Performing Department
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Non Technical Summary
With the support of a GusNIP PPR grant, the Chicago Horticultural Society will enhance the impact of its produce prescription program, VeggieRx. Individuals with or at risk of diet-related illnesses are referred by healthcare providers at 3 FQHC clinics in disinvested Chicago communities. The program is offered weekly at no cost in English and Spanish, providing SNAP/Medicaid participants with produce boxes, multiple opportunities for nutrition and cooking education, and a supportive community.The proposed project will sustain the program's dramatic growth over the past five years, and enable VeggieRx to achieve several key goals during the grant period: 1) Increase fruit and vegetable consumption in target communities: up to 1500 eligible participants and 3000 additional household members will receive an estimated 96,000 pounds of produce, supporting GusNIP goals to reduce food insecurity and improve dietary health through increased produce consumption; 2) Deepen engagement with participants, healthcare partners, and community organizations, including specific goals to increase program engagement duration, decrease participant food insecurity, expand nutrition and cooking education, increase collaboration and evaluation with FQHC partners, and consult with FQHCs/community organizations on replicating the VeggieRx model; and 3) Expand depth and rigor of outcome evaluation, particularly as a research partner with NTAE on an ADA-funded study that will augment core GusNIP evaluation data collection for diabetic patients and serve the GusNIP goal of better understanding PPR impact on reducing healthcare use and associated costs. A GusNIP grant will thus enable VeggieRx to impact food security and health for thousands of Chicagoans each year.
Animal Health Component
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Research Effort Categories
Basic
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Applied
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Developmental
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Goals / Objectives
The VeggieRx project will increase the availability and consumption of fresh produce in food-insecure Chicago communities through an integrated approach to the health challenges faced by community members. Over the two-year grant period, Windy City Harvest (WCH) will administer it's VeggieRx prescription produce program, providing fresh produce, recipes, bilingual in-person and online nutrition and cooking education, and a supportive interactive community, positively affecting participants' nutrition and health. WCH will partner with 2 Federally Qualified Health Centers (FQHCs) to implement VeggieRx in 3 priority Chicago communities. Partnering clinicians identify patients with or at risk of developing a diet-related health condition and refer them into the program. Participants are from low-income households and primarily identify as Black or Latinx, reflecting the demographics of partnering clinics and surrounding neighborhoods.The project will sustain the program's dramatic growth over the past five years, and enable VeggieRx to achieve several key goals during the grant period: 1) Increase fruit and vegetable consumption in target communities: up to 1500 eligible participants and 3000 additional household members will receive an estimated 96,000 pounds of produce, supporting GusNIP goals to reduce food insecurity and improve dietary health through increased produce consumption; 2) Deepen engagement with participants, healthcare partners, and community organizations, including specific goals to increase program engagement duration, decrease participant food insecurity, expand nutrition and cooking education, increase collaboration and evaluation with FQHC partners, and consult with FQHCs/community organizations on replicating the VeggieRx model; and 3) Expand depth and rigor of outcome evaluation, particularly as a research partner with NTAE on an ADA-funded study that will augment core GusNIP evaluation data collection for diabetic patients and serve the GusNIP goal of better understanding PPR impact on reducing healthcare use and associated costs.
