A Pilot Fruit and Vegetable Prescription (FVRx) Program Improves Local Fruit and Vegetable Consumption, Nutrition Knowledge, and Food Purchasing Practices

Abstract

Fruit and Vegetable Prescription (FVRx) programs rely on diverse community and clinic partnerships to improve food security and fruit and vegetable consumption among medically underserved patient populations. Despite the growth in these programs, little is known about the feasibility or effectiveness of the unique partnerships developed to implement FVRx programs conducted in both community and free safety-net clinic settings. A 6-month nonrandomized controlled trial of an FVRx program was pilot tested with 54 Supplemental Nutrition Assistance Program (SNAP)–eligible adults with diet-related chronic conditions. The intervention combined monthly produce prescriptions for local produce at a farmers market, SNAP-Ed direct nutrition education, and health screenings for low-income adults. Process and outcome evaluations were conducted with respective samples using administrative program data (recruitment, retention, and prescription redemption) and self-administered pre- and postintervention surveys with validated measures on dietary intake, nutrition knowledge and behavior, and food purchasing practices. Descriptive statistical analyses were conducted. The FVRx program retained 77.3% of participants who spent nearly 90% of their prescription dollars. After the intervention, the FVRx group reported significantly increased total intake of fruits and vegetables, knowledge of fresh fruit and vegetable preparation, purchase of fresh fruits and vegetables from a farmers market, and significantly altered food purchasing practices compared with the control group. Community-based nutrition education organizations enhance the feasibility and effectiveness of community and clinic-based FVRx programs for improving low-income adults’ ability to enhance food and nutrition-related behaviors.

Food Insecurity and Less Frequent Cooking Dinner at Home Are Associated with Lower Diet Quality in a National Sample of Low-Income Adults in the United States during the Initial Months of the Coronavirus Disease 2019 Pandemic

“…Due to the positive association between cooking frequency and diet quality, more efforts and continued support is needed to help households at risk for food insecurity both procure and prepare enough nutritious food to support a healthy diet. [63][64][65][66][67][68] The recent changes to the Thrifty Food Plan, which SNAP benefits are based on, will increase SNAP benefits by 21% and are an important step that may help food insecure households afford the true cost of a healthy diet. 69 It will be important for future research to investigate whether or not/ how these benefit increases influence cooking behaviors and diet quality.…”

Effects of a Fruit and Vegetable Prescription Program With Expanded Education for Low-Income Adults

“…Given the structural challenges safety-net clinics face and high rates of health disparities among their low-income patients, safety-net clinics could benefit from partnering with community-based organizations offering nutrition education, such as local County Extension Offices, to deliver tailored and evidence-based nutrition education (Stotz & Thompson et al, 2019). As these organizations expand partnerships with various community food resource organizations (e.g., FVRx programs, food banks, and food pantries), the partnerships formed could improve the likelihood patients will connect with and utilize healthy foods (Marpadga et al, 2019; Slagel et al, 2021).…”

“…One community site included primarily low-income and Hispanic residents, and the other included residents from a low-income housing community. These sites and partnerships were based on the prior year’s partnerships and study (Slagel et al, 2021). Based on these existing partnerships and their prior experiences, the recruitment from these sites was determined most feasible, ethical, and supportive of highly underserved communities.…”

“…The 2018 Athens FVRx program (May 15—November 8, 2018) expanded the Athens Pilot FVRx program model (Slagel et al, 2021) to include: (a) Augmented education component including both nutrition and financial literacy education, (b) increased intensity of nutrition education from monthly to weekly, and (c) the clinical biomarker assessments (Figure 2).…”

“…Recent evidence suggests an FVRx program combining produce prescription and culturally tailored nutrition education for low-income adults improves several behaviors supportive of purchasing and consuming locally grown fruits and vegetables over standard health care alone (Slagel et al, 2021). However, there is still little understanding of how intensive direct education combined with produce prescriptions can improve dietary and health behaviors over single-level interventions.…”