Factors Associated with Produce Prescription Program Enrollment and Benefit Use among Patients with Diabetes and at Risk for Food Insecurity

Top Things to Know

Equitable reach is a critical challenge in FIM programs.

Participant engagement and utilization are key determinants of impact in PRx and broader FIM models.

Differences in use by demographics indicate that tailoring delivery methods may improve participation and maximize FIM program benefits.

Summary of Conclusion/Findings

This observational cohort study examined factors associated with enrollment and benefit use in a produce prescription (PRx) program among adults with type 2 diabetes at risk for food insecurity within a large health system. Of 9,644 individuals contacted, only 22.6% enrolled, and among those assigned to the intervention, 79.2% activated their benefit cards, though 21% never used them, indicating meaningful gaps in program uptake. Enrollment was significantly lower among older adults, men, individuals enrolled in Medicaid, those living in higher-deprivation areas, and non-Black racial/ethnic groups, suggesting disparities in initial program reach. Among participants who did engage, higher benefit use was associated with older age and being married, while high blood pressure was linked to lower spending and higher BMI to greater spending. Overall, the findings demonstrate that demographic and socioeconomic factors strongly influence both participation and utilization, potentially shaping the effectiveness of PRx interventions. The study highlights that variability in engagement may partly explain inconsistent clinical outcomes observed in FIM programs.