Julian Xie1,2, Ashley Price2, Neal Curran3, Truls Østbye2. 1. Duke University School of Medicine, 8 Searle Center Dr, Durham, NC27710, Telephone: +1- 919-684-9026. 2. Duke University Department of Family Medicine and Community Health, Suite 400, 2200 W. Main Street, Durham, NC27705, USA, Telephone: +1-919-681-3178. 3. Reinvestment Partners, 110 E Geer St, Durham, NC27701, USA, Telephone: +1-919-667-1000.
Abstract
OBJECTIVE: To evaluate a Produce Prescription Programme's utilisation, and its effects on healthy food purchasing and diabetes control among participants with type 2 diabetes. DESIGN: Prospective cohort study using participants' electronic health records (EHR) and food transaction data. Participants were categorized as "Frequent Spenders" and "Sometimes Spenders" based on utilisation frequency. Multivariate regressions assessed utilisation predictors; and programme effects on fruit/vegetable purchasing (spending, expenditure share, variety) and on diabetes-related outcomes (HbA1c, BMI, blood pressure). SETTING: Patients enrolled by clinics in Durham, North Carolina, USA. Participants received $40 monthly for fruits and vegetables at a grocery store chain. SUBJECTS: 699 food-insecure participants (353 with diabetes). RESULTS: Being female and older was associated with higher programme utilisation; hospitalisations were negatively associated with programme utilisation. Frequent Spender status was associated with $8.77 more in fruit/vegetable spending (p < 0.001), 3.3% increase in expenditure share (p = 0.007), and variety increase of 2.52 fruits and vegetables (p < 0.001). For $10 of Produce Prescription Dollars spent, there was an $8.00 increase in fruit/vegetable spending (p < 0.001), 4.1% increase in expenditure share, and variety increase of 2.3 fruits/vegetables (p < 0.001). For the 353 participants with diabetes, there were no statistically significant relationships between programme utilisation and diabetes control. CONCLUSIONS: Programme utilisation was associated with healthier food purchasing, but the relatively short study period and modest intervention prevent making conclusions about health outcomes. Produce Prescription Programmes can increase healthy food purchasing among food-insecure people, which may improve chronic disease care.
OBJECTIVE: To evaluate a Produce Prescription Programme's utilisation, and its effects on healthy food purchasing and diabetes control among participants with type 2 diabetes. DESIGN: Prospective cohort study using participants' electronic health records (EHR) and food transaction data. Participants were categorized as "Frequent Spenders" and "Sometimes Spenders" based on utilisation frequency. Multivariate regressions assessed utilisation predictors; and programme effects on fruit/vegetable purchasing (spending, expenditure share, variety) and on diabetes-related outcomes (HbA1c, BMI, blood pressure). SETTING:Patients enrolled by clinics in Durham, North Carolina, USA. Participants received $40 monthly for fruits and vegetables at a grocery store chain. SUBJECTS: 699 food-insecure participants (353 with diabetes). RESULTS: Being female and older was associated with higher programme utilisation; hospitalisations were negatively associated with programme utilisation. Frequent Spender status was associated with $8.77 more in fruit/vegetable spending (p < 0.001), 3.3% increase in expenditure share (p = 0.007), and variety increase of 2.52 fruits and vegetables (p < 0.001). For $10 of Produce Prescription Dollars spent, there was an $8.00 increase in fruit/vegetable spending (p < 0.001), 4.1% increase in expenditure share, and variety increase of 2.3 fruits/vegetables (p < 0.001). For the 353 participants with diabetes, there were no statistically significant relationships between programme utilisation and diabetes control. CONCLUSIONS: Programme utilisation was associated with healthier food purchasing, but the relatively short study period and modest intervention prevent making conclusions about health outcomes. Produce Prescription Programmes can increase healthy food purchasing among food-insecure people, which may improve chronic disease care.
Authors: Ronit A Ridberg; Amy L Yaroch; Nadine Budd Nugent; Carmen Byker Shanks; Hilary Seligman Journal: J Prim Care Community Health Date: 2022 Jan-Dec
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