FRESHRX NEW MEXICO ENHANEMENT

• Sponsoring Institution: National Institute of Food and Agriculture
• Project Status: ACTIVE
• Funding Source: OTHER GRANTS
• Reporting Frequency: Annual
• Accession No.: 1029144
• Grant No.: 2022-70423-38069
• Cumulative Award Amt.: $499,984.00
• Proposal No.: 2022-06761
• Project Start Date: Aug 15, 2022
• Project End Date: Aug 14, 2025
• Grant Year: 2022
• Program Code: [PPR]- Produce Prescription

Recipient Organization
NEW MEXICO FARMERS MARKETING ASSOCIATION
731 MONTEZ ST
SANTA FE,NM 87501

Performing Department
(N/A)

Non Technical Summary
The FreshRx New Mexico Enhancement project will significantly increase the reach of the New Mexico Farmers' Marketing Association's (NMFMA's) current produce prescription program that supports rural and underserved low-income healthcare patients with incentives and nutrition education to increase their consumption of fresh New Mexico grown fruits and vegetables. The Enhancement project will more than double the total number of participants by reaching: 954 new patients over three years, in 11 new communities, all of which are rural plus one American Indian pueblo. Additionally, the Enhancement project will allow the NMFMA to expand support for community healthcare workers (CHWs), and to increase nutrition education through our healthy eating text message platform. At the same time, the NMFMA will substantially expand its evaluation work through an American Diabetes Association (ADA) funded NTAE diabetes pilot project, to advance knowledge on the impacts of PPR on primary GusNIP outcomes, fruit and vegetable intake, food security, health and healthcare utilization and costs, among patients with type 2 diabetes. As presented in the original grant, New Mexico is a poor state with especially high rates of food insecurity and preventable diseases such as obesity, diabetes and hypertension. Recent spikes in inflation have made putting fresh food on the table even harder for many. The NMFMA's close ties with all the state's farmers' markets and food hubs, along with solid health clinic relationships provide fertile ground for expanding this work. By targeting a combination of current clinic partners and new partners, we will both be able to start immediately in 2022 with those partners already up and running, as well as expand to new communities beginning in 2023. The Expansion will focus on several goals and objectives. The goals are to: 1) Expand reach; 2) Enhance engagement; and 3) Improve evaluation.

Animal Health Component

50%

Research Effort Categories

Basic

50%

Applied

50%

Developmental

(N/A)

Classification

Knowledge Area (KA)	Subject of Investigation (SOI)	Field of Science (FOS)	Percent
704	6099	1010	100%

Knowledge Area
704 - Nutrition and Hunger in the Population;

Subject Of Investigation
6099 - People and communities, general/other;

Field Of Science
1010 - Nutrition and metabolism;

Keywords

fresh local food

healthy food

nutrition

nutrition incentives

Goals / Objectives
The FreshRx New Mexico Enhancement project will significantly increase the reach of the New Mexico Farmers' Marketing Association's (NMFMA's) current produce prescription program that supports rural and underserved low-income healthcare patients with incentives and nutrition education to increase their consumption of fresh New Mexico grown fruits and vegetables. The Enhancement project will more than double the total number of participants by reaching: 954 new patients over three years, in 11 new communities, all of which are rural plus one American Indian pueblo. Additionally, the Enhancement project will allow the NMFMA to expand support for community healthcare workers (CHWs), and to increase nutrition education through our healthy eating text message platform. At the same time, the NMFMA will substantially expand its evaluation work through an American Diabetes Association (ADA) funded NTAE diabetes pilot project, to advance knowledge on the impacts of PPR on primary GusNIP outcomes, fruit and vegetable intake, food security, health and healthcare utilization and costs, among patients with type 2 diabetes.

