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Li Z, Zhang FF, Cash SB, Hager K, Trevino L, Folta SC. Caregiver perceptions of a pediatric produce prescription program during the COVID-19 pandemic. Front Nutr 2024; 11:1304519. [PMID: 38577157 PMCID: PMC10991727 DOI: 10.3389/fnut.2024.1304519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/07/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Produce prescription programs are rapidly expanding as a type of Food is Medicine intervention with prospects for mitigating food insecurity and reducing diet-related health disparities. Gaining insight into participant perspectives on program logistics and perceived impacts is crucial to program success and improvements. Methods Between May and June 2021, we conducted individual and small group interviews with 23 caregivers with children aged 1-5 years who participated in a produce prescription program from 2020 to 2021 in Texas, U.S. They were provided with a gift card to a major national grocery retailer to purchase fresh produce. The card was reloaded $60 monthly for 8 months with automatic roll-over of unused funds to the next month. Participants also received nutrition education in the form of two videos. A deductive analysis approach was employed, and NVivo qualitative data analysis software was used to perform coding and to assist with subsequent analyses. Results All 23 participants were female, with an average age of 37.5 years, and the majority identified as Hispanic/Latino (83%). About 43% of the families had three or more children. Six themes were generated from interviews. Three of these themes were related to program logistics: (1) ease of program use; (2) participant satisfaction with the incentive; and (3) desire for additional store options. The remaining main themes pertained to program impact: (1) the enhanced ability to purchase produce; (2) the usefulness of the nutrition education; and (3) persistent challenges encountered when preparing the produce for picky eaters and young children. Conclusion A pediatric produce prescription program was perceived as logistically easy and a helpful source of financial support for accessing fresh produce. Program features such as card-based incentive system and partnership with major grocery retailer were favored by participants. For future program design, it may be beneficial to consider collaborating with multiple grocery outlets and enhancing the intensity and targeting of nutrition education.
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Affiliation(s)
- Zhongyu Li
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Sean B. Cash
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Kurt Hager
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Leo Trevino
- Amistad Community Health Center, Corpus Christi, TX, United States
| | - Sara C. Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
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Rhodes EC, Pérez-Escamilla R, Okoli N, Hromi-Fiedler A, Foster J, McAndrew J, Duran-Becerra B, Duffany KO. Clients' experiences and satisfaction with produce prescription programs in California: a qualitative evaluation to inform person-centered and respectful program models. Front Public Health 2024; 12:1295291. [PMID: 38572012 PMCID: PMC10990041 DOI: 10.3389/fpubh.2024.1295291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/26/2024] [Indexed: 04/05/2024] Open
Abstract
Background Produce prescription programs have strong potential to improve food security, fruit and vegetable consumption, and health across the life course. Understanding clients' experiences and satisfaction with produce prescription programs is critical for evaluating the person-centeredness and quality of these programs. The objectives of this study were to (1) describe client experiences and satisfaction with produce prescription programs, with an emphasis on the extent to which they felt they were treated with respect and dignity, and (2) identify recommendations for improving client experiences. Methods We conducted four focus group discussions with clients of produce prescription programs in two Federally Qualified Health Centers in California. We used a modified framework analysis approach and organized participants' experiences with programs into themes. Results Three themes captured participants' program experiences. First, respectful produce prescription programming encompassed interactions with individuals delivering the programs that felt respectful (e.g., program staff showing they cared about participants' health and offering timely assistance with financial incentives) and disrespectful (e.g., not receiving prompt responses to questions about incentives), as well as aspects of program design perceived to be respectful (e.g., provision of gift cards as financial incentives, which offered privacy when purchasing produce). Second, having autonomy to use gift cards to choose their preferred fresh fruits and vegetables was viewed as a positive experience, though participants desired greater autonomy to shop at stores other than the program designated stores. Third, participants frequently discussed program usability, with some reporting that joining the programs and using the cards was easy, and others describing difficulties activating cards and using them at stores due to cashiers' lack of awareness of the programs. Overall, participants were highly satisfied with the programs. To improve client experiences, they recommended increasing privacy (e.g., by educating cashiers on the programs so that clients do not need to explain in public what the card is for) and autonomy (e.g., allowing cards to be used at other chain or local stores). Discussion Our findings inform efforts to make produce prescription programs more person-centered and respectful, which in turn may increase program demand, engagement, and impact.
