Produce Prescription Dose Response: A Randomized Community Trial

Top Things to Know

Higher produce prescription benefit amounts were associated with greater redemption, lower food insecurity, and higher fruit and vegetable intake.

Significant improvements in food security and fruit and vegetable intake were observed when comparing $110/month to $40/month.

The findings suggest that underfunded PRx programs may limit participant engagement and impact, but more research needed to determine dose needed for improved clinical outcomes.

Summary of Conclusion/Findings

This randomized community trial evaluated the impact of three produce prescription (PRx) doses ($40, $80, or $110 monthly) delivered for six months to 242 adults receiving services from a community-based organization in Stockton, California; participants were predominantly Hispanic (82.6%) and female (97.1%). The intervention provided electronic benefits redeemable only for fruits and vegetables at major grocery retailers, making this a produce prescription (PRx) intervention. Higher PRx doses were associated with a dose-response pattern across key Food Is Medicine process outcomes, including benefit redemption, food security, and fruit and vegetable intake. At 3 months, participants receiving $110/month had significantly lower food insecurity (47.4% vs. 74.3%, p=0.01) and higher fruit and vegetable intake (2.89 vs. 2.51 cups/day excluding fries, p=0.03) compared with those receiving $40/month. Benefit redemption also increased with dose, with redemption rates at 3 months of 60.2%, 67.6%, and 70.4% in the $40, $80, and $110 groups, respectively; the $110 group showed significantly higher redemption than the $40 group over the full study period (p=0.04). The study was not powered to detect clinical health outcomes, had substantial loss to follow-up, and was conducted in a predominantly Hispanic, female population, which may limit generalizability.