Recipient Organization
PARKVIEW HOSPITAL, INC.
10501 CORPORATE DR
FORT WAYNE,IN 468451700
Performing Department
Health & Well-Being
Non Technical Summary
Summary:Parkview Hospital's VeggieRx to HEAL program ("VeggieRx" herein) began as a pilot program with 30 participants in 2019. As the VeggieRx staff implements the three-year USDA GusNIP funding awarded in 2021 to serve 850 individuals in Allen County - a transformational community project - that same staff is planning for the next phases as the program evolves. Parkview providers as well as community providers can make referrals to the program. Through the use of best practices, and with providers referring eligible patients to the program, successful results for participating patients are being achieved, and we have the capacity to expand the program. That is, to help meet the patient need, this USDA Program Enhancement proposal will 1) expand the reach of VeggieRx in Allen County (adding obesity as a qualifying health condition) and 2) provide service to three (3) rural counties in northeast Indiana.Allen County VeggieRx expansion: Providers and interested individuals have shown enough of an interest in adding individuals (children and adults) with obesity that VeggieRx staff prioritized this diagnosis as the next to be added to the qualifying health conditions for program participation. In fact, two minors with obesity interested in the program were turned away because of program ineligibility. The expansion will include serving 150 additional Allen County individuals (75 each year in years two and three of this award) who have obesity - children or adults, following the same provider referral process as in the original VeggieRx program. Each participant will receive $50 per month for six months, just as participants in the original VeggieRx program. As the program expands to include obesity as a qualifying health condition, we anticipate that the diversity of participants will expand, too. Adding .4 FTE (thereby increasing the 10-month .6 FTE VeggieRx Coordinator provided in the original VeggieRx USDA PPR award to a 12-month 1.0 FTE), .2 FTE dietitian, continuing debit card provider fees (adhering to 2 CFR 200.320, through Federally-regulated procurement standards), $50/debit card/month x 6 months for each participant, data evaluation, staff training, and staff mileage will support the addition of participants in Allen County.Rural VeggieRx expansion: Earlier in 2022, the VeggieRx to HEAL program received a grant from the Indiana Department of Health to create a planning study to introduce VeggieRx in rural counties in northeast Indiana where Parkview has community hospitals. Making the VeggieRx program replicable has always been the aim. This program enhancement includes debuting the VeggieRx program in the counties of Huntington, Kosciusko and LaGrange in northeast Indiana. Each county will receive funding for 240 participants total over the program period (40 each in years two and three: 80 participants in three counties per year) at the same $50 per participant per month for six months as the Allen County program. In the three rural counties, qualifying health conditions will remain the same as the original Allen County VeggieRx program: individuals with prediabetes, diabetes, individuals with cardiac diseases and underserved women with an at-risk pregnancy. The addition of individuals with obesity as a qualifying health condition would be applicable in the rural program. Adding a .8 FTE coordinator, continuing debit card provider fees (adhering to 2 CFR 200.320, through Federally-regulated, procurement standards), $50/debit card/month x 6 months for each participant, mileage and data evaluation assistance will support the addition of these three counties.The Fresh Connect system, an About Fresh product platform, will be used - just as with the original VeggieRx program - where participants will utilize a debit-like card to redeem produce prescription fresh fruits and vegetables. Each month, VeggieRx participant debit cards will receive $50, and the participant will redeem at eligible grocery stores and/or farmers markets. The ease of Fresh Connect technology is a time saver for VeggieRx staff, provides usability to participants and lends professionalism and organization to the program.The VeggieRx data collection component has provided data to track the program's success, as well as plan for future program expansion. Specifically, all VeggieRx participants take a pre- and post-survey to gauge their fruit and vegetable consumption, cooking skills, healthy eating knowledge and risk for food insecurity. The first round of VeggieRx data shows that 89 percent of participants completed the program in full; 49 percent of participants increased their vegetable consumption; and 24 percent are more comfortable cooking with fresh produce. Data has already also revealed how VeggieRx can positively health care costs: 62 percent of round one VeggieRx participants had improved their systolic blood pressure (the top number) and 33 percent noted an increase in their general health.Our ProjectObjective:Produce Prescription (PPR) programs have been introduced as a practice to help at-risk populations consume more fresh produce. Parkview has made a commitment to addressing social determinants of health and, specifically, breaking down barriers to access healthy food. The VeggieRx program fortifies Parkview's relationship with our providers, as the program dispenses a tangible, healthy food incentive to health-marginalized patients who are Medicaid eligible. The existing VeggieRx program serves individuals with prediabetes, diabetes, individuals with cardiac diseases and underserved women with an at-risk pregnancy in Allen County. With this enhancement, we will add individuals (children and adults) with obesity as a qualifying health factor to the current USDA-funded PPR in Allen County: VeggieRx program. The rural expansion of VeggieRx to HEAL in Huntington, Kosciusko and LaGrange counties (all in northeast Indiana) will follow the same guidelines, serving individuals with prediabetes, diabetes, individuals with cardiac diseases, underserved women with an at-risk pregnancy, and individuals who are obese, and referred to the program by a provider - either Parkview or community-provider. In all locations and counties, the aim is to increase fresh produce intake, improve health, reduce healthcare costs (claims with Medicaid) and reduce household food insecurity. To maintain consistency throughout the VeggieRx to HEAL program - especially in measuring results - the goals and outcomes, in adding individuals with obesity and to the three-county rural expansion, will be the same.
