Washington State Department of Health, Tumwater, WA 98501, USA.
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Int J Environ Res Public Health. 2022 Sep 2;19(17):11010. doi: 10.3390/ijerph191711010.
People with low incomes suffer disproportionately from diet-related chronic diseases and may have fewer resources to manage their diseases. The "food as medicine" movement encourages healthcare systems to address these inequities while controlling escalating healthcare costs by integrating interventions such as produce prescriptions, in which healthcare providers distribute benefits for fruit and vegetable purchases. The purpose of this study was to identify perceived facilitators and barriers for designing and implementing produce prescriptions within the healthcare system. Nineteen semi-structured in-depth interviews were conducted with experts, and interviews were analyzed using thematic analysis. Overall, interviewees perceived that produce prescriptions could impact patients' diets, food security, disease management, and engagement with the healthcare system, while reducing healthcare costs. Making produce prescriptions convenient to use for patients, while providing resources to program implementers and balancing the priorities of payers, will facilitate program implementation. Integrating produce prescriptions into the healthcare system is feasible but requires program administrators to address implementation barriers such as cost and align complex technology systems (i.e., electronic medical records and benefit/payment processing). Engaging patients, clinics, retailers, and payers in the design phase can improve patient experience with a produce-prescription program; enhance clinic and retail processes enrolling patients and redeeming benefits; and ensure payers can measure outcomes of interest.
低收入人群不成比例地受到与饮食相关的慢性病的影响，他们可能拥有的资源较少，无法管理自己的疾病。“以食物为药物”运动鼓励医疗保健系统通过整合诸如农产品处方等干预措施来解决这些不平等问题，这些干预措施包括医疗保健提供者为购买水果和蔬菜分配利益。本研究的目的是确定在医疗保健系统中设计和实施农产品处方的感知促进因素和障碍。与专家进行了 19 次半结构化深入访谈，并使用主题分析对访谈进行了分析。总的来说，受访者认为农产品处方可以影响患者的饮食、粮食安全、疾病管理和与医疗保健系统的互动，同时降低医疗保健成本。使农产品处方对患者来说方便使用，同时为计划执行者提供资源，并平衡支付方的优先事项，将有助于计划的实施。将农产品处方整合到医疗保健系统中是可行的，但需要计划管理员解决实施障碍，例如成本和调整复杂的技术系统（即电子病历和福利/付款处理）。在设计阶段让患者、诊所、零售商和支付方参与其中，可以改善患者对农产品处方计划的体验；增强诊所和零售流程，让患者注册和兑换福利；并确保支付方能够衡量其感兴趣的结果。
