Participant Perspectives on a Food Is Medicine Intervention for Gestational Diabetes Prevention: A Mixed-Methods Pilot Study Full Names of

Introduction : Gestational diabetes mellitus (GDM) affects 6–9% of U.S. pregnancies, disproportionately impacting women with obesity, low socioeconomic status, and certain racial/ethnic backgrounds. Food Is Medicine (FIM) programs embed food provision within clinical care but remain scarce for Medicaid-enrolled pregnant women at GDM risk. A prototype FIM intervention (MANGO) was feasible, acceptable, and well-received among at-risk pregnant women, though nutrition education materials were underutilized and cultural/literacy barriers limited engagement for some participants. Methods : This mixed-methods, human-centered design pilot tested four food box types (meal kits, prepared meals, hybrid boxes, whole-food groceries) delivered weekly over 8 weeks to 10 Medicaid-eligible pregnant women in Texas and the Northeast U.S. Data included baseline/follow-up surveys (n = 7) and semi-structured interviews (n = 5), analyzed descriptively and thematically. Results : Most participants reported easier healthy eating, increased fruit/vegetable intake, and cost/time savings; 85.7% rated the program 10/10 for recommendation likelihood. Fresh produce was most valued; prepared meals showed mixed acceptability due to cultural fit. Qualitative themes included enrollment ease, underused nutrition education, literacy/language barriers, and limited understanding of GDM risk rationale. Conclusions : Strengths include participant-informed design process conducted across two geographically and demographically distinct U.S. regions prior to a full-scale trial. Limitations include small sample size, single-coder qualitative analysis, and language constraints during interviews. Findings suggest future FIM trials should incorporate culturally tailored foods, simplified/multilingual education, clearer risk communication, and post-program support. MANGO demonstrates feasibility and acceptability of FIM for GDM prevention, informing design of a future fully powered randomized controlled trial. Clinical trial number : not applicable