Progress 06/15/23 to 06/14/24
Outputs
Target Audience:The Los Angeles County Department of Public Health (DPH) partnered with two healthcare organizations, Venice Family Clinic (VFC) and Asian Pacific Healthcare Venture (APHCV) to implement the Produce Prescription Project (PRX) across five clinics in Los Angeles County, California. VFC is a non-profit, Federally Qualified Health Center located in West Los Angeles that primarily serves Medicaid, low socioeconomic status patients. The patient population is ethnically diverse and includes 54% Hispanic, 25% White, 9% African American, 3% Asian, 1% Pacific Islander, and 8% Other. APHCV is a nonprofit community health center located in Metro/East Los Angeles and 30% of their patient population are uninsured/underinsured with 89% of patients living in households with incomes at or below 200% of the Federal Poverty Level. Nearly 60% of APHCV patients identify as Asian, including 19% Thai, 14% Filipino, 7% Cambodian, 6% Bangladeshi, and 3% Chinese;30% of APHCV patients are Latino. Efforts to reach our target audiences (target populations) include extrapolating data from VFC and APHCV's electronic health records to identify patients who are low-income (defined as enrolled in Medicaid, screened positive for food insecurity, and diagnosed with type 2 diabetes). Patients who met these criteria werecontacted and asked if they would beinterested in participating in the PRX, locally known as Fresco y Saludable/Fresh and Healthy. Based on preliminary data obtained from the baseline core metrics survey, 63% of PRX participants were female, 69% were Hispanic/Latino, and 16% were Asian. Of those who lived in households experiencing food insecurity, 66% were Hispanic/Latino, 19% were Asian, 4% were African American, and 3% were White. By age, 70% of participants were between the ages of 45-65 and 17% were age 65 and older. Over half (52%) of participants found it very hard or somewhat hard for themselves or their households to regularly eat healthy foods in the last 12 months. When asked about the reasons for not eating healthier foods in the last 12 months, healthy foods being too expensive was the primary reason, with 83%reporting this being the reason often or sometimes true. Changes/Problems:DPH's partner, V4V, entered into a new contract with a new technology firm to redeem incentives using a different electronic platform at participating grocery stores. During this transition, VFC and APHCV paused program participant enrollment for two months, while V4V pilot tested the new electronic debit cards to ensure it was compatible with participating grocery stores point-of-sales (POS) system. This did not cause any major delays in program expenditure. Both healthcare organizations took advantage of this period by focusing their efforts on post-participation data collection and contacting their participants to hear feedback on the program thus far. Currently, VFC and APHCV are administering the new debit cards to program participants with no significant issues. What opportunities for training and professional development has the project provided?
Nothing Reported
How have the results been disseminated to communities of interest?
Nothing Reported
What do you plan to do during the next reporting period to accomplish the goals?The primary focus for the next reporting period will be to ensure that VFC and APHCV have met their participant total enrollment goals (810 participants from VFC and 460 participants from APHCV) and that data collection has beencompleted and documented. DPH will continue monthly check-in meetings with VFC and APHCV to ensure that the clinic sites are on track to meet their programmatic goals. Additionally, DPH will continue to review participant-level core metrics data every quarter. Upon completion of data collection, data will be cleaned, matched, and analyzed to assess for program impact.
Impacts
What was accomplished under these goals?
