Recipient Organization
COUNTY OF HUDSON
567 PAVONIA AVE
JERSEY CITY,NJ 07306
Performing Department
(N/A)
Non Technical Summary
An estimated 12.2% of Hudson County residents live in food insecure homes and lack access to nutritious food needed to support good health (Feeding America, 2022). The reduced access to healthy food puts these individuals at an increased risk for developing or worsening symptoms of chronic conditions including prediabetes, diabetes and hypertension which are linked to higher healthcare costs. The Hudson County Produce Prescription and Food Pharmacies Initiative will utilize USDA funds to operate a produce prescription and food pharmacy model in partnership with three local federally qualified health centers (FQHCs) serving low-income patients in the Hudson County area: Alliance Community Healthcare, Metropolitan Family Health Network, and North Hudson Community Action. Through the proposed project, Hudson County and partnering health clinics will develop on-site food pharmacies, where patients receiving produce prescriptions can redeem vouchers on a regular basis for free fruits and vegetables. Vouchers will be distributed via a referral system in which a healthcare provider has provided a diagnosis for prediabetes, diabetes and hypertension. Project evaluation will include monitoring of blood pressure, blood sugar levels, blood lipid levels, and weight over time. Further, the proposed program will provide participating patients with comprehensive nutrition education and other non-financial incentives for healthier eating via partnership with the Rutgers University Cooperative Extension to build sustainable, healthy habits among patients. Additional health and quality of life metrics that will be tracked and measured among participants include increased food and nutrition security, improved understanding of healthy eating, intention to continue eating more fruits and vegetables, and adherence to and utilization of healthcare plans. Hudson County will also partner with the Rutgers University Department of Family and Community Health Sciences to conduct rigorous project evaluation which will be supported by consistent, thorough data collection and reporting by healthcare providers. The research and evaluation completed by Rutgers will yield new evidence of the effectiveness of produce prescription programs and demonstrate the value of community-driven incentives to increase fruit and vegetable intake among undeserved, food insecure groups.
Animal Health Component
65%
Research Effort Categories
Basic
15%
Applied
65%
Developmental
20%
Goals / Objectives
The major goals of this project are to improve dietary health, decrease rates of food insecurity, and reduce healthcare costs and utilization by providing low-income individuals that suffer from, or are at risk of developing, diet-related health conditions with fresh produce and nutrition education programming. Establishing produce prescription programs with on-site food pharmacies at three of the county's federally qualified health centers (FQHC's) will allow Hudson County to address some of the social determinants of health by aiding in the improvement of dietary health through increased consumption of fruits and vegetables. By partnering with local FQHCs and obtaining direct access to the population in need, the proposed food pharmacies will increase the accessibility of fresh fruits and vegetables to low-income residents in Hudson County, thus improving food security. Engaging patients in preventative care and teaching healthy eating behaviors will help reduce long-term medical costs to patients and providers and decrease the utilization of emergency care and prescription drugs. The program goals can be broken down into three areas of focus:Focus Area 1: The improvement of dietary health through increased consumption of fruits and vegetablesObjective 1.1: Establish produce prescription programs with on-site food pharmacies at three of the county's federally qualified health centers (FQHCs): (1) Alliance Community Healthcare, (2) North Hudson Community Action Corporation, and (3) Metropolitan Family Health Network.Objective 1.2: Offer bi-weekly nutrition education classes to support reports of increased nutritional knowledge from an estimated 80% of participants.Objective 1.3: Provide regular distributions of produce to promote an increase in reported produce intake by at least 20%Objective 1.4: Monitor the impact of a fruit and vegetable-rich diet to see improvements in health indicators such as reduction in the utilization of healthcare visits as well as positive changes in anthropometric measurements, blood pressure, blood glucose levels and blood lipid levels.Focus Area 2: The reduction of individual and household food insecurityObjective 2.1: Provide each participant with $80 in produce vouchers per month ($40 voucher provided at bi-weekly nutrition education sessions) to support regular purchases of fresh produce.Objective 2.2: Promote program utilization to produce improved food security and lowered perceived risk for at least 50% of participants based on responses to either 2-item hunger vital sign or 6-item short form USDA-FSSM.Objective 2.3: At the end of the first year, participants and their families should be enrolled in food assistance benefits to sustain household food security.Focus Area 3: The reduction in healthcare use and associated costsObjective 3.1: Increase reported adherence to and utilization of health care plans for at least 30% of participants by implementing nutrition education and improving access to nutritious food.Objective 3.2: Promote improvements in self-efficacy by increasing nutrition knowledge, fostering environmental support and reducing barriers to a nutritious diet so that 80% of participants will report intention to adopt and maintain diet behaviors to improve health outcomes.
Project Methods
Planning:Purchase refrigerators to be installed at health clinics to create on-site food pharmacies.Develop a referral system and protocols for physicians to write the Produce Prescriptions.Establish schedule for produce deliveries (will be completed via Mercy for My Neighbor, who will transport the produce from a local grocery wholesaler).Establish procedures for partnering health clinics to report programmatic data.Implementation:Hire a part-time Registered Dietitian to work one day at each participating clinic per week.225 unduplicated patients (estimated 75 per clinic) will receive $40 produce vouchers on a bi-monthly basis ($80 per month) in alignment with nutrition education classes.225 unduplicated patients will have access to nutrition education classes on a bi-monthly basisHands-on instruction in food as medicine will be provided. Curriculum will be tailored based on participant needs, demographics and stages of behavior change.Weekly stocking of the three food pharmacies by Mercy for My Neighbor with a variety of fresh, nutrient-rich, and local produceData from smart refrigerators will be evaluated on a quarterly basis to determine purchasing patterns, allowing for stocking strategy to be adjusted as appropriate.One-on-one and group nutrition planning with a registered dietitian to develop recipe ideas and strategies to incorporate more nutritious options into their diet for themselves and their households.Evaluation:Clinics will collect baseline data on participating patients that are enrolled in the Produce Prescription program including height and weight, HbA1c Levels, Blood Lipid Levels and food security (using either 2-item hunger vital sign or 6-item short form USDA-FSSM). Participants will also participate in focus groups or complete questionnaires which will be used to measure progress in nutrition knowledge, attitudes toward healthy eating, self-efficacy, and commitment to adhere to health behaviors.Clinics will collect quarterly data and final data on patient progress.Medical costs and healthcare utilization will be assessed based on provider and patient reportingRutgers will perform all data analysis related to the Produce Prescription Program and provide our office with project evaluation reports detailing information on patient outcomes quarterly and a final report detailing the overall impact of the program at the culmination of grant funding.Research analysis and program evaluation will allow for the creation of guidelines and best practices to be used by other municipalities or organizations to establish their own Produce Prescription programs and food pharmacies.