Progress 09/15/23 to 09/14/24
Outputs
Target Audience:The project seeks to bring the benefits of consuming fresh fruits and vegetables to New Orleans and Baton Rouge residents who are Medicaid-eligible and living with a chronic disease, in an effort to improve health, increase food access, and reduce healthcare use. Though Market Umbrella is a New Orleans-based organization, a vital component of this project is directing residents to local resources, including Baton Rouge farmers markets to purchase fruits and vegetables once the program has concluded. In an effort to strengthen the local food system to sustain improvements to food access achieved during this project, Market Umbrella will establish relationships with health organizations in Baton Rouge, as we have in New Orleans.To be eligible to enter into the program, participants would be identified by the clinic representative as meeting the program eligibility: Medicaid-eligible, food insecure, and at risk for or managing a diet related health condition such as prediabetes, diabetes, heart disease, and hypertension. Further analysis will be conducted to invite program participants who are in zip codes eligible for home produce delivery via Top Box Foods Louisiana. The Clinical partners have a sufficient population of patients in both cities that would meet the criteria above. Changes/Problems:With the departure of our executive director and other key staff members, including our finance director, the year posed challenges related to leadership, institutional knowledge, and financial oversight. To overcome these, we made internal promotions and hired new staff to strengthen our team and ensure continued program progress. A major logistical challenge occurred with the delivery of produce boxes, caused by vehicle malfunctions and repairs, which delayed recruitment for the next cohort. Seasonal variability of fresh produce, particularly during the summer, also added to the challenges. Despite these setbacks, we remain committed to the success of the program. We are focused on resolving these issues and ensuring the integrity of the project moving forward, with special reporting requirements outlined in the award Terms and Conditions being closely adhered to. What opportunities for training and professional development has the project provided?The project has provided several valuable opportunities for training and professional development. The project facilitated attendance at various conferences and mini convenings, offering team members insights into the latest trends and best practices in health and nutrition programs. Participants gained exposure to new methodologies and strategies to improve program outcomes. Furthermore, the project provided the opportunity to be actively involved in a research study, allowing team members to contribute to the evaluation of the Produce Prescription Program (PPR) and gain hands-on experience in research design and data collection. These experiences have equipped the project team with essential skills and knowledge, enhancing both their professional development and the program's overall impact. 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?In the upcoming project year, the program will continue its collaboration with existing partners to ensure the seamless execution of recruitment, enrollment, data collection, and produce box distribution. Regular meetings with partners and the NTAE will persist to address challenges and optimize the program's effectiveness. Additionally, efforts will be made to onboard a new clinic, expanding the program's reach and services. The program will also focus on recruiting new participants and establishing partnerships with additional organizations to broaden its impact. Overall, the next reporting period will emphasize enhanced collaboration, rigorous evaluation, and targeted strategies to improve the health and well-being of Medicaid-eligible residents in New Orleans and Baton Rouge.
Impacts
What was accomplished under these goals?
During this project year (PY), we made significant progress toward achieving the goals outlined in our ADA grant. We successfully established implementation and evaluation protocols with key partners, including Crescent Care (clinical partner), Dillard University (evaluation support), and Top Box Foods (produce supplier), and executed all required MOUs and DUAs with these partners and the NTAE team. We secured IRB approval through the NTAE's Single IRB (SIRB) to support the Produce Prescription Program (PPR). Beginning in Fall 2023, we held weekly meetings with our partners and the NTAE ADA team to plan and execute a four-day in-person training in New Orleans from October 28 to November 1. Additionally, we collaborated on the first draft of cost analysis worksheets to meet the program's financial goals. In January 2024, we successfully launched the program with 62 participants, initiating enrollment, data collection, and produce box distribution. As the program progressed, we expanded our reach by recruiting three additional clinics in the greater New Orleans area. Moving forward, we aim to make up for lost time from Year 1 by increasing program enrollment and impact.
