Allison V Schlosser1, Samantha Smith2, Kakul Joshi3, Anna Thornton3, Erika S Trapl3, Shari Bolen4,5,6,7. 1. Department of Bioethics, School of Medicine, Case Western Reserve University, Cleveland, OH, USA. avs29@case.edu. 2. Epidemiology, Surveillance, & Informatics, Cuyahoga County Board of Health, Parma, OH, USA. 3. Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA. 4. Better Health Partnership, Cleveland, OH, USA. 5. Department of Medicine, MetroHealth Medical Center, Cleveland, OH, USA. 6. Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA. 7. Center for Health Care Research and Policy, Case Western Reserve University at the MetroHealth System, Cleveland, OH, USA.
Abstract
BACKGROUND: Although research shows produce prescription (PRx) programs increase fruit and vegetable (FV) consumption, little is known about how participants experience them. OBJECTIVE: To better understand how participants experience a PRx program for hypertensive adults at 3 safety net clinics partnered with 20 farmers' markets (FMs) in Cleveland, OH. DESIGN: We conducted semi-structured interviews with 5 program providers, 23 patient participants, and 2 FM managers. PARTICIPANTS: Patients interviewed were mainly middle-aged (mean age 62 years), African American (100%), and women (78%). Providers were mainly middle-aged men and women of diverse races/ethnicities. INTERVENTION: Healthcare providers enrolled adult patients who were food insecure and diagnosed with hypertension. Participating patients attended monthly clinic visits for 3 months. Each visit included a blood pressure (BP) check, dietary counseling for BP control, a produce prescription, and produce vouchers redeemable at local FMs. APPROACH: Patient interviews focused on (1) beliefs about food, healthy eating, and FMs; (2) clinic-based program experiences; and (3) FM experiences. Provider and market manager interviews focused on program provision. All interviews were audio-taped, transcribed, and analyzed thematically. KEY RESULTS: We identified four central themes. First, providers and patients reported positive interactions during program activities, but providers struggled to integrate the program into their workflow. Second, patients reported greater FV intake and FM shopping during the program. Third, social interactions enhanced program experience. Fourth, economic hardships influenced patient shopping and eating patterns, yet these hardships were minimized in some participants' views of patient deservingness for program inclusion. CONCLUSIONS: Our findings highlight promises and challenges of PRx programs for economically disadvantaged patients with a chronic condition. Patient participants reported improved interactions with providers, increased FV consumption, and incorporation of healthy eating into their social networks due to the program. Future efforts should focus on efficiently integrating PRx into clinic workflows, leveraging patient social networks, and including economic supports for maintenance of behavior change.
BACKGROUND: Although research shows produce prescription (PRx) programs increase fruit and vegetable (FV) consumption, little is known about how participants experience them. OBJECTIVE: To better understand how participants experience a PRx program for hypertensive adults at 3 safety net clinics partnered with 20 farmers' markets (FMs) in Cleveland, OH. DESIGN: We conducted semi-structured interviews with 5 program providers, 23 patientparticipants, and 2 FM managers. PARTICIPANTS: Patients interviewed were mainly middle-aged (mean age 62 years), African American (100%), and women (78%). Providers were mainly middle-aged men and women of diverse races/ethnicities. INTERVENTION: Healthcare providers enrolled adult patients who were food insecure and diagnosed with hypertension. Participating patients attended monthly clinic visits for 3 months. Each visit included a blood pressure (BP) check, dietary counseling for BP control, a produce prescription, and produce vouchers redeemable at local FMs. APPROACH: Patient interviews focused on (1) beliefs about food, healthy eating, and FMs; (2) clinic-based program experiences; and (3) FM experiences. Provider and market manager interviews focused on program provision. All interviews were audio-taped, transcribed, and analyzed thematically. KEY RESULTS: We identified four central themes. First, providers and patients reported positive interactions during program activities, but providers struggled to integrate the program into their workflow. Second, patients reported greater FV intake and FM shopping during the program. Third, social interactions enhanced program experience. Fourth, economic hardships influenced patient shopping and eating patterns, yet these hardships were minimized in some participants' views of patient deservingness for program inclusion. CONCLUSIONS: Our findings highlight promises and challenges of PRx programs for economically disadvantaged patients with a chronic condition. Patientparticipants reported improved interactions with providers, increased FV consumption, and incorporation of healthy eating into their social networks due to the program. Future efforts should focus on efficiently integrating PRx into clinic workflows, leveraging patient social networks, and including economic supports for maintenance of behavior change.
Entities:
Keywords:
disparities; health education; hypertension; nutrition; patient education
Authors: Allison V Schlosser; Kakul Joshi; Samantha Smith; Anna Thornton; Shari D Bolen; Erika S Trapl Journal: Transl Behav Med Date: 2019-10-01 Impact factor: 3.046
Authors: Sarah A Stotz; Nadine Budd Nugent; Ronit Ridberg; Carmen Byker Shanks; Ka Her; Amy L Yaroch; Hilary Seligman Journal: Prev Med Rep Date: 2022-08-13
Authors: Cole Heasley; Becca Clayton; Jade Muileboom; Anna Schwanke; Sujani Rathnayake; Abby Richter; Matthew Little Journal: Arch Public Health Date: 2021-07-23