Food as Medicine: Design and Implementation of a Produce Prescription Program at Federally Qualified Health Centers

BACKGROUND: The Bronx faces high food insecurity rates. Previous health center-based programs to improve fruit and vegetable intake and address food insecurity showed limited provider engagement and participant uptake. To address these gaps, we implemented a redesigned Food as Medicine Produce Prescription program at federally qualified health centers in New York City. METHODS: We enrolled adults (≥18 years) screening positive for food insecurity. Provider engagement was measured through Best Practices Advisory alerts and direct referrals; participant uptake was tracked by enrollment and retention (January 2023-April 2024). RESULTS: By April 2024, 1790 Best Practices Advisory generated 911 expressions of interest and 34 direct referrals, leading to 395 enrollments. Of these, 145 completed 6 months, 202 dropped out, and 48 remained active. Completers attended 10 of 12 distributions on average; 315 participants joined 35 food demonstrations. CONCLUSIONS: Provider input and engagement were critical to successful recruitment and retention.