Table 2

Characteristics of included studies

PublicationStudy type/DesignInterventionComparatorContext/SettingFood pantry/Bank characteristicsParticipantsOutcome variablesResultsFacilitators/
Barriers to Implementation
Bencivenga et al (2008)47 Single-arm preintervention/postintervention3-month intervention adapted and implemented the American Cancer Society’s Tell a Friend programme in a network of 18 food pantries, targeted at increasing use of mammography among rural, age-eligible women. For 3 months, all entering female food pantry clients were screened for eligibility. Those meeting income and other eligibility requirements were scheduled free mammograms, those not meeting income eligibility received voucher for free mammogram.Within-participant preinterventionIntervention implemented in 18 food pantries in rural Indiana County, PennsylvaniaNetwork of 18 food pantries, staffed by employees and volunteers, serving high numbers of rural clients aged ≥40 years302 rural women aged ≥40 years who had not had a mammogram within the past year or did not have one scheduledBiometric outcomes: number of cancers diagnosed through mammograms provided
Other outcomes:
reach of the programme
Number of mammograms provided
302 of 379 queried women were ≥40 years old
158 were in need of a mammogram
138 received a mammogram through the programme
13 received their first ever mammogram
three women were diagnosed with breast cancer, one at stage I (local), two at stage II (regional), all received treatment
Facilitators: evidence-based intervention; involved multilevel, multiorganisation cancer coalition; completed with volunteer staffing.
Barriers: labour/ time intensive; some pantry patrons were missed because study volunteers not always available.
Kennedy et al (2009)48 Randomised trial; two-arm pilot study with participants randomised to intervention or control6-month trial testing feasibility of a mobile pantry plus nutrition education to increase consumption of healthy foods to manage overweight/obesity among African–American women. Intervention arm received nutrition and physical activity education from peer educator in classroom setting, 6–12 servings of fresh F&V per week for 24 weeks, healthy cooking demonstrations and recipes for healthy preparation techniques. Intervention arm kept 7-day food and physical activity diary for 1 week each month. Data collected at baseline and monthly for 6 months.Control arm met with peer educator once per month for 6 months to measure blood pressure and weight, and received same nutrition and physical activity information to read at home.Study conducted in community centre located in East Baton Rouge Parish, Louisiana. The ‘rolling store’ mobile pantry parked outside the community centre on the same day each week from 2 to 6 pm. Participants in the intervention group received 9–14 choices (approximately 6–12 servings) of assorted fresh F&V each week at no cost. F&V varied weekly, and participants received one or more new choices each week.Mobile pantry staffed by volunteer, providing choice of fresh F&V 1 day per week40 African–American women aged ≥18 years, with BMI 25–40 kg/m2 and no recent underlying diseases or medications that could interfere with study participation or outcomesBiometric outcomes: weight; BMI; waist circumference; blood pressure
Other outcomes:
dietary intake (via modified Food Frequency Questionnaire): energy (kcal/day), dietary fibre (g/day), fruit/fruit juice (servings/day), vegetables (servings/day)
31-item Impact of Weight on Quality-of-Life instrument
36-item Short Form Health Survey
Significant reductions in weight and BMI
No change in blood pressure
Significant increases in intake of total dietary fibre, fruit/fruit juice and vegetables
No difference in energy intake
Significant increases in self-esteem and emotional well-being
No change in overall quality of life or general health
Facilitators: used trained peer educator and store operator (less costly); convenient location of mobile pantry in target community.
Barriers: Sustainable intervention would require funding or a cooperative to buy F&V at less than retail price and staff to handle distribution, education and bookkeeping.
Flynn et al (2013)49 Single-arm preintervention/postintervention6-week cooking programme taught food pantry clients plant-based recipes to improve dietary quality of food purchases, decrease food expenditures, improve food security and lower BMI. Programme included 6 weeks of cooking classes and 6 months of follow-up, with one appointment per month. Participants observed and ate a plant-based meal based on provided recipes. During meals, staff discussed four nutrition themes: health benefits of olive oil; meat/poultry/seafood not needed daily; protein in vegetables; ingredients used and to look for them in food pantries. Participants received a bag of groceries that contained most of the ingredients for that week’s meal. Data collected at baseline, 6 weeks and 6 months.Within-participant preinterventionStudy conducted by the Rhode Island Community Food Bank in Providence, Rhode Island. Participants were recruited from food pantries in the area. Data collection took place during food pantry open hours, implying that at least some intervention implementation took place within food pantries.Minimal detail is provided with respect to characteristics of the food bank or food pantries85 adult food pantry clients identified by pantry staff with access to transportation, willingness to try new recipes and ability to be contacted by phoneBiometric outcomes: BMI; weight; waist circumference
Other outcomes:
F&V consumption
Food purchases (via shopping receipts)
Food security (USDA Household Food Security Survey Module)
Significant decrease in BMI and body weight
Significant decrease in waist circumference
Significant increase in number of plant-based meals eaten per week
Significant increase in number of different types of F&V consumed per month
Significant decreases in dollars spent per week on meat, carbonated beverages, desserts, snacks and total dollars spent on food
Significant decrease in food insecurity
Facilitators: participants reimbursed small amounts of cash for attendance, providing grocery receipts, and completing follow-up. Participants were not required to assist in recipe preparation, meaning cooking skills were not required for participation.