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Affiliation(s)
- Elizabeth C. Rhodes
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
- Emory Global Diabetes Research Center, Emory University, Atlanta, GA, United States
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, United States
- Yale-Griffin Prevention Research Center, Derby, CT, United States
| | - Ngozi Okoli
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, United States
- Community Alliance for Research and Engagement, Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Amber Hromi-Fiedler
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Jaime Foster
- Yale-Griffin Prevention Research Center, Derby, CT, United States
| | - John McAndrew
- Yale-Griffin Prevention Research Center, Derby, CT, United States
- Wholesome Wave, Bridgeport, CT, United States
| | - Beatriz Duran-Becerra
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, United States
- Community Alliance for Research and Engagement, Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Kathleen O’Connor Duffany
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, United States
- Yale-Griffin Prevention Research Center, Derby, CT, United States
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Tariq S, Olstad DL, Beall RF, Spackman E, Lipscombe L, Dunn S, Lashewicz BM, Elliott MJ, Campbell DJ. Exploring the prospective acceptability of a healthy food incentive program from the perspective of people with type 2 diabetes and experiences of household food insecurity in Alberta, Canada. Public Health Nutr 2024; 27:e66. [PMID: 38305101 DOI: 10.1017/s1368980024000429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
OBJECTIVE FoodRx is a 12-month healthy food prescription incentive program for people with type 2 diabetes (T2DM) and experiences of household food insecurity. In this study, we aimed to explore potential users' prospective acceptability (acceptability prior to program use) of the design and delivery of the FoodRx incentive and identify factors influencing prospective acceptability. DESIGN We used a qualitative descriptive approach and purposive sampling to recruit individuals who were interested or uninterested in using the FoodRx incentive. Semi-structured interviews were guided by the theoretical framework of acceptability, and corresponding interview transcripts were analysed using differential qualitative analysis guided by the socioecological model. SETTING Individuals living in Alberta, Canada. PARTICIPANTS In total, fifteen adults with T2DM and experiences of household food insecurity. RESULTS People who were interested in using the FoodRx incentive (n 10) perceived it to be more acceptable than those who were uninterested (n 5). We identified four themes that captured factors that influenced users' prospective acceptability: (i) participants' confidence, views and beliefs of FoodRx design and delivery and its future use (intrapersonal), (ii) the shopping routines and roles of individuals in participants' social networks (interpersonal), (iii) access to and experience with food retail outlets (community), and (iv) income and food access support to cope with the cost of living (policy). CONCLUSION Future healthy food prescription programs should consider how factors at all levels of the socioecological model influence program acceptability and use these data to inform program design and delivery.
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Affiliation(s)
- Saania Tariq
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
| | - Reed F Beall
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
| | - Eldon Spackman
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
| | - Lorraine Lipscombe
- Department of Medicine, Temerty School of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sharlette Dunn
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
| | - Bonnie M Lashewicz
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
| | - Meghan J Elliott
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
| | - David Jt Campbell
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, ABT2N 1N4, Canada
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Sadler RC, Saxe-Custack A. 'Nobody Shops at the Neighborhood Store': Leveraging a Community's Pediatric Fresh Produce Prescription Program to Inform Future Participating Store Redemption Locations. CITIES & HEALTH 2023; 8:70-81. [PMID: 38585045 PMCID: PMC10997326 DOI: 10.1080/23748834.2023.2281764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/06/2023] [Indexed: 04/09/2024]
Abstract
Research examining the nature of food shopping often considers proximity to the nearest or overall distance travelled to multiple stores. Such studies make up a portion of new work on so-called 'food deserts' and the issues inherent in the term, including that most people do not shop at their nearest store, and mobility challenges vary vastly from one person to the next. Increasing the knowledge base on shopping characteristics could be useful for behavioral interventions and programs aimed at increasing healthy food shopping. In this study, we examined the shopping characteristics of 627 caregivers whose children were enrolled in a pediatric fresh produce prescription program at one of three large pediatric clinics in Flint, Michigan. We compared these characteristics to the potential of a new food cooperative to improve geographic accessibility to healthy food. In particular, we propose the expansion of the prescription program to this new cooperative for health-related as well as local economic development reasons. Our work bridges topics of interest to researchers and practitioners working in nutrition, food access, and economic development.
