297 Food is medicine: assessing medically tailored meals through a health equity lens for Hispanic/Latinx and monolingual Spanish-speaking populations

Objectives/Goals: To evaluate disparities in diabetes outcomes between Hispanic/Latinx and non-Hispanic participants in a medically tailored meal intervention, assess effect modification by ethnicity/language, and explore cultural factors influencing intervention effectiveness for diverse T2DM populations. Methods/Study Population: This mixed-methods study, part of the Changing Health through Food Support for Diabetes RCT (n = 246), compares standard diabetes care to a 6-month medically tailored meal intervention for T2DM patients with food insecurity. It examines differences in intervention effectiveness among Latinx, Spanish-speaking participants and non-Latinx, English-speaking participants from San Francisco and Alameda counties. Quantitative measures include HbA1c, food security scores, and hospitalization rates. Qualitative interviews explore diabetes management, food access, and cultural factors. Baseline disparities are assessed using t-tests and chi-square analyses, while longitudinal changes are evaluated with mixed-effects models. Thematic analysis of qualitative data identifies emerging patterns. Results/Anticipated Results: We expect to find significant baseline disparities in glycemic control and food security between Latinx- and Spanish-speaking participants compared to their counterparts. The medically tailored meal intervention is anticipated to show differential effectiveness, with potentially smaller improvements among Latinx and Spanish-speaking groups. While we hypothesize that medically tailored meals will lead to improved glycemic control and reduced food insecurity across all groups, the magnitude of improvement may vary. Qualitative data are expected to reveal unique cultural and linguistic barriers contributing to these disparities, as well as insights into the acceptability and cultural appropriateness of the intervention. Discussion/Significance of Impact: This study will inform culturally tailored medically tailored meal interventions for Hispanic/Latinx- and Spanish-speaking populations, addressing disparities in diabetes outcomes and food security. Findings will shape “food is medicine” initiatives and policies to reduce chronic disease burden and health inequities in diverse communities.