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Progress 09/15/22 to 09/14/23
Outputs
Target Audience:Theproject seeks to bring the benefits of consuming fresh fruits and vegetables to New Orleans and Baton Rouge residents who are Medicaid-eligible and living with a chronic disease, in an effort to improve health, increase food access, and reduce healthcare use. Though Market Umbrella is a New Orleans-based organization, a vital component of this project is directing residents to local resources, including Baton Rouge farmers markets to purchase fruits and vegetables once the program has concluded. In an effort to strengthen the local food system to sustain improvements to food access achieved during this project, Market Umbrella will establish relationships with health organizations in Baton Rouge, as we have in New Orleans.To be eligible to enter into the program, participants would be identified by the clinicrepresentative as meeting the program eligibility: Medicaid-eligible, food insecure, and at risk for or managing a diet related health condition such as pre-diabetes, diabetes, heart disease, and hypertension. Further analysis will be conducted to invite program participants who are in zip codes eligible for home produce delivery via Top Box Foods Louisiana. The Clinical partnershavea sufficient population of patients in both cities that would meet the criteria above. Changes/Problems:As the Program unfolded, we encountered substantial changes and faced challenges that prompted a reevaluation of our initial approach. These adjustments were necessitated by various factors that influenced the trajectory of the project. Here's a narrative detailing the major changes and the rationale behind them: Partner Attrition:Unexpected partner attrition introduced unforeseen disruptions to the project timeline. Shifts in partner capacitysignificantly impacted the program's overall momentumand launch. In response, we initiated outreach to identify new partners.Despite the challenges, preserving the collaborative spirit remains a top priority, and concerted efforts are underway to ensure a seamless continuation of the program.IRB Process:The Institutional Review Board (IRB) approval process encountered unanticipated challenges, leading to delays in obtaining the required ethical clearance for the project. Acknowledging the importance of ethical standards, we have actively collaborated with the NTAE's SIRB to expedite the IRB approval process. Although these delays were beyond our control, we are committed to aligning project activities with approved protocols and maintaining the highest ethical standards.Participation in ADA Study:The decision to participate in the American Diabetes Association (ADA) study introduced complexities and specific requirements that influenced the overall design and execution of the project. Embracing this opportunity, we incorporated the study's unique reporting and evaluation criteria into our project plan. This collaboration not only enhances the scientific rigor of our evaluation but also contributes valuable insights to the broader understanding of produce prescription programs.Staff Turnover with Departure of Executive Director and Key Staff:The departure of our executive director and two key staff members presented challenges related to project continuity,leadership, and institutional knowledge. In response, we have addressedstaff capacity with internal promotions and new hires. Amidst these changes and challenges, our commitment to the success of the Program remains unwavering. We recognize the significance of transparent communication and adaptability in navigating unforeseen circumstances. Special reporting requirements specified in the award Terms and Conditions will be diligently adhered to, offering detailed updates on the resolution of these challenges and the strategies employed to maintain the project's integrity. What opportunities for training and professional development has the project provided? The project has opened valuable avenues for training and professional development, fostering continuous growth and expertise enhancement. One notable opportunity was the attendance at the GusNIP mini convening in Chicago, where practitioners convened to share insights, experiences, and best practices. This gathering served as a rich platform for learning, enabling the exchange of ideas and innovative approaches in the field. Moreover, participation in the American Public Health Association (APHA) conference was a pivotal experience. This conference not only provided a broader perspective on the latest advancements in public health but also offered a unique opportunity to delve into best practices for implementation and collaboration with clinical partners. Engaging with experts and thought leaders at APHA facilitated a deeper understanding of effective strategies, thereby enriching the project's methodology and approach. Both events underscored the project's commitment to staying abreast of industry trends and leveraging external knowledge to refine practices. These professional development opportunities have not only contributed to individual skill sets but have also enhanced the project's overall effectiveness by incorporating cutting-edge insights and fostering a network of collaborative partnerships. The project has opened valuable avenues for training and professional development, fostering continuous growth and expertise enhancement. One notable opportunity was the attendance at the GusNIP mini convening in Chicago, where practitioners convened to share insights, experiences, and best practices. This gathering served as a rich platform for learning, enabling the exchange of ideas and innovative approaches in the field. Moreover, participation in the American Public Health Association (APHA) conference was a pivotal experience. This conference not only provided a broader perspective on the latest advancements in public health but also offered a unique opportunity to delve into best practices for implementation and collaboration with clinical partners. Engaging with experts and thought leaders at APHA facilitated a deeper understanding of effective strategies, thereby enriching the project's methodology and approach. Both events underscored the project's commitment to staying abreast of industry trends and leveraging external knowledge to refine practices. These professional development opportunities have not only contributed to individual skill sets but have also enhanced the project's overall effectiveness by incorporating cutting-edge insights and fostering a network of collaborative partnerships. 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?Throughout the next project year, the program will continue its collaboration with partners, ensuring the seamless execution of recruitment, enrollment, data collection, and produce box distribution. Regular meetings with partners and the NTAE will persist, maintaining a collaborative approach to address any challenges and optimize the program's effectiveness. In summary, the upcoming reporting period will witness a concerted effort to achieve the program's goals through enhanced collaboration, rigorous evaluation, and targeted strategies to improve the health and well-being of Medicaid-eligible residents in New Orleans and Baton Rouge.
