Addressing Diabetes by Elevating Access to Nutrition: The ADELANTE Study

Inclusion Criteria:

   - For main study (index/intervention) participants:

Inclusion criteria:

   1. Age (as of date of enrollment):

   Lower age limit: 18 years Upper age limit: none (only exclude for cause, e.g., disease
   and functional limitations, as detailed below)

   2. Gender: men and women

   3. Ethnicity: self-identification as Hispanic/Latino/Chicano/Spanish

   4. Have evidence of diabetes (ICD-10 diagnosis, HbA1c > 6.5%, use of insulin) in the
   electronic health record

   5. Have indicated food insecurity according to the screening 2-item Hunger Vital Sign
   questionnaire

   6. Have a Body Mass Index (BMI) of 25 or higher

   7. Receiving care at our partnering community health centers (e.g., Clinica de la Raza)

   8. Currently residing in Alameda County and not expecting to relocate in the next 6-month
   to 1 year

8) Access to phone or computer, email, and some internet for access to remote intervention
and completion of follow-up measures 9) Able and willing to enroll and provide informed
consent.

For household members:

Inclusion criteria:

   1. over the age of 12;

   2. significantly involved in supporting nutrition in the home including food shopping,
   preparation, social support for healthy nutrition;

   3. able to provide consent; and

   4. willingness to complete some questionnaires and attend a single group session.

Exclusion Criteria:

Unable to provide consent

Active substance use or psychotic disorders that would impair participation in a group
lifestyle intervention or interfere with follow-up assessments

Other exclusions:

Inability to speak, read or understand English and/or Spanish

Lacking mailing address for delivery of food box

Planned relocation or pregnancy