Implementation and Effectiveness Outcomes of a Pilot Comparative Effectiveness Randomized Controlled Trial Evaluating a Food Is Medicine Program Among At-Risk Pediatric Populations

Top Things to Know

Both produce vouchers and home delivery were implemented with high fidelity, and families overwhelmingly found them helpful; especially the voucher model, which offered more choice.

The voucher group experienced a statistically significant reduction in AST levels, a marker linked to metabolic dysfunction and pediatric liver disease risk.

Children in both intervention groups increased fruit and vegetable intake and showed improved nutrition security, while controls declined or showed no improvement.

Summary of Conclusion/Findings

This pilot randomized controlled trial evaluated two Food Is Medicine (FIM) strategies (produce vouchers and home produce delivery) among 150 Medicaid‑eligible children aged 5–12 years with overweight or obesity. Both interventions were feasible and highly acceptable, with voucher families redeeming 88% of their allocated funds and delivery families receiving all planned produce shipments. Parents in both groups reported that the programs helped reduce grocery costs and supported increased fruit and vegetable intake. While most biometric outcomes did not significantly change, the voucher group showed a significant decrease in AST liver enzyme levels, suggesting potential early liver‑health benefits. Small, non‑significant improvements in child fruit and vegetable consumption and nutrition security were observed in both intervention arms relative to controls. Overall, findings indicate that FIM programs are practical, well‑received, and promising for improving dietary behaviors in at‑risk pediatric populations, though larger studies are needed to confirm health impacts.