Impacts
What was accomplished under these goals?
Beginning in early 2023, MU has been collaborating with the NTAE and is participating as one of 5 partners selected for a 3-year study supported by an American Diabetes Association (ADA) grant to examine the impact and effectiveness of produce prescriptions. These augmented funds will support a more scientifically rigorous evaluation of the VeggieRx program through: 1) the establishment of a comparable control group of patients receiving "standard of care", outcomes of whom will be compared to PPR participant outcomes, 2) enhanced survey modules focusing on diabetes-related outcomes (e.g., Diabetes Distress) and clinical measurements (e.g., HbA1c, weight), 3) collection of meaningful health utilization and associated costs measures of PPR participants (e.g., # of missed medical appointments, # of dietitian-led diabetes education classes, # of well-visits attended) to understand potential PPR impacts on these measures, 4) qualitative exploration to understand key stakeholder perspectives of PPR program engagement, 5) a program cost analysis to understand the total costs of implementing GusNIP PPR, and 6) a cost-effectiveness analysis to compare the costs of implementing PPR versus "standard of care" on glycemic outcomes (i.e., HbA1c) and health-related quality of life of patients with type 2 diabetes. Goals #5 and #6 will be completed by (1) extract cost (and/or charge) and utilization data for individuals enrolled in the PPR before, during, and after participation, and (2) link that cost (and/or charge) and utilization data with clinical data (from electronic health records) and participant-level core metrics survey data. Funding from this ADA grant do not overlap with GusNIP funding. MU will continue to cooperate with the core evaluation of GusNIP programs and the NTAE, by collecting core shared firm- and participant-level measures, as outlined by NTAE. Through increased active collaboration and cooperation with the NTAE and a supplementary ADA-funded research study of diabetes-related outcomes (NTAE-led) MU not only will be able to systematically evaluate MU's VeggieRx program through a shared core evaluation of GusNIP PPRs on FVI and Food Security of PPR participants, but also through a shared evaluation of a GusNIP PPR programs on diabetes-related outcomes, including healthcare use and costs, of patients with diabetes. In this way, MU will contribute to a better understanding of the impact of produce prescription programs on GusNIP priority objectives: health care outcomes, costs, and utilization. These findings are a key contribution to understanding the proof of concept of PPR programs, findings of which may have tremendous implications for sustained funding for PPRs through adoption of such programs into healthcare and agricultural policy. During this project year (PY), we accomplished several key tasks as required by the ADA grant including: establishing project implementation and evaluation protocols with clinical partner (Crescent Care), university-based evaluation support (Dillard University), and produce supplier (Top Box Foods). We executed all required MOU/DUAs with these partners and the NTAE as required. We secured IRB approval through the NTAE's SIRB (single IRB) to support both our entire PPR project. We met with aforementioned partners and NTAE ADA team on a weekly basis starting in Fall 2023 to plan a robust 4 day, in-person training held October 28 - November 1, 2023 in New Orleans. We collaborated with partners to complete the first draft of cost analysis worksheets as required to meet program cost goals of the ADA project. We launched program recruitment, enrollment, data collection, and produce box distribution during the first week of January 2024.
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