低收入移民和少数族裔癌症患者普遍存在食品不安全问题。据我们所知，这项随机对照试验首次前瞻性地研究了粮食不安全干预措施对癌症结局的影响，目的是为解决癌症患者粮食不安全问题的循证干预措施提供信息。

在四个纽约市安全网癌症诊所的117名癌症患者(N = 117)中，进行了一项三组随机对照试验。Arms包括基于医院癌症诊所的食品储藏室(arm 1)、食品代金券加储藏室(arm 2)和家庭杂货交付加储藏室(arm 3)。在6个月时评估治疗完成情况(主要结果)和全部预约出勤率。在基线和6个月时评估食物安全状况、抑郁症状(患者健康问卷-9)和生活质量评分(癌症治疗功能评估-一般)。

代金券+食品储藏室的处理完成率最高(94.6%)，其次是杂货配送+食品储藏室(82.5%)和食品储藏室(77.5%);P = .046)。所有组的食品安全得分显著提高，患者健康问卷-9和癌症治疗功能评估总分在食品储藏室和分娩加食品储藏室组显著提高。我们在这项初步研究中的发现表明，在提高治疗完成度方面，代金券加食品室是最有效的干预措施，它符合我们有希望的干预措施的先验标准(90%)。所有干预措施都表明，对于有营养状况受损、生活质量下降和生存期较差风险的医疗服务不足、粮食不安全的癌症患者，有改善粮食安全的潜力。应对所有癌症患者进行食物不安全筛查，并提供基于证据的食物不安全干预措施。

Abstract

Purpose: Food insecurity is prevalent among low-income immigrant and minority patients with cancer. To our knowledge, this randomized controlled trial is the first to prospectively examine the impact on cancer outcomes of food insecurity interventions, with the goal of informing evidence-based interventions to address food insecurity in patients with cancer.

Methods: A three-arm randomized controlled trial was conducted among food-insecure (18-item US Department of Agriculture Household Food Security Survey Module score ≥ 3) patients with cancer (N = 117) at four New York City safety net cancer clinics. Arms included a hospital cancer clinic-based food pantry (arm 1), food voucher plus pantry (arm 2), and home grocery delivery plus pantry (arm 3). Treatment completion (primary outcome) and full appointment attendance were assessed at 6 months. Food security status, depression symptoms (Patient Health Questionnaire-9), and quality-of-life scores (Functional Assessment of Cancer Therapy-General) were assessed at baseline and at 6 months.

Results: Voucher plus pantry had the highest treatment completion rate (94.6%), followed by grocery delivery plus pantry (82.5%) and pantry (77.5%; P = .046). Food security scores improved significantly in all arms, and Patient Health Questionnaire-9 and Functional Assessment of Cancer Therapy-General scores improved significantly in the pantry and delivery plus pantry arms.

Conclusion: Our findings in this preliminary study suggest that voucher plus pantry was the most effective intervention at improving treatment completion, and it met our a priori criterion for a promising intervention (≥ 90%). All interventions demonstrated the potential to improve food security among medically underserved, food-insecure patients with cancer at risk of impaired nutrition status, reduced quality of life, and poorer survival. All patients with cancer should be screened for food insecurity, with evidence-based food insecurity interventions made available.

原文链接

pubmed.ncbi.nlm.nih.gov/35709430/

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