Performing Department
(N/A)
Non Technical Summary
In collaboration with multiple healthcare partners, Shalom Farms will implement a 6 monthProduce Prescription Program for 3 cohorts of 20 participants each year for three years.Participant health outcomes will be collected by clinical partners at the beginning of the programand again at the conclusion of each phase. Each cohort will include a 12 week activemanagement phase and a 12 week sustainability phase. This project seeks to understand whetherthe following interventions induce measurable, meaningful health behavior changes: 12 weeks ofactive programming combined with 12 weeks of sustained management, coaching and peersupport, and nutrition and food skills education.The project's goals are as follows: To increase access to fresh, local, GusNIP-qualifying fruits and vegetables for individuals experiencing food insecurity and/or managing chronic diet related conditions. To expand knowledge of cooking skills in order to increase utilization of fresh produce within participant diets. And to decrease utilization of healthcare services for chronic, diet-related disease through increased consumption of fresh produceShalom Farms is uniquely positioned to administer this pilot project due to their decadelong history of operating the program in collaboration with multiple partners. The organizationhas a long-standing commitment to the communities it serves, and has a proven and trustedreputation of delivering high quality programming to those most in need. Further, theorganization is uniquely positioned for produce-centered programming because of theiragricultural operations, which utilize volunteer labor to help subsidize the cost of fresh producefor program participants.
Animal Health Component
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Research Effort Categories
Basic
100%
Applied
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Developmental
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Goals / Objectives
Goal #1: Increase access to fresh, local, GusNIP-qualifying fruits and vegetables for individuals experiencing food insecurity and/or managing chronic diet related conditions.Goal #2: Expand knowledge of cooking skills in order to increase utilization of fresh produce within participant diets.Goal #3: Decrease utilization of healthcare services for chronic, diet-related disease through increased consumption of fresh produce.
Project Methods
The Shalom Farms Produce Prescription Program will provide participants with weekly prescriptions of fresh, Certified Naturally Grown (CNG) produce from the organization's two farms. Shalom Farms has operated two farm production sites since its inception and on average produces more than 200,000 pounds per growing season. 80-90 percent of the produce for the PPR will be from the farm sites, with additional produce supplied through relationships with two existing regional produce hubs in Richmond, VA.The produce provided will vary by season. Spring cohorts can expect abundant leafy greens, such as kale, collards, and lettuce, along with root crops such as beets, turnips, and radishes. Summer cohorts can expect produce such as summer squash, zucchini, tomatoes, bell peppers, cucumbers, and eggplant. Fall cohorts can expect cabbages, carrots, fresh herbs, leafy greens such as lettuce, kale, and collards, and winter squash, among others. Produce quantity also varies by season and availability, but will average 10-15 pounds per weekly prescription, or two servings per household member per day. The justification for this quantity comes from research findings that the average person consumes < 3 servings of fruit and vegetables per day, and drastic improvements to health are found when consumption increases to at least 5 servings per day.Shalom Farms is excited by the opportunity to implement a new 6 month Produce Prescription Program design as a result of this funding, which will include a 12 week active management phase and a 12 week sustainability phase for each cohort. Individuals enrolled in Shalom Farms' previous Produce Prescription iterations generally found 12 weeks an approachable duration, and attendance was higher than in longer interventions.During the active management phase, program participants will work with Shalom Farms' Produce Prescription Program Manager and Community Engagement Manager for the duration of the cohort. The Program Manager will work with participants to establish and monitor SMART goals related to their desired health goals, and provide weekly check-ins, health coaching calls, and bi-weekly nutrition education. On alternating weeks, the Community Engagement Manager will provide hands-on food skills classes to help participants make the most of their produce prescription and reinforce nutrition lessons. Participants will learn new and exciting ways to incorporate fresh produce into their diets in order to meet their SMART goals. Collectively, Shalom Farms staff will invest 426 hours of staff time per 12-week session.Shalom Farms understands that 12 weeks of produce, education, and support is a good place to start but may not fully catalyze health behavior change and that nutrition insecurity will not be solved through a 12-week or even a 6-month program; participants will require ongoing, sustainable access to healthy food in order to maintain healthy eating habits. During the additional 12-week sustainability phase, patients will receive vouchers to purchase fruits and vegetables at the Shalom Farms Mobile Market (13 available locations per week, May through December). Valued at 6 pounds of produce per member of the household, the vouchers will enable participants to purchase their choice of produce, ideally integrating this sustainable and affordable source of food into their regular meal planning.To measure and evaluate biometric outcomes, healthcare partners will conduct health screenings at the beginning of the program, at the end of the active phase, at the end of the sustainability phase, and at one-year post-program enrollment. Shalom Farms, in collaboration with the lead consultant evaluator and researcher, Dr. Rebecca Hagedorn-Hatfield, will conduct participant surveys to gather qualitative data in order to assess program efficacy and learn directly from participants what is and isn't working about the program design and implementation.In this new iteration of a Produce Prescription Program supported by GusNIP, Healthcare Partners will:Conduct the program eligibility screening utilizing the Six-Item Food Security Scale, along with regular physical screening to establish risk for chronic, diet-related disease (obesity, hypertension, T2 diabetes),Refer eligible individuals to Shalom Farms for readiness assessment, andShare protected electronic biometric health data before, during, and after the program interventionShalom Farms will:Screen potential participants for Health Behavior Change Readiness and conduct initial health behavior survey to establish baselineEnroll eligible participants (20/cohort) into the study three times per year. Overall, Shalom Farm will enroll a total of 180 participants (9 cohorts). This sample size was determined through an a priori power analysis, conducted using G*Power version 3.1.9.6 (Faul et al. 2007) and inflated to account for attrition and community needs. Effect size estimates are inconsistent among published studies on producing prescription programs, therefore we estimated moderate effect size (parital η2 = 0.06, equates to Cohen's F=0.25) to calculate the needed sample across four measurement time points with 80% power (p ≤0.05).During the 12-week active phase of each cohort, Shalom Farms will:Provide a weekly fresh produce prescription at no cost to program participants. Produce is grown locally at Shalom Farms' two Certified Naturally Grown farms.The Produce Prescription Program Manager and the Community Engagement Manager will provide alternating nutrition and cooking skills education classes to help program participants make the most of the produce they've received in their weekly prescription. Participants who have to miss a class will have access to digital resources, including recipes, demonstration videos, and including a home delivery of their produce prescription (when necessary)Provide a weekly transportation stipend for participants who express a transportation challengeProvide 1:1 health coaching check-ins to monitor progress towards participant identified SMART goals and encourage program participationDuring the 12-week sustainability phase, Shalom Farms will:Provide weekly vouchers for produce, redeemable at the Shalom Farms Mobile Market (13 sites per week). Each voucher is valued at 6 pounds of produce per member of the household. It is important to note for beyond the sustainability phase that the Mobile Market provides produce at a low cost aimed at community and family affordability. What can be purchased at the Mobile Market for $1 would cost upwards of $5 at a traditional farmers market or grocery store.Provide data collection support to healthcare partners, including survey design and evaluationWith the lead evaluation consultant and researcher, conduct health behavior surveys at 12 weeks, 24 weeks, and 1 year to assess program outcomes.