Medically Tailored Meals for Patients with Heart Disease in Rural Maine: Lessons Learned and Next Steps

Problem: Cardiac disease is the leading cause of death in the United States. Social determinants of health (SDOH), including food insecurity, strongly influence heart disease risk factors and outcomes. Prior studies providing medically tailored meals to patients have shown promising results but have largely been conducted in urban areas. Franklin County, Maine, the target location for this intervention, is a rural setting with more food insecurity and cardiovascular disease than other parts of Maine. Approach: This program, called Healthy Links, delivered medically tailored meals to patients with cardiac disease and SDOH needs who were living in Franklin County, a rural county in Maine. The 12-week program began with a wellbeing assessment administered by Area Agency on Aging staff. Then each participant received 2 deliveries of 5 heart-healthy meals. Based on identified needs, participants were offered relevant services, such as nutrition education, financial services, and transportation resources. Outcomes: A total of 58 patients were offered the program and 16 enrolled. Of those who enrolled, 4 (25%) received all 10 meals, 4 (25%) received 5 meals, and 8 (50%) declined all meals. The most common reason for declining meals was that the participant believed the service was unnecessary (6 participants). Self-report of food security on a Likert scale was collected for 2 participants and improved slightly. Next Steps: This project developed a promising model that could be more impactful with closer examination of patient preferences. As screening for food insecurity increases, effective interventions are needed. This project shows the feasibility of food delivery through interorganizational collaboration and highlights the importance of matching the intervention to the self-identified needs of participants. The study team plans to evaluate cardiovascular outcomes in patients who received medically tailored meals and maintains an interest in engaging patients in rural settings.