Online Program

Assessing the outcomes of farmers market voucher programs implemented in health care settings for overweight and obese children

Monday, November 4, 2013 : 8:50 a.m. - 9:10 a.m.

Shikha Anand, MD, MPH, National Initiative for Children's Healthcare Quality, Boston, MA
Lydia Oberholtzer, MS, Department of Agricultural Economics and Rural Sociology, Senior Researcher, Penn State University, Takoma Park, MD
Ashley Fitch, MA, Fruit and Vegetable Prescription Program, Wholesome Wave, Bridgeport, CT
Skye Cornell, MBA, Wholesome Wave, Bridgeport, CT
Despite recent evidence that rates of obesity may be decreasing, socioeconomic disparities persist. Barriers to accessing healthful foods, and limited understanding of the connection between food and health in low-income populations have been identified as contributors. In 2010, Wholesome Wave developed a program to: 1) create a direct connection between food and health; and 2) promote physical and financial access to fresh local foods for families living in underserved urban and rural communities.

Each family is given a prescription for fruits and vegetables that can be redeemed every 1-2 weeks at a farmers market within their community. Prescriptions are administered monthly for 6 months by a primary care team in the context of goal-setting to promote healthy weight. Prescriptions equal $1 per family member per day ($128 per month for a family of four). By making a direct connection between fruit and vegetable consumption and health for vulnerable families in the primary care setting, and having that message resound in the community farmer's market, the program promotes changes in shopping habits, replacement of nutritionally poor foods with fresh fruits and vegetables, and, ultimately, changes to weight and BMI. In 2012, the Fruit and Vegetable Prescription Program served 380 overweight or obese individuals and their families, 306 (80.5%) children ages 2-18 and 74 pregnant women (19.5%) in 11 underserved communities across the US. 295 (81.9%) were publically insured, 206 (63%) did not enter college, and 209 (56.3%) did not primarily speak English at home. This presentation will describe the implementation and qualitative evaluation of this program, with a focus on the program's impact on: 1) changes in family knowledge, attitudes, and behaviors regarding fruit and vegetable consumption and farmers markets; 2) health outcomes; 3) integration of health promotion across healthcare and farmers market settings; and 3) market revenue and sustainability.

Learning Areas:

Administer health education strategies, interventions and programs
Clinical medicine applied in public health
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public

Learning Objectives:
Explain the key components of the Fruit and Vegetable Prescription Program and its impact on behavior, health, and community outcomes Identify key successes and challenges in creating robust partnerships between farmers markets and community health centers. Describe the role of an integrated healthcare-farmers market program in community-wide strategies for health promotion in underserved communities.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the cofounder, Medical Director, and Advisory Board Chair for the Fruit and Vegetable Prescription Porgram. I am also currently Director of Strategic Alliances and Initiatives and Obesity Program Director at the National Initiative for Children's Healthcare Quality, an Assistant Professor at the Boston University School of Medicine. I provide leadership for Collaborate for Healthy Weight, a HRSA intiative that uses quality improvement across primary care, public health and community agencies in 48 communities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.