{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T19:13:50Z","timestamp":1781118830823,"version":"3.54.1"},"reference-count":40,"publisher":"American Diabetes Association","issue":"3","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100006512","name":"School of Medicine, Duke University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006512","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000097","name":"National Center for Research Resources","doi-asserted-by":"publisher","award":["UL1TR001117"],"award-info":[{"award-number":["UL1TR001117"]}],"id":[{"id":"10.13039\/100000097","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019480","name":"North Carolina General Assembly","doi-asserted-by":"publisher","award":["22-038-2008"],"award-info":[{"award-number":["22-038-2008"]}],"id":[{"id":"10.13039\/100019480","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>\u201cFood Is Medicine\u201d approaches are popular disease management strategies for patients experiencing food insecurity (FI) and diet-sensitive conditions; however, few studies consider heterogeneous treatment effects (HTE) across patient subpopulations. We estimate HTE of a prescription for produce (PRx) tested within a randomized controlled trial of patients with diabetes at risk of FI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>We use machine learning to estimate HTE of a PRx conducted within an integrated health system, academic medical center, and primary care network in the southeastern U.S. This trial included 2,155 patients enrolled in the health system\u2019s diabetes registry with at least one hemoglobin A1c (HbA1c) measurement in the prior year and at-risk status for FI. Participants received $80\/month for 12 months on a debit card covering fruit and vegetable purchases. Outcomes included HbA1c change (post- minus preintervention) and any postintervention emergency department (ED) utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>For HbA1c, the largest negative standardized difference in HbA1c change between intervention arms was observed among participants with HDL cholesterol &amp;gt;50.67 mg\/dL and triglycerides &amp;gt;82.5 mg\/dL (estimate [SE] \u22120.25% [0.12], \u22122.7 mmol\/mol [1.3]; P = 0.019). For ED visits, the largest reduction in probability of any postintervention visits between arms was observed among individuals with low outpatient (OP) utilization, nonprivate and non-Medicare insurance, LDL cholesterol &amp;gt;78.5 mg\/dL, and age &amp;gt;50.5 years (estimate [SE] \u22120.2 [0.05]; P &amp;lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Our findings suggest that social factors (e.g., age and OP utilization) and clinical factors (e.g., cholesterol) may impact PRx effectiveness for diabetes management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/doc26-0005","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T20:39:22Z","timestamp":1778272762000},"page":"468-477","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["Heterogeneous Treatment Effects of a Prescription for Produce Subsidy on Diabetes Care Management"],"prefix":"10.2337","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7448-0479","authenticated-orcid":false,"given":"Stephanie B.","family":"Jordan","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Stanford University School of Medicine 1 , Palo Alto, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Dennis","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Duke University School of Medicine 2 , Durham, NC"},{"name":"Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine 3 , Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan E.","family":"Spratt","sequence":"additional","affiliation":[{"name":"Duke Population Health Management Office, Duke University Health System 4 , Durham, NC"},{"name":"Division of Endocrinology and Metabolism, Duke University School of Medicine 5 , Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8091-1941","authenticated-orcid":false,"given":"Jashalynn C.","family":"German","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Duke University School of Medicine 5 , Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Brucker","sequence":"additional","affiliation":[{"name":"Department of Biostatistics & Bioinformatics, Duke University School of Medicine 6 , Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy","family":"Wirth","sequence":"additional","affiliation":[{"name":"Reinvestment Partners 7 , Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal","family":"Curran","sequence":"additional","affiliation":[{"name":"Reinvestment Partners 7 , Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenia M.","family":"Hinz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University School of Medicine 8 , Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5393-6246","authenticated-orcid":false,"given":"Connor D.","family":"Drake","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Duke University School of Medicine 2 , Durham, NC"},{"name":"Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System 9 , Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"2026061014522155300_B1","unstructured":"U.S. Centers for Disease Control and Prevention\n          . 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