Recipient Organization
BRIGHTER BITES
535 PORTWALL
HOUSTON,TX 77029
Performing Department
(N/A)
Non Technical Summary
The Brighter Bites Produce Prescription program has a mission to tackle the underlying issues and behaviors affecting the health of residents in Galena Park, Texas. By teaming up with healthcare providers (Legacy Community Health), corporate partners (DoorDash), and institutional collaborators (Galena Park ISD), this initiative aims to offer a targeted health solution for children who are at higher risk of dietary-related health problems. The program focuses on increasing access to fresh fruits and vegetables, providing personalized nutrition education, and offering tailored healthcare.The project's goal is to reach 300 individuals in the early stages of developing eating habits, before serious dietary health problems develop. This effort concentrates on pediatric patients aged 3 to 18 who visit the Legacy Health School-Based Health Clinics in Galena Park. The program comprises three main phases: planning and recruitment, direct services, and a wrap-up and evaluation period.The process starts with clinicians prescribing the produce prescription program during routine well-child visits or through outreach based on patients' medical history. Once patients give consent and complete required lab work, they become part of the study. Lab work is standard for patients with a BMI in the 85th percentile or higher. Initial health measurements are taken, and parents or guardians fill out a survey to gather behavioral and dietary information.Enrolled families receive bi-weekly deliveries of produce bags via DoorDash for a total of 32 weeks. During this time, participants are offered monthly virtual nutrition education sessions covering food preparation, recipes, and cooking skills. These sessions use evidence-based materials and follow CATCH and Virtual Culinary Medicine lesson plans led by trained staff.At the end of the 32 weeks, parents complete a post-program survey, and health data is collected during follow-up wellness visits. The program's aim is to boost fruit and vegetable consumption, improve nutrition security, and decrease the risk factors for dietary diseases. By doing so, the reliance on healthcare services and associated costs among low-income families can be reduced. The program's effectiveness is evaluated in terms of food security, behavior changes, health improvements, and decreased health care reliance.Based on the evaluation's outcomes, the Produce Prescription Program could become a permanent part of Brighter Bites' services in line with their strategic plan. Brighter Bites aims to expand its ability to enhance the long-term health of children and families in underserved communities. Their goals include becoming a recognized provider of Food as Medicine initiatives and extending these programs from Houston to all cities they serve nationwide.
Animal Health Component
(N/A)
Research Effort Categories
Basic
100%
Applied
(N/A)
Developmental
(N/A)
Goals / Objectives
The primary goals and objectives of the Brighter bites Produce Prescription Program are to demonstrate and evaluate the impact of this project on:Goal 1: The improvement of dietary health through increased consumption of fruits and vegetables.Objective 1.1, Pediatric Health Outcomes: Improve child health outcomes obtained from chart reviews for the following measures: BMI, blood pressure, hemoglobin A1c, AST, ALT, and lipid panels.Objective 1.2, Adolescent emotional health outcomes: Improve adolescent patient's behavioral and emotional health. Legacy Behavioral Health Therapists will utilize the Patient Health Questionnaire for Adolescents (PHQ-A) in order to evaluate the impact of the Produce Prescription intervention on adolescent patient's behavioral and emotional health.Objective 1.3, Dietary Outcomes: Increased frequency of fruit and vegetable intake, reduced consumption of soda and other sugar-sweetened foods and beverages, increased incidence of meals cooked from scratch. Improve parental dietary intake including fruit and vegetable consumption.Goal 2: The reduction of individual and household food insecurity.Objective 2.1, Household food security and nutrition security: Food security will be measured using the validated two-item Hunger vital sign. Nutrition security will be measured using a four-item validated screener. These items will be self-reported by parents or guardians.Goal 3: The reduction in healthcare use and associated costs.Objective 3.1, Healthcare usage: We will assess healthcare usage and associated costs using tracking data from Legacy, including the number of Well-visits and the number of visits due to illness during the 6 months prior to the intervention, during the intervention, and one-month post-intervention.Objective 3.2, Healthcare usage long-term: Legacy clinicians will also collect and share data from pediatric patients' pre- and post-program annual well-visits, including BMI percentiles, weight, blood pressure, and hemoglobin A1c, ALT, AST, and lipids, demonstrating an improvement in health markers, which can contribute to decreased healthcare utilization and associated costs long-term.
Project Methods
Brighter Bite's programs have a long history of demonstrating positive behavior change and improvements in health outcomes; this project promises similar results while providing several unique advantages beyond BB's core program model. Through a multi-sector collaboration with healthcare providers (Legacy), corporate partners (DoorDash), and institutional partners (Galena Park ISD), this project will leverage the strengths of each partner to provide a targeted health intervention for children most at-risk for developing dietary disease by increasing access to fruits and vegetables, tailored nutrition education, and personalized healthcare.?In order to effectively implement this Produce Prescription Program, BB and Legacy leadership and clinic staff have created an efficient enrollment workflow and project timeline. BB and Legacy aim to enroll approximately 300 individuals, divided across two cohorts, composed of patients from all four clinic locations. This project will have three distinct phases: a four-month planning and recruitment period, September 2023 - December 2023; a 17-month period of direct services beginning in January 2024 and through May 2025, and a three-month wrap-up and evaluation period ending June 2025.A clinician will prescribe eligible pediatric patients the produce prescription program during their routine well-child visit or via outreach after clinicians review historical health records from August 2023. A trained clinic staff member will be responsible for describing the details of the program to the patient and ensuring any questions are answered. The parent/legal guardian will sign a consent form if they agree to participate in this proposed study. After consent is obtained and patients have completed the recommended lab work, patients will be considered enrolled in the study. All lab work is part of the usual standard of care for patients in the 85th BMI percentile or higher. At baseline, chart reviews will be conducted to obtain measures of various health outcomes. Parents/guardians will also be asked to complete a baseline survey to obtain information on behavioral and dietary outcomes.Once enrolled, produce bags will be delivered to families bi-weekly via DoorDash or picked up from the centralized distribution site for a total of 32 weeks (16 doses). BB will be responsible for providing DoorDash with the necessary information through an encrypted server. During the intervention period, monthly virtual nutrition education lessons will be offered to parents where they can learn more about food preparation, recipes, and cooking skills. Trained BB and Nourish (UTHealth) staff members will implement the CATCH and Virtual Culinary Medicine lesson plans using evidence-based materials.At the end of the 32 weeks, parents will be asked to complete a post-program survey. Health data will be collected from follow-up Well-visits post-intervention. Mixed methods qualitative and quantitative methods will be used with parents to assess the acceptability of the program, to gain insight into the experience of families receiving fresh produce bags, to identify possible strategies for program improvement, and to understand how parents perceive that the intervention activities impacted their families. These data will be recorded, transcribed, and stored in secure password-protected computers/servers accessible only to trained staff on the team.