Development of user-centered design for screening, referral, and enrollment of Medicaid adults with hypertension in a health care by Food™ pilot study

BACKGROUND: Food is medicine (FIM) partnerships are increasing. There are no standard practices that integrate user-centered design (UCD) in screening, referral, and enrollment process for FIM programs. 

METHODS: This mixed-methods study, based on UCD principles and the Fogg Behavior Model, used quantitative and qualitative data to understand multiple users' perspectives on screening, referral, and enrollment processes for a Health Care by Food™ pilot study. 

RESULTS: Most eligible participants (73%) enrolled in the study. Patients who were eligible but did not participate expressed embarrassment about discussing their food situation, lack of understanding of the type of foods being offered, and not wanting to take resources from others. Health care providers found the screening and referral process easy to implement. Patients who enrolled in the study found the process acceptable. 

CONCLUSION: User-informed screening, referral, and enrollment processes can support the creation of more acceptable systems to connect people with needed food resources.