Fruit and Vegetable Prescription (FVRx) programs rely on diverse community and clinic partnerships to improve food security and fruit and vegetable consumption among medically underserved patient populations. Despite the growth in these programs, little is known about the feasibility or effectiveness of the unique partnerships developed to implement FVRx programs conducted in both community and free safety-net clinic settings. A 6-month nonrandomized controlled trial of an FVRx program was pilot tested with 54 Supplemental Nutrition Assistance Program (SNAP)–eligible adults with diet-related chronic conditions. The intervention combined monthly produce prescriptions for local produce at a farmers market, SNAP-Ed direct nutrition education, and health screenings for low-income adults. Process and outcome evaluations were conducted with respective samples using administrative program data (recruitment, retention, and prescription redemption) and self-administered pre- and postintervention surveys with validated measures on dietary intake, nutrition knowledge and behavior, and food purchasing practices. Descriptive statistical analyses were conducted. The FVRx program retained 77.3% of participants who spent nearly 90% of their prescription dollars. After the intervention, the FVRx group reported significantly increased total intake of fruits and vegetables, knowledge of fresh fruit and vegetable preparation, purchase of fresh fruits and vegetables from a farmers market, and significantly altered food purchasing practices compared with the control group. Community-based nutrition education organizations enhance the feasibility and effectiveness of community and clinic-based FVRx programs for improving low-income adults’ ability to enhance food and nutrition-related behaviors.

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Fruit and Vegetable Prescription (FVRx) Programs combine produce prescriptions and nutrition education to reduce fruit and vegetable consumption barriers and promote health among low-income patient populations. This study examined whether a multi-level FVRx intervention model with intensive education improves dietary behaviors, food security, and health outcomes over single-level interventions alone. A 6-month nonrandomized, parallel, controlled trial was conducted with one intervention, FVRx ( n = 31) and two comparison groups, Ad hoc Nutrition Education ( n = 13) and Control ( n = 16). The FVRx group received produce prescriptions (US$1/day/household member) redeemable at a farmer’s market, two SNAP-Ed programs, one financial literacy program, and monthly health screenings. The Nutrition Education (NE) group participated in one SNAP-Ed program, and the Control group received safety-net clinic care only. Surveys assessed dietary intake, food security, food purchasing practices, and financial and food resource management. Pre–post clinical biomarkers (blood lipid and hemoglobin A1c) and monthly biometrics (anthropometrics and blood pressure) were measured. Descriptive analysis and one-way analysis of variance (ANOVA) were conducted. Compared with comparison groups, FVRx participants significantly increased the frequency of consuming dark green vegetables, FVRx (0.36 ± 0.72); NE (0.14 ± 0.33); Control (−0.09 ± 0.19) cups/day ( p < .05). FVRx participants significantly improved multiple healthful food purchasing practices, and the ability to afford more utilities (FVRx (33%); NE (0%); Control (10%); p < .05). Limited changes were observed in food security and clinical biomarker outcomes between groups. Combining expanded nutrition and financial literacy education with produce prescriptions improves low-income adults’ financial and food resources, preference, knowledge, purchase, and consumption of locally grown vegetables over single-level interventions.

Study Design, Setting, Participants, Intervention: College freshmen (N = 29) living on campus who store food in their dorm were recruited via flyers and class announcements. Participants received $60 to complete an online version of a demographic questionnaire, the HFI (a 117item checklist separated into 15 categories designed to assess the availability/accessibility of healthy/unhealthy foods in the home), the FPC (a 41-item checklist separated into 5 categories designed to assess availability of food preparation supplies), and a researcher visit, which happened within 24 hours of completing online questionnaires. A trained researcher conducted an in-home observational assessment at the student residence using the HFI and FPC. The study was approved by the University of Florida Institutional Review Board. Outcome Measures and Analysis: Reliability was determined by comparing participant-reported HFI and FPC responses to those of the researcher using Kappa statistics and Spearman correlations. Results: For the HFI, Cohen's kappa ranged from 0.50 to 0.92 for the 15 categories. Spearman correlations between staff and participant food category scores ranged from 0.73 to 0.96. With respect to the FPC, Cohen's kappa ranged from 0.61 to 0.67 for all 5 subscales, and Spearman correlation scores ranged from 0.65 to 0.97. Conclusions and Implications: Self-reported HFI and FPC is a reliable way to determine the HFE of college students living in dorms. Data collected through this method may provide a valid and inexpensive alternative to inhome researcher visits.