(OR21-07-24) A Comparative Feasibility Study To Evaluate Fruit and Vegetable Delivery Methods in a Produce Prescription Program for Head Start Parent-Child Dyads

Objectives: To compare fruit and vegetable (FV) delivery methods for a produce prescription program (PRxP) for Head Start parent-child dyads using a comparative feasibility study. FV are critical to health throughout life. PRxP increase FV intake for children and adults, but optimal PRxP FV delivery methods have not been evaluated.

Methods: We implemented a 12-week randomized controlled pilot PRxP with weekly FV education materials at 3 Texas Head Start sites. Parents received a weekly FV box (PB; $50 value), picked up at Head Start site, or $50 loaded onto a Walmart FV-restricted gift card (GC) each week. Satisfactory feasibility outcomes were >80% for retention, acceptability (% agree/strongly agree FV quality high and % no FV waste), and fidelity (% bags delivered; % gift cards reloaded). We assessed effectiveness as mean change in daily FV servings between groups and satisfaction using qualitative exit interviews. We used descriptive and independent t-test statistics and directed content analysis to analyze quantitative and qualitative data.

Results: We randomized 13 and 16 dyads and retained 53.8% (n=7) and 68.8% (n=11) in PB and GC group, respectively. For both groups (n=18), parents (36.4+10.7 years old) were mostly mothers (72%), Hispanic (50%) or Black (44%). Children were 3.8+0.8 years old and 50% female. 85% of PB and 90% of GC group agreed/strongly agreed FV were high quality. 70% and 80% wasted no vegetables and 87% and 80% wasted no fruit in PB and GC group. 100% of PB were delivered and 83% of GC were reloaded on time. On average, parents increased daily servings of fruit by 0.6+1.1 vs 0.4+0.6 and vegetable by 0.7+1.4 vs 0.2+0.5 in PB versus GC group. Children increased daily servings of fruit by average 0.1+0.9 vs 0.1+0.5 and vegetable by 0.4+0.8 vs 0.2+0.4 in PB versus GC group. Changes in FV intake between groups was not statistically significant. From exit interviews, both groups were satisfied and reported their children eating and asking for more FV; PB group valued novel vegetables but had challenges preparing them.

Conclusions: Both PRxP FV delivery methods had high acceptability, fidelity, and satisfaction, but moderate retention and effectiveness, with little difference between groups. Studies with larger sample sizes are needed to compare delivery methods more rigorously.

Funding Sources: Texas A&M Institute for Advancing Health Through Agriculture