Online Program

Farm to Health Center Initiative: Piloting a vegetable distribution at a community health center

Sunday, November 1, 2015

Rachel Erdil, BA, School of Medicine, University of Massachusetts Medical School, Worcester, MA
Kathryn Bailey, BA, School of Medicine, University of Massachusetts Medical School, Worcester, MA
Elizabeth Rosen, BA, School of Medicine, University of Massachusetts Medical School, Worcester, MA
Melanie Gnazzo, M.D., Family Health Center of Worcester, Worcester, MA
Blair Robinson, BA, University of Massachusetts Medical School, Worcester, MA
Introduction: Food insecurity (FI) is linked to poor health outcomes and 1 in 10 households are FI in Worcester, MA. A local community health center (CHC) with 95% of patients below 200% FPL has no formal process for screening or addressing FI. The Farm-to-Health-Center Initiative seeks to reduce FI and increase vegetable consumption by assessing FI, offering weekly free farm-fresh vegetables, and promoting provider-patient conversations about FI.

Approach: The Initiative is a medical student-initiated partnership between a CHC physician and farm (Community Harvest Project). A convenience sample of 115 patients identified 5 favorite vegetables from pictures, allowing the farm to grow crops matching patients’ cultural palettes. In 2014, we distributed 6692 lbs of vegetables (772-1148 lbs/week to 75-157 households/week). Lists of food pantries and WIC/SNAP referrals were also provided to connect patients with food assistance resources.

Results: 67% of patients were food insecure using the 2-question Hunger Vital Sign. Cost (45%) and dislike (21%) were major barriers to vegetable consumption. 55% of patients reported worrying about running out of food before they had money to buy more; 48% reported never speaking to their healthcare provider about their food situation. After receiving vegetables, 46% tried a new vegetable and 60% started eating more vegetables.

Discussion: A high demand exists for supplemental vegetables, yet conversations about food are limited in the clinical setting. When free and accessible, patients are willing to try new foods. Going forward, CHCs could play a key role identifying and addressing FI and connecting patients to local resources.

Learning Areas:

Advocacy for health and health education
Program planning

Learning Objectives:
Define food insecurity and the 2-question Hunger Vital Sign screening tool Discuss the value of conducting a thorough needs assessment before implementing a new program

Keyword(s): Food Security, Underserved Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Rachel has been involved with nutrition education and research since her first year at UMass Medical School. She co-founded the UMMS student nutrition group; worked with dieticians at UMMS last summer to develop and teach cooking classes to patients; and developed and implemented a nutrition curriculum for middle and high school students at the African Community Education Center in Worcester, MA.
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.