Examining the context, logistics, and outcomes of food prescription programs: A scoping review

Cafer, Anne; Rosenthal, Meagen; Smith, Parker; McGrew, Danielle; Bhattacharya, Kaustuv; Rong, Yiran; Yang, Yi; Yang, Johnny; Nguyen, Janet; Arnold, Austin

doi:10.1016/j.sapharm.2022.09.007

Cited by 15 publications

(10 citation statements)

References 28 publications

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“…Despite this, however, the majority of participants described their overall health as "better" or "the same" as one year prior during the post-intervention survey, perhaps underscoring limitations of the CCHS General Health survey tool in identifying modest longitudinal improvements in self-perceived health (49). Overall, our research corresponds to other studies that show mixed or minimal impacts on measurable health outcomes resulting from food prescribing programs (11,12), although most interventions are short-lived (i.e., between 12 and 52 weeks), few measure clinical health outcomes, and further longitudinal studies are needed to assess long-term nutritional impacts (12,50).…”

Section: Discussionsupporting

confidence: 71%

“…Despite this, our study exhibits several strengths. The intervention was 52 weeks, which is longer than most previously published evaluations of food prescribing interventions (12,50) and allowed us to assess long-term impacts on participants. We used validated research tools to assess food security, food consumption, and self-reported health.…”

Section: Discussionmentioning

confidence: 99%

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A 52-week fresh food prescribing program reduces food insecurity and improves fruit and vegetable consumption in Ontario, Canada

Little

Dodd

Grewal

et al. 2023

Preprint

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Background: Food insecurity is linked with suboptimal diet and comprises an important risk factor for nutrition-related chronic diseases. Fruit and vegetable prescription programs are designed to improve access to healthy foods, but there is limited evidence on the impacts of such programs in the Canadian context. The objective of this study was to assess changes in food security, food consumption, and health among adult participants of a fresh food prescribing program in Guelph, Ontario, Canada. Methods: A total of 57 food insecure individuals with ≥ 1 cardio-metabolic condition or micronutrient deficiency received fresh food prescriptions from their healthcare practitioner and received weekly vouchers for an online produce market. We used a single-arm repeated-measures evaluation and paired t-tests to assess changes in food security, food intake, self-reported health, and blood biomarkers of cardio-metabolic, and nutritional health. Linear regression models were used to assess factors associated with change in fruit and vegetable consumption and voucher usage. Results: Food insecurity improved following the proportion of participants classified as severely food insecure fell from 47.4–24.5%. Consumption of fruit, dark green vegetables, orange vegetables, and other vegetables increased during the intervention (p < 0.05). Mean fasting insulin and ascorbic acid levels improved (p < 0.05). Worse food insecurity and lower fruit and vegetable consumption at baseline, as well as more frequent interaction with healthcare providers, were associated with a greater increase in fruit and vegetable consumption from pre- to post-intervention (p < 0.05). Conclusions: Fruit and vegetable prescription programs may improve food security and increase fruit and vegetable consumption, but further research is needed to determine their long-term health impacts.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

A 52-week fresh food prescribing program reduces food insecurity and improves fruit and vegetable consumption in Ontario, Canada

Little

Dodd

Grewal

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Studies examining their effectiveness have shown that interventions involving screening and referral for SDOH can enhance physicians’ awareness of the prevalence of these determinants. However, a lack of training, guidance, and support for healthcare providers hampers the early detection of ACEs and the connection of local healthcare services with food assistance programs [ 22 , 33 ]. Recently, the Centers for Medicare and Medicaid have started offering incentives to encourage innovation in the screening and addressing SDOH, further promoting their adoption in medical practices [ 5 ].…”

Section: Healthcare Workers’ Role In Screening Liaison Evaluation And...mentioning

confidence: 99%

“…The most common model is fruit and vegetable vouchers, constituting 63% of these initiatives. Vouchers offer a designated value for fresh produce at specific locations [ 33 ]. Food Prescription Programs (FPPs) offer discounted or free vouchers for fruits and vegetables to those with food insecurity and chronic conditions.…”

Section: Models and Tools Related To Sdohmentioning

confidence: 99%

Role of Effective Policy and Screening in Managing Pediatric Nutritional Insecurity as the Most Important Social Determinant of Health Influencing Health Outcomes

