Food security and clinical outcomes of the 2017 Georgia Fruit and Vegetable Prescription program

Objective: Evaluate improvements in food security and health outcomes associated with participation in a produce prescription program. Design: Program evaluation with repeated measures over 6 months. Setting: Six sites across Georgia. Participants: Of the 159 enrolled through primary care sites, 122 participants were considered graduates (attended at least 3 of the 6 monthly visits). The majority of program graduates were Black (78.7%), earned <$25,000 annually (76.6%), and were food insecure (74.2%). Intervention: Six-month program offering group-based nutrition and cooking education along with subsidies for fresh produce worth $1 per family member per day, redeemable weekly. Main Outcome Measures: Food security, blood pressure, body mass index, waist circumference, and glycated hemoglobin. Analysis: Linear mixed models estimating association of change in outcomes with program visits 1-6. Fixed effects included participant sex and age, whereas random effects included random intercepts and slopes for the site of program participation and participants. Results: Participation in a produce prescription program combining subsidies for produce and nutrition education decreased food insecurity (P < 0.001) and diastolic blood pressure significantly (P = 0.019). Conclusions and Implications: These findings highlight the promise of this program and similar programs for improving patient food security and health outcomes among the most vulnerable, underserved communities while aiding in setting realistic expectations and suggestions for program implementation.