Project Methods
VeggieRx provides weekly boxes of produce, nutrition education, recipes, and cooking demonstrations--all at no cost--to SNAP-eligible and Medicaid-enrolled participants. Produce is sourced primarily throughlocal produce distributor and longtime WCH partner Midwest Foods; local and regional growers are prioritized, including WCH farms, and produce selection incorporates participant feedback and preferences. The program is offered weekly for 40 weeks from February through November in both English and Spanish. Many participants also purchase additional produce below retail cost at farm markets at all distribution sites; participant feedback reflects their appreciation for this convenient incentive provided at VeggieRx distributions.During its 2022-2024 GusNIP project, WCH developed a new data management system and implemented a new point of sale (POS) system for WCH markets and VeggieRx distributions, streamlining operations and improving data tracking/analysis and participant experience. WCH will continue to develop and leverage these resources, for example by analyzing participant trends in choice-based food access and purchasing at the retail store at Farm on Ogden.VeggieRx will continue to refine and improve participant feedback sessions, held both in English and in Spanish. These sessions, first implemented in late 2020, go beyond surveys to focus on overall program experience, desired changes, and comments on produce suitability and quality. Session feedback is then incorporated into strategic discussions of how to improve the program for the coming year. Additional mid-year feedback sessions were added in fall 2022, enabling staff to more quickly respond to participant needs. Feedback is also gained throughout the year through the VeggieRx Facebook group and through suggestion boxes added at distributions in 2023, helping WCH respond to emerging and time-sensitive concerns.WCH will continue to bolster nutrition and cooking education--an essential component of the program--and provide a range of opportunities to meet individual participant needs. Twice per month, the Chicago Partnership for Health Promotion--a VeggieRx partner since the program's inception--will provide in-person nutrition and cooking classes at each VeggieRx site in both English and Spanish, using recipes that correspond to the weekly produce box. For participants who prefer flexible class options, VeggieRx will provide virtual classes. Bilingual nutrition education and cooking demonstrations from the Chicago Partnership for Health Promotion will be held weekly on Facebook Live and posted to the VeggieRx Facebook group for later viewing.For participants seeking more in-depth produce cooking knowledge, WCH will also offer hands-on cooking courses in English and in Spanish, held in small six-week cohorts of eight participants each. Taught by Good Food is Good Medicine and first piloted in 2022, these courses were established in response to participant input, one of many examples of how WCH incorporates feedback to improve outcomes and respond to participant needs. Additional options for in-person learning include in-depth one-to-one nutrition consultations at the Farm on Ogden location (which serves three-quarters of VeggieRx participants) with a Registered Dietician Nutritionist from LCHC. The dietician attends weekly distributions at WCH's Farm on Ogden and has onsite access to patients' medical records, increasing positive healthcare utilization.An enhanced focus on nutrition and cooking education serves the program's goal to address food access holistically, supporting participants as they establish sustainable habits that advance their personal and family health goals. To remove barriers to accessibility and provide flexibility and autonomy, nutrition/cooking education is not a program requirement. This model was developed with input from VeggieRx participants.WCH will also continue to deepen its collaboration and evaluation with healthcare partners through quarterly evaluation meetings, established in 2021, which focus on sharing best practices and aligning outcome tracking across VeggieRx sites. Facilitated by WCH's new data management system, VeggieRx is working increasingly with partners to understand the value of reporting/evaluation alignment and shared metrics to compare the efficacy and impact of interrelated programs across the sector.In addition, WCH will continue to improve health clinic partnership effectiveness through monthly meetings with frontline care coordinators (initiated in 2020) and leadership teams (established in 2021) at partner FQHCs. Frontline staff, who play a key role in supporting, communicating, and recruiting for VeggieRx, are kept informed of the latest information and updates, and share open feedback from patients and staff, enabling VeggieRx staff to respond quickly and make changes as needed. Identified "champions" at each partner site communicate VeggieRx information to healthcare providers, and are essential to the program's success. Leadership team meetings focus on strategic planning and growth, discussing evaluation priorities, and sharing participant feedback.WCH actively pursues replication of its programs, and frequently disseminates its model through consultations and trainings. WCH is regularly contacted by organizations locally and nationally seeking to learn more about its program models. During the grant period, WCH will provide consulting/training to 3-5 FQHCs or community organizations on the VeggieRx model.During the grant period, WCH will continue partnering with NTAE as one of five GusNIP PPR sites participating in a multisite clinical trial funded by the American Diabetes Association (ADA), grant # 7-22-ICTSN-40 (PI Byker Shanks). The study--which includes LCHC VeggieRx patients--examines the impact and effectiveness of PPR programs, and will support a more rigorous evaluation of the VeggieRx program through: 1) establishing a control group of patients receiving standard of care, and comparing control group outcomes to PPR outcomes; 2) enhanced survey modules focused on diabetes-related outcomes (e.g., diabetes distress) and clinical measurements (e.g., HbA1c, weight); 3) qualitative interviews to inform program feasibility, sustainability, lessons-learned, and recommendations for improvement; 4) collection of health utilization and associated costs to understand potential PPR impacts on the cost of care; and 5) an analysis of cost-effectiveness to understand the costs of implementing PPR programs compared to standard of care on glycemic outcomes and health-related quality of life of patients with type 2 diabetes.