Produce prescription programs (PPR) have become increasingly common to address the poor health outcomes associated with food insecurity and diet-related chronic disease. These programs involve “prescriptions” for fruits and vegetables within a routine medical visit for eligible individuals. Benefits of PPRs include increased fruit and vegetable purchasing and consumption, reduced household food insecurity, and improved clinical health outcomes. However, only a few regionally bound studies focus on experience of those health care providers (HCP) who make the ‘prescription.’
The purpose of this study is to explore HCP perspectives and experiences with PPRs funded by the United States Department of Agriculture Gus Schumacher Nutrition Incentive Program (USDA GusNIP).
Study Design, Setting, Participants
Multiple methods including descriptive survey (n = 34) followed by individual key-informant interviews. Interviewees were HCPs (n = 16) from across the United States recruited through USDA GusNIP PPR networks. Interviews were conducted via videoconference, recorded, and transcribed verbatim.
Transcripts were coded using thematic qualitative analysis methods by three independent coders using Atlas.ti (Mac Version 8.1.1).
Three cross-cutting key themes emerged. First, HCPs shared challenges of PPRs including: lack of time/staff, difficulty with provider and patient engagement, steep “trial and error” learning curve, and formidable barriers related to data sharing and research-related requirements (e.g., Institutional Review Board approval). Second, HCPs elucidated best practices/lessons learned (e.g., establishing a ‘program champion’) as a response to the experienced challenges. Third, HCPs expressed robust program satisfaction and desire to expand sustainable PPRs. HCPs also provided a shared understanding of the need for rigorous program evaluation to establish sustained funding and policies, but contextualized this need with the aforementioned challenges with collecting and sharing patient-related data outcomes.
Findings provide emergent best practices and indicate what additional resources are needed to sustainably implement and rigorously evaluate PPRs.