Fresh Start: A Comprehensive Pilot Produce Prescription Program to Improve Food Literacy and Glycemic Control in Rural, Uninsured Patients

Abstract

Produce prescription (PRx) programs improve access to fresh fruits and vegetables. However, many programs lack culinary focused nutrition education or behavioral support to promote sustainable lifestyle changes. The pilot Fresh Start PRx (FSPRx) program was a 20-week PRx program. The purpose of this study was to examine the impact of the FSPRx program on food literacy, lifestyle behaviors, and health outcomes (e.g., glycemic control) with rural, uninsured patients with type-2 diabetes. Adult patients (n = 56) diagnosed with type-2 diabetes enrolled in the pilot FSPRx program. The FSPRx program consisted of telephone-based health coaching, group educational sessions, and a PRx. Patients completed diet quality, food literacy, and physical activity questionnaires and had blood drawn for hemoglobin A1C (HbA1C) pre- and post-intervention. Twenty-seven patients had a significant improvement in both fruit and vegetable consumption. Nineteen patients had an increase in total food literacy scores, budgeting skills, meal planning and prepping, nutrition resourcefulness, and physical activity confidence after the intervention. Patients had an average HbA1C decline of .79% (n = 27, P = .01, t = 2.49). This pilot suggests comprehensive PRx programming that integrates culinary and food literacy focused education and behavioral support may be effective in improving patients' diet quality, knowledge, skills, self-efficacy, and health.