A recent study in the Journal of Nutrition Education and Behavior finds that a food literacy education program improved food-related knowledge and practical skills among rural, uninsured adults with diabetes, although disparities in food literacy scores persisted among racial and ethnic groups

April 8, 2026 – A recent study in the Journal of Nutrition Education and Behavior (JNEB), published by Elsevier, examined the impact of a Food is Medicine (FIM) and food literacy education program on rural, uninsured adults with type 2 diabetes. Findings suggest that even when educational programs are effective overall, additional cultural tailoring may be needed to ensure that all participants benefit equally.

Researchers evaluated changes in participants’ food literacy using a validated assessment tool before and after the intervention. Findings showed that overall food literacy scores improved significantly following participation in the program, suggesting that education focused on building food-related knowledge and practical skills may help individuals better navigate food choices and prepare healthy meals.

The Fresh Start FIM + Food Literacy intervention included nine group classes focused on practical food skills such as meal planning, shopping, budgeting, and food preparation, along with health coaching support and produce prescriptions, which provide patients with monetary vouchers, produce boxes, or deliveries of fresh fruits and vegetables as a form of medical treatment. The study included 150 adults recruited through four safety net clinics in rural eastern North Carolina that are members of the North Carolina Association of Free and Charitable Clinics (NCAFCC), a statewide network serving uninsured and underinsured populations. Participants attended educational sessions held at local community sites and received support designed to help them incorporate healthy foods into their daily routines while managing diabetes.

Despite overall improvements, the study also identified disparities in food literacy across racial and ethnic groups. Hispanic participants had significantly lower food literacy scores than White participants both before and after the intervention, particularly in areas such as meal planning, shopping, and budgeting.

“Food literacy involves more than simply knowing what foods are healthy. It includes the skills needed to plan meals, shop on a budget, prepare food, and navigate complex food environments,” said Brandon J. Stroud, MPH, RDN, CHES, corresponding author of the study, Teaching Instructor, and Co-Director of the Farm2Clinic Initiative at East Carolina University. “Programs that combine nutrition education with practical skill-building may help individuals better manage chronic conditions such as diabetes.”

These findings highlight the potential value of integrating food literacy education into Food is Medicine and produce prescription programs. The authors note that culturally tailored educational approaches may further strengthen these programs and help address persistent disparities in nutrition knowledge and food-related skills among underserved populations.