Project Goal #1:Improve healthy eating behaviors among low-income populations Intended Outcome:By September 2024, 80% of PPX participants will increase their daily intake of fruits and vegetables. The Los Angeles County Department of Public Health (DPH) partnered with the University of California, San Francisco, Vouchers 4 Veggies - EatSF Voucher Program (V4V) to provide eligible participants with an electronic debit card worth $40 per month for six months that can only be used to purchase fresh fruits and vegetables at participating Albertsons, Kroger, and Walmart grocery stores. Locally known as Fresco y Saludable/Fresh and Healthy, participants in this program receive one card per household. Participants are eligible for the program if they meet the following criteria: 1) enrolled in Medicaid, 2) screened positive for food insecurity, and 3) diagnosed with prediabetes or type 2 diabetes. To assess improvements in healthy eating behaviors, DPH partnered with two healthcare organizations, Venice Family Clinic (VFC) and Asian Pacific Healthcare Venture (APHCV) to administer a validated, 10-item fruit and vegetable intake survey to all Fresco y Saludable participants during enrollment (at the beginning of the program) and at 6 months (at program completion). Participants must complete the survey in order to receive their produce prescription benefits. Surveys wereadministered in-person at the clinic site or verbally over the phone and documented in Qualtrics. From June 2023 to March 2024, VFC and APCHV clinic staffenrolled 529 participants into Fresco y Saludable out of 1,481 eligible patients. Clinic staff have issued $136,760.00 in benefits and participants have purchased $83,145 worth of fresh fruits and vegetables participating grocery stores. To support healthy eating behaviors, both healthcare organizationsoffered over 250 nutrition education activities, ranging from Supplemental Nutrition Assistance Program Education (SNAP-Ed) nutrition education classes to one-on-one consultations with a Registered Dietitian Nutritionist. VFC and APHCV diabetes and health educators administer a 10-item fruit and vegetable survey at enrollment (baseline) and program completion (6 months) to assess participants daily fruit and vegetable intake. DPH is currently working with the Nutrition Incentive Hub to analyze this data and assess program impact on daily fruit and vegetable consumption. DPH will provide technical assistance to VFC and APHCVto ensure that these surveys are completed and are accurate; DPH will help reviewthe surveys in Qualtrics every 3 months. Project Goal #2:Increase household food security among low-income populations. Intended Outcome:By September 2024, 25% of PRX participants will improve their household food security as assessed using the Six-Item Short Form of the Food Security Survey Module (6-item food insecurity screener). Due to limited financial resources and other socioeconomic factors, low-income populations are at risk for being food insecure, defined as the lack of consistent access to enough food for an active, healthy lifestyle. Through the partnership with V4V, eligible Fresco y Saludable participants will receive $40 every month for six months to purchase fresh fruits and vegetables at participating grocery stores through an electronic debit card. The card also offers coupons on other healthy food items, such as bread, cheese, and yogurt, and has a website and app that participants can use to view these coupons, check their card balance, and find participating grocery stores. The website and app will be managed by the technology firm Solutran, in which V4V has acontractwith. Additionally, VFC and APHCV routinely refer program participants to other local food resources such as food pantries, the Supplemental Nutrition Assistance Program (SNAP), andclinic sites where free produce and food are distributedonce a month. To measure improvements in household food security status, DPH partnered with VFC and APHCVdiabetes and health educators to administer a validated, 6-item food insecurity screener to all participants during enrollment (at the beginning of the program) and at 6 months (program completion). Participants must complete the survey in order to receive their Healthy Savings card. Surveys wereadministered in-person at the clinic site or verbally over the phone and documented in Qualtrics. Preliminary data from the core metric baseline survey duringJune 2023 - May 2024 showed that 64% of participants were food insecure at the time they completed the survey. Fresco y Saludable program implementation at VFC and APHCV began in April 2022 and currently DPH is working with the Nutrition Incentive Hub to analyze the program participants' post-participation data. VFC and APHCVdiabetes and health educatorscontinue to administerthe food insecurity screener at program enrollment and program completion (6 months) to measure the impact of Fresco y Saludable. DPH provides technical assistance to VFC and APHCV to ensure that these surveys are completed and DPH is helping toreviewthem in Qualtrics every 3 months. Project Goal #3:Reduce the risk of developing diet-related chronic disease and associated complications. Intended Outcome:By September 2024, PRX will develop and implement a standardized program infrastructure to monitor participants for blood pressure and HbA1c improvements. Evaluation efforts will be able to use data generated by this infrastructure to assess and quantify health outcomes related to PPR participation. Research has shown an association between healthy eating patterns that are high in fruits and vegetables and lowering of the risk of developing hypertension (HTN). HTN in people