Progress 09/15/23 to 09/14/24
Outputs
Target Audience:The target audience for this project is pediatric families experiencing food insecurity who are Medicaid enrolled. Patients were reached through their health care provider's office - the provider screens patients for food insecurity and refers patients who have experienced food insecurity within the past 12 months to Prisma Health's Pediatric Food Security Navigator (PFN). The PFN meets with the families and offers the produce prescription program (PPR) to eligible families who have experienced food insecurity in the past 30 days. From the beginning of the program through February 29, 2024 (the lastest data pull and report - the next report will be available this winter), 285families were referred to theproduce prescription program. A majority of families enrolled in the program are people of color, with Hispanic/Latino families representing 65.1% of participants, and 31.6%requiring interpretation to Spanish. Theaverage age of the pediatric patient at the time of referral was 3.3years old, and the average household of the pediatric patient included 2 adults, 1.2school-aged children, and 1.3children under the age of 5. Changes/Problems:A significant barrier in the first year of the program was transportation - patients often were unable to pick up their FoodShare box at clinic locations during the designated period of time, citing transportation barriers as the reason. At the end of the first reporting period, we finalized a partnership with Meals on Wheels to deliver boxes to patients' homes. We are pleased to report that the partnership with Meals on Wheels has been successful throughout the second year of the project. We will continue to work with Meals on Wheels through the duration of the project. The second barrier in the first year was to enrollment. FoodShare's original Logistics Associate left FoodShare at the end of July 2023, and enrolling patients was more challenging until the position was refilled in February 2024. We are pleased to report that Suli Sorcia-Herrera has brought skill, passion, and efficiency to the role over the past months. Suli continues to enroll referred patients in the PPR program and manage the significant logistics of the program. During the second year of the program, we began administering post-program surveys. With the position vacancy at FoodShare for several months, both pre- and post-program surveys were not being administered. Since Suli's arrival, however, both have resumed with relative success. During the second year, we also changed the timeframe of the post-program survey. Instead of becoming eligible at 9 months into the program, participants are now offered the post-program survey at 6 months into the program. To date, we have 28 matched pre- and post-program surveys, and are confident that we will reach 100-130 matched surveys by the end of our project. A large number of participants will become eligible for the post-program survey in the next several months, which will contribute to our ability to succeed in collecting these surveys. While our produce prescription program had a slower start than we would have liked, we have addressed barriers as they have arisen, and as we begin the third year of the project, we are confident in the model we have built for produce prescription. Our program model has become stronger as we have managed the challenges and barriers, and now better meets the needs of the patients and families that are served. What opportunities for training and professional development has the project provided?Susan Frantz, Food Security Director, LiveWell Greenville, participated in professional development related to this project during the project period: GusNIP Communities of Practice calls SC Food is Medicine Annual meeting, December 2023 REACH Awardee Meeting, which included sessions on Produce Prescription, Atlanta, May 2024 Sally Wills, Executive Director, LiveWell Greenville, attended the GusNIP Project Directors' meeting in December 2023. How have the results been disseminated to communities of interest?Data has been shared at the quarterly Food Security Coalition partner meetings. The Food Security Coalition has over 50 partner community organizations. Dr. Blakely Amati at Prisma Health wrote a blog post on Food Security Navigation for the American Association of Pediatrics on March 20, 2024. Kara Davis presented the project evaluation to other GusNIP external evaluators on February 22, 2024. What do you plan to do during the next reporting period to accomplish the goals?During the next reporting period, we will continue to refer patients to the produce prescription program. Our goal is to enroll 25-30 new patients per month in the program for most of the third year of the project period. We are on track to be able to meet these goals. We will analyze the budget continually to determine when the referrals and enrollment in the program should decrease or stop. Specific actions for the next reporting period: Maintain monthly enrollment numbers to 25-30 new patients per month Continue to refine the delivery model through our partnership with Meals on Wheels Continue to use DoorDash when Meals on Wheels is not a viable option for delivery Administer the post-program surveys to work toward our goal of 100-130 matched pre and post surveys. Pull, analyze, and report on demographic data of program participants.
Impacts
What was accomplished under these goals?