Verma,

Bettag

et al. 2023

Nutrients

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Social Determinants of Health (SDOH) impact nearly half of health outcomes, surpassing the influence of human behavior, clinical care, and the physical environment. SDOH has five domains: Economic Stability, Education Access and Quality, Health Care Access and Quality, Neighborhood and Built Environment, and Social and Community Context. Any adversity arising out of these interlinked domains predominantly affects children due to their greater susceptibility, and the adverse outcomes may span generations. Unfavorable SDOH may cause food insecurity, malnutrition, unbalanced gut microbiome, acute and chronic illnesses, inadequate education, unemployment, and lower life expectancy. Systematic screening by health care workers and physicians utilizing currently available tools and questionnaires can identify children susceptible to adverse childhood experiences, but there is a deficiency with respect to streamlined approach and institutional support. Additionally, current ameliorating supplemental food programs fall short of pediatric nutritional requirements. We propose a nutrition-based Surveillance, Screening, Referral, and Reevaluation (SSRR) plan encompassing a holistic approach to SDOH with a core emphasis on food insecurity, coupled with standardizing outcome-based interventions. We also propose more inclusive use of Food Prescription Programs, tailored to individual children’s needs, with emphasis on education and access to healthy food.

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“…A meta-analysis that studied the context, analysis, and scope of food prescription programs found that there are questions about food programs’ long-term effectiveness, impact on health behaviors, screening of eligible participants, and logistics of program implementation [ 11 ]. Additionally, a systematic review of articles regarding food prescriptions' impact found that most studies conducted on food programs’ effectiveness had small sample sizes [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Current State of Food Prescriptions Used to Treat Cardiometabolic Risk Factors in the US Adult Population

Bourenane,

Emon

2024

Cureus

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Cardiometabolic syndrome is unfortunately widely prevalent in medically underserved areas with one possible non-pharmacological solution being food prescriptions from food pharmacies. Food prescriptions are defined as when a physician prescribes certain foods as a treatment for health conditions. There seems to be a promising future for food prescriptions; however, there is a huge literature gap. Given this lack of knowledge regarding this burgeoning practice, we decided to review the current state of food prescriptions used to treat cardiometabolic conditions in the US adult clinical setting. A thorough search of PubMed and Google Scholar databases for articles written about food prescriptions' impact on cardiometabolic risk factors was done. The keywords used included “food prescriptions, vegetables prescription, produce prescription, fruit prescriptions, food pharmacy, food as medicine, cardiometabolic, blood pressure, glucose, insulin, cholesterol, obesity, BMI, body mass index, triglycerides, and microalbuminuria." Of the 637 articles found with the associated keywords, 115 were kept after being screened by title and abstract. Finally, after a full-text record screening, 30 articles were deemed eligible based on our inclusion criteria. We analyzed the health markers, patient populations, methods of food procurement, and financial incentives in food prescription programs. On average, the implementation of food prescription programs decreased participants' BMI, waist circumference, blood pressure, and HbA1c. Participants in the programs were primarily comprised of African American, Hispanic, underinsured, low-income, older, and women groups. Programs with subsidies and vouchers had a higher compliance rate, and food sourced from farmers' markets, grocers, and mobile vendors had the best program compliance rates. According to the literature, adherence to food prescription programs on average decreases the BMI, blood pressure, waist circumference, and Hb1Ac of participants. However, those are the only biomarkers being studied currently, and future studies should incorporate other markers of chronic conditions. For example, a reliable indicator of cardiometabolic health is total cholesterol/HDL cholesterol, which should be measured in future experiments. Additionally, insulin, glucose, triglycerides, and LDL cholesterol are all great markers of cardiometabolic health that can be measured in the future. The current implementation of many food prescription programs is in medically underserved areas. The patient populations are typically low-income, under- or uninsured, food insecure, and originating from diverse ethnic backgrounds. In the future, food prescription studies should be done on other ethnic populations including but not limited to Native Americans who also carry a large burden of preventable and chronic illnesses.

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Examining the context, logistics, and outcomes of food prescription programs: A scoping review

Cited by 15 publications

References 28 publications

A 52-week fresh food prescribing program reduces food insecurity and improves fruit and vegetable consumption in Ontario, Canada

A 52-week fresh food prescribing program reduces food insecurity and improves fruit and vegetable consumption in Ontario, Canada

Role of Effective Policy and Screening in Managing Pediatric Nutritional Insecurity as the Most Important Social Determinant of Health Influencing Health Outcomes

Current State of Food Prescriptions Used to Treat Cardiometabolic Risk Factors in the US Adult Population

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