with type 2 diabetes doubles the risk of cardiovascular disease. Lowering blood pressure among patients with type 2 diabetes is associated with decreased mortality, improved clinical outcomes, and decreased health care costs. PRX targets patients diagnosed with type 2 diabetes or prediabetes. DPH partnered with VFC and APHCV to establish a standardized program infrastructure across three VFC clinic sites and two APHCV clinic sites to monitor any changes in clinical health outcomes as a result of program participation. Participants must have their blood pressure and glycated hemoglobin (HbA1c) measured and documented in the electronic health record by staff prior to receiving produce prescription benefits. A blood pressure measurement must be taken the day of enrollment into the program (baseline) and HbA1c must be collected within three months of participant's enrollment date. Both blood pressure and HbA1c are reassessed at six months, when the participants complete the program. DPH established separate data-sharing agreements with VFC and APHCV to share deidentified patient-level data including blood pressure and HbA1c measurements. The data sharing agreement allowed DPH to collaborate with both healthcare organizationsto coordinate the collection, extraction, and analysis of data that are being used to evaluate the impact of nutrition incentives and diet-related chronic disease risk factors. Since program initiation, DPH and the two healthcare organizations have established a working program and data infrastructure to monitor the HbA1c and blood pressure of program participants. On a monthly basis, VFC and APHCV sends updated EHR data files with the measurements to DPH, which includes new participants as well as those who have completed the post-participation measurements. DPH reviews and resolves any data quality issues.
Publications
- Type:
Journal Articles
Status:
Published
Year Published:
2023
Citation:
Ayala V, Caldwell JI, Darwish-Elsherbiny F, Shah D, Kuo T. Implementing a Produce Prescription Program at Three Federally Qualified Health Centers to Help Patients Manage Their Diabetes or Prediabetes: A Qualitative Assessment of Clinic Staff Experiences in Los Angeles County, California, USA. Diabetology. 2023;4(3):282-293. https://doi.org/10.3390/diabetology4030025
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Progress 06/15/22 to 06/14/23
Outputs
Target Audience:The Los Angeles County Department of Public Health (DPH) partnered with two healthcare organizations, Venice Family Clinic (VFC) and Asian Pacific Healthcare Venture (APHCV) to implement the Produce Prescription Project (PRX) across five clinics in Los Angeles County, California. VFC is a non-profit, Federally Qualified Health Center located in West Los Angeles that primarily serves Medicaid, low socioeconomic status patients. The patient population is ethnically diverse and includes 54% Hispanic, 25% White, 9% African American, 3% Asian, 1% Pacific Islander, and 8% Other. APHCV is a nonprofit community health center located in Metro/East Los Angeles and 30% of their patient population are uninsured/underinsured with 89% pf patients living in households with incomes at or below 200% of the Federal Poverty Level. Nearly 60% of APHCV patients identify as Asian, including 19% Thai, 14% Filipino, 7% Cambodian, 6% Bangladeshi, and 3% Chinese. 30% of APHCV patients are Latino. Efforts to reach our target population include extrapolating data from VFC and APHCV's electronic health records to identify patients who are low-income (defined as enrolled in Medicaid, Medi-Cal in California), screened positive for food insecurity, and diagnosed with type 2 diabetes. Patients who met these criteria arecontacted and asked if they would beinterested in participating in the PRX, locally known as Fresco y Saludable/Fresh and Healthy. Based on preliminary data obtained from the baseline core metrics survey, 73% of PRX participants are female and 90% are Hispanic or Latino.. Of those who are food insecure, 88% are Hispanic or Latino, 7% African American, 3% Asian, and 2% American Indian or Alaska Native. By age, 67% of participants are between the ages of 45-65 and 19% are age 65 and above. Among participants, 85% reported that COVID-19 made it hard to make ends meet and 74% have used a food pantry as a result of COVID-19. Changes/Problems:One of the participating grocery stores, Kroger modified their internal process payment systems, and this impacted how incentives were redeemed at stores. Participants' Healthy Savings cards were either declined or indicated zero balance, when they, in fact, had sufficient funds in their account. As a result, this issue caused a decrease in the dollar value of incentives redeemed, given thatnearly 80% of Fresco y Saludable participants shop at Kroger-owned grocery stores.DPH's partner, V4V connected with Kroger and the technology firm, Solutran, to address this issue and provided training materials and information to grocery store managers and cashier staff on how to process Healthy Savings card payments. VFC and APHCV paused program enrollment for one month until the issue was resolved. During this one-month waiting period, both healthcare partners took advantage of theextra timeto concentrate on post-participation data collection, reassess their clinic workflow, and contacted all their participants to hear their feedback on the program thus far. The issue has now been resolved, and DPH developed additional handouts for the clinic partners to use in order to educate the participants on how to utilize their Healthy Savings card at Kroger. What opportunities for training and professional development has the project provided?
