Feasibility of Medically Tailored Meals for Pediatric Populations Experiencing Serious Illness and Inconsistent Access to Needed Calories from Healthy Foods - Consistent access to needed calories from healthy foods are fundamental to the health of pediatric populations, including those with serious illnesses, for example, cancer. One approach being studied to improve consistent access to food in the pediatric cancer context is to provide gift cards for an online grocery delivery platform. Prior research of compensatory cost coping with illness-related financial burden suggests that parents stretch food dollars by purchasing lower priced food with poor nutritional value. We also know that parents and siblings cope with illness-related financial burden by going without food to conserve household assets to meet the needs of the child who is ill, which can worsen parents and siblings’ nutritional intake and thus their health. To address inconsistent access to needed calories from healthy foods in households experiencing serious pediatric illness, we need holistic models of care that integrate food and nutrition with state of the science clinical care. Medically tailored meals (MTM; home-delivered meals tailored to medical needs of individuals with inconsistent access to needed calories from healthy foods + barriers to preparing healthy meals) that consider nutrition, treatment-related symptoms, and parental time demands offer a Food is Medicine approach to addressing inconsistent access to needed calories from healthy foods in pediatric populations with serious illnesses. In studies of adults with health conditions, MTM interventions were associated with better health outcomes and less health care spending. We extend the MTM concept to pediatric populations experiencing serious illness using pediatric cancer as proof of concept. Our purpose is to determine the feasibility of our methods and the MTM intervention for a future efficacy trial to improve access to needed calories from healthy food for households of children experiencing serious illnesses like cancer where nutritional status is fundamental to treatment tolerance and thus health outcomes. We will accomplish our aims by collaborating with a small business that makes tasty, healthy frozen meals. Our primary research question is: is an intervention that provides healthy, frozen meals tailored to tastes of children undergoing chemotherapy feasible and acceptable to the children and their primary parental caregiver? During year 1, we will conduct taste tastings with children undergoing chemotherapy to inform adaptation of meal flavorings to treatment-related taste alterations (Aim 1). In year 2, we will collect quantitative and qualitative data at multiple time points from children undergoing chemotherapy and their parents to inform rapid, data-driven refinements in our methods and intervention. Our results will inform the potential and protocol for a future full-scale trial and later cost effectiveness studies to advance our goal of advancing holistic models of care that integrate food and nutrition with state of the science clinical care. The project aligns well with the socio-ecological perspective of National Institutes of Nursing Research’s 2022-2026 strategic plan, and its models of care research lens.
