Recipient Organization
RURAL HEALTH NETWORK OF SCNY, INC., THE
455 COURT ST
BINGHAMTON,NY 139041650
Performing Department
(N/A)
Non Technical Summary
The Produce Prescription Program of South Central New York (PRxSCNY) project will expand and enhance the Rural Health Network of South Central New York's current GusNIP PPR program. Building on experiences to date, the project will enroll 670 individuals through 25 healthcare clinics in the rural counties of Broome, Chenango, Delaware, Tioga, and Tompkins in New York State.The project responds to both growing community needs and increased demand from healthcare providers and eligible individuals. In the rural communities served, longer travel distances, high transportation costs, and limited food retail options often make it difficult for households to access healthy food. At the same time, high rates of diet-related conditions and low fruit and vegetable consumption across the region underscore the importance of expanded intervention.Bringing together healthcare and local food system partners, the PRxSCNY project addresses nutrition and food security needs of adults 18+ and households with children with a diet-related health risk or condition, specifically cardiovascular disease, diabetes, or pre-diabetes. Healthcare providers through three hospital systems and the Rural Health Network's Community Health Workers will screen and enroll eligible individuals, providing $360 in produce prescription incentives during the six-month program. Incentives are provided in the form of vouchers that can be redeemed at over 50 locations including farmers' markets, farm stores, and local grocers; or a weekly box of local produce. A total of $241,500 in incentives will be distributed. Nutrition and health education, regular communication from the PRx team, and strong partnerships with healthcare providers and local farms and food businesses will support sustained improvements in dietary health.Key project goals include 1) improving dietary health and reducing food insecurity through access to and consumption of local and regional fresh fruits and vegetables; 2) improving health outcomes and reducing urgent healthcare utilization and associated costs; 3) increasing participation and retention in PRx; and 4) strengthening integration of PRx within healthcare delivery. A robust evaluation will demonstrate effectiveness achieving project goals and outcomes.
Animal Health Component
(N/A)
Research Effort Categories
Basic
(N/A)
Applied
(N/A)
Developmental
(N/A)
Goals / Objectives
Goal 1: Improve dietary health and reduce food insecurity through increased availability and consumption of local and regional fruits and vegetables.Outcomes:1.1.670 participants enrolled through 25 healthcare clinics.1.2. Expansion to rural Chenango County in clinic locations with existing healthcare partners.1.3. $241,500 in PPR incentives distributed.1.4. 75% of participants report increased consumption of fruits and vegetables as measured by a pre/post survey.1.5. 60% of participants increase utilization of local farm and food sources, as measured by redemption data.1.6. 60% reduction in number of participants reporting high levels of food insecurity.1.7. 60% of participants engage in nutrition education.1.8. 60% report increased knowledge of nutrition, how to include more fruits and vegetables in diets, and how diet affects health as measured by pre/post surveys.1.9. Increase the availability of home delivery for healthy produce.1.10. Increase the total number of firms where participants can shop for healthy produce.Goal 2: Improve health outcomes and reduce urgent healthcare utilization and associated costs for program participants.Outcomes:2.1. 70% of participants report that the program helped improve their health.2.2. 25% of participants report being able to reduce the medication needed to control diet-related conditions.2.3. 50% of participants with elevated HbA1c, high blood pressure, or high levels of LDL cholesterol report a decrease from pre/post.2.4. 25% average decrease in ER visits by program participants.2.5. 70% of providers report that participation in PRx improved patient relationships.Goal 3: Increase participant engagement and retention in the PRx program.Outcomes:3.1. Provide nutrition and health education opportunities to all participants.3.2. 10% increase in participant retention annually, as measured by incentive redemption and pre/post survey completion.3.3. Increase opportunities for participants to share experiences and provide feedback to strengthen program operations.?Goal 4: Strengthen integration of PRx as a nutrition service within the healthcare delivery system.Outcomes:4.1. 25 healthcare providers trained to implement screening and referrals for food and nutrition insecurity.4.2. Increased provider understanding of nutrition-related supports.4.3. Create and strengthen pathways for PRx redemption across participating healthcare and retail partners.
