Performing Department
(N/A)
Non Technical Summary
Waianae Coast Comprehensive Health Center (WCCHC) is located in the heart of Waianae on Oahu's West Side. As the leading primary health care provider for over 50,000 residents, WCCHC also serves as a vital emergency safety net during health or environmental crises. The WCCHC 'ohana (family) is a true reflection of the surrounding communities: culturally diverse, deeply committed to community, the true embodiment of Aloha Spirit.While WCCHC's service area is renowned for its breathtaking landscapes, underlying challenges reveal significant disparities in health and socioeconomic conditions. Widespread poverty, food insecurity, and inadequate housing contribute to rising rates of chronic disease and poor health outcomes. These alarming trends threaten the future well-being of the community, with nearly half of local adults now experiencing food and nutrition insecurity. Access to affordable, nutritious food--especially fruits and vegetables--is crucial for preventing chronic diseases and improving health outcomes, yet remains an urgent unmet need.Programs like Produce Rx play a critical role in addressing these challenges. They alleviate food insecurity, promote better health, and strengthen the local economy by supporting agricultural infrastructure. Equitable access to healthy food is a pressing need across Hawai'i, particularly in Waianae. WCCHC is uniquely positioned to collaborate with community stakeholders in creating innovative solutions to combat the interconnected burdens of food insecurity and chronic disease. The need for action is urgent, and WCCHC is ready to lead the way toward a healthier, more resilient community.
Animal Health Component
33%
Research Effort Categories
Basic
33%
Applied
33%
Developmental
34%
Goals / Objectives
WCCHC's West Oahu Produce Rx Program aims to fill the gap in accessibility and affordability of nutritious, locally grown fruits and vegetables for low-income individuals at risk for, or diagnosed with, a nutrition-related chronic condition. This project will use a collaborativeapproach to improve health outcomes among those at greatest risk while expanding local food producers' economic opportunities and agricultural infrastructure. The goals and objectives outlined below help form a roadmap to ensure meaningful program deployment.Goal 1: Improve health outcomes through the increased consumption of fruits and vegetables.Objective: Provide 36 customized, culturally relevant educational resources supporting knowledge acquisition on nutrition and healthy eating principles, the impact of dietary habits on chronic disease prevention or management, and nutritious recipes that honor traditional food preparation methods.Goal 2: Alleviate individual and household food insecurity.Objective: Maximize incentive benefit for each participant by achieving 75-90% of goal enrollment by incentive month 4.Goal 3: Reduce healthcare utilization and associated costs among program participants.Objective: Mandate regular follow-up appointments with Produce Rx prescribing providers to support primary care as the appropriate venue for managing health conditions, as opposed to current trends in utilization that reflect a growing reliance on emergency care for addressing routine needs.
Project Methods
Aligned with the primary goals of the GusNIP grants program, WCCHC's West Oahu Produce Rx (WOPRx) Program addresses gaps in accessibility and affordability of nutritious, locally grown fruits and vegetables. The WOPRx program provides an integrated, reproducible process by which high-risk community members and existing SNAP EBT and Medicaid beneficiaries can increase their purchasing power for healthy foods. This will be achieved through an incentive-based program that offers participants two incentive redemption options to choose from:Paper Produce Vouchers - Participants can redeem vouchers at WCCHC's M?keke Farmers Markets, which operate at three convenient locations along the Waianae Coast. All market vendors are trained to ensure proper voucher redemption. The M?keke markets accept SNAP EBT and participate in Hawaii's Da Bux Double Up Food Bucks Program, allowing participants to shop for healthy food while maintaining freedom of choice. Participants will receive $90 in vouchers per month for up to 12 months, or up to $1,080 in Produce Rx incentives. Educational resources will be provided at the time of monthly voucher pick-up.Produce Delivery - Participants can opt for bi-weekly produce deliveries from Farm Link Hawaii (FLH). FLH improves access to nutritious foods through an innovative online marketplace that connects local growers and food producers from across the islands with their buyers. Each delivery will include an educational resource and a curated Farmer's Choice produce box worth $45, for a total of up to $1,080 in Produce Rx incentives per participant over 12 months. FLH also accepts SNAP EBT and participates in the Da Bux Double Up Food Bucks Program.The WOPRx Program is scheduled to launch on February 10th, aligning with WCCHC's annual community event, the Eat Local Challenge. This popular event attracts a large number of community members, making it an ideal platform for program marketing and outreach.The WOPRx Program aims to enroll 150 eligible participants during a 12-month incentive period, with a target of reaching 75-90% enrollment by the fourth month. Eligibility will be based on the following criteria:1. Adults, 18 yrs and older2. SNAP EBT Recipient or Medicaid Beneficiary3. Food Insecurity (positive PRAPARE screening within previous 6 months)4. Increased risk or diagnosis with a nutrition-related chronic health condition(s)Staff Training, Stakeholder Engagement, OutreachAt least one training session will be offered to medical providers and staff to introduce the WOPRx Program and provide an overview of key program features including duration and incentive amount, eligibility criteria, referral process, and clinical measures required for data reporting. The WOPRx team will provide a follow up every three months, or as needed, to encourage participant referral volumes, and ensure proper program awareness among staff.The WOPRx team will conduct community outreach at WCCHC's M?keke Farmers Markets by distributing program flyers, setting up banners, and engaging directly with attendees. This outreach aims to inform current patients about potential eligibility and provide guidance to community members interested in establishing care at WCCHC to receive a program referral. By leveraging the vibrant atmosphere of the M?keke Farmers Markets, the WOPRx team can effectively connect with the community and promote access to the program.Referral Process and Enrollment Eligible participants will be referred by WCCHC medical providers through the Food as Medicine program referral template in the electronic medical record (EMR) system. For patients with prediabetes or diabetes, providers will place a lab order to update hemoglobin A1c levels as appropriate. The WOPRx Team will collaborate with patients and providers throughout the program as needed to update program measures, collect data, and request program referrals. The WOPRx team receives an automated referral list at 1:30pm daily displaying New or Open program referrals. The team contacts patients to confirm interest and initiate program enrollment. Participants are provided with important program documents for review and signature, including informed consent and terms of participation. They are assigned a unique program ID for use in data collection and tracking incentive redemption.EvaluationThe WOPRx Program will utilize a mixed-methods approach to data collection and evaluation, ensuring all the required participant and firm-level core metrics are accounted for. WCCHC's third-party evaluator, Dr. Monica Esquivel of UH Manoa, has extensive research experience in food access and food security. Her knowledge and background will guide our evaluation processes, ensuring adequate measurement of program impact. Data collection will include pre and post-program assessments and participant biometrics such as DSQ scale, PRAPARE Food Security and NSS screening, Healthcare Cost Savings Estimator Tool, relevant socioeconomic and demographic information; qualitative data (observation/conversation logs, program satisfaction), body composition, lab work as indicated (A1c), and blood pressure. Body composition will be obtained using the Tanita MC-980 Plus, a gold-standard, FDA-cleared body composition analyzer. Special attention will be paid to measurements of total body weight, fat mass, lean mass, and visceral fat score. The Healthcare Cost Savings Estimator Tool is a validated tool used to quantify the financial impact of wellness programs on healthcare utilization and associated costs. This is accomplished, in part, by measuring averted emergency room visits and hospitalizations among program participants.