Promoting Healthy Food Access and Nutrition in Primary Care: A Systematic Scoping Review of Food Prescription Programs

Abstract

Objective To conduct a scoping review to synthesize evidence on food prescription programs. Data Source A systematic search of PubMed, CINAHL, Web of Science, Embase, and the Cochrane Library was conducted using key words related to setting, interventions, and outcomes. Study Inclusion and Exclusion Criteria Publications were eligible if they reported food prescription administered by a health care practitioner (HCP) with the explicit aim of improving healthy food access and consumption, food security (FS), or health. Data Extraction A data charting form was used to extract relevant details on intervention characteristics, study methodology, and key findings. Data Synthesis Study and intervention characteristics were summarized. We undertook a thematic analysis to identify and report on themes. A critical appraisal of study quality was conducted using the Mixed Methods Appraisal Tool (MMAT). Results A total of 6145 abstracts were screened and 23 manuscripts were included in the review. Food prescriptions may improve fruit and vegetable consumption and reduce food insecurity (FI). Evidence for impacts on diet-related health outcomes is limited and mixed. The overall quality of included studies was weak. Addressing barriers such as stigma, transportation, and poor nutrition literacy may increase utilization of food prescriptions. Conclusion Food prescriptions are a promising health care intervention. There is a need for rigorous studies that incorporate larger sample sizes, control groups, and validated assessments of dietary intake, food security, and health.

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

“…Produce prescription programs have been implemented in primary care settings to address FI and diet quality and many targeting adults have been evaluated for feasibility and impact [ 25 , 26 ]. Few programs specifically addressing families with young children have been evaluated and all, except one [ 27 ], have used a client-choice, external-to-the-home model of providing supplemental produce resources (e.g., farmer’s market or food pantry vouchers) [ 28 , 29 , 30 , 31 , 32 , 33 , 34 ].…”

A Produce Prescription Program in Eastern North Carolina Results in Increased Voucher Redemption Rates and Increased Fruit and Vegetable Intake among Participants

“…This aligns with findings from Trapl, et al [6] who found daily fruit intake increased from an average of 1.6 servings to 2.4 servings, and daily vegetable intake increased from 1.7 to 2.5 servings, comparing preto post-intervention. In a scoping review [13], it was found that although food prescriptions can improve FV intake and reduce food insecurity, there is a need for more rigorous studies, with larger sample sizes, control groups, and validated measures of diet, food security, and health outcomes.…”

“…Bryce and colleagues [9] found that the fresh Rx program in Detroit resulted in a statistically significant decrease in HbA 1 C but no changes in blood pressure (BP) or BMI. Ferrer, et al [5], Veldheer, et al [10], and Haddad-Lacle, et al [12] all found reductions in HbA 1 C. Overall, in a scoping review of 23 food prescription programs, Little et al [13] found that food prescriptions can improve FV intake and reduce food insecurity, but there was limited and mixed evidence for impacts on diet-related health outcomes (BP, weight, BMI, HbA1c) [13].…”

Exploring Perceptions of a Fresh Food Prescription Program during COVID-19

“…However, evidence surrounding the impacts of produce prescription programs is still being researched, with 85% of produce prescription studies having been published over the last 4 years (12). Participant input is integral to help guide future interventions that address social needs, and there is a need for qualitative studies that capture participant feedback on how they were impacted by social programs, such as food prescription programs, during the pandemic [ 12 , 13 ].…”