Evaluation of a Fresh Fruits and Vegetables Prescription Program in Rural America

Top Things to Know

FIM interventions must consider not just access, but adequate nutritional “dosage” to achieve clinical impact.

FIM programs should integrate wraparound services to address these barriers and enhance therapeutic value.

Tailoring FIM interventions to cultural preferences and household dynamics could optimize impact and equity.

Summary of Conclusion/Findings

This study evaluated a voucher-based fruit and vegetable prescription program in rural America targeting food-insecure patients with diabetes or prediabetes. Using a natural experiment design, researchers compared HbA1c outcomes between participants who received vouchers and a control group placed on a waitlist. Although the treated group showed a significant pre-post reduction in HbA1c (−0.86), matching methods revealed no statistically significant difference between the treated and control groups. Redemption rates were moderately high (median 80%), suggesting good engagement, but the average monthly voucher value ($34.18) may have been insufficient to meet recommended produce intake. Exploratory analysis hinted at better outcomes among Hispanic participants and small families, though these findings were not statistically significant. The study concludes that while voucher programs may offer modest benefits, their impact on glycemic control is likely smaller than previously reported and may be limited by dosage and structural barriers.