Increasing Fruits and vegetable consumption among SNAP recipients through an innovative prescription program: Appalachian Farmacy

Introduction: Food insecurity prevalence in Washington County, TN is 14.3% yet 61% of SNAP eligible residents are food insecure. Food insecurity is associated with inadequate consumption of fruits and vegetables, as well as increased risk of chronic disease. Tennessee ranks 47th in the Nation with only 6.7% consuming the recommended fruits and vegetable intake. The Farmacy Pilot Program was developed to encourage increased consumption of produce and to reduce food insecurity among SNAP recipients. Methods: This program provided vouchers to SNAP recipients and their families to buy fresh fruits and vegetables at the farmers market and in the grocery store as a monthly prescription. Participants were recruited from a clinic and two community centers in Washington County. Participants were given $28 - $112 a month depending on household size. Participants were required to attend at least two nutrition classes. Baseline and 6-month follow up assessments were done of food intake patterns among 29 participants, and focus groups were held (n= 11) and a total of 22 interviews conducted. Mixed methods approach was used for analysis: survey data was analyzed on SPSS and thematic analysis conducted for the qualitative data. Results: Major themes that emerged were: decreased cost of produce, increased positive perception of fruits and vegetables, improved perception of their personal health after change in diet, and increased utilization of farmers markets. Barriers identified were cultural and language hurdles, market variability in cost and quality of produce, and transportation. Survey findings included increased intake of green vegetables (t= -2.13, p =.042). Other findings lacked statistical power to detect significance yet were of clinical significance: improvements in frequency of produce consumption, produce variety, and a reduction in food insecurity. Discussion: Providing additional funds targeted on fresh produce can increase food security and increased quantity, frequency and variety of fruits and vegetables consumed. Promoting utilization of farmers market offers a promising avenue for increased consumption of fresh produce and improved social connectedness in the community