Impact of the Food4Moms Produce Prescription Program on Readiness for Healthy Eating, Fruit and Vegetable Intake, and Food Security

Produce prescription programs (PRx) targeting different populations and conditions have been found to be effective. However, few have focused on pregnant women. The objectives of this study were to assess the impact of the Food4Moms (F4M) PRx on 1) healthy eating stages of change 2) intake of fresh produce, and 3) household food security among pregnant Latina women. F4M recruited low-income Latinas living in Greater Hartford, Connecticut that received a "produce prescription" from a Registered Dietitian based at the community-based organization (CBO) where the program was implemented. Participants were offered $100 per month for 10 months through Fresh Connect debit cards to purchase fresh produce from two food retailers or the equivalent value in fresh produce delivered at home. To be fully enrolled in F4M, participants had to complete a baseline survey and the first nutrition education interactive session. Enrolled participants were offered additional nutrition education sessions at the CBO and received text messages with nutrition tips as well as reminders to spend their remaining benefit balances towards the end of each month. A single-group pre-post study design was used to assess the impact of F4M 10 months after the card activation. No attrition bias was detected when comparing the characteristics of those completing (N=113) vs. those not completing the endline survey (N=41). Pre-post Wilcoxon signed-test or paired t-test analyses showed that F4M had a positive impact on healthy eating readiness (p < 0.001), the consumption of fruits (p < 0.001) and vegetables (p < 0.001), and household food security (p = 0.034). F4M is a promising community-engaged PRx program that may improve readiness for healthy eating, produce intake, and household food security. Implementation research is needed to find out how to effectively scale out and sustain programs like F4M. The study was registered in ClinicalTrials.gov (identifier: NCT05907616).