Abstract

<h3>Background</h3> FVRx programs combining produce prescription and nutrition education have the potential to improve multiple diet-related behaviors of low-income adults. In 2018, the Athens FVRx program expanded nutrition education from 1 SNAP-Ed program (2017) to 2 SNAP-Ed programs and 1 financial literacy program. <h3>Objective</h3> To examine the effects of an FVRx program with expanded nutrition education and financial literacy education on nutrition and clinical outcomes in low-income adults. <h3>Study Design, Settings, Participants</h3> A 6-month non-randomized, parallel, controlled trial with 1 intervention (FVRx [n = 31]) and 2 comparison groups (Ad-hoc Nutrition Education (n = 10), and control [n = 16]). The final analytic sample (n = 36) included food insecure adults with a diet-related condition (mean age 53.8 ± 12.2 years (<i>P</i> < 0.05), 91.7% female, 33.3% Black). The FVRx group received produce prescriptions redeemable at a farmers market, 2 SNAP-Ed programs, 1 financial literacy program, and monthly health screenings (June-December 2018). FVRx and control groups were recruited by clinic and community site partners. The Nutrition Education group was recruited during participation in 1 SNAP-Ed program. <h3>Measurable Outcome/Analysis</h3> Pre- and post-intervention, 3 separate self-administered surveys assessed dietary intake, food security, food purchasing practices, and financial and food resource management. Clinical biomarkers (blood lipids, HbA1c) and biometrics (blood pressure, BMI) were measured. Descriptive analysis and one-way ANOVA were conducted. <h3>Results</h3> Post-intervention, FVRx participants significantly increased the frequency of consuming vegetables (once a day-once a week) by 22.2%, and knowledge, purchase, and preference of seasonally and locally available produce by (44.4%, 72.2%, and 16.7% respectively) compared to the comparison groups (<i>P</i> < 0.05). FVRx participants significantly increased healthful food purchasing practices and the ability to afford more bills (33%) (eg, utilities) compared to the comparison groups (<i>P</i> < 0.05). Changes in food security, clinical biomarker, and biometric measures were not significant between groups. <h3>Conclusion</h3> Combining expanded nutrition and financial literacy education with produce prescription improves low-income adults' financial and food resources, knowledge, purchase, preference, and consumption of locally grown vegetables.

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