Nutrition Security Among Medicaid Patients With Diabetes or Prediabetes After Completing a Produce Prescription Program.

Abstract

To increase access to fresh produce for Medicaid patients with type 2 diabetes or prediabetes, a local health department partnered with 3 Federally Qualified Health Centers to implement a produce prescription program in Los Angeles County. Program participants received $40 per month for 6 months through an electronic debit card to purchase fresh fruits and vegetables at participating grocery stores. This observational study assessed improvements in participants' nutrition security, defined as the consistent access, availability, and affordability of foods and beverages that promote well-being and prevent disease. Program participants completed a questionnaire that included a 2-item household nutrition security screening tool and a 6-item household food security module at the program's beginning (baseline) and end (follow-up). Analyses were based on 1,309 participants who completed the questionnaire at both time points. After completing the program, the proportion of participants who reported being nutrition secure increased by an absolute 15.5% from baseline (from 23.2% to 38.7%). This improvement in nutrition security was statistically significant after adjusting for sociodemographics, baseline food security status, and fruit and vegetable consumption (adjusted odds ratio = 2.95; 95% CI, 2.11-4.13). Despite the nutrition incentive, most participants (85.6% vs 88.4% at baseline, <i>P</i> = .03) still stated healthy foods were "too expensive"-although more of them reported being able to locate a store that had healthy food options after completing the program. This "food as medicine" intervention demonstrated short-term improvements in nutrition security among Medicaid patients with diabetes or prediabetes, suggesting it successfully fulfilled a basic social and disease management need of this population.