Other Titles
Rising Star Poster/Presentation
Abstract
Poor diet is the leading identifiable cause of poor health.1 Diets high in produce are recommended to improve chronic diseases.2 Food insecurity, the inability to access sufficient food to meet basic needs,3 has higher rates among rural households.4 Produce Prescription Programs (PPP) successfully pair access to fruits/vegetables with education by a dietician6 for people with chronic disease. Health care providers (HCPs) are well-suited to screen for food insecurity and refer patients to PPPs. However, day-to-day practice demands make this challenging .7,8 This project examined HCPs perceptions of and barriers to referring patients to PPPs.
Methods: A rural county in Indiana, with higher-than-average rates of obesity and food insecurity.9 HCPs (n=24) practicing in the county were contacted to participate. They received a presentation on food insecurity, diet-related chronic disease, and PPPs. Following the presentation, a 10-item survey evaluated their knowledge, perceptions, and barriers to referring patients to the PPPs.
Findings: HCPs (N= 24) completed the survey. 46% of the providers reported ‘no awareness’ of PPPs before the presentation. 71% knew food insecurity was a problem in their county. 75% reported they were ‘comfortable’/ ‘very comfortable’ screening for food insecurity. 58% felt they had time to discuss healthy nutrition during appointments. Primary barriers to positive dietary change for patients were cost and knowledge of nutritious foods. HCPs identified barriers to implementing PPP, as lack of time to screen/refer, and lack of staff knowledge of the PPPs. All HCPs agreed PPPs would benefit their patients. The support needed to facilitate screening/referrals included staff training and assistance with the electronic health record (EHR).
Discussion: Most HCPs believed PPPs would be beneficial. HCPs knew that food insecurity was a problem but lacked a readily available screening tool. The primary barriers to dietary change by HCPs (cost of nutritious food and knowledge) are addressed in PPPs through dietician education and produce vouchers. While HCPs indicated that they have adequate time to discuss healthy eating with their patients, the time required to screen/refer to PPPs was a barrier. The findings suggest that educating HCPs is integral to the success of PPPs. Planning for a PPP should address the perceived barriers identified by HCPs, specifically education, time for screening and referral, staff training, and EHR support.
Notes
References:
1. Kerr, D., Barua, S., Glantz, N., Conneely, C., Kujan, M., Bevier, W., & Sabharwal, A. (2020). Farming for Life: Impact of medical prescriptions for fresh vegetables on cardiometabolic health for adults with or at risk of type 2 diabetes in a predominantly Mexican American population. BMJ Nutrition, Prevention & Health, 3. DOI: 10.1136
2. Center for Disease Control and Prevention (2024, May 15). About the Division of Nutrition, Physical Activity, and Obesity. https://www.cdc.gov/nccdphp/divisions-offices/about-the-division-of-nutrition-physical-activity-and-obesity.html
3. Frank, H. E., Guzman, L. E., Ayalasomayajula, S., Albanese, A., Dunklee, B., Harvey, M., ...& Tovar, A. (2024). Developing and testing a produce prescription implementation blueprint to improve food security in a clinical setting: A pilot study protocol. Pilot Feasibility Studies, 10(1):51. DOI: 10.1186/s40814-024-01467-7
4. Rabbitt, M. P., Hales, L. J., Burke, M. P., & Coleman-Jensen, A. (2023). Household food security in the United States in 2022 (Report No. ERR-325). U.S. Department of Agriculture, Economic Research Service. https://doi.org/10.32747/2023.8134351.ers
5. Feeding America (n.d.). Hunger in rural communities. www.feedingamerica.org/hunger-in-America/rural-hunger-facts.
6. Mozzaffarian, D., Aspry, K. E., Garfield, K., Kris-Etherton, P., Seligman, H., Velarde, G. P.,... & Yang, E. (2024). “Food Is Medicine” strategies for nutrition security and cardiometabolic health equity: JACC State-of-the-Art review. Journal of the American College of Cardiology, 83(8), 843-864. DOI: 10.1016/j.jacc.2023.12.023.
7. Parkview Health (n.d.). VeggieRx. https://www.parkview.com/health resources/veggierx
8. Caldwell, J. I., Palimaru, A., Cohen, D. A., Shah, D., & Kuo, T. (2023). Food insecurity screening in safety-net clinics in Los Angeles County: Lessons for post-pandemic planning. The Journal of the American Board of Family Medicine, 36(2), 240-250.
9. Parkview Health (2022). Parkview Health 2022 CHNA. https://www.parkview.com/-/media/parkview-media/file/2020-pa---albright/2022-whitley-county-chna.ashx
Sigma Membership
Alpha
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Health Promotion and Disease Prevention, Community Health, Poor Diet, Food Insecurity, Rural, Food Insecurity Screening
Recommended Citation
Ward, Heather Joy; GiaQuinta, Sarah; and Storey, Susan, "Provider Perspectives of Produce Prescription Programs in a Rural Community: Evaluating Barriers" (2025). Biennial Convention (CONV). 101.
https://www.sigmarepository.org/convention/2025/posters_2025/101
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Invited Presentation
Acquisition
Proxy-submission
Date of Issue
2025-12-10
Provider Perspectives of Produce Prescription Programs in a Rural Community: Evaluating Barriers
Indianapolis, Indiana, USA
Poor diet is the leading identifiable cause of poor health.1 Diets high in produce are recommended to improve chronic diseases.2 Food insecurity, the inability to access sufficient food to meet basic needs,3 has higher rates among rural households.4 Produce Prescription Programs (PPP) successfully pair access to fruits/vegetables with education by a dietician6 for people with chronic disease. Health care providers (HCPs) are well-suited to screen for food insecurity and refer patients to PPPs. However, day-to-day practice demands make this challenging .7,8 This project examined HCPs perceptions of and barriers to referring patients to PPPs.
Methods: A rural county in Indiana, with higher-than-average rates of obesity and food insecurity.9 HCPs (n=24) practicing in the county were contacted to participate. They received a presentation on food insecurity, diet-related chronic disease, and PPPs. Following the presentation, a 10-item survey evaluated their knowledge, perceptions, and barriers to referring patients to the PPPs.
Findings: HCPs (N= 24) completed the survey. 46% of the providers reported ‘no awareness’ of PPPs before the presentation. 71% knew food insecurity was a problem in their county. 75% reported they were ‘comfortable’/ ‘very comfortable’ screening for food insecurity. 58% felt they had time to discuss healthy nutrition during appointments. Primary barriers to positive dietary change for patients were cost and knowledge of nutritious foods. HCPs identified barriers to implementing PPP, as lack of time to screen/refer, and lack of staff knowledge of the PPPs. All HCPs agreed PPPs would benefit their patients. The support needed to facilitate screening/referrals included staff training and assistance with the electronic health record (EHR).
Discussion: Most HCPs believed PPPs would be beneficial. HCPs knew that food insecurity was a problem but lacked a readily available screening tool. The primary barriers to dietary change by HCPs (cost of nutritious food and knowledge) are addressed in PPPs through dietician education and produce vouchers. While HCPs indicated that they have adequate time to discuss healthy eating with their patients, the time required to screen/refer to PPPs was a barrier. The findings suggest that educating HCPs is integral to the success of PPPs. Planning for a PPP should address the perceived barriers identified by HCPs, specifically education, time for screening and referral, staff training, and EHR support.
Description
This Doctor of Nursing Practice project surveyed 24 healthcare providers in a rural community. The project explored their perspectives on food insecurity, diet-related chronic disease, and produce prescription programs. The findings help identify barriers to screening for and referring to a produce prescription program. This will help guide program development in the future.