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Affiliation(s)
- Richard C. Sadler
- Departments of Public Health and Family Medicine, Michigan State University, Flint, MI, USA
| | - Amy Saxe-Custack
- Departments of Public Health and Food Science & Human Nutrition, Michigan State University, Flint, MI, USA
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Jack SM, Orr E, Campbell KA, Whitmore C, Cammer A. A framework for selecting data generation strategies in qualitative health research studies. J Hum Nutr Diet 2023; 36:1480-1495. [PMID: 36617529 DOI: 10.1111/jhn.13134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 01/03/2023] [Indexed: 01/10/2023]
Abstract
BACKGROUND Qualitative health research has the potential to answer important applied health research questions to inform nutrition and dietetics practice, education and policy. Qualitative health research is a distinct subdiscipline of qualitative inquiry that purposefully draws upon the context of healthcare and emphasises health and wellness. METHODS Qualitative health research is defined by two parameters: (1) the focus of the study and (2) the methods used. When considering the methods to be used, decisions are required about the type of data to be generated (e.g., transcripts, images and notes) and the process involved in data generation (e.g., interviews, elicitation strategies and observations) to answer the research question(s). Drawing upon examples from nutrition and dietetics literature, this paper provides a framework to support decision-making for nutrition and dietetics researchers and clinician researchers designing conducting qualitative health research. RESULTS The guiding questions of the framework include: What types of data will be generated? Who is involved in data generation? Where will data generation occur? When will data generation occur? How will data be recorded and managed? and How will participants' and researchers' emotional safety be promoted? CONCLUSION Questions about the types of data, those involved, where and when, as well as how safety can be maintained in data generation, not only support a more robust design and description of data generation methods but also keep the person at the centre of the research.
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Affiliation(s)
- Susan M Jack
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Elizabeth Orr
- Department of Nursing, Brock University, St. Catharines, Ontario, Canada
| | | | - Carly Whitmore
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Allison Cammer
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Lowery CM, Henderson R, Curran N, Hoeffler S, De Marco M, Ng SW. Grocery Purchase Changes Were Associated With A North Carolina COVID-19 Food Assistance Incentive Program. Health Aff (Millwood) 2022; 41:1616-1625. [PMID: 36343315 PMCID: PMC10191414 DOI: 10.1377/hlthaff.2022.00902] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Many low-income Americans experience food insecurity, which may have been exacerbated by economic instability during the early stages of the COVID-19 pandemic in 2020. In this study we assessed the impact of Healthy Helping, a short-term fruit and vegetable incentive program aimed at alleviating food insecurity and improving diet quality for Supplemental Nutrition Assistance Program participants, on grocery purchases, using transaction data from a large supermarket chain in North Carolina. We compared Healthy Helping participants' purchases of key food groups before and during the program with purchases by control shoppers participating in federal food assistance programs during the same period. Healthy Helping enrollment was associated with a $26.95 increase in monthly spending on fruit, vegetables, nuts, and legumes-an increase of 2.5 grams of fiber per 1,000 kilocalories purchased-and other shifts in the composition of food purchases, relative to control shoppers. These findings suggest that the program increased healthy food purchases while also increasing dollar sales at participating retailers. On average, participants did not use the full benefit; future research should explore factors associated with non- or underuse of benefits, to inform program design and outreach.
