Journal of nutrition education and behavior · 2026
Feasibility of Home-Delivery and Voucher-Based Produce Prescription Programs Among Adults with Overweight or Obesity and Nutrition Insecurity.
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Miller Hailey N, Olawole Wura, Lee Ashauna, Ngige Azuka Amaka, Okonkwo Philip, Chepkorir Joyline, Stephens Janna, Himmelfarb Cheryl R
Аннотация
OBJECTIVE: Evaluate the feasibility of 2 produce prescription delivery mechanisms in a two-arm, pilot, randomized controlled trial at a Baltimore community market.
PARTICIPANTS: Forty-eight adults with overweight or obesity experiencing nutrition insecurity (65% women, 83% non-Hispanic Black).
INTERVENTION(S): Produce vouchers or home-delivered produce boxes for 8-weeks, with behavioral support.
VARIABLES MEASURED: Recruitment, retention, fidelity, satisfaction, and changes in nutrition security, diet quality, self-efficacy, weight, and blood pressure.
ANALYSIS: The Wilcoxon signed-rank test assessed changes in outcomes. Effect sizes were evaluated using the rank-biserial correlation and Kendall's W.
RESULTS: Participant retention (88%), produce prescription redemption (75% to 99%), and satisfaction (93%) were high. Participant engagement in behavioral support varied. Participants had improvements in nutrition security (+0.5, r = 0.87), diet (+3.0, r = 0.50), fruit intake (+0.50, r = 0.64), self-efficacy (+3.0, r = 0.57), and systolic blood pressure (-4.0 mm Hg, r = -0.77).
CONCLUSIONS AND IMPLICATIONS: Both delivery mechanisms were feasible and led to improvements in key outcomes. Larger studies are needed to establish effectiveness.
PARTICIPANTS: Forty-eight adults with overweight or obesity experiencing nutrition insecurity (65% women, 83% non-Hispanic Black).
INTERVENTION(S): Produce vouchers or home-delivered produce boxes for 8-weeks, with behavioral support.
VARIABLES MEASURED: Recruitment, retention, fidelity, satisfaction, and changes in nutrition security, diet quality, self-efficacy, weight, and blood pressure.
ANALYSIS: The Wilcoxon signed-rank test assessed changes in outcomes. Effect sizes were evaluated using the rank-biserial correlation and Kendall's W.
RESULTS: Participant retention (88%), produce prescription redemption (75% to 99%), and satisfaction (93%) were high. Participant engagement in behavioral support varied. Participants had improvements in nutrition security (+0.5, r = 0.87), diet (+3.0, r = 0.50), fruit intake (+0.50, r = 0.64), self-efficacy (+3.0, r = 0.57), and systolic blood pressure (-4.0 mm Hg, r = -0.77).
CONCLUSIONS AND IMPLICATIONS: Both delivery mechanisms were feasible and led to improvements in key outcomes. Larger studies are needed to establish effectiveness.