Protocol of a community-based produce prescription intervention; produce for health in Hampshire county’s food desert communities

<b>Background:</b> There is growing evidence on the need for a strategic focus on food insecurity and its effect on the burden of chronic health conditions. <b>Aim:</b> The study aimed to determine the effects of a produce prescription program on diet, self-efficacy for developing a healthy diet, food security status, and use of healthcare services and to explore experiences with using a Nutrition Incentive program (i.e. produce prescription) among people with or at risk for chronic health conditions. <b>Methods:</b> This community participatory research employed a single-arm pre-posttest study design, including 210 participants with or at risk of chronic health conditions using the Community Health Centers in Western Massachusetts. This produce prescription intervention gives participants access to a debit card preloaded with $40/month to spend on fresh produce at participating retail stores and educational activities focusing on growing, shopping for, and cooking with fresh fruits and vegetables for two years. Process (e.g. recruitment, adherence, and satisfaction) and effect outcomes (e.g. dietary intake, food security, self-efficacy, and healthcare utilization) are collected. Repeated measures ANOVA and multivariate regression analyses will be used for primary and secondary outcomes, using sociodemographic variables as covariates. <b>Summary:</b> this pilot study's findings will contribute to increasing evidence on the effects of prescription programs for self-management of chronic health conditions and to future research to inform implementation strategies, policy changes for sustainable food systems.