Strengthening care through Food is Medicine: Healthcare provider-patient relationships and provider fulfillment in a produce prescription program

INTRODUCTION: Produce prescription programs (PPRs) are evidence-based strategies increasingly used to address food insecurity and prevent or manage diet-related chronic disease. Fresh to Flourish is a PPR implemented in 2 Colorado-based practices within the CommonSpirit Health system. This qualitative study explored: (1) how implementing Fresh to Flourish impacts provider-patient relationships, and (2) the fulfillment experience of PPR referral providers. 

METHODS: Virtual 1:1 key informant interviews were conducted with healthcare providers. Interviews were recorded, transcribed verbatim, and independently double coded using a deductive codebook aligned with the 7 constructs of the Theoretical Framework of Acceptability of Healthcare Interventions. 

RESULTS: Ten interviews were completed across 1 rural and 1 suburban Colorado practices. Four themes emerged: (1) providers perceived Fresh to Flourish as valuable to patient care; (2) discussions about financial strain and food insecurity prompted referrals; (3) providers appreciated the simple referral process and on-site program staff; and (4) providers shared insights about integrating Fresh to Flourish into clinical workflow and systems.

 CONCLUSIONS: As aligned with the supporting theory, providers demonstrated high affective attitude, ethical alignment, and perceived effectiveness of Fresh to Flourish, with minimal burden and strong self-efficacy. Overall, providers viewed Fresh to Flourish as impactful while emphasizing the need to expand access and reduce barriers.