Nothing Reported
How have the results been disseminated to communities of interest?
Nothing Reported
What do you plan to do during the next reporting period to accomplish the goals?The next reporting period will be the final year of Fresco y Saludable. The primary focus will be to ensure that VFC and APHCV have met their participant enrollment goals (850 participants from VFC and 400 participants from APHCV) and that data collection has beencompleted (and documented). DPH will develop a schedule for each health centerthat highlights program enrollment and evaluation goals per month. DPH will continue monthly check-in meetings with VFC and APHCVto ensure that the clinic sites are on track to meet their programmatic goals. Instead of reviewing data every quarter, DPH will review participant-level core metrics survey on a monthly basis.
Impacts
What was accomplished under these goals?
Project Goal #1: Improve healthy eating behaviors among low-income populations Intended Outcome: By September 2024, 80% of PPX participants will increase their daily intake of fruits and vegetables. DPH partnered with University of California, San Francisco, Vouchers 4 Veggies - EatSF Voucher Program (V4V) to provide eligible participants with an electronic debit card worth $40 per month for six months that can only be used to purchase fresh fruits and vegetables at participating Albertsons, Kroger, and Walmart grocery stores. Locally known as Fresco y Saludable/Fresh and Healthy, participants in this program receive one card per household. Participants are eligible for the program if they meet the following criteria: 1) enrolled in Medicaid, 2) screened positive for food insecurity, and 3) diagnosed with prediabetes or type 2 diabetes. To assess improvements in healthy eating behaviors, DPH partnered with two healthcare organizations, Venice Family Clinic (VFC) and Asian Pacific Healthcare Venture (APHCV) to administer a validated, 10-item fruit and vegetable intake survey to all Fresco y Saludable participants during enrollment (at the beginning of the program) and at 6 months (at program completion). Participants must complete the survey in order to receive their produce prescription benefits. Surveys wereadministered in-person at the clinic site or verbally over the phone and documented in Qualtrics. From June 2022 to March 2023, VFC and APCHV clinic staffenrolled 479 participants into Fresco y Saludable out of 2,483 eligible patients. Clinic staff have issued $88,840.00 in benefits and participants have purchased $70,260.37 worth of fresh fruits and vegetables participating grocery stores. To support healthy eating behaviors, both healthcare organizationsoffered over 200 nutrition education activities, ranging from Supplemental Nutrition Assistance Program Education (SNAP-Ed) nutrition education classes to one-on-one consultations with a Registered Dietitian Nutritionist. Preliminary data from the 10-item fruit and vegetable intake survey betweenJune 2022 to August 2022 shows the average daily fruit and vegetable intake of participants was2.64 cups (standard deviation 0.71). This included0.94 cups of fruits (standard deviation 0.36) and 1.66 cups of vegetables (standard deviation 0.45). Fresco y Salduable program implementation at APHCV and VFC began in April 2022 and currently DPH is working with the Nutrition Incentive Hub to analyze the program participants post-participationdata. VFC and APHCV diabetes and health educatorscontinue to administerthe survey at program enrollment and program completion (6 months) to measure the impact of Fresco y Saludable. DPH will provide technical assistance to VFC and APHCVto ensure that these surveys are completed and are accurate; DPH will help reviewthe surveys in Qualtrics every 3 months. Project Goal #2: Increase household food security among low-income populations. Intended Outcome: By September 2024, 25% of PRX participants will improve their household food security as assessed using the Six-Item Short Form of the Food Security Survey Module (6-item food insecurity screener). Due to limited financial resources and other socioeconomic factors, low-income populations are at risk for being food insecure, defined as the lack of consistent access to enough food for an active, healthy lifestyle. Through the partnership with V4V, eligible Fresco y Saludable participants will receive $40 every month for