Feasibility of a Home-Delivery Produce Prescription Program to Address Food Insecurity and Diet Quality in Adults and Children

Abstract

Produce prescription programs aim to improve food insecurity (FI) and nutrition but their effectiveness is unclear. We conducted a pilot study to demonstrate the feasibility and explore the potential impact of a family-based, home-delivery produce prescription and nutrition education program. We measured enrollment, satisfaction, participation, and retention as measure of feasibility. Adult participants answered pre-post self-report questionnaires assessing FI, child and adult fruit and vegetable intake, and culinary literacy and self-efficacy. To understand participants’ lived experiences, qualitative interviews were conducted at the 6-month time point. Twenty-five families were enrolled. Feasibility measures indicate participants were generally satisfied with the program but there were important barriers to participation. Qualitative data revealed themes around reduced food hardship, healthy eating, budget flexibility, and family bonding. Fruit and vegetable consumption increased in a small subgroup of children, but post-intervention intake remained below recommended levels, particularly for vegetables. FI scores were not significantly different post-intervention, but qualitative findings indicated improved access and reliability of food. This is the first intervention of its kind to be evaluated for feasibility and our results suggest the intervention is well-received and supportive. However, further study, with a larger sample size, is needed to understand factors influencing participation and assess effectiveness.

A Qualitative Study on the Motivators, Barriers and Supports to Participation in a Pediatric Produce Prescription Program in Hawai‘i

“…Participants found the online market unappealing, citing the smaller variety of produce available online and the inability to hand pick the produce as reasons for not favoring this option. Contrary to our findings, previous research has found that delivery services enhanced participation in Produce Rx programs among low-income households in urban settings [ 22 ]. In the future, program improvements could be made to overcome other barriers cited by participants.…”

“…Participants were particularly motivated by the positive effect that the program had both on the child and shared that the benefits were experienced by other family members, even though the program was really designed for just the participating child. This was similar to another pilot study which found that enhanced family bonding and positive experiences for children as a benefit of a Produce Rx program [ 22 ].…”

“I Felt Like I Had Something I Could Do About It”: Pediatric Clinician Experiences With a Food Insecurity-Focused Produce Prescription Program

“…In addition, there is very limited data available on food delivery produce prescription programs in urban pediatric populations. [12][13][14][15] As pediatric practices continue to expand produce prescription models as a viable FI intervention, it is important to understand the lived experiences of clinicians to ensure these intervention strategies are feasible within their busy workflow. In addition, while there are studies that detail caregivers' perspective on food resources and food prescription programs, there are limited data regarding the experiences of pediatric clinicians referring patients into these programs and how they perceive these programs' effectiveness.…”

“…In addition, while there are studies that detail caregivers' perspective on food resources and food prescription programs, there are limited data regarding the experiences of pediatric clinicians referring patients into these programs and how they perceive these programs' effectiveness. [11][12][13][14][15][16] To address these gaps in research, pediatric clinicians were interviewed to explore their experiences after enrolling patients in a novel produce prescription program in an urban primary-care clinic in Washington, DC.…”

Using Modern Modalities to Improve Population Health and Advance Food and Health Equity

“…Studies of produce prescription programs have found that, in addition to limited proximity to prescription redemption locations, barriers to redeeming produce prescriptions include limited mobility, limited or unreliable transportation, and lack of childcare . In recent years, produce prescription programs have begun to deliver fruits and vegetables to participants’ homes, but these have been pilot studies or serve adults …”