Research question: Does a produce box delivery program have positive impacts on health and wellness measures, including mood, for participants?
Background: Food insecurity (FI) is a growing health problem, worsening during the COVID-19 pandemic. During the height of the COVID-19 pandemic, the Census Household Pulse Survey (2020) revealed that 23% of surveyed households in the United States experienced food insecurity (FI) or the unreliable access to sufficient affordable, quality, and nutritious food. Black and Latinx individuals reported disproportionately higher rates of FI at 36% and 32%, respectively, versus 18% for white individuals. Fresh food prescription programs (FFRx) have been shown to increase healthy eating and decrease FI, but few FFRx are community-informed or theory-based. Our FFRx was a delivery program developed to alleviate FI for families and older adults. It was implemented in an academic medical center and guided by the capabilities, opportunities, motivations, and behaviors and theoretical domains framework.
Sample: 150 participants who lived in Forsyth County and who identified as having food insecurity.
Methods: Our study team tested impacts of a FFRx program using mixed methods research, focusing on pre- and post-intervention changes in FI, fruit and vegetable (FV) intake, depression, and loneliness, measured at six-month intervals. We also evaluated our program via semi-structured interviews and surveys.
Results: Our pilot data showed positive impacts on food insecurity. The themes from the semi-structured interviews and surveys included that the program promoted healthy dietary habits, improved access to high-quality foods, improved well-being, enhanced financial well-being, and alleviated logistical barriers to accessing food and cooking.
Clinical implication: Our pilot program ended in October 2021. We took what we learned from the pilot data and have expanded our work into a USDA-funded multidimensional produce delivery program. We plan to evaluate health and wellness outcomes of this program over time in partnership with the YMCA and The Produce Box, a local produce delivery service. We hope to inform clinical practitioners on ways to implement and evaluate programs such as this utilizing implementation science principles and work to influence larger policy regarding support for food support programs.
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After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.