Browsing by Author "Dawkins, Emily"

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    Delivering Food Resources and Kitchen Skills (FoRKS) to Adults with Food Insecurity and Hypertension: A Pilot Study
    (MDPI, 2023-03-17) Rivera, Rebecca L.; Adams, Mariah; Dawkins, Emily; Carter, Amy; Zhang, Xuan; Tu, Wanzhu; Peña, Armando; Holden, Richard J.; Clark, Daniel O.; Medicine, School of Medicine
    Food insecurity affects nearly 50 million Americans and is linked to cardiovascular disease risk factors and health disparities. The purpose of this single-arm pilot study was to determine the feasibility of a 16-week dietitian-led lifestyle intervention to concurrently address food access, nutrition literacy, cooking skills, and hypertension among safety-net primary care adult patients. The Food Resources and Kitchen Skills (FoRKS) intervention provided nutrition education and support for hypertension self-management, group kitchen skills and cooking classes from a health center teaching kitchen, medically tailored home-delivered meals and meal kits, and a kitchen toolkit. Feasibility and process measures included class attendance rates and satisfaction and social support and self-efficacy toward healthy food behaviors. Outcome measures included food security, blood pressure, diet quality, and weight. Participants (n = 13) were on average {mean (SD)} aged 58.9 ± 4.5 years, 10 were female, and 12 were Black or African American. Attendance averaged 19 of 22 (87.1%) classes and satisfaction was rated as high. Food self-efficacy and food security improved, and blood pressure and weight declined. FoRKS is a promising intervention that warrants further evaluation for its potential to reduce cardiovascular disease risk factors among adults with food insecurity and hypertension.
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    Group education program for hypertension control
    (Wiley, 2020-11) Meredith, Ashley H.; Schmelz, Andrew N.; Dawkins, Emily; Carter, Amy; Medicine, School of Medicine
    Hypertension continues to be a health crisis, with multiple approaches attempting to define best practices for management. The objective of our hypertension group education program is to improve patient health outcomes through engaging a multidisciplinary health professional team. A 6-hour group curriculum was created with a focus on nutrition, lifestyle, and medication approaches to hypertension management, while incorporating personally identified behavior change goals and barriers. Outcomes were tracked pre-program, at program completion, and 6 and 12 months post-program completion. Program participants demonstrated immediate and sustained improvements in blood pressure readings and attainment of personal behavior change goals. Group hypertension education classes are an effective way to care for patients. Additional healthcare resources should be dedicated to creating and evaluating educational delivery models that are sustainable and provide results over time, including financial implications to the health system.
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    The Food Resources and Kitchen Skills intervention: Protocol of a randomized controlled trial
    (Public Library of Science, 2025-02-06) Peña, Armando; Dawkins, Emily; Adams, Mariah; Moser, Lyndsi R.; Carter, Amy; Rivera, Rebecca L.; Reinoso, Deanna; Tu, Wanzhu; Holden, Richard J.; Clark, Daniel O.; Psychiatry, School of Medicine
    Introduction: Individuals with food insecurity are disproportionately burdened by hypertension (HTN) and type 2 diabetes and face greater barriers to self-managing these conditions. Methods: Food Resources and Kitchen Skills (FoRKS) is an ongoing 2-arm parallel randomized controlled trial (RCT) that will enroll 200 adults (35-75 y) with food insecurity and elevated systolic blood pressure (≥120 mmHg) at a large federally qualified health center (FQHC) network in Central Indiana. Blood pressure is measured using an ambulatory blood pressure monitoring (ABPM) device. The (FoRKS, N = 100) intervention integrates hypertension self-management education and support (SMES) with a home-delivered ingredient kit and cooking skills program (16 weeks). Enhanced Usual Care (EUC, N = 100) includes usual care services by the FQHC network, SMES classes (separate from FoRKS), and grocery assistance. This paper describes the protocol for this RCT that will: 1) test the efficacy of FoRKS compared to EUC for reducing systolic blood pressure using an intention to treat protocol, 2) identify behavior change levers (e.g., engagement, social support) and their associations with change in food insecurity, diet quality, and systolic blood pressure, 3) examine the maintenance of outcomes, and 4) assess cost-effectiveness. Conclusions: Establishing that a food insecurity and SMES intervention, compared to usual care services, is feasible in FQHCs and efficacious for improving blood pressure and related outcomes would have important public health implications. Understanding the behavior change levers of FoRKS that are associated with changes in health outcomes, whether these outcomes are maintained, and its cost-effectiveness will inform future efforts to address health disparities.