Health Outcomes of Produce Prescription Programs Associated with Gus Schumacher Nutrition Incentive Program Funding.

Abstract

The US Department of Agriculture's Gus Schumacher Nutrition Incentive Program (GusNIP) funds produce prescription (PPR) programs that allow healthcare to support patients in accessing fruits and vegetables. This hybrid systematic narrative review identified 16 studies of PPR programs associated with GusNIP funding in some way that examined health outcomes, including clinical measures and healthcare utilization. Program designs were heterogeneous, sample sizes were generally small, and methodological rigor was often low, with most studies using a prepost design and none using a randomized control group. Fewer than half of the studies examining clinical values showed an association between PPR participation and improved health outcomes (for example, three of eight studies measuring weight or body mass index showed a statistically significant reduction, as well as two of the six studies measuring glycosylated hemoglobin). Only three studies examined healthcare utilization, two of which showed improvements in hospitalization and/or emergency department utilization. Overall, evidence for the health impact of PPRs is nascent but growing. PPRs with capacity should engage in rigorous study designs and examine a variety of downstream health and utilization outcomes.