Source: YMCA METROPOLITAN WASHINGTON submitted to NRP
YMCA PRODUCE PRESCRIPTION PROJECT (YPRX)
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
ACTIVE
Funding Source
Reporting Frequency
Annual
Accession No.
1029383
Grant No.
2022-70424-38459
Cumulative Award Amt.
$500,000.00
Proposal No.
2022-07030
Multistate No.
(N/A)
Project Start Date
Sep 15, 2022
Project End Date
Sep 14, 2026
Grant Year
2022
Program Code
[PPR]- Produce Prescription
Recipient Organization
YMCA METROPOLITAN WASHINGTON
1112 16TH ST NW STE 720
WASHINGTON,DC 200364824
Performing Department
(N/A)
Non Technical Summary
The YMCA Produce Prescription (YPRx) project is a collaboration between the YMCA of Metropolitan Washington, Mary's Center, (a federally qualified health center (FQHC)), Hungry Harvest, Carefirst BlueCross BlueShield Community Health Plan (a Medicaid managed care organization (MCO)), and the Johns Hopkins Bloomberg School of Public Health (JHSPH). YPRx will 1) address diet quality and food insecurity among Medicaid-enrolled adults with prediabetes and 2) evaluate potential systems-level enhancements to PRPs in decreasing healthcare utilization affiliated with food insecurity and diet-related diseases. YPRx participants are Mary's Center patients who are enrolled in Carefirst Medicaid and are prediabetic.YPRx is a randomized control study with two cohorts:Intervention: 75 adults who will concurrently receive weekly deliveries of fresh produce bags and the Diabetes Prevention Program (DPP) for one yearControl: 75 adults who will receive weekly deliveries of produce for one year. Participants will be eligible for DPP after YPRx evaluation.Both cohorts will be compared against aggregate data of prediabetic individuals not enrolled.JHSPH will evaluate YPRx with the goal of answering two questions:What is the impact of adding disease-specific, evidence-based health education to produce prescriptions on participants' health?What are best practices among FQHCs and MCOs in reducing health system utilization associated with food insecurity and diet-related diseases?
Animal Health Component
(N/A)
Research Effort Categories
Basic
60%
Applied
(N/A)
Developmental
40%
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
7036099101025%
7046099308025%
7246099101025%
8056099000125%
Goals / Objectives
There are two goals of the YPRx. By September 2025, YPrx will: Increase health outcomes and individual and household food security among 150 pre-diabetic Medicaid recipients, and Decrease healthcare use of food insecurity and diet-related diseases through a care coordination model between providers, community-based organizations and Medicaid Managed Care. Johns Hopkins Bloomberg School of Public Health will evaluate YPRx with the goal of answering two questions:What is the impact of adding disease-specific, evidence-based health education to produce prescriptions on participants' health?What are best practices among FQHCs and MCOs in reducing health system utilization associated with food insecurity and diet-related diseases?
Project Methods
JHSPH will use mixed-methods to evaluate impact on individuals and healthcare systems. Individual metrics include: food security, dietary intake, food choices/behaviors, weight change, physical activity, and HbA1c. System metrics include health system utilization. Qualitative evaluation will identify the most impactful roles of CBOs, FQHCs, and MCOs in Produce Prescription Programs.Process Evaluation:A process evaluation will be conducted throughout the entire program and will monitor the YPRx program processes and challenges. Metrics will be tracked via WELLD and Hungry Harvest's data, and will include: # of participants referred to YPRx from Carefirst, # of participants enrolled, # of participants who completed the program, boxes of produce distributed, and ease of operations. Participant surveys will be distributed during and upon completion of YPRx to evaluate their experience during and after YPRx. JHSPH will also conduct interviews with program leads from each organization and qualitative line-by-line coding and thematic analysis will be used to learn about each organization's experience with YPRx implementation and administration.Outcome evaluation:An outcome evaluation will be conducted to assess the effectiveness of YPRx on individual health outcomes and healthcare utilization. Data for the outcome evaluation will come from participant surveys, Y participant records in WELLD, and participant medical records and claims data from Carefirst. To evaluate participants' food security, and dietary quality including consumption of fruits and vegetables, JHSPH will disseminate pre and post surveys for all 150 participants to complete before and after their full year of YPRx deliveries. Food insecurity will be measured using the 18-question US Household Food Security Screener Module. Dietary quality will be measured using the NCI Dietary Screener. To evaluate positive health outcomes of YPRx, including weight, physical activity and HBa1c, JHSPH will use data tracked by the Y via WELLD.

Progress 09/15/23 to 09/14/24

Outputs
Target Audience:The project implementation has not yet started due to delays in IRB approval. Changes/Problems:Our project has experienced a significant delay due to delays in IRB approval. Our initial partner in this project, Carefirst Medicaid of DC, lost their contract with Washington DC early 2023. As such, the Y had to find a new Medicaid partner and enter an intensive MOU process. This process was completed with Amerigroup DC in March 2024. Once complete, the Y then had to coordinate the IRB process with Amerigroup and Johns Hopkins. We experienced another hurdle in September 2024, when Johns Hopkins told us they couldn't continue with the IRB because the Y did not have a FWA (we did not know this requirement), and they were not the principle investigator of this project. We then worked with our TA from the Gretchen Swanson Center to convince Johns Hopkins continue with the evaluation, and the Y applied for FWA. Thus, the final submission of the IRB occured in early November, and final approval was received in late November. What opportunities for training and professional development has the project provided?The project implementation has not yet started due to delays in IRB approval. How have the results been disseminated to communities of interest?The project implementation has not yet started due to delays in IRB approval. What do you plan to do during the next reporting period to accomplish the goals?IRB approval has just been received in late November 2023. As such, we plan to begin implementation of our project. During the next reporting period, we anticipate increasing health outcomes and individual and household food security among 150 pre-diabetic Medicaid recipients, and decreasinghealthcare use of food insecurity and diet-related diseases through a care coordination model between providers, community-based organizations and Medicaid Managed Care.

Impacts
What was accomplished under these goals? The project implementation has not yet started due to delays in IRB approval.

Publications


    Progress 09/15/22 to 09/14/23

    Outputs
    (N/A)

    Impacts
    What was accomplished under these goals? Project has not yet started. This reporting period was dedicated to capacity building. During this time we have finalized MOUs, operations and the IRB.

    Publications