Abstract Body: Introduction: Black communities in the U.S. are among the most disenfranchised in terms of equal access to healthy food and nutrition education. As a result, Black Americans are more likely to consume low quality foods with poor nutritional value that are associated with cardiometabolic disease. Medically tailored meals (MTM) are a promising food-is-medicine intervention to address nutrition inequities, but they lack the ability to provide nutrition education and behavior change skills. Shared medical appointments (SMA) can offer the education and training needed to achieve sustainable healthy eating behaviors. This study examines the feasibility and acceptability of MTM and MTM+SMA in a Black community with cardiometabolic disease.

Hypothesis: We hypothesize that 1) the study is feasible (≥ 40% recruitment rate, ≥ 70% retention rate in each arm), 2) the intervention is feasible (≥75% SMA attendance, ≥ 60% meals consumed) and 3) the intervention is acceptable (net promoter score (NPS) >9 in the MTM and MTM+SMA arms).

Methods: This is a three-arm feasibility and acceptability RCT. Study arms include: (1) MTM (2 meals daily for 10 weeks), (2) MTM+SMA (same MTM plus 10 weekly 1–2-hour group medical visits), and (3) MTM-Later (waitlist control- same MTM provided after the intervention period). Participants were adults (≥18 years old) who self-identify as Black/African American and have cardiometabolic disease.

Results: A total of 67 participants were randomized to the three study arms; MTM (n=24), MTM+SMA (n=21) and MTM-Later (n=22). Study feasibility thresholds were exceeded (recruitment rate 76%, retention rate 84% (MTM), 76% (MTM+SMA) and 88% (MTM-Later)). The MTM+SMA arm did not achieve the feasibility threshold for session attendance (63%), but the MTM and MTM+SMA arms did achieve the threshold for meals consumed (79% in MTM, 83% in MTM+SMA). The intervention acceptability threshold was exceeded in the MTM+SMA group (NPS 9.4), but not in the MTM group (NPS 7.7).

Conclusions: MTM and MTM+SMA are promising food-is-medicine interventions for under-resourced populations with evidence for cardiometabolic disease. Providing MTM alone may have limited satisfaction. Future studies are needed to explore appropriate frequency and timing of SMA to support nutrition-focused care plans. This pilot study provides crucial evidence for the potential feasibility and acceptability of food-is-medicine approaches for patients experiencing cardiometabolic disease.