In August 2016, providers in the Penn State Health System in Central Pennsylvania will be able to prescribe a weekly box of fresh and locally grown produce to patients identified as either at-risk for chronic disease or food insecure through a new innovative program called Penn State ProduceRx.
Food prescription programs are starting to crop up around the country, but unlike many similar programs, this novel program integrates all members of the patients’ health care team. Research has shown that simply increasing access to fruits and vegetables is not enough to change eating habits. ProduceRx will increase access to fruits and vegetables as well as provide a nutritional education component in collaboration with registered dietitians, dietetic interns and medical students from the Penn State Milton S. Hershey Medical Center (PSHMC).
Participants will receive nutritional education through weekly printed newsletters and biweekly YouTube cooking videos. The YouTube videos may feature guest physicians, community members, health administrators and other health care workers in an attempt to sustainably connect the community to this initiative. Local farmers will also be included in the newsletters and videos, in an effort to highlight those individuals directly contributing to the health and wellbeing of their community.
Sarayna Schock, a first-year medical student native to central Pennsylvania, developed the ProduceRx program. She has strong ties to the local community and her own personal struggles with weight throughout her childhood inspired the program’s creation. Her goal was to target adolescent patients and their families, whom similar to her own, worked full-time and had little nutritional education. She became inspired to change the local food system and provide adolescent patients and their families the tools they need to utilize fresh and local fruits and vegetables in their diet. After enlisting in the Air Force and traveling to the “blue zone” of Okinawa, she began to understand the value of fresh produce, the crucial role it plays in the diet, and its impact on overall health and longevity. (‘Blue zones’ refer to areas of the world where people experience long life expectancies and very low rates of chronic diseases).
The program follows a Community Supported Agriculture (CSA) structure, where local farms offer a certain number of shares to the public. The initial partnering farm, Strites’ Orchard, will open up their pre-existing CSA delivery points across Central PA to ProduceRx participants in order to increase accessibility of the program to patients who do not live within the immediate area of PSHMC. Strites’ Orchard will offer the CSA shares at a discounted price. Grant funding will be used to further subsidize the shares, so that participants will pay an affordable $10 weekly copayment. EBT/SNAP benefits may be used to pay this copayment.
ProduceRx will not be contractual like most existing CSA programs, which require an upfront payment for an entire season of produce. Instead, ProduceRx will allow the patient to order CSA shares on a weekly basis. These weekly shares will consist of six to eight different fruits and vegetables grown locally and harvested just prior to packaging. Following Strites’ existing CSA model, all participants will receive identical produce in their share. This will allow the ProduceRx team to develop recipes, create cooking videos and provide nutritional tips to all participants based specifically around their weekly share. As an additional incentive, patients will be able to visit Strites’ farm on open “U-pick” days and pick additional fruit and vegetables at no cost.
This holistic community-centered approach will facilitate connectedness and solidarity between the healthcare system and those it serves. ProduceRx has the potential to set a precedent for other health systems across the country. While the PSHMC and Penn State College of Medicine are located more rurally than most academic medical centers, the ProduceRx model may be replicable at urban health care institutions where the local community has strong ties to farmers already delivering produce to the community.
ProduceRx aims to support patient health, improve patient outcomes and make quality produce more accessible and affordable to patients. The program will consist of a research component to examine its feasibility and measure its impact and influence on patients’ lives and eating habits. Research data from this program will allow for adjustment and tailoring of future interventions to best meet participating patients’ and prescribers’ needs.
It is well understood that many clinic visits and comorbidities are associated with underlying weight and nutrition issues. It is essential that health care workers have time to adequately address these acute issues and be able to provide a reasonable means to tackle the pertinent underlying chronic issues of poor nutrition and obesity. Although providers may attempt to discuss nutrition with patients as clinic time permits, the information provided may be disconnected from the patient’s reality. Providers may prescribe nutritional advice to a family without providing the patient with adequate information on procuring or preparing fresh produce. Penn State ProduceRx recruits an entire community of resources to improve access to fresh, quality, nutritious foods, while simultaneously providing comprehensive nutritional education to patients and their families. Patients and providers will soon begin to have the tools they need to make healthful eating a sustainable reality for the patients who need it most.
As Hippocrates said, “Let food be thy medicine and medicine be thy food.”