Evaluation of a Produce Prescription Program for Patients with Diabetes: A Longitudinal Analysis of Glycemic Control
Objective: Produce prescriptions have shown promise to improve diabetes care, although most studies used small samples or lacked controls. Our objective was to evaluate impacts of a produce prescriptions program on glycemic control for patients with diabetes.
Research Design and Methods: Participants included a non-random enrollment of 252 patients with diabetes who received produce prescriptions and 534 similar controls from two clinics in Hartford, CT. The start of the COVID-19 pandemic in March 2020 coincided with program implementation. Produce prescription enrollees received vouchers ($60/month) for six months to purchase produce at grocery retail. Controls received usual care. Primary outcome was change in glycated hemoglobin (HbA1c) between treatment and controls at six months. Secondary outcomes included 6-month change in systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI), hospitalizations, and emergency department admissions. Longitudinal generalized estimating equation models, weighted with propensity score overlap weights, assessed changes in outcomes over time.
Results: At six months, there was no significant difference in change in HbA1c between treatment and control groups, with a difference of 0.13 percentage points (95% CI: -0.05, 0.32). No significant differences were observed for change in SBP (3.85 mmHg ( -0.12, 7.82)), DBP (-0.82 mmHg (-2.42, 0.79)), or BMI (-0.22 kg/m2 (-1.83, 1.38)). The incidence rate ratios for hospitalizations and emergency department visits were 0.54 (0.14, 1.95) and 0.53 (0.06, 4.72).
Conclusion: A 6-month produce prescription program for patients with diabetes, implemented during the onset of the COVID-19 pandemic, was not associated with improved glycemic control.