six months to purchase fresh fruits and vegetables at participating grocery stores through an electronic debit card or "Healthy Savings" card. The card also offers coupons on other healthy food items, such as bread, cheese, and yogurt, and has a website and app that participants can use to view these coupons, check their card balance, and find participating grocery stores. The website and app will be managed by the technology firm Solutran, in which V4V has acontractwith. Additionally, VFC and APHCV routinely refer program participants to other local food resources such as food pantries, the Supplemental Nutrition Assistance Program (SNAP), and clinic sites where free produce and food are distributed once a month. To measure improvements in household food security status, DPH partnered with VFC and APHCVdiabetes and health educators to administer a validated, 6-item food insecurity screener to all participants during enrollment (at the beginning of the program) and at 6 months (program completion). Participants must complete the survey in order to receive their Healthy Savings card. Surveys wereadministered in-person at the clinic site or verbally over the phone and documented in Qualtrics. Preliminary data from the core metric baseline survey duringJune 2022 - August 2022 showed that 82% of participants were food insecure at the time they completed the survey. Fresco y Salduable program implementation at APHCV and VFC began in April 2022 and currently DPH is working with the Nutrition Incentive Hub to analyze the program participants' post-participation data. VFC and APHCVdiabetes and health educators continue to administerthe food insecurity screener at program enrollment and program completion (6 months) to measure the impact of Fresco y Saludable. DPH will provide technical assistance to VFC and APHCV to ensure that these surveys are completed and are; DPH is helping toreviewthem in Qualtrics every 3 months. Project Goal #3: Reduce the risk of developing diet-related chronic disease and associated complications. Intended Outcome: By September 2024, PRX will develop and implement a standardized program infrastructure to monitor participants for blood pressure and HbA1c improvements. Evaluation efforts will be able to use data generated by this infrastructure to assess and quantify health outcomes related to PPR participation. Research has shown an association between healthy eating patterns that are high in fruits and vegetables and lowering of the risk of developing hypertension (HTN). HTN in people with type 2 diabetes doubles the risk of cardiovascular disease. Lowering blood pressure among patients with type 2 diabetes is associated with decreased mortality, improved clinical outcomes, and decreased health care costs. PRX targets patients diagnosed with type 2 diabetes or prediabetes. DPH partnered with VFC and APHCV to establish a standardized program infrastructure across three VFC clinic sites and two APHCV clinic sites to monitor any changes in clinical health outcomes as a result of program participation. Participants must have their blood pressure and glycated hemoglobin (HbA1c) measured and documented in the electronic health record by staff prior to receiving produce prescription benefits. A blood pressure measurement must be taken the day of enrollment into the program (baseline) and HbA1c must be collected within three months of participant's enrollment date. Both blood pressure and HbA1c are reassessed at six months, when the participants complete the program. DPH established separate data-sharing agreements with VFC and APHCV to share deidentified patient-level data including blood pressure and HbA1c measurements. The data sharing agreement allowed DPH to collaborate with both healthcare organizationsto coordinate the collection, extraction, and analysis of data that are being used to evaluate the impact of nutrition incentives and diet-related chronic disease risk factors. Since program initiation, DPH and the two healthcare organizations have established a working program and data infrastructure to monitor the HbA1c and blood pressure of program participants. On a monthly basis, VFC and APHCV sends updated EHR data files with the measurements to DPH, which includes new participants as well as those who have completed the post-participation measurements. DPH reviews and resolves any data quality issues.
