Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
32 participants
OBSERVATIONAL
2016-08-31
2016-12-31
Brief Summary
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To establish the overall feasibility of an effective "prescription produce" program for at-risk and underserved patients - called "ProduceRx" - by utilizing produce from regional farms in addition to the resources of the Penn State Health System and an interdisciplinary team of healthcare workers (dietitians, dietetic interns, and medical students).
To provide a proof-of-concept for this model (i.e. ProduceRx + interdisciplinary approach to health education) for other healthcare institutions.
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Detailed Description
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Patients will be recruited by the abovementioned physicians based on the physicians' interpretation of the two qualifications for the program: "high-risk" or "underserved." Recruiting materials such as informational brochures and advertisement signs (both electronic and printed) will be utilized to help these providers explain the program to qualifying patients without sacrificing time in the office. If selected patients elect to participate in the program, they will visit the ProduceRx website at https://sites.psu.edu/producerx and register for the program. Initial registration will feature an informed consent form to participate in research associated with this program. Patients will have the option of consenting or declining to consent to participation in this research. For those that consent, they will complete their initial survey through REDCap before bring routed to the participating farm's weekly ordering platform. Those patients who decline to consent will be automatically routed to the participating farm's ordering platform to order their first weekly box.
The survey will be a modified version of the CDC's Behavioral Risk Factor Surveillance System Questionnaire (BRFSS). This survey will assess patients' demographic characteristics, as well as health characteristics and behaviors. Demographic variables include age, race/ethnicity, education level, and employment status. Health characteristics include self-reported medical conditions, and height and weight (for calculation of body mass index). The survey will ask participants to self-report fruit and vegetable consumption and perceived barriers to consumption. Level of physical activity will also be monitored throughout the program to see if it is affected by changes in nutrition. Additionally, investigators will measure compliance of patients with the program; compliance will be defined as the number of weeks that patients voluntarily participate (purchase weekly boxes of produce) throughout the program from the time that they register with the program until the end of the pilot in December 2016.
During subsequent weeks, patients will visit the farm's website directly to order their weekly produce boxes. Participants will be asked to complete a post-program questionnaire at the end of the pilot in December 2016. Meanwhile, the main ProduceRx website will function as a platform for nutritional education delivery (delivered by medical students, registered dietitians, dietetic interns, as well as opportunities for other healthcare workers and community members), with links to the program's YouTube cooking/nutrition videos and postings of electronic versions of the printed newsletters. The website will also feature a calendar of upcoming local events, such as nature hikes, outdoor walks, free cooking classes, and farmers' markets, in order to facilitate an overall healthy lifestyle outside of the actual program. Additionally, the website will feature a comments section for participants to ask questions and communicate with one another. This comments section will be monitored to ensure appropriate commenting.
At the end of the program, a focus group will be held at Penn State Hershey Medical Center (PSHMC) to evaluate the functionality/feasibility of the pilot, including logistical convenience, how much produce was utilized each week, and what challenges participants faced integrating the produce and educational content into their daily lives. The focus group will ideally last from 45 to 90 minutes and will be moderated by Sarayna Schock, an MSII and PI on this study. A semi-structured interview guide will be used and responses will be recorded to adequately capture all feedback. These focus group responses will be recorded and transcribed by research volunteers and analyzed by an interdisciplinary research team to identify emergent themes.
To ease the burden of time constraints already imposed on physicians, participating healthcare providers will be surveyed via email at the end of the pilot to evaluate their perceived program efficacy, the benefit of the program to their patients, and elicit program feedback. A semi-structured survey created with REDCap will be used to solicit specific responses, in addition to open feedback.
Conditions
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Study Design
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ECOLOGIC_OR_COMMUNITY
PROSPECTIVE
Study Groups
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Participating Patients
Participating patients will receive a prescription for weekly CSA produce boxes with nutritional education
Produce boxes with nutritional education
CSA produce boxes "prescribed" to study participants with free online nutritional education included
Participating Providers
Participating providers will be surveyed at the end of the pilot to evaluate their perceived program efficacy, the benefit of the program to their patients, and elicit program feedback.
No interventions assigned to this group
Interventions
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Produce boxes with nutritional education
CSA produce boxes "prescribed" to study participants with free online nutritional education included
Eligibility Criteria
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Inclusion Criteria
2. Individuals at risk for developing chronic illness and metabolic disease as identified by PCP, care coordinator, or a participating physician from an abovementioned specialty.
3. Individuals willing to participate in the program and complete a pre-program survey and a post-program survey in December 2016.
4. Individuals with access to transportation to and from the CSA drop-off sites.
5. Individuals willing/able to pay the $10 subsidized "copay" for the weekly box of produce (federal food stamps in the form of SNAP/EBT vouchers will be accepted by Strites Orchard as a means of payment).
6. Individuals that speak English.
7. Individuals with difficulty obtaining fresh produce or lack of knowledge regarding healthy cooking methods and nutrition, as determined by PCP or a participating physician from an abovementioned specialty.
8. Prescribers (physicians, nurse practitioners, and physician assistants) in the Penn State Hershey Health system in the departments of Family and Community Medicine, General Pediatrics, Internal Medicine, General Surgery and Minimally Invasive Surgery/Bariatric, Endocrinology, and Cardiology.
Exclusion Criteria
2. Individuals unaffiliated with the Penn State Hershey Health System.
3. Individuals who already have sufficient fruits and vegetables in their diet as determined by the participating physician.
4. Non-English speaking participants.
18 Years
75 Years
ALL
Yes
Sponsors
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Milton S. Hershey Medical Center
OTHER
Responsible Party
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Sarayna Schock
MSII
Locations
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Penn State Milton Hershey Medical Center
Hershey, Pennsylvania, United States
Countries
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References
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Kraschnewski JL, George DR, Rovniak LS, Monroe DL, Fiordalis E, Bates E. Characterizing customers at medical center farmers' markets. J Community Health. 2014 Aug;39(4):727-31. doi: 10.1007/s10900-014-9818-x.
Related Links
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Main ProduceRx program website
Other Identifiers
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STUDY00005088
Identifier Type: -
Identifier Source: org_study_id
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