Impact of a pediatric produce prescription intervention on food security and perceived nutrition-related behaviors: A mixed-methods study

Objectives: Poor Food security (FS) is associated with risk of diet-related diseases and rising healthcare costs. Produce Prescription Interventions (PRx) are emerging clinical tools to improve FS and diet quality, but their impact in families with children is not well established. This study evaluates the impact of a pediatric PRx on FS and nutrition-related behaviors.

Methods: Adult caregivers of children (0-18) were enrolled within a 6-month produce delivery and nutrition education intervention. A validated food security survey was administered pre/post intervention to determine FS scores and Food Secure status. Statistical analyses tested pre-post differences in FS scores and proportion of scores within the Food Secure range. Semi-structured interviews were performed post-intervention to explore families? experiences with low FS and healthy behaviors and were thematically analyzed.

Results: Between October 2021 and December 2022, 82 families were enrolled, 65 completed FS survey at baseline and 54 completed it at post-intervention. FS scores improved post-intervention (P?<?.05) and a greater proportion of household- and child-level scores fell within the Food Secure range post-intervention (P?<?.05). Twenty-eight interviews were analyzed. Three salient themes were identified: (1) value of healthcare-based screening and intervention, (2) food and education motivate behavior change, and (3) perceptions of post-intervention lifestyle sustainability.

Conclusions: Participation in the PRx was associated with improvements in FS and nutrition-related attitudes and behaviors. PRx can be implemented by health systems to improve FS and health behaviors associated with risk for diet-related diseases. Longer-term support may be needed to maintain healthy behavior changes associated with PRx participation.