Publications
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Progress 06/15/21 to 06/14/22
Outputs
Target Audience:The Los Angeles County Department of Public Health (DPH) will partner with two healthcare organizations, Venice Family Clinic (VFC) and Asian Pacific Healthcare Venture (APHCV) to implement PRX across four clinics in Los Angeles County, California. VFC is a non-profit, Federally Qualified Health Center located in West Los Angeles that primarily serves low socioeconomic status patients enrolled in Medicaid. The patient population is ethnically diverse and includes 54% Hispanic, 25% White, 9% African American, 3% Asian, 1% Pacific Islander, and 8% Other. APHCV is a nonprofit community health center located in Metro/East Los Angeles; 30% of their patient population are uninsured/underinsured with 89% includingincomes at or below 200% of the Federal Poverty Level. Nearly 60% of APHCV patients are Asian, including 19% Thai, 14% Filipino, 7% Cambodian, 6% Bangladeshi, 3% Chinese, and 30% are Latino. Efforts to reach our target population include extrapolating data from VFC and APHCV's electronic health record to identify patients who are low-income (defined as enrolled in Medicaid - known asMedi-Cal in California), screened positive for food insecurity, and diagnosed with type 2 diabetes. Patients who met these criteria will be contacted and asked if they are interested in participating in the program, locally known as Fresco y Saludable/Fresh and Healthy. Changes/Problems:No major changes to the program approach and methods occurred during this reporting period. DPH experienced a slight delay in program implementation related to department's response to COVID-19, which impacted the timeline to enter into agreements with program partners. What opportunities for training and professional development has the project provided?
Nothing Reported
How have the results been disseminated to communities of interest?
Nothing Reported
What do you plan to do during the next reporting period to accomplish the goals?PRX will be implemented at three Venice Family Clinic (VFC) sites, Simms/Mann Health and Wellness, Irma Colen Health Center and Rose Clinic, and one Asian Pacific Healthcare Venture (APHCV) site, Belmont Health Center beginning April 2022. The goal is to reach a total of 800 participants (550 participants at VFC; 250 participants at APHCV). Trainings were provided to VFC and APHCV staff on how to screen, enroll, and document eligible PRX participants. To support program fidelity, trainings and technical assistance will be continuously reassessed to staff. The Healthy Savings card redemption data will be managed by our partner, University of California, San Francisco, Vouchers 4 Veggies (V4V) Program and will be sent to DPH monthly. Participant-level core metric surveys will be reviewed quarterly by DPH to ensure data integrity. VFC and APHCV clinic leadership will review to ensure participants have complete biomarkers (blood pressure and hemoglobin A1c) data that is documented in the patients' electronic health record.
Impacts
What was accomplished under these goals?
