Abstract Body: Introduction
Food is Medicine, including produce prescription programs, aim to address food and nutrition insecurity while promoting health among patients with diet sensitive conditions. NutriConnect tested the effect of two produce prescription strategies, compared with usual care, on fruit and vegetable (F&V) intake and food security at 6 months among socioeconomically disadvantaged with elevated cardiovascular risk who were recently hospitalized.
Hypothesis
We hypothesized that participants randomized to the NutriConnect Delivery arm would demonstrate greater increases in F&V intake at 6 months compared with those in the NutriConnect Credit arm, and that both intervention arms would demonstrate greater increase in F&V intake at 6 months compared with usual care.
Methods
Eligible participants were recently hospitalized adults with food or financial insecurity and elevated cardiovascular risk. Participants were randomized (1:1:1) into three arms: Delivery (pre-selected food items), Credit (grocery coupon via email), or Usual Care (referral to community resources). The primary outcome was change in F&V intake at 6 months. Secondary outcomes included food security and self-reported health status. F&V intake was measured using 10 items from the Dietary Screener Questionnaire (DSQ). Linear mixed-effects models were used to assess changes in F&V intake over time. Household food security was analyzed using a modified Poisson model with robust standard errors.
Results
NutriConnect participants (n=126) had a mean age of 55.5 years (SD=12.8) and were predominantly female (60.3%). Most had at least a secondary education (85.7%) and identified as Black (62.7%). Medicaid (34.9%) and Medicare (26.2%) were the most common insurance types. Employment status varied: 40.5% reported being disabled, while 13.5% and 7.1% reported full-time and part-time employment, respectively. The median BMI was 31 (IQR: 24.7–38.3). Nearly half (46.8%) had diabetes, 81.7% had hypertension, and 58.7% reported hypercholesterolemia. Average F&V intake was 2.3 cups/day (SD = 0.5). (Table 1) Interim 6-month retention rates were 64% in the Delivery group, 42% in the Credit group, and 51% in the Usual Care group. The trial is scheduled to conclude in Nov 2025.
Conclusions
NutriConnect will generate new evidence on the comparative effects of different modes of produce prescription implementation. Future research can build on these findings to support larger-scale adaptation, implementation, and evaluation.