Patient Characteristics Associated with Uptake of a Monthly Free Produce Distribution at a Health Center

Abstract

Abstract Objectives In recent decades it has been well established that social determinants have a profound impact on health. In response, some healthcare providers are implementing social service programs alongside traditional medical care. Research on these interventions, however, points to low patient uptake. We aim to understand patient characteristics associated with use of a monthly, free produce market at a health center. Methods The participants of this study are patients at a health system in Massachusetts, which operates a free, monthly produce market for patients and the public. There are no eligibility requirements for market registration. Participants were recruited in primary care waiting rooms and at the market. The analysis uses baseline surveys of study participants and administrative attendance records from the market. Risk ratios for attending at least one market were estimated using multivariable robust Poisson regression. Results Of the 712 patients enrolled in the study, 35% attended at least one market. After attending their first market, they attended 43% (IQR: 0%, 70%) of the following markets. Factors associated with attending at least one market include having at least one child in the household (Risk ratio: 1.32; 95% CI: 0.98, 1.78), having a monthly income below $2500 (1.39; 95% CI: 1.07, 1.80), being married (1.47; 95% CI: 1.06, 2.03), and being a homemaker (1.44; 95% CI: 1.07, 1.94) or unemployed (1.41; 95% CI: 0.99, 2.00). The magnitudes of the associations differ by the participant's language (English, Spanish, Portuguese). Conclusions Patients more likely to use a free produce market at a health center include those with lower incomes, dependent family members, and fewer work-related responsibilities. The use of the market by low-income patients supports a hypothesis that healthcare-based food assistance programs open to all will be used by those most in need. By eliminating eligibility requirements, health center produce markets reduce both the administrative burden on the health system and the stigma associated with use of food assistance. Qualitative research is ongoing to determine how to increase accessibility of the produce market to those who may have limited available time. Funding Sources This work is supported by SIREN UCSF, the Office of the Massachusetts Attorney General, and general operating funds from The Greater Boston Food Bank.