Project Goal #1: Improve healthy eating behaviors among low-income populations Intended Outcome: By September 2024, 80% of PPX participants will increase their daily intake of fruits and vegetables. DPH plan on implementing PRX at Venice Family Clinic (VFC) and Asian Pacific Healthcare Venture (APHCV) health centers in April 2022. This program is an expansion of our current PPR, and it will incentivize eligible participants to purchase fresh fruits and vegetables at participating grocery stores through an electronic debit card. PRX participants will receive one card per household and can redeem up to $40 per month for six months at Kroger locations (i.e., Food 4 Less, Ralphs) and Walmart. Participants are eligible for the program if they meet the following criteria: 1) enrolled in Medicaid, 2) screened positive for food insecurity, and 3) diagnosed with type 2 diabetes. To assess improvements in healthy eating behaviors, DPH will partnered with VFC and APHCV to administer a validated, 10-item fruit and vegetable intake survey to all Fresco y Saludable participants during enrollment (at the beginning of the program) and at 6 months (at program completion). Participants must complete the survey in order to receive their PRX benefits. DPH collaborated with the Nutrition Incentive Program Training, Technical Assistance, Evaluation and Information Center (NTAE) to translate the 10-item survey in Spanish and both VFC and APHCV staff will receive on how to effectively administer the survey to participants. Project Goal #2: Increase household food security among low-income populations. Intended Outcome: By September 2024, 25% of PRX participants will improve their household food security as assessed using the Six-Item Short Form of the Food Security Survey Module (6-item food insecurity screener). Due to limited financial resources and other socioeconomic factors, low-income populations are at risk for being food insecure, defined as the lack of consistent access to enough food for an active, healthy lifestyle. We aim to increase food insecurity by providing eligible PRX participants with $40 every month for 6 months via electronic debit card to purchase fresh fruits and vegetables only at participating grocery stores, such as Kroger and Walmart. Our PRX partner, University of California, San Francisco, Vouchers 4 Veggies (V4V) Program will leverage their current agreement with Solutran, a financial technology firm, to administer the fruit and vegetable incentives on the debit cards, referred to as "Healthy Savings" card. The card offers coupons on other healthy food items, such as bread, cheese, and yogurt, and has a website and app participants can use to view these healthy food coupons, check their card balance, and find participating grocery stores. The website and app will be managed by Solutran. Both VFC and APHCV are DPH Supplemental Nutrition Assistance Program Education (SNAP-Ed) partners and PRX participants will be referred to SNAP-Ed nutrition education classes, free produce distributions at clinic sites and to Supplemental Nutrition Assistance Program (SNAP) or food stamps. Collectively with these referrals to food resources, we anticipate this will assist in increasing household food security status among our participants. To measure improvements in household food security status, DPH will partner with VFC and APHCV health educators to administer a validated, 6-item food insecurity screener to all PRX participants during enrollment (at the beginning of the program) and at 6 months (at program completion). PRX participants must complete the survey in order to receive their Healthy Savings card. DPH collaborated with NTAE to translate the 6-item survey in Spanish and both VFC and APHCV staff will receive on how to effectively administer the survey to participants. Project Goal #3: Reduce the risk of developing diet-related chronic disease and associated complications. Intended Outcome: By September 2024, PRX will develop and implement a standardized program infrastructure to monitor participants for blood pressure and HbA1c improvements. Evaluation efforts will be able to use data generated by this infrastructure to assess and quantify health outcomes related to PPR participation. Research has shown an association between healthy eating patterns that are high in fruits and vegetables and lowering the risk of developing hypertension (HTN). HTN in people with type 2 diabetes doubles the risk of cardiovascular disease. Lowering blood pressure among patients with type 2 diabetes is associated with decreased mortality, improved clinical outcomes, and decreased health care costs. PRX targets patients diagnosed with type 2 diabetes. DPH will partner with VFC and APHCV to establish a standardized program infrastructure across 3 VFC clinic sites and 1 APHCV clinic sites to monitor any changes in clinical health outcomes as a result of program participation. Participants must have their blood pressure and glycated hemoglobin (HbA1c) measured and documented in the electronic health record by staff prior to receiving PRX benefits. A blood pressure measurement must be taken the day of enrollment into the program (baseline) and HbA1c must be collected within three months of participant's enrollment date. Both blood pressure and HbA1c will be reassessed at six months, when the participants benefit expires. DPH will established separate data-sharing agreements with VFC and APHCV to share deidentified patient-level data including blood pressure and HbA1c measurements. The data sharing agreement allows DPH to collaborate with VFC and APHCV to coordinate the collection, extraction, and analysis to evaluate the impact of nutrition incentives and diet-related chronic disease risk factors.
Publications
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