Effect of a Fruit and Vegetable Prescription Program on Children’s Fruit and Vegetable Consumption

Effect of a Fruit and Vegetable Prescription Program on Children’s Fruit and Vegetable Consumption

ORIGINAL RESEARCH — Volume 16 — June 13, 2019

Ronit A. Ridberg, PhD, MS1,2; Janice F. Bell, PhD, MN, MPH1; Kathryn E. Merritt, MPH3; Diane M. Harris, PhD, MPH4; Heather M. Young, PhD, RN1; Daniel J. Tancredi, PhD2,5 (View author affiliations)

Suggested citation for this article: Ridberg RA, Bell JF, Merritt KE, Harris DM, Young HM, Tancredi DJ. Effect of a Fruit and Vegetable Prescription Program on Children’s Fruit and Vegetable Consumption. Prev Chronic Dis 2019;16:180555. DOI: http://dx.doi.org/10.5888/pcd16.180555external icon.

PEER REVIEWED

On This Page

• Abstract
• Introduction
• Methods
• Results
• Discussion
• Acknowledgments
• Author Information
• References
• Tables

Summary

What is already known on this topic?

Fruit and vegetable prescription programs increase access and affordability of healthy foods among adults, but their effect on children’s dietary behavior is not known.

What is added by this report?

Among families with children who were overweight or had obesity (n = 883, 1 child per household) in a 4- to 6-month prescription program at federally qualified health centers, we found a dose propensity–adjusted increase in fruit and vegetable consumption of 0.32 cups per day for each additional visit, with an equal portion attributed to changes in vegetable consumption and fruit consumption.

What are the implications for public health practice?

Clinically based fruit and vegetable prescription programs with nutrition education may be an effective way to improve diets for children in low-income households.

Abstract

Introduction

Most children in families with low income do not meet dietary guidance on fruit and vegetable consumption. Fruit and vegetable prescription programs improve access to and affordability of health-supporting foods for adults, but their effect on dietary behavior among children is not known. The objective of this study was to describe the extent to which exposure to a fruit and vegetable prescription program was associated with changes in consumption among participants aged 2 to 18.

Methods

We used data from a modified National Cancer Institute screener to calculate fruit and vegetable intake among 883 children who were overweight or had obesity and participated in a 4- to 6-month fruit and vegetable prescription program at federally qualified health centers during 4 years (2012-2015). Secondary analyses in 2017 included paired t tests to compare change in fruit and vegetable consumption (cups/day) between first and last visits and multivariable linear regressions, including propensity dose–adjusted models, to model this change as a function of sociodemographic and program-specific covariates, such as number of clinical visits and value of prescription redemption.

Results

We found a dose propensity–adjusted increase of 0.32 cups (95% confidence interval, 0.19–0.45 cups) for each additional visit while holding constant the predicted number of visits and site. An equal portion of the change-score increase was attributed to vegetable consumption and fruit consumption (β = 0.16 for each).

Conclusion

Fruit and vegetable prescription programs in clinical settings may increase fruit and vegetable consumption among children in low-income households. Future research should use a comparison group and consider including qualitative analysis of site-specific barriers and facilitators to success.