Barriers: none mentioned.
Seligman et al (2015)50 Single-arm pre/post pilot intervention6-month pilot intervention in which food pantries provided clients with T2D with diabetes-appropriate foods, blood sugar monitoring, primary care referrals and diabetes self-management support. Food boxes were designed to last 1–2 weeks, depending on household size. Boxes contained whole grains, lean meats, beans, low-sodium vegetables, no-sugar-added fruit and shelf-stable dairy products, and were supplemented with perishable items including fresh produce, milk, yoghurt, cheese, bread and frozen lean meat. Boxes also included recipes and cooking tips to encourage healthy eating. Data collected at baseline and 6 months.Within-participant preinterventionThree food banks: Food Bank of Corpus Christi, Texas; Redwood Empire Food Bank in Santa Rosa, California; Mid-Ohio Foodbank in Grove City, Ohio. Each food bank selected 3–32 affiliated pantries in their service area to implement the intervention. Two food banks involved clinics in the participant recruitment process.Food banks were allowed flexibility in selecting food pantries for implementation as long as intervention and evaluation components could be implemented.
Of the three food banks, two distributed boxes monthly and one distributed boxes biweekly.
768 food insecure food pantry clients (final analytical sample of 687) with T2D (HbA1c≥6.5% or a previous T2D diagnosis plus presentation of diabetes medication prescription bottles). If referred by clinics, participants were verified to be food insecure.Biometric outcomes: HbA1c (continuous); proportion of participants with poor glycaemic control (HbA1c>9%); BMI
Other outcomes: diabetes self-management outcomes: 56-item survey assessing severe hypoglycaemic episodes, diabetes self-efficacy, diabetes distress, medication non-adherence and trade-offs between buying food vs medicine/medical supplies
F&V intake (servings per day)
Food box satisfaction
Food security status (USDA six-item screener)
Significant improvements in mean HbA1c
No change in proportion of individuals with poor glycaemic control
No results for BMI reported
Significant increase in diabetes self-efficacy
Significant decreases in diabetes distress, medication non-adherence and making trade-offs between buying food vs medicine/medical supplies
Significant increase in F&V intake
88% preferred the diabetes-appropriate food box to regular food pantry options; 87% ate all or most of its contents
No change in food security
Facilitators: Each food bank was allowed to select partnering food pantries. Each food bank was allowed to tailor the programme to fit its preferences, capacity and workflow.
Barriers: The intervention was implemented across a heterogeneous group of food banks and pantries; some sites had difficulty retaining participants because they served a mobile population.
Palar et al (2017)51 Single-arm pre/post pilot intervention6-month intervention provided food pantry clients (with T2D and/or HIV) with meals and snacks intended to meet 100% of their daily caloric requirements. The intervention targeted improving nutrition, mental health and health behaviours. Snacks and meals were tailored to meet nutrition guidelines for healthy diet using average energy requirements for daily meals (1800–2000 kcal for people living with HIV and 1800 kcal for people with T2D). Meals were based on Mediterranean diet, focusing on fresh foods with a few prepackaged foods offered as snacks or grocery items. Participants received food twice per week. Data collected at baseline and 6 months.Within-participant preinterventionStudy conducted at Project Open Hand, a San Francisco Bay Area, California non-profit organisation that provides food assistance to seniors and individuals with life-threatening and chronic illnesses.Non-profit organisation that provides free meals and groceries to >8000 seniors and people with life-threatening and/or chronic illnesses.
Pantry employs a nutritionist that helped develop intervention and meal plans.
Pantry selected potential participants based on record of service adherence.
