Objectives: Poor Food security (FS) is associated with risk of diet-related diseases and rising healthcare costs. Produce Prescription Interventions (PRx) are emerging clinical tools to improve FS and diet quality, but their impact in families with children is not well established. This study evaluates the impact of a pediatric PRx on FS and nutrition-related behaviors. Methods: Adult caregivers of children (0-18) were enrolled within a 6-month produce delivery and nutrition education intervention. A validated food security survey was administered pre/post intervention to determine FS scores and “Food Secure” status. Statistical analyses tested pre-post differences in FS scores and proportion of scores within the “Food Secure” range. Semi-structured interviews were performed post-intervention to explore families’ experiences with low FS and healthy behaviors and were thematically analyzed. Results: Between October 2021 and December 2022, 82 families were enrolled, 65 completed FS survey at baseline and 54 completed it at post-intervention. FS scores improved post-intervention ( P < .05) and a greater proportion of household- and child-level scores fell within the “Food Secure” range post-intervention ( P < .05). Twenty-eight interviews were analyzed. Three salient themes were identified: (1) value of healthcare-based screening and intervention, (2) food and education motivate behavior change, and (3) perceptions of post-intervention lifestyle sustainability. Conclusions: Participation in the PRx was associated with improvements in FS and nutrition-related attitudes and behaviors. PRx can be implemented by health systems to improve FS and health behaviors associated with risk for diet-related diseases. Longer-term support may be needed to maintain healthy behavior changes associated with PRx participation.

Background/Objective: In total, 17.9% of households with children experienced food insecurity (FI) in 2023. Produce prescription interventions (PRx) are a viable intervention to address FI and improve diet quality. Few studies have explored home-delivered PRxs in children. The objective of this qualitative study is to explore the experience of a novel PRx among families with young children in households at risk of experiencing FI and diet-related chronic disease. Methods: Semi-structured interviews were conducted with caretakers after the completion of a 12-month PRx. Interviews were recorded, transcribed, and analyzed using thematic analysis to identify emergent themes. Univariate descriptive statistics were used to describe baseline demographics. Results: Twenty-five families were enrolled, from which eighteen completed the program and fifteen agreed to participate in an interview. All participants were African American women. The mean age was 30.2 (±6.4) years old, and the median household size was three. Qualitative data analysis revealed three major themes. (1) The produce delivery partially alleviated financial stress, contributing to increased produce consumption patterns; (2) the intervention positively shifted the nutrition- and cooking-related knowledge and behavior of families; and (3) familial and programmatic barriers affected participation and engagement. Conclusions: PRxs are a viable option to support families to lessen the burden of FI from financial hardship and build healthy dietary habits. These insights can inform future PRx program development, delivery, evaluation, and policy or funding decisions. Future research should examine the sustained impact of PRx on healthy eating, health outcomes among caregivers and their children, and the healthcare cost and utilization rates among PRx participants.

Objective: The Community Health Worker Institute (CHWI) addresses health-related social needs (HRSNs) by integrating Community Health Workers (CHWs) into patient care. This study explores the barriers and facilitators to HRSN referrals and the integration of CHWs within clinical teams. Methods: Qualitative interviews were conducted with CHWs, CHWI program staff, and clinicians from ambulatory care clinics. Semi-structured interviews, guided by the Consolidated Framework for Implementation Research, were audio-recorded, transcribed, and analyzed using rapid qualitative methods. Results: Preliminary findings found that while clinicians support the CHWI and referral program, time constraints during patient visits likely hinder effective screenings and referrals. CHWs are seen as valuable advocates but continue to face challenges due to confusion about their clinical role from patients and clinicians. Hierarchical power dynamics seen between providers and CHWs likely contribute to this confusion. Clinics with strong leadership, clear role delineation, and clinical site preparation appear to have better CHW integration. Conclusion: CHWs play a crucial role in addressing HRSNs, but their integration into clinical teams requires overcoming logistical and educational challenges. These findings offer insights for improving the HRSN referral process and integrating CHWs into healthcare systems.