This produce prescription project was developed to reduce the number of people experiencing food insecurity in Greenville county, South Carolina, and to increase access to fresh fruits and vegetables for this population. The target audience is pediatric patients who are enrolled in Medicaid who are experiencing food insecurity. During the reporting period, which is the second year of this three year project, the project partners (Prisma Health, LiveWell Greenville, FoodShare Greenville, and the Institute for the Advancement of Community Health at Furman University) met monthly to discuss any issues that arose in the previous month. The team is committed to the project, to the monthly meetings, and to working together to execute the project successfully. Beginning in 2021, health care providers at Prisma Health have been universally screening for food insecurity in pediatric patients. Patients experiencing food insecurity are referred to the Pediatric Food Resource Navigator (PFN) at Prisma Health, who refers or connects them to resources, including SNAP, WIC, and beginning in February 2023, the produce prescription program with FoodShare Greenville (FSG). FSG enrolls the referred patients in its healthy food box program, through which patients receive 15 pounds of fresh produce every other week for 9 months. If the patient responds to the pre-program survey, they are eligible for one additional month of boxes. After 9 months, if the patient responds to the post-program survey, the patient is eligible for 2 additional months of FSG boxes. The PFN checks in with the referred patients at 1 month and 6 months after their enrollment to re-screen for food insecurity. During this reporting period, the project has grown significantly. During the first FoodShare box cycle of the reporting period in September 2023, boxes were distributed to 91 families. By the last FoodShare box cycle in August 2024, 172 boxes were distributed. This reporting period, our project is making significant progress toward meeting the objectives in Goal 1 and Goal 2. Data regarding food insecurity is collected at the initial patient screening, at the 1-month follow-up, and at the 6-month follow-up. As of February 29, 2024 (the most recent data pull and report), the data shows that the percentage of families who are experiencing food insecurity initially (97.2%, n=284 patients) decreased at the 1-month (62.9%, n=186) and 6-months (25%, n=28) follow-up conversations. The decreases in rates of food insecurity from initial screening to 6-months mirror the decreases from our larger PFN work. The impact of these findings cannot be overstated. Though the data is not complete, the produce prescription program has provided fresh fruits and vegetables to families who experience food insecurity, and the program has assisted in reducing the number of families who experience food insecurity. 293 families were eligible to be referred to the produce prescription program, and during this reporting period, 199 families were actively enrolled (this accounts for patients who declined enrollment, dropped out of the program, or who had been referred to the program but not yet enrolled). During the reporting period, 2867 FoodShare boxes were redeemed, meaning that families experiencing food insecurity received a total of 43,005 pounds of fresh produce.
Publications
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Progress 09/15/22 to 09/14/23
Outputs
Target Audience:The target audience for this project is pediatric families experiencing food insecurity who are Medicaid enrolled. Patients were reached through their health care provider's office - the provider screens patients for food insecurity and refers patients who have experienced food insecurity within the past 12 months to Prisma Health's Pediatric Food Security Navigator (PFN). The PFN meets with the families and offers the produce prescription program (PPR) to eligible families who have experienced food insecurity in the past 30 days. From February 1 - August 31, 2023, 94.6% of the families offered PPR agreed to be referred to the program. A majority of families enrolled in the program are people of color, with 54.4% of families preferring or requiring Spanish language. The average age of the pediatric patient at the time of referral was 3.5 years old, and the average household of the pediatric patient included 2 adults, 1.5 school-aged children, and 1.4 children under the age of 5. Changes/Problems:A significant barrier in the first year of the program was transportation - patients often were unable to pick up their FoodShare box at clinic locations during the designated period of time, citing transportation barriers as the reason. In May, we began a partnership with DoorDash to deliver boxes directly to the homes of patients who had not picked up their boxes at the clinic location they had designated, and in August, we finalized a partnership with Meals on Wheels to deliver boxes to patients' homes. Due to the two delivery options, our redemption rate has increased, and at the end of the project period, approximately 75-80% of the FoodShare boxes that had been ordered through the PPR had been picked up or delivered. Earlier in the year, only 60-65% of the ordered boxes were picked up, with the patient usually citing transportation barriers as the reason. We are confident that the delivery options will increase the redemption rate to near 90% during the next project period. The second barrier was to enrollment. FoodShare's original Logistics Associate left FoodShare at the end of July, and enrolling patients has been more challenging without that position. FoodShare is actively working to fill the position, but a slow-down in enrollment is likely during the fall of 2023. The Associate must be fluent in Spanish, as approximately 50% of the patients referred to PPR speak only Spanish, and enrollment in the program is contingent on the patient