Evaluation of a Produce Prescription (PRx) Program With Food Literacy and Culinary Medicine Education for Rural, Uninsured Patients With Type-2 Diabetes

PurposeProduce prescription (PRx) programs improve the nutrition and health of participants; however, best practices to optimize and sustain dietary changes have not been established. This study examined the acceptability and impact of food literacy and culinary education aligned with a PRx.DesignSingle-group pre-post design, process evaluation.Setting4 primary care safety-net clinics.Subjects150 rural, uninsured patients with type-2 diabetes.Intervention20-week PRx intervention with 9 food literacy and culinary-focused group classes.MeasuresAttendance, satisfaction, knowledge, food purchasing and consumption changes, food literacy scores, diet changes.AnalysisClosed-ended survey responses and sociodemographics were analyzed using descriptive statistics. Open-ended responses were analyzed thematically. Paired Sample t-tests and Wilcoxon signed-rank test compared pre- vs post-food literacy scores and diet changes; multiple linear regression examined the effect of program participation on food literacy scores.ResultsTaste testing had the greatest influence on food behavior changes followed by the PRx and nutrition education. Food literacy significantly increased (89.1 (19.5) to 100.9 (19.5)), (<i>P</i> < .001) and was positively predicted by group class attendance (B = 1.366, P = .044). Diet quality improved (whole grains, <i>P</i> < .001, fruits, <i>P</i> = .03, and vegetables, <i>P</i> < .001).ConclusionFood literacy and culinary-focused nutrition education within a PRx amplified healthy food behavior changes and should be examined for long-term effectiveness in promoting and sustaining dietary changes.