Fresh prescription: Improving nutrition education and access to fresh produce in detroit
Omar J, Heidemann D, Blum-Alexander B, Uju-Eke C, Alam Z, Willens DE, Wisdom K. Fresh prescription: Improving nutrition education and access to fresh produce in detroit. Journal of General Internal Medicine 2017; 32(2):S752.
Journal of General Internal Medicine
STATEMENT OF PROBLEM OR QUESTION (ONE SENTENCE): Lack of basic knowledge of nutrition and limited access to fresh produce contribute to difficulty in controlling chronic diseases like obesity, diabetes, and cardiovascular disease among underserved adults in Detroit. OBJECTIVES OF PROGRAM/INTERVENTION (NO MORE THAN THREE OBJECTIVES): To improve patient's knowledge of nutrition and confidence in their ability to eat healthy. To improve access to fresh produce by 1) providing financial support, 2) introducing patients to new local Detroit farmer's markets. DESCRIPTION OF PROGRAM/INTERVENTION, INCLUDING ORGANIZATIONAL CONTEXT (E.G. INPATIENT VS. OUTPATIENT, PRACTICE OR COMMUNITY CHARACTERISTICS): Fresh Prescription is a program that serves patients at several different sites in the Detroit area. We implemented Fresh Prescription at our tertiary-care academic institution in the outpatient Internal Medicine clinic. Eligible participants with body mass index >25 and motivation to learn healthy eating habits were enrolled by their primary care physician from July- September 2016. Participants were given a $10 reward on a rechargeable debit card for completing a nutrition educational counseling session, which could include tele-counseling, cooking demonstrations, and other events. They were able to redeem their reward at local farmer's markets or with boxed food deliveries to receive a maximum total of $40 in fresh produce. Patients underwent a total of 4 counseling sessions over 6 weeks and received an additional $20 boxed food delivery for returning for a 12 week follow up. MEASURES OF SUCCESS (DISCUSS QUALITATIVE AND/OR QUANTITATIVE METRICS WHICH WILL BE USED TO EVALUATE PROGRAM/INTERVENTION): Success was measured through comparison of pre- and post-survey responses. FINDINGS TODATE (IT IS NOT SUFFICIENT TOSTATE FINDINGS WILL BEDISCUSSED):Atotal of 149 patients were referred to the program by their primary care physician. 39 of these patients were enrolled, and 28 patients completed the program (72% completion rate). Post-survey responses are available for 27 of the 39 patients enrolled in the program. 96% of participants reported they were better able to manage their health and their chronic conditions. 78% of participants reported an increase in their daily intake for fresh fruits and vegetables, with an average increase of 2 cups/day. 48% of participants reported a decrease in their intake of unhealthy food items, with an average decrease of 1 item/day. There was an increase in measures of knowledge base, which included ability to select, prepare, and store fresh produce. 85% of participants reported better knowledge of where to buy fresh produce. Price, access, and transportation were still noted to be barriers for many participants. Of the 39 patients who completed the program, 16 returned for follow up on biometrics, including weight and blood pressure. 5 of 16 participants had weight loss, and 5 of 16 had improvement in blood pressure. KEYLESSONS FORDISSEMINATION(WHATCAN OTHERS TAKE AWAY FOR IMPLEMENTATION TO THEIR PRACTICE OR COMMUNITY?): Increasing general nutrition knowledge base among participants led to an increase in the amount of fresh produce consumed, a decrease in unhealthy food items consumed, and increase in ability to manage chronic health conditions. Providing financial resources and improving access to fresh produce are important in supporting patients in an underserved population while encouraging healthy eating habits.