answering the pre-program survey questions, often over the phone. While our produce prescription program has had a slower start than we would have liked, we have addressed barriers as they have arisen, and as we approach the second year of the project, we are confident in the model we have built for produce prescription. With the hiring of the new FoodShare Logistics Associate and two options for FoodShare box delivery to mitigate transportation challenges, our program model has become stronger and better meets the needs of the patients and families that are served. What opportunities for training and professional development has the project provided?Two members of the Greenville PPR team participated in professional development related to this project during the project period: Susan Frantz, Food Security Director, LiveWell Greenville: GusNIP National Convening, June 2023 Monthly Communities of Practice calls SC Local Food Summit - all FoodShare SC staff attended including Susan, August 2023 Anna Baumgartner, FoodShare Greenville Program Director, Mill Village Ministries: GusNIP National Convening, June 2023 Growing Local Conference, Columbia, SC, August 2023 How have the results been disseminated to communities of interest?We have not widely shared the results of the produce prescription program at this time. Once we have pre and post program participant level data, we will share with our coalition networks and develop a wider communication plan. What do you plan to do during the next reporting period to accomplish the goals?During the next reporting period, we will continue to refer patients to the produce prescription program. Our goal is to enroll 25-30 new patients per month in the program for the second year of the project period. We are on track to be able to meet these goals. Specific actions for the next project period: Onboard new FoodShare Logistics Associate Increase monthly enrollment numbers to 25-30 new patients per month Determine which pediatric clinics and providers are referring patients to the PFN Outreach to clinics and providers who are not referring patients to the PFN to raise awareness about the services the PFN provides, include PPR Continue to refine the delivery model through our partnership with Meals on Wheels Continue to use DoorDash when Meals on Wheels is not a viable option for delivery Explore options to make the program more accessible to people living in the more rural parts of the county where delivery is currently unavailable Administer the first post-program surveys and begin evaluation of patients who have completed the program
Impacts
What was accomplished under these goals?
This produce prescription project was developed to reduce the number of people experiencing food insecurity in Greenville county, South Carolina, and to increase access to fresh fruits and vegetables for this population. The target audience is pediatric patients who are enrolled in Medicaid who are experiencing food insecurity. During the reporting period, which is the first year of this three year project, the first 4-5 months were spent planning with partner organizations, determining logistics, hiring and on-boarding the Pediatric Food Security Navigator (PFN) at Prisma Health and the FoodShare Logistics Associate, and designing the survey instruments and evaluation protocol. By the end of the reporting period, the project partners (Prisma Health, LiveWell Greenville, FoodShare Greenville, and the Institute for the Advancement of Community Health at Furman University) meet monthly to discuss any issues that have arisen in the previous month. The team is committed to the project, to the monthly meetings, and to working together to execute the project successfully. Beginning in 2021, health care providers at Prisma Health have been universally screening for food insecurity in pediatric patients. Patients experiencing food insecurity are referred to the PFN at Prisma Health, who refers or connects them to resources, including SNAP, WIC, and beginning in February 2023, the produce prescription program with FoodShare Greenville (FSG). FSG enrolls the referred patients in its healthy food box program, through which patients receive 15 pounds of fresh produce every other week for 9 months. After 9 months, if the patient responds to the post-program survey, the patient is eligible for 3 additional months of FSG boxes. The PFN checks in with the referred patients at 1 month and 6 months after their enrollment to re-screen for food insecurity. Data regarding food insecurity is collected at the initial patient screening, at the 1-month follow-up, and at the 6-month follow-up. As of August 31, the data shows that the percentage of families who are experiencing food insecurity initially (96.8%, n=156 patients) decreased at the 1-month (73%, n=115) and 6-months (24%, n=25) follow-up conversations. The decreases in rates of food insecurity from initial screening to 6-months mirror the decreases from our larger PFN work. The first round of post-program surveys will begin in the next reporting period, and we anticipate that this trend will continue. The impact of these findings cannot be overstated. Though the data is not complete, the produce prescription program has provided fresh fruits and vegetables to families who experience food insecurity, and the program has assisted in reducing the number of families who experience food insecurity. 165 families were eligible to be referred to the produce prescription program, and at the end of this reporting period, 89 families were actively enrolled (this accounts for patients who declined enrollment, dropped out of the program, or who had been referred to the program but not yet enrolled). During the project period, 485 FoodShare boxes were redeemed, meaning that families experiencing food insecurity received a total of 7,275 pounds of fresh produce.
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