Project Methods
The PRxSCNY project efforts are centered around five key areas: planning and training; screening and enrollment; nutrition incentive redemption; participant education; and project evaluation.Planning & Training: Rural Health Network staff will provide training for healthcare providers from three partner hospital systems and Rural Health Network's Community Health Workers, including a refresher for established providers, that includes administering surveys and any other enrollment paperwork, verifying eligibility, participant support and sets expectations of both the provider and PRx program. As part of the project expansion to Chenango County, the project staff will meet with and train healthcare providers and other community partners.Training will also be provided for all food retail firms where participants can shop with their nutrition incentives. Topics will include voucher redemption, tracking, reimbursement protocols, and compliance with project regulations. Project staff will update existing pre- and post- surveys to reflect metrics required for NTAE reports (including fruit and vegetable consumption and self-reported food security) and verify with Reporting Advisor.Screening & Enrollment: Healthcare providers will screen individuals for eligibility, and disseminate surveys through a Qualtrics link and hard copy. Once enrolled, participants will have the option to utilize vouchers, or a weekly box of produce from local farms - to be picked up or home-delivered. Once enrolled, Rural Health Network will provide information on where to redeem nutrition incentives, transportation options, and other community resources through the Getting Started Guide. Program information and nutrition education will also be communicated regularly through social media, website, and program newsletter (electronic and mailed), and a text platform. Participants will be enrolled in the program for a total of six months, and complete pre- and post-surveys.Nutrition Incentive Redemption: At least 22 unique farm and food businesses, with over 50 locations, will participate in the program to accept the PRx incentives for healthy fruits and vegetables. Rural Health Network staff will work with each participating firm to collect monthly and quarterly firm-level data, which will be incorporated into the program evaluation. Alongside the existing incentive options (vouchers and local food box), Rural Health Network staff will explore the integration of electronic redemption cards for incentives. Staff will collect information about the point of sale technology that firms are already using to find a solution that easily integrates to most PRx vendors. Rural Health Network staff will also speak with other similar-sized PRx programs nationally to see what has been most effective. Vendors and participants will be involved in selection, testing, and implementation.Participant Education: Participants will receive regular nutrition education through access to classes in the community; weekly text messages and newsletters (email or mailed); resources available on the program website; and through social media. The project will work with external community partners and internal Community Health Educators to connect PRx participants with educational opportunities throughout their enrollment in the program.Evaluation: Rural Health Network will work with several partners, including Cornell University, to complete a robust evaluation that includes a process assessment documenting the process, challenges, and success of implementation and operations, and an outcome assessment documenting effectiveness in improving dietary health through increased consumption of fruits and vegetables; reducing individual and household food insecurity; and reducing healthcare use and associated costs among eligible participants. Specific evaluation goals include: a) measure progress towards goals/objectives including: improved food security, fruit and vegetables consumption and health outcomes, sustained changes to participants diets, contribution to the local food economy, and integrated food/medical systems. b) Analyze behavior change and health outcomes data between the pre/post surveys. c) Inform program improvement through process evaluation. d) Contribute to the body of knowledge around PRx programs and health outcomes.?Two main types of data will be collected: (1) Project-level and firm-level data, to be collected monthly or quarterly via digital or paper forms from participating GusNIP firms (farmers markets, grocery stores, etc.); and (2) Participant-level data, to be collected by cohort via survey (paper and pencil, online, by phone, or mailed), and claims data through the regional health information exchange (HIE). All data will be de-identified and coded to ensure anonymity and protect PHI. The PD and/or Co-PD will send redemption firms a spreadsheet for their site, and will send healthcare firms a Qualtrics survey link via e-mail or provide paper forms to collect individual program participant data. Individuals will enter survey data on a digital device (computer, tablet) or a paper form. Paper forms will be entered into Qualtrics. The evaluation team will use this data to assess recruitment, retention, satisfaction, and health outcomes to ensure that the program is achieving the intended impact. The project will also utilize Ripple Effect Mapping exercises to assess long term impact.