Evaluating the impact of an implementation blueprint on a produce prescription program's implementation outcomes

Top Things to Know

Tailored implementation strategies, including workflow improvements, reduced referral burden, and clinic champions, may increase PRx program reach and delivery capacity without compromising participant satisfaction.

Implementation outcomes improved more clearly than dietary outcomes, highlighting the importance of evaluating program adoption, referral processes, and operational performance alongside patient health measures.

As Food Is Medicine programs scale, implementation blueprints developed with healthcare and community partners may help address common barriers to uptake and sustainability.

Summary of Conclusion/Findings

This pilot pre-post study evaluated whether a co-designed implementation blueprint could improve implementation outcomes for VeggieRx, a Rhode Island produce prescription (PRx) program that provides biweekly home deliveries of locally grown vegetables to patients with food insecurity and diet-related illnesses. Following introduction of tailored implementation strategies targeting barriers such as referral burden, workflow inefficiencies, provider awareness, patient engagement, and program sustainability, household referrals increased by 57.9% (38 to 60 referrals) and households receiving produce increased by 86.2% (29 to 54 households) from 2022 to 2023. Participants enrolled in the evaluation study (n=44) reported high acceptability, with a median of 81.0% of responses indicating they “liked very much” the vegetables received and 88.6% reporting that they used most or all of the vegetables delivered. Food security improved modestly, with the proportion classified as having high or marginal food security increasing from 18.2% at baseline to 36.6% at 6-month follow-up (Cohen’s h=0.42). In contrast, nutrition security and self-reported vegetable intake showed little change over the study period.