1. Fruit & Vegetable Prescription Programs in Georgia
Disclaimer: I don’t work for WWG anymore!
Rachael Ward
Nutrition Director
ACCESS

2. Wholesome Wave Georgia
Statewide network partner of Wholesome Wave
Separate 501c3
Mission: Increase access to fresh, healthy, locally grown food for all Georgians
Main programs:
Georgia Fresh for Less
Fruit & Vegetable Prescription Program (now Georgia Food for Health)
SNAP enrollment

3. Food Insecurity & Chronic Disease in Georgia
1.4 million Georgians receive SNAP benefits every month
1.1 million Georgians have diabetes
3.4 million Georgians have hypertension
1 in 5 Georgians are food insecure
30% of adults are obese
1 in 4 Georgia children are food insecure
35% of children obese
1 in 7 Oregonians are food insecure
30% of Oregon adults obese

4. Fruit & Vegetable Prescription Program (FVRx)
Launched the first FVRx program in the southeast in 2015
Affordable access to fruits & vegetables and healthy eating through partnership with healthcare providers, community organizations and fresh produce retailers
Evidence based model of preventative healthcare with a demonstrated impact, resulting in healthier communities, food systems, and local economies

5. 2018 FVRx Sites Athens Nurses Clinic Harrisburg Family Clinic
9 cohorts at 7 locations (cohorts of households)
Ranged from large hospital systems to small family clinics
All serve clients on Medicaid/Medicare
Grady Asa Yancy Health Center
Grady Primary Care Clinic
Grady Ponce de Leon Center
Grady Diabetes Clinic (2 cohorts)
Good Samaritan Health Center (2 cohorts)

6. Model Target audience: Duration: Components:
Patients with food insecurity & diet related chronic illnesses
Duration:
6 months (May-Oct)
Components:
6 weeks cooking education
6 monthly clinic visits
Weekly Rx redemption
Patients screened by healthcare providers using EMRs and phone calls, Dr’s recruited into program

7. Cooking Education Different curriculums by site
Front loaded in first 6 weeks
Focused on cooking healthy on a budget
Emphasis on fresh and local foods
Nutrition education wrapped in
Gift of a major piece of cooking equipment at the end (crockpot, food processor, etc)
Cooking Matters & local curriculums

8. Monthly Clinic Visits
Vitals taken: height, weight, waist circumference, blood pressure
Healthy living class
Peer support
Goal setting
Supportive classes (budgeting, meal prep, gardening, etc)
Prescriptions given out for the month
Additional metrics like body fat percentage, A1Cs taken at pre and post

9. Weekly F&V Prescriptions
$1/household member/day (family of 4 received $28/week)
Only to be spent on fresh fruits & veggies
Written by a healthcare professional (PA, dietician, etc)
Redeemed with local farmers at:
Farmers markets, on site farm stands, Marta markets, CSA boxes
Paper prescriptions given and exchanged for tokens at market
Assistance with transportation to markets
Not need to be written by a dr, just someone well respected

10. Evaluation Pre & Post surveys Demographics
Knowledge, attitudes, practices around healthy eating and local foods
F&V consumption
Biometric measurements (A1c, Triglycerides, HDL, LDL, total cholesterol, heart rate)
Monthly surveys
BMI, BP, waist circumference, F&V consumption
6 months post
Reunion & activity
Repeat post survey
Focus groups & interviews

11. Retention
Needed to attend at least 3/6 monthly clinic visits and complete pre & post surveys
Reminder texts and calls each week
Peer support
Cooking equipment incentives
Peer champions
Transportation assistance to attend classes and redeem vouchers
Retention rates ranged from 48% to 91%
Later added in Rx redemption at least once a month as criteria for retention

12. 2017 Evaluation Results: Snapshot
$47,376
fruit & vegetable prescriptions redeemed
219
Households enrolled
75-89%
decrease in food insecurity indicators
3.1
More servings of fruit consumed each week on average
5.1
More servings of vegetables consumed each week on average 5%
decrease in waist circumference on average
10.6%
decrease in Body Mass Index on average

13. 2017 Evaluation Results: Demographics

14. 2017 Evaluation Results: Food Security

15. 2017 Evaluation Results: Barriers to Consumption
Significant changes in what made eating F&V difficult pointed out with arrow
-48% decrease in those who said cost was a barrier
-22% decrease in those who said knowledge of prep was a barrier
-52% decrease in those who reported that they had any barriers to eating F&V!

16. 2017 Evaluation Results: Knowledge
0 – No knowledge 1- Little knowledge 2 - Some knowledge 3 – Very knowledgeable *significant increases in all sites

17. 2017 Evaluation Results: Consumption
Fruit: 3.1 more servings per week
Other veg: 5.1 more servings per week
Shopped for produce 0.9 times more per week
Cooked 0.5 more meals at home
Statistically significant increases: Other vegetable consumption, produce shopping frequency

18. 2017 Evaluation Results: Biometrics
BMI decrease by 10.6% on average
Waist circumference decrease by 5% on average
Systolic BP decrease 8.8% on average
Diastolic BP decrease 2.2% on average

19. 2017 Evaluation Results: Participant Feedback
“The best part of the program was the visits to the market, and the warmth of the people in the market. It was one of the best experiences I've had. I also liked the way they taught us how to cook, thanks to that now I cook healthier. And the group of people that make up the program I liked”

20. Thank you! Questions?
Rachael Ward Nutrition Director ACCESS