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Affiliation(s)
- Caitlin M Lowery
- Caitlin M. Lowery, University of North Carolina, Chapel Hill, North Carolina
| | | | - Neal Curran
- Neal Curran, Reinvestment Partners, Durham, North Carolina
| | | | | | - Shu Wen Ng
- Shu Wen Ng , University of North Carolina
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Kahlon MK, Aksan NS, Aubrey R, Barnes J, Clark N, Cowley-Morillo M, Engelman L, Guerra J, Guevara A, Marshall A, Hoelscher DM. Effect of Brief Produce Exposure and Unconstrained Grocery Gift Cards on Caregiver Influence on Diet of Elementary Age Children: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2212973. [PMID: 35622367 PMCID: PMC9142863 DOI: 10.1001/jamanetworkopen.2022.12973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
IMPORTANCE Children's diets affect health trajectories but are difficult to influence, especially for resource-constrained families. OBJECTIVE To assess the effectiveness of providing 4 weeks of grocery gift cards and small produce boxes to caregivers on their ability to support healthy shifts in children's diets. DESIGN, SETTING, AND PARTICIPANTS This 2-group randomized clinical trial was conducted from May to July 2021, with 4 weeks of intervention and follow-up at 8 weeks. Resources were provided curbside at 3 schools, 3 housing sites, and 1 after-school site for use at home. Participants consisted of 1 index child ages 5 to 11 years with 1 index caregiver from 68 low-income families. Data were analyzed from July 2021 through March 2022. INTERVENTIONS During each week for 4 weeks, caregivers were offered 10-lb (4.5 kg) boxes of fruits and vegetables, $10.00 grocery gift cards, an additional $10.00 gift card over the last 3 weeks triggered by a task completion, and a 1-time choice of a $25.00 food preparation tool. MAIN OUTCOMES AND MEASURES Index child and caregiver diets were measured together over the phone at baseline, 4 weeks, and 8 weeks using the 2019 to 2020 Texas School Physical Activity and Nutrition (SPAN) tool, which measures the number of times food items were eaten over the prior day to report a SPAN Healthy Eating Index (SHEI) score and subscores for specific categories of foods (range, 0-57, with higher scores indicating a more healthful diet). RESULTS Among 68 children (mean [SD] age, 8.2 [1.7] years; 35 [51.5%] girls) and caregivers (mean [SD] age, 37.9 [7.9] years; 63 mothers [92.6%]) from primarily low-income families, 26 caregivers were Hispanic or Latino (38.2%), while 18 caregivers were Black (26.4%), 25 caregivers were White (36.7%), and 24 caregivers had more than 1 race (35.3%). Most families were below the federal poverty level (41 of 60 families that reported income [68.3%]). Per participating caregiver, a mean (SD) 2.7 [1.4] fruit and vegetable boxes and $42.35 ($25.46) worth of gift cards were picked up over 4 weeks. Mean (SE) child SPAN SHEI increased from 32.03 (0.62) times/d to 33.75 (0.69) times/d at 4 weeks (ie, postintervention) and 34.03 (0.69) times/d 4 weeks later (ie, at 8 weeks of follow-up). Mean (SE) child fruit and vegetable intake increased from 5.31 (0.47) times/d to 5.78 (0.51) times/d postintervention and 6.03 (0.51) times/d at follow-up. Children in the control group did not have improved diet (overall mean [SE] SHEI: 31.48 [0.58] times/d at baseline, 31.68 [0.54] times/d postintervention, and 31.81 [0.52] times/d at follow-up; mean [SE] fruit and vegetable intake: 5.21 [0.45] times/d at baseline, 4.77 [0.45] times/d postintervention, and 4.68 [0.41] times/d at follow-up). Compared with children in the control group, mean SHEI was increased for children in the intervention group by 2.07 times/d postintervention and 2.23 times/d at follow-up. Improvements as a function of program dose were statistically significant for child SHEI (P = .01) and fruit and vegetable intake (P = .03). No significant changes in caregiver diets were found. CONCLUSIONS AND RELEVANCE This study found that easily accessed fruits and vegetables and unconstrained grocery store cards provided directly to caregivers over 4 weeks resulted in improvements in child diet, which were sustained over 4 additional weeks. Future work may investigate whether diet improvement from a brief intervention optimized for caregiver flexibility reflects a natural maximum or potential for greater improvements on extension. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04827654.
