Influence of a Prenatal Fruit and Vegetable Prescription Program on Diet and Household Food Security in a Low-Income, Urban Community

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INTRODUCTION: A prenatal fruit and vegetable prescription program (FVPP) was introduced in Flint, Michigan to increase access to fresh produce during pregnancy. This program provides $15 fresh fruit and vegetable prescriptions to all prenatal patients during office visits, redeemable at a local farmers market and mobile market/food hub. The current study assessed changes in diet and food security throughout pregnancy among patients exposed to the prenatal FVPP. METHODS: This non-controlled longitudinal trial included prenatal patients at two low-income urban clinics presenting before 16 weeks' gestation. Participants completed surveys to assess diet (one automated 24-hour dietary recall) and food security (US Household Food Security Module: Six Item Short Form - National Center for Health Statistics), with follow-up surveys at mid-pregnancy and postpartum. RESULTS: A total of 118 pregnant women (mean age 26.32 ± 5.04 years, range 18-39 years) enrolled in the current study. Most identified as Black/African American (54.2%, n = 64), received Medicaid (66.9%, n = 79), and participated in The Special Supplemental Nutrition Program for Women, Infants, and Children or WIC (62.4% at midpoint). Participants received an average of 8.81 ± 2.30 fruit and vegetable prescriptions, with two-thirds redeeming at least one (66.9%, n = 79). Household food security worsened from baseline to midpoint (p = 0.076) but improved from midpoint to postpartum (p = 0.013). Participants reported notable changes in dietary behaviors at critical points during their pregnancy. Primarily, significant improvements in mean daily consumption of fruits and vegetables (p = 0.027); total vegetables (p = 0.015); and vegetables excluding potatoes (p = 0.030) were observed from early pregnancy to midpoint. Alternatively, mean daily intake of fruits and vegetables (p = 0.007) and total vegetables (p = 0.029) decreased between midpoint in pregnancy and the early postpartum period. DISCUSSION: This study reveals the influence of a prenatal FVPP on diet and food security among prenatal patients living in one low-income, urban community. Results signal an urgent need for coordinated and comprehensive maternal supports that better address food and nutrition security during pregnancy and the early postpartum period.

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