Project Overview: Deeply entrenched poverty, limited transportation options, and vast food deserts pose considerable health risks to many communities in Idaho, contributing to and exacerbating diabetes and other medical conditions. The 1st and 16th street neighborhoods of Nampa are no exception; at the Terry Reilly Health Services locations serving these communities, the proportion of patients with poor diabetes control is far in excess of the statewide average, and many people report poor or fair health. In an effort to address the problem, Idaho Primary Care Association (IPCA) is working with Terry Reilly Health Services (TRHS) and other community partners to launch a Fruit and Vegetable Prescription Program (FVRx), an evidence-based program that promotes access to healthful, nutritious food through partnerships between healthcare providers, local food suppliers and community members. The program will initially target patients with uncontrolled diabetes and other co-morbidities and their family members. In year two, IPCA will support the continuation of the FVRx program at TRHS, while extending the project to Valley Family Health Care (VFHC).
The goal of the project is to improve health outcomes for high-risk patients with diabetes and other chronic conditions by improving access to healthful and nutritious foods.
Project objectives are to:
- Improve patient health by allowing providers to prescribe fruits and vegetables as part of a nutritious diet;
- Empower patients to adopt new eating patterns and develop cooking skills required to create lasting lifestyle changes; and
- Benefit local retailers and farmers by increasing demand for fruits and vegetables to sustain access to wholesome and nutritious food.
2018-2019 Project Outcomes:
- Enrolled a total of 174 patients in the three 12-week sessions;
- Of the 174 enrolled patients, 108 (62%) received nutrition education from a dietician through either a one-on-one session or group appointment, or during a cooking class, qualifying them to receive free produce at the weekly produce market;
- Eighty-five (85) of the 108 eligible patients (78.7%) attended the weekly produce market at least four times over the course of the program to acquire free produce;
- For this group of 85 patients (those who both attended a RDN individual or group appointment or cooking class, AND visited the produce market at least four times over the course of the program), there was an average reduction in HbA1c of 1.6%. Of this group, 38 patients (44.7%) reduced their BMI;
- Through partnership with the Boise Mobile Farmers Market, provided access to fresh fruits and vegetables for participants in the first program session. The program was beneficial to the market as well as to the participants: the partnership increased produce sales at the Boise Mobile Farmers Market mobile market by 27.8%, including approximately $5,527 paid to local farmers, and approximately $1,843 to help support the Mobile Market.
2019-2020 Expected Project Activities:
- Continue the FVRx program at TRHS, focusing on high-risk diabetic patients with A1C>8.0%;
- Spread FVRx pilot program to Valley Family Health Care’s Payette health center site. Participation may be extended beyond the Payette location to meet the target enrollment goal;
- Educate providers on FVRx program and provide training on how to enroll eligible patients;
- Distribute FVRx coupons to be redeemed for fresh fruits and vegetables at the Boise Mobile Farmers Market and Pantera Market;
- Identify billable registered dietitian services and determine steps needed for billing;
- Conduct an evaluation of the project to assess outcomes; and
- Share best practices and challenges with other CHCs in Idaho to inform them about the FVRx program, promote food security, and share model policies and procedures.
Project Partners: InvestHealth Nampa, Boise Mobile Farmer’s Market, Saint Luke’s Health System, St. Alphonsus Regional Medical Center, Idaho Healthcare Coalition, HealthComm Solutions, Terry Reilly Health Services, Valley Family Health Care.
About the Grantee
The Idaho Primary Care Association (IPCA) has been the leading state advocate for community-based health care programs since 1983. The association plays a vital role in educating federal, state and local policy makers about issues relating to health care and the role of community health centers. The IPCA also provides training and technical assistance to Idaho’s community health centers in the areas of community development, quality improvement, workforce development and health center operations. For more information, visit www.idahopca.org.