Evaluating Covered California's Grocery Support Program

NCT07215897 | Active Not Recruiting

• 2 other identifiers: 24-4254821-C027-11
• Study Type: interventional
• Target: 6,975
• Locations: 1 country
• Sites: 1

Brief Summary

This is a pragmatic randomized controlled trial (RCT) of Covered California's Grocery Support Program. This pragmatic RCT will test the efficacy of providing a monthly food card benefit for adults with food insecurity, a chronic condition, and incomes below 250% of the federal poverty level (FPL) compared with a group who receives a lump sum payment.

Conditions

Chronic Conditions, Multiple; Chronic Conditions; Food Insecurity; Low-Income Population

Keywords

chronic conditions; food insecurity; grocery benefit; low-income

Outcome Measures

Primary Outcomes (1)

• Change in food insecurity status

  Measured by 2-item Hunger Vital Sign, a validated tool to assess food insecurity. Responses that indicate that food sometimes or often did not last or ran out before the end of the month indicate food insecurity

  Baseline, 12 months

Secondary Outcomes (7)

• Change in nutrition security

  Baseline, 12 months

• Change in diet quality

  Baseline, 12 months

• Proportion of participants with acute health care utilization

  2 years before study start until 12 months after

• Proportion of hospital admissions

  2 years before study start until 12 months after

• Proportion of hospital readmissions

  2 years before study start until 13 months after

Other Outcomes (17)

• Change in proportion of participants with low food security

  Baseline, 12 months

• Change in why participants could not/did not eat healthy foods

  Baseline, 12 months

• Change in self-reported number of health visits

  Baseline, 12 months

Study Arms (2)

Monthly grocery support program

EXPERIMENTAL

The intervention entails the provision of an $80 monthly payment (adjusted by household size) in the form of a re-loadable cash card to be used at food retailers including food retailers who sell non-food item.

Other: Grocery Support Monthly Program

One-time grocery support payment

ACTIVE COMPARATOR

At the end of the study period (12 months), active comparator participants are provided a lump sum payment of $960 (adjusted by household size) as a re-loadable cash card to use at food retailers. No intervention is provided during the 12-month evaluation period.

Other: Grocery Support One-Time Payment

Interventions

Grocery Support Monthly Program OTHER

$80 monthly (adjusted by household size), re-loadable cash card for use at food retailers to purchase fresh and packaged foods, baby food and formula, and/or non-alcoholic drinks

Monthly grocery support program

Grocery Support One-Time Payment OTHER

No intervention is provided during the 12-month evaluation period. A $960 one-time (adjusted by household size) cash card for use at food retailers provided after the 12 month evaluation period to purchase fresh and packaged foods, baby food and formula, and/or non-alcoholic drinks

One-time grocery support payment

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Members of the household are eligible to participate if the recruited participant:
• Active Covered California member
• Adult \>= 18 years of age
• Has a chronic condition identifiable in Covered California's medical claims
• Screened positive for food insecurity via 2-item Hunger Vital Sign
• Income \<250% federal poverty level

You may not qualify if:

• Negative for food insecurity via 2-item Hunger Vital Sign
• Income ≥250% federal poverty level

Sponsors & Collaborators

• University of California, San Francisco: lead
• Covered California: collaborator

Study Sites (1)

Social Interventions Research and Evaluation Network (SIREN), University of California, San Francisco

San Francisco, California, 94107, United States

Location

MeSH Terms

Conditions

Multiple Chronic Conditions; Chronic Disease

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Laura M Gottlieb, MD, MPH

  University of California, San Francisco

  PRINCIPAL INVESTIGATOR

• Caroline Fichtenberg, PhD

  University of California, San Francisco

  PRINCIPAL INVESTIGATOR

• Danielle Hessler Jones, PhD

  University of California, San Francisco

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Participants (n=6,975) were randomized into the intervention n=3,486) or active comparator (n=3,489) stratified by preferred language (English vs. non-English) and Covered California metal tier (Silver vs. Bronze). The intervention consists of a monthly or lump sum grocery support program provided in the form of a reloadable cash card usable at food retailers including those that sell non-food items.

Study Record Dates

• First Submitted: October 7, 2025
• First Posted: October 14, 2025
• Study Start: February 1, 2025
• Primary Completion: April 30, 2026
• Study Completion (Estimated): August 30, 2026
• Last Updated: October 15, 2025

Record last verified: 2025-10

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)