A Prescription Produce Program integrating lifestyle behavior counseling and health education: A program description and evaluation

Abstract

Prescription Produce Programs (PPPs) are increasingly being used to address food insecurity and healthy diets. Yet, limited evidence exists on the effectiveness of integrating lifestyle counseling within a PPP to promote dietary and health behaviors. To describe the implementation of a 6- or 12-week PPP integrating lifestyle counseling to low-income adults. The PPP was implemented as part of a wellness and care coordination program and included: (i) a screening for social needs, (ii) PPP health education and lifestyle counseling visits, and (iii) distribution of produce. We conducted a pre- and post-descriptive analysis. We also reported a case study illustrating the PPP implementation and a Strengths/Weaknesses/Opportunities/Threats analysis. Fifty-three participants (85% Black American, 64% female, mean age: 66 years) completed the PPP. Food insecurity scores significantly decreased between pre- and post-enrollment in the PPP (P = .002). Compared with pre-enrollment, participants who completed the PPP reported an increase in the frequency of fruits and vegetables intake (χ² = 12.6, P = .006). A majority of the participants (77%) reported setting and achieving at least one health-related goal by the end of the program. A strength of the PPP included the long-standing relationship with community partners. Weaknesses included the survey burden, the need for additional personnel, and the need for a sustained funding source. Integrating lifestyle counseling within a PPP can promote food security and a healthy diet. Future research is warranted using rigorous research methods, including randomization and a comparison group.

A program designed to provide healthy fruits and vegetables to communities with limited access to healthy food was successfully implemented through an academic-community partnership.

Lay Summary

Prescription Produce Programs (PPPs) are programs designed to help provide healthy fruits and vegetables to individuals who have limited access to healthy food. PPPs have been increasingly implemented in the clinical setting, due to the clear links between diet and several chronic medical conditions. In this study, we describe the implementation of a 6- or 12-week PPP to assess the immediate needs of individuals as well as provide goal setting and health education to support healthy behaviors. We evaluated the strengths and weaknesses of conducting the PPP and looked at health outcomes for individuals who participated in the PPP. We found that the partnerships with community members and organizations were a strength of the PPP and identified future areas for improvement, including reducing the number of surveys we asked participants to complete, increasing personnel for running the PPP, and identifying a sustainable funding source for the PPP. We also found that on average, individuals who participated in the PPP had greater food security by the end of the program. At the end of the program, the participants reported a higher frequency of fruit and vegetable consumption and felt more self-sufficient in being able to do so.