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Affiliation(s)
- Maninder K. Kahlon
- Department of Population Health, Dell Medical School, The University of Texas at Austin
| | - Nazan S. Aksan
- Department of Population Health, Dell Medical School, The University of Texas at Austin
| | - Rhonda Aubrey
- Department of Population Health, Dell Medical School, The University of Texas at Austin
| | - Jenn Barnes
- Boys and Girls Clubs of the Austin Area, Austin, Texas
| | - Nicole Clark
- Department of Population Health, Dell Medical School, The University of Texas at Austin
| | - Maria Cowley-Morillo
- Department of Population Health, Dell Medical School, The University of Texas at Austin
| | - Lindsey Engelman
- Department of Population Health, Dell Medical School, The University of Texas at Austin
| | - Julia Guerra
- Department of Population Health, Dell Medical School, The University of Texas at Austin
| | - Alejandro Guevara
- Department of Population Health, Dell Medical School, The University of Texas at Austin
| | - Allison Marshall
- Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health in Austin
| | - Deanna M. Hoelscher
- Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health in Austin
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Vargo L, Ciesielski TH, Embaye M, Bird A, Freedman DA. Understanding SNAP Recipient Characteristics to Guide Equitable Expansion of Nutrition Incentive Programs in Diverse Food Retail Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094977. [PMID: 35564371 PMCID: PMC9101614 DOI: 10.3390/ijerph19094977] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/06/2022] [Accepted: 04/15/2022] [Indexed: 12/04/2022]
Abstract
Structural barriers, such as food costs, reduce access to healthy foods for populations with limited income, including those benefitting from the Supplemental Nutrition Assistance Program (SNAP). Nutrition incentive programs seek to address this barrier. Evaluations of SNAP-based incentive programming often focus on one setting (i.e., either farmers’ markets or grocery stores). We examined use patterns, characteristics, and preferences among 253 SNAP consumers with access to incentive programming at both a farmers’ market and a grocery store located within five miles of their home. Cross-sectional survey data were collected in 2019 in two Ohio cities. Despite geographic access, 45% of those surveyed were not using the incentive program; most non-users (80.5%) were unaware of the program. Program users compared to non-users had higher household incomes (p < 0.001) and knew more people using the program (p < 0.001). Grocery stores were the most common setting of use (59%); 29% used at farmers’ markets; 11% used in both settings. User characteristics varied by store setting based on demographics, program experience, fruit and vegetable purchasing and consumption patterns, and social dynamics related to use. Our findings support comprehensive awareness-raising efforts and tailored implementation of incentive programming that attends to diverse segments of SNAP consumers to promote equity in program reach.
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Affiliation(s)
- Lauren Vargo
- Mary Ann Swetland Center for Environmental Health Research, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Timothy H Ciesielski
- Mary Ann Swetland Center for Environmental Health Research, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Milen Embaye
- Mary Ann Swetland Center for Environmental Health Research, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Ana Bird
- Produce Perks Midwest, Cincinnati, OH 45241, USA
| | - Darcy A Freedman
- Mary Ann Swetland Center for Environmental Health Research, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
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Little M, Rosa E, Heasley C, Asif A, Dodd W, Richter A. Promoting Healthy Food Access and Nutrition in Primary Care: A Systematic Scoping Review of Food Prescription Programs. Am J Health Promot 2021; 36:518-536. [PMID: 34889656 PMCID: PMC8847755 DOI: 10.1177/08901171211056584] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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.
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Affiliation(s)
- Matthew Little
- School of Public Health and Social Policy, 8205University of Victoria, Victoria, BC, Canada
| | - Ebony Rosa
- School of Public Health and Social Policy, 8205University of Victoria, Victoria, BC, Canada
| | - Cole Heasley
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada.,Department of Chemistry, 3653University of Guelph, Guelph, ON, Canada
| | - Aiza Asif
- Department of Biomedical Sciences, 3653University of Guelph, Guelph, ON, Canada
| | - Warren Dodd
- School of Public Health Sciences, 8430University of Waterloo, Waterloo, ON, Canada
| | - Abby Richter
- Guelph Community Health Center, Guelph, ON, Canada
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