Accepted for/Published in: JMIR Formative Research
Date Submitted: Oct 10, 2025
Date Accepted: Mar 12, 2026
Optimizing navigation and text-messaging interventions to promote participation in a Food is Medicine program among people participating in cardiac rehabilitation: Human-Centered Design Study
ABSTRACT
Background:
Food is Medicine (FIM) programs integrate interventions such as medically tailored meals or produce prescriptions into clinical care. However, there is limited evidence on how to design these programs to be responsive to the lived experiences of participants to optimize initiation, engagement, and long-term retention.
Objective:
Our goal was to develop interventions to promote initiation, engagement, and retention in FIM programs that are responsive to the lived experiences of participants.
Methods:
We used a human-centered design (HCD) approach to engage current and former cardiac rehabilitation (CR) participants in the development of interventions to promote participation and engagement in a FIM program. We recruited participants through invitations sent via electronic health record (EHR) message. We interviewed participants about their experiences, preferences, and unmet needs related to healthy eating and program design. Additionally, we elicited participant feedback on draft versions of patient navigator scripts and text messages promoting healthy eating habits.
Results:
A total of 6 participants identified key priorities including culturally relevant food options, clear and timely communication, transportation and scheduling flexibility, and personalized support for navigating food resources. Feedback on navigator scripts and text messages emphasized the importance of being concise and warm with respectful language that was easy to understand, while avoiding stigmatizing or overly clinical phrasing. Participants also suggested that messages should reflect empathy and offer actionable information to increase trust and engagement with the program. Trust in the healthcare system and a sense of dignity in receiving food support emerged as critical themes influencing overall satisfaction and retention.
Conclusions:
Using an HCD approach, we gained insights about the need for culturally sensitive and personalized approaches that helped us develop navigator scripts and text messages to promote participation in a FIM program. Food is Medicine, human-centered design, cardiovascular disease, nutrition intervention, health equity.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.