Animal Health Component
0%
Research Effort Categories
Basic
100%
Applied
0%
Developmental
0%
Goals / Objectives
Project goals, objectives, intended outcomesObjective:Produce Prescription (PPR) programs have been introduced as a practice to help at-risk populations consume more fresh produce. Parkview has made a commitment to addressing social determinants of health and, specifically, breaking down barriers to access healthy food. The VeggieRx program fortifies Parkview's relationship with our providers, as the program dispenses a tangible, healthy food incentive to health-marginalized patients who are Medicaid eligible. The existing VeggieRx program serves individuals with prediabetes, diabetes, individuals with cardiac diseases and underserved women with an at-risk pregnancy in Allen County. With this enhancement, we will add individuals (children and adults) with obesity as a qualifying health factor to the current USDA-funded PPR in Allen County: VeggieRx program. The rural expansion of VeggieRx to HEAL in Huntington, Kosciusko and LaGrange counties (all in northeast Indiana) will follow the same guidelines, serving individuals with prediabetes, diabetes, individuals with cardiac diseases, underserved women with an at-risk pregnancy, and individuals who are obese, and referred to the program by a provider - either Parkview or community-provider. In all locations and counties, the aim is to increase fresh produce intake, improve health, reduce healthcare costs (claims with Medicaid) and reduce household food insecurity. To maintain consistency throughout the VeggieRx to HEAL program - especially in measuring results - the goals and outcomes, in adding individuals with obesity and to the three-county rural expansion, will be the same.Goals- Improve the amount of fresh produce that is available to adults identified as being food insecure and adults who are on Medicaid or uninsured with prediabetes, diabetes, have cardiac diseases or individuals with an at-risk pregnancy, and individuals (children and adults) with obesity, in Allen, Huntington, Kosciusko and LaGrange counties- Reduce urgent healthcare utilization and associated healthcare costs- Reduce the prevalence of food insecurity and chronic health diseases in low-income individuals in Allen, Huntington, Kosciusko and LaGrange countiesOutcomes- At least 40% increase in fruit and vegetable intake during program, via pre- and post-survey, and at six-month post-program- At least 30% increase in nutrition knowledge and self-efficacy (confidence preparing produce, fruit and veggie requirements, etc., via pre- and post-survey)- At least 70% of clients in program to be retained from start to finish- Decrease in blood pressures on average 5 points or more (in 6 months) for those with hypertension- Decrease in A1C by 0.5 point or more for those with pre-diabetes/diabetes- 60% reduction in food insecurity in adult participants who screened positive- 25% reduction in urgent healthcare utilization and associated healthcare costs (i.e., ED visits)Improvement Plan: VeggieRx clients remain engaged (even an Alumni group) and increase utilization of community health centers; measure feasibility of more redemption sites (convenience stores); have 'lifestyle' prescriptions (such as exercise prescriptions) become standard protocol in healthcare, followed by movement to shared medical appointments with lifestyle medicine focus; reduction in prediabetic and diabetic population; reduction of individuals with heart disease; and a reduction of individuals who are obese.
Project Methods
Parkview Hospital's VeggieRx to HEAL program ("VeggieRx" herein) began as a pilot program with 30 participants in 2019. As the VeggieRx staff implements the three-year USDA GusNIP funding awarded in 2021 to serve 850 individuals in Allen County - a transformational community project - that same staff is planning for the next phases as the program evolves. Parkview providers as well as community providers can make referrals to the program. Through the use of best practices, and with providers referring eligible patients to the program, successful results for participating patients are being achieved, and we have the capacity to expand the program. That is, to help meet the patient need, this USDA Program Enhancement proposal will 1) expand the reach of VeggieRx in Allen County (adding obesity as a qualifying health condition) and 2) provide service to three (3) rural counties in northeast Indiana.Allen County VeggieRx expansion: Providers and interested individuals have shown enough of an interest in adding individuals (children and adults) with obesity that VeggieRx staff prioritized this diagnosis as the next to be added to the qualifying health conditions for program participation. In fact, two minors with obesity interested in the program were turned away because of program ineligibility. The expansion will include serving 150 additional Allen County individuals (75 each year in years two and three of this award) who have obesity - children or adults, following the same provider referral process as in the original VeggieRx program. Each participant will receive $50 per month for six months, just as participants in the original VeggieRx program. As the program expands to include obesity as a qualifying health condition, we anticipate that the diversity of participants will expand, too. Adding .4 FTE (thereby increasing the 10-month .6 FTE VeggieRx Coordinator provided in the original VeggieRx USDA PPR award to a 12-month 1.0 FTE), .2 FTE dietitian, continuing debit card provider fees (adhering to 2 CFR 200.320, through Federally-regulated procurement standards), $50/debit card/month x 6 months for each participant, data evaluation, staff training, and staff mileage will support the addition of participants in Allen County.