Feasibility of Home-Delivery and Voucher-Based Produce Prescription Programs Among Adults with Overweight or Obesity and Nutrition Insecurity

OBJECTIVE: Evaluate the feasibility of 2 produce prescription delivery mechanisms in a two-arm, pilot, randomized controlled trial at a Baltimore community market. PARTICIPANTS: Forty-eight adults with overweight or obesity experiencing nutrition insecurity (65% women, 83% non-Hispanic Black). INTERVENTION(S): Produce vouchers or home-delivered produce boxes for 8-weeks, with behavioral support. VARIABLES MEASURED: Recruitment, retention, fidelity, satisfaction, and changes in nutrition security, diet quality, self-efficacy, weight, and blood pressure. ANALYSIS: The Wilcoxon signed-rank test assessed changes in outcomes. Effect sizes were evaluated using the rank-biserial correlation and Kendall's W. RESULTS: Participant retention (88%), produce prescription redemption (75% to 99%), and satisfaction (93%) were high. Participant engagement in behavioral support varied. Participants had improvements in nutrition security (+0.5, r = 0.87), diet (+3.0, r = 0.50), fruit intake (+0.50, r = 0.64), self-efficacy (+3.0, r = 0.57), and systolic blood pressure (-4.0 mm Hg, r = -0.77). CONCLUSIONS AND IMPLICATIONS: Both delivery mechanisms were feasible and led to improvements in key outcomes. Larger studies are needed to establish effectiveness.