“The Shelves Are Bare”: The Impact of COVID-19 on Families Enrolled in a Pediatric Produce Prescription Program

Abstract

A large pediatric clinic in Flint, Michigan, implemented a produce prescription program for youth to address enduring challenges with food access and food insecurity. Approximately 18 months later, on March 23, 2020, the State of Michigan issued a "stay home, stay safe" executive order in response to the COVID-19 pandemic. This study sought to (1) explore caregiver experiences with access to and utilization of the prescription program during COVID-19; and (2) understand perceived changes in the food environment during the "stay home, stay safe" executive order. MethodsResearchers collected data through recorded, semi-structured telephone interviews with caregivers of children who received at least one produce prescription and had previously enrolled in a preliminary effectiveness study on the prescription program. We transcribed the recordings verbatim for textual analysis. Examining the qualitative data using thematic analysis, we identified patterns across transcripts and formulated illustrative themes. ResultsFifty-six caregivers (mean age, 41.3 ± 10.3 years) participated in interviews. The majority were female (91%), African American (70%), and Flint residents (75%). Recurrent themes, each centered around changes in the food environment resulting from COVID-19, emerged: (1) produce prescription access and utilization; (2) food access constraints; (3) food shopping adjustments; and (4) food insecurity stress. Perceived consequences of COVID-19 included increased anxiety related to food shopping and food insecurity alongside challenges accessing and utilizing the produce prescription program. ConclusionsThis study highlights the many ramifications of the COVID-19 pandemic on vulnerable families. More comprehensive efforts are necessary to address substantial barriers to healthy food access and affordability caused by the recent pandemic.

Clients’ experiences and satisfaction with produce prescription programs in California: a qualitative evaluation to inform person-centered and respectful program models

“…They also wanted to shop at Asian or Mexican grocery stores as well as stores with greater variety and higher quality produce, noting that in some cases they did not use the cards because of limited or low-quality produce. These findings are consistent with an evaluation of a produce prescription program in which participants reported that they had faced challenges with accessing high-quality fruits and vegetables before the COVID-19 pandemic and these challenges worsened during the pandemic ( 39 ). A study conducted by Lyonnais and colleagues found that participants reported that available locations where vouchers could be redeemed did not have the foods they were looking for and that this was a barrier to voucher redemption ( 29 ).…”

Caregiver perceptions of a pediatric produce prescription program during the COVID-19 pandemic

“…Although interest in research and healthcare policy related to food is medicine interventions is growing rapidly, programs prioritizing children are still limited. Only eight studies have aimed to understand the experience of caregivers in pediatric programs in the past decades (27)(28)(29)(30). In more recent qualitative studies of pediatric produce prescription programs operated during the COVID-19 pandemic, themes from the perspectives of caregivers revealed exacerbated economic challenges related to the pandemic, adaptations made in response to program implementation, and perceived favorable program effects on healthy food access and family dietary habits (28)(29)(30).…”

“…Only eight studies have aimed to understand the experience of caregivers in pediatric programs in the past decades (27)(28)(29)(30). In more recent qualitative studies of pediatric produce prescription programs operated during the COVID-19 pandemic, themes from the perspectives of caregivers revealed exacerbated economic challenges related to the pandemic, adaptations made in response to program implementation, and perceived favorable program effects on healthy food access and family dietary habits (28)(29)(30). These previous studies underscored the diversity of experiences with produce prescription program, which could be affected geographic and temporal factors.…”