72 Project Open Hand clients aged ≥18 years, with certified diagnosis of HIV and/or T2D, English or Spanish speaking, and income under 300% federal poverty lineBiometric outcomes: fasting glucose; HbA1c; proportion of participants with optimal glycaemic control (HbA1c<7%); BMI
Other outcomes: Food security (USDA Household Food Security Survey Module)
Diet quality (18-item Multifactor Screener)
Depressive symptoms (Patient Health Questionnaire)
Hazardous drinking (Alcohol Use Disorders Identification Test); binge drinking
Current smoking
Illicit drug use
Competing demands (giving up healthcare needs for food, or vice versa)
Acute-care utilisation
HIV-specific measures: internalised HIV stigma; self-reported antiretroviral adherence
Diabetes-specific measures: diabetes distress; diabetes self-efficacy
No change in fasting glucose,
HbA1c, proportion with optimal glycaemic control, or BMI
Significant decrease in BMI for participants with T2D
Significant decrease in food insecurity severity
Significant decrease in consumption of fatty foods
Significant increase in consumption of F&V and dairy
No change in consumption of sugary foods
Significant reduction in depressive symptoms
Significant reduction in binge drinking; No change in hazardous drinking or current smoking or illicit drug use
Significant decreases in competing demands
No change in hospitalisations or emergency department visits
Significant increase in antiretroviral therapy adherence No change in HIV stigma
Significant decrease in diabetes distress Significant increase in diabetes self-efficacy
Facilitators: the project was not cost intensive (ie, food cost $6.58/day per participant). Participants were paid $20 cash after each interview and $10 for completing a blood draw. Allowed Project Open Hand to create list of potential participants who were adherent to their services to maximise intervention fidelity. Clients requiring home-delivered meals or a special diet (eg, renal or vegetarian) were excluded.
Barriers: all participants with T2D were new clients to Project Open Hand, as they had only recently begun providing services to clients with T2D.
Seligman et al (2018)52 Randomised controlled trial; two-arm study with participants randomised to intervention or wait-list control6-month intervention provided blood glucose and HbA1c testing, primary care referrals, formal DSME classes with 1-on-1 check-ins with educators, and twice-monthly diabetes appropriate food boxes. Food packages adhered to guidelines for diabetes management and were intended to provide 20%–25% of monthly food needs. Packages included shelf-stable and perishable items, including lean proteins, eggs, low-fat dairy, legumes and nuts, F&V, whole grains and canned products low in sodium/added sugar. Data collected at baseline, 3 months and 6 months.Wait-list control group received standard food pantry services for 6 months, then received a modified intervention with results not presented in this article.Three food banks: Alameda County Community Food Bank in Oakland, California; Gleaners Community Food Bank of Southeastern Michigan in Detroit, Michigan; Houston Food Bank, in Houston, Texas. Each food bank selected affiliated pantries in their service area to conduct the intervention, with 27 food pantries participating.Food banks were part of Feeding America network.
Each food bank independently assembled and distributed food boxes through the partnering food pantry where each client was recruited.
Minimal information provided about the pantries, except that participants were allowed to take part in regular pantry distributions, in addition to the intervention food packages.
568 participants with T2D (HbA1c≥7.5%), aged ≥18 years, were an existing or new food pantry client, spoke English or Spanish, had a phone or mailing address, and intended to remain in the area of the food pantry for at least 12 months. Cognitive impairment, current pregnancy (or <6 weeks postpartum), and/or a history of type one diabetes were exclusion criteria.Biometric outcomes: HbA1c (continuous); proportion with HbA1c<7.5%
Other outcomes: Food security status
Food stability
F&V and added sugar intake
Hypoglycaemic episodes
Trade-offs between food and medication/medical supplies
Cost-related medication nonadherence
Diabetes distress
Diabetes self-efficacy
Diabetes self-care
Medication adherence
Intervention satisfaction
No change in HbA1c or in proportion with HbA1c<7.5%
Significant improvements in food security status and food stability
Significant improvements in F&V consumption
No change in added sugar consumption
Significant improvement in trade-offs between food and medication/medical supplies
No change in hypoglycaemic episodes, cost-related medication nonadherence, diabetes distress, depression, diabetes self-efficacy, diabetes self-care or medication adherence
Facilitators: used food bank/pantry staff and volunteers; Education sessions were scheduled during food distributions.
Barriers: amount of food distributed was limited by food bank capacity (twice-monthly food packages were relatively large); participants expressed difficulty getting food packages to their homes (eg, transportation challenges); participants were not restricted to only the diabetes appropriate food;
only ~20% of participants fully engaged with the intervention (ie, attended both education sessions; picked up ≥9 of 11 food boxes; and reported ≥1 primary care appointment during intervention).
  • BMI, body mass index; DSME, diabetes self-management education; F&V, fruits and vegetables; HbA1c, glycated haemoglobin; T2D, type 2 diabetes; USDA, US Department of Agriculture.