Produce prescription (FVRx) programs: a systematic review
Date
2023
Authors
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Publisher
University of Delaware
Abstract
Produce prescription (FVRx) programs have been established to support the consumption of fruits and vegetables (FVs), particularly among individuals at risk for diet-related chronic diseases or food insecurity through referral by a healthcare provider. To date, published literature on food prescription programs solely focused on FVs has not been synthesized. Thus, the purpose of this study was to conduct a systematic review among children and adults to examine if FVRx programs improve food security, increase FV intake, and/or improve cardiovascular disease risk factors. ☐ A systematic review with searches across three databases was conducted. All records were uploaded into Covidence, a systematic review management software program. Duplicates were removed and selection of studies was determined based on review of the title/abstract and subsequent review of full-text articles by two independent reviewers. Disagreements were resolved by consensus with a third reviewer. Eligibility criteria included studies published in the US in English between August 2012-2022. Eligible studies had to include exposure to a FVRx program defined as enrolled participants with or at risk for a diet-related chronic disease and/or food insecurity, referral by a healthcare provider or identified through a healthcare facility, and use of a monetary prescription redeemed at a farmers’ market and/or grocery stores and an outcome of food security and/or FV intake and/or cardiovascular risk factors. Reported data were extracted from eligible articles and synthesized. ☐ A total of 949 records were identified and 241 duplicates were automatically removed. Of the 708 titles/abstracts reviewed, 47 were identified for full text review. Nineteen studies were selected for inclusion with one additional study identified from the handsearching of references of eligible articles. All 5 of the 14 studies that measured food security and conducted inferential statistics reported an improvement in food security. Mixed findings were reported for fruit, vegetable, and FV intake. A total of 8 studies assessed at least 1 cardiovascular disease risk factor with mixed findings reported for HbA1c and less evidence supporting improvements in blood pressure and blood lipids. FVRx programs appear to offer an opportunity to improve food security, a key social determinant of health associated with chronic disease. FVRx programs may also contribute to increased intake of FVs and improved HbA1c; however, more research with stronger study designs and assessment measures are needed.
Description
Keywords
Produce prescription programs, Chronic diseases, Food insecurity, Healthcare facility