (HbA1c >8%) will be recruited from Jefferson Health. Eligible patients will be randomized to one of three arms: 1) usual care, 2) 12 weeks of home-delivered MTM, or 3) MTM + 12 months of tele-MNT. All participants (n = 600) will complete three follow-up assessments at 3, 6, and 12 months. The primary outcome is change in HbA1c at 6 months. Secondary outcomes include change in HbA1c at 3 and 12 months and cost-effectiveness of the intervention at 6 and 12 months. Conclusion Findings from Project MiNT will inform MTM coverage and financing decisions, how to structure services for scalability and system-wide integration, and the role of these services in reducing health disparities.
BACKGROUND: Research has shown that among people with type 2 diabetes mellitus, reduction in hemoglobin A1c (HbA1c) prevents long term complications. Medically tailored meals (MTM) and telehealth-delivered medical nutrition therapy (tele-MNT) are promising strategies for patient-centered diabetes care. OBJECTIVES: Project MiNT will determine whether provision of MTM with and without the addition of telehealth-delivered medical nutrition therapy improves HbA1c and is cost effective for patients with type 2 diabetes mellitus. METHODS: Patients with poorly controlled type 2 diabetes mellitus (HbA1c >8%) will be recruited from Jefferson Health. Eligible patients will be randomized to one of three arms: 1) usual care, 2) 12 weeks of home-delivered MTM, or 3) MTM + 12 months of tele-MNT. All participants (n = 600) will complete three follow-up assessments at 3, 6, and 12 months. The primary outcome is change in HbA1c at 6 months. Secondary outcomes include change in HbA1c at 3 and 12 months and cost-effectiveness of the intervention at 6 and 12 months. Conclusion Findings from Project MiNT will inform MTM coverage and financing decisions, how to structure services for scalability and system-wide integration, and the role of these services in reducing health disparities.
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