Impact of a Prescription Produce Program on Diabetes and Cardiovascular Risk Outcomes

Authors

Susan Veldheer, Department of Family and Community Medicine, Pennsylvania State University College of Medicine, Hershey, PA; Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA. Electronic address: sveldheer@psu.edu.
Christina Scartozzi, Department of Family and Community Medicine, Penn State Health St. Joseph Medical Center, Reading, PA.
Candace R. Bordner, Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA.
Chinwendu Opara, WellSpan Medical Group, York, PA.
Brittany Williams, Lehigh Valley Health NetworkFollow
Lisa Weaver, Department of Family and Community Medicine, Penn State Health St. Joseph Medical Center, Reading, PA; Penn State University Berks Campus, Reading, PA.
Diana Rodriguez, Racial and Ethnic Approaches to Community Health (REACH) Project, Pennsylvania State University College of Medicine, Hershey, PA.
Arthur Berg, Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA.
Christopher Sciamanna, Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA; Department of General Internal Medicine, Pennsylvania State University College of Medicine, Hershey, PA.

Document Type

Article

Publication Date

12-1-2021

Publication Title

Journal of nutrition education and behavior

E-ISSN

1878-2620

Department(s)

Department of Medicine

Keywords

diabetes self-management education, fruit and vegetable prescriptions, type 2 diabetes

Abstract

OBJECTIVE: To evaluate the impact of a fruit and vegetable prescription program on diabetes and cardiovascular risk outcomes. DESIGN: Single-arm pre-post study. SETTING: Primary care clinic in a community-based hospital. PARTICIPANTS: Adults with type 2 diabetes (n = 97), aged > 18 years, with hemoglobin A1c (HbA1c) ≥ 7.0%, and a body mass index (BMI) of ≥ 25 kg/m. INTERVENTION: Over 7 months, participants received monthly group-based diabetes self-management education (DSME) and monthly vouchers ($28-$140/month) redeemable for fruits and vegetables at local markets. ANALYSIS: Biomarker changes (HbA1c, BMI, and blood pressure) were assessed with paired t tests. Voucher distribution and redemption were tracked, and voucher redemption rates were calculated. Linear mixed-effect regression models tested associations between biomarkers, voucher redemption rates, and participant characteristics. RESULTS: There was a -1.3% (P < 0.001) postprogram change in HbA1c. Reduced HbA1c was associated with higher voucher redemption rates (P = 0.032) and a change in diabetes medications (P = 0.003). There were no associations with BMI, but blood pressure was positively associated with voucher redemption. CONCLUSIONS AND IMPLICATIONS: Fruit and vegetable prescription programs may improve diabetes outcomes by incentivizing DSME uptake and retention. Future randomized trials are warranted to identify strategies to improve DSME engagement and voucher redemption rates and assess mechanisms through which these programs influence health outcomes.

Volume

53

Issue

12

First Page

1008

Last Page

1017

DOI

10.1016/j.jneb.2021.07.005

PubMed ID

34426064

Recommended Citation

Veldheer, S., Scartozzi, C., Bordner, C. R., Opara, C., Williams, B., Weaver, L., Rodriguez, D., Berg, A., & Sciamanna, C. (2021). Impact of a Prescription Produce Program on Diabetes and Cardiovascular Risk Outcomes. LVHN Scholarly Works. Retrieved from https://scholarlyworks.lvhn.org/research-historical-works/11
DOI: 10.1016/j.jneb.2021.07.005