Project Methods
Methods for the project include:• Expanding patients at current clinic partners (90 patients total), allowing three current clinic partners to reach new clinics within their networks (70 patients), and partnering with 13 new clinics (two partner networkds) to expand in 11 new rural communities (274 patients)• Expanding support for community healthcare workers (CHWs), and to increase nutrition education through our healthy eating text message platform.• Engaging senior at American India Taos Publeo Health and Community Services through a local food box pilot.• Expanding communication with patients including new bilingualwelcome packets, GoodFoodNM text messages, tours at farmers markets with CHWs, and cooking classes for wrap-around support.• Expanding ourevaluation work through an American Diabetes Association (ADA) funded NTAE diabetes pilot project, to advance knowledge on the impacts of PPR on primary GusNIP outcomes, fruit and vegetable intake, food security, health and healthcare utilization and costs, among patients with type 2 diabetes.

Progress 08/15/22 to 08/14/23

Outputs
Target Audience:FreshRx participants are low-income New Mexicans with diet-related conditions such as diabetes, high blood pressure and obesity. Participants are enrolled by healthcare providers, the majority of whom are Federally Qualified Health Centers. These clinics serve a predominantly Hispanic population, and the majority of participants identified as Hispanic. In addition, a subset of FreshRx participants during this reporting period were Native American. These participants were enrolled through diabetes prevention and education programs on Taos Pueblo and at First Nations Community HealthSource in Albuquerque. Both the Hispanic population and the Native populations have been targeted due to the health disparities these groups continue to face, with persistently high levels of food insecurity and diet related health conditions. Further, FreshRx targets the farm direct markets across the state of New Mexico, with incentives redeemed at farmers' markets and through local food hubs. The farm direct market is targeted in order to maximize the economic impact of the food dollars associated with the program, and to reach communities where access to fresh produce is often limited. Farm direct markets in Native communities are targeted in particular in order to promote food sovereignty, as well as economic development in these areas.? Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? All farmers' market managers, food hub managers and vendors receive in person or virtual training on how to implement the program in their particular setting. All FreshRx champions at clinic sites receive one on one and virtual training on how to implement the program, including enrollment of participants, monthly and annual reporting. All FreshRx champions are invited to attend cooking demonstrations and classes provided to participants. Community health workers supporting the work of the American Diabetes Association study received training needed to implement the program, including training on best practices for obtaining patient consent, administering surveys, enrolling, and supporting patients in keeping with the guidelines of the study. How have the results been disseminated to communities of interest? Results are shared with champions and clinic partners during one-on-one meetings, as well as at online Community of Practice meetings. An in person community of practice will be convened for Native American healthcare providers to both disseminate results and improve program design. Results are shared with market managers at the NMFMA's annual conference. The NMFMA has conducted evaluation, including interviews, and surveys with clinic partners, and these results will be shared in July 2024, at an upcoming state-wide Food is Medicine Summit in September 2024 and at the NMFMA's annual conference in March, 2025. What do you plan to do during the next reporting period to accomplish the goals? The majority of the remaining funding for incentives will be used to support the American Diabetes Association study through Presbyterian Health Services in Santa Fe. Participants will receive CSA type bags of produce each week for 16 weeks. Subsequently, a control group will receive vouchers to be used at participating farmers' markets. Participants in the American Diabetes Association Study, both in the intervention and control groups, will continue to receive nutrition education, including cooking classes offered through Presbyterian Community Health. During the off-season, two new clinic partners will enroll participants to receive CSA type bags.

Impacts
What was accomplished under these goals? 455 participants were enrolled and received incentives for fresh fruits and vegetables. Five new clinic sites implemented FreshRx during this period, and two existing sites expanded the number of participants. Participants from Taos Pueblo were enrolled and produce provided to them by the Native led Red Willow Center. Participants from the Native led First Nations Community Health Source were enrolled, and produce was provided to them by a Native farmer from a neighboring Pueblo. American Diabetes Association study launched. In addition to existing partners, two new food hubs, one new farm, and one new farmers' market provided food for the incentives.

Publications