Food is medicine programs for pregnant women in the United States: a systematic review.

Background: Approximately 12.5% of households with children in the United States are food insecure. As national priorities evolve to address food insecurity, food is medicine (FIM) programs may be a part of the solution. However, there is a gap in evidence on the maternal and birth outcomes of FIM programs.

Purpose: The goal of this systematic review was to understand the overall public health impacts of FIM programs for pregnant populations.

Methods: This systematic review was conducted in accordance with PRISMA guidelines. A search strategy was used to locate peer-reviewed literature through EBSCOhost and PubMed, and grey literature (e.g. websites, reports, booklets, and presentations) through a custom Google search in October 2022 and again in October 2024. Sources were independently screened by two researchers. Data were extracted independently by two researchers according to the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.

Results: Nine peer-reviewed and 20 grey literature programs met inclusion criteria. Limited data made it difficult to determine FIM program reach (demographics) or maintenance. Effectiveness outcomes included fruit and vegetable intake, food security, and birth outcomes. Programs were adopted by healthcare providers across all regions of the United States. The core provisions and components implemented included fruits and vegetables or ready-to-eat meals, which were provided through vouchers, coupons, or prepackaged boxes.

Conclusions: This review offers a timely summary of FIM programs for pregnant women. Future research should focus on consistent reporting of measures and metrics. Additionally, longer-term studies are needed to build evidence for program sustainability.