The purpose of this study is to assess the effectiveness of the produce prescription program at improving weight status and obesity-related health outcomes of participants, to examine the impacts of the program on household food insecurity and nutrition security, to examine the impacts of the program on participating adolescents' dietary behavioral outcomes, their home nutrition environment and feeding practices and to examine the impacts of the program in reducing healthcare use and associated costs
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
600
Participants will receive 16 produce bags, each containing approximately 50 servings of F\&V. The produce bags will be assembled by Brighter Bites at school sites using donated produce and delivered to houses using DoorDash. F\&V bags will be distributed to families every 2 weeks for 16 distributions (over approximately 32 weeks). Participants will also receive nutrition education, including MyPlate.gov's Start Simple App for adolescents, and a Virtual Culinary Medicine Program for parents; these nutrition education programs are theory-driven, tailored to diverse populations, and proven to support behavior change.
Participants in this group will be selected from de-identified Electronic Health Record (EHR) provided by Legacy Community Health with a 1-to-1 match to the intervention group participant's demographic characteristics and Medicaid eligibility.
The University of Texas Health Science Center at Houston
Houston, Texas, United States
Change in body mass index (BMI)
This will be collected from chart reviews as these measures are routinely collected for all pediatric patients in this weight classification based on the American Association of Pediatric recommendations.
Time frame: baseline , post intervention (32 weeks after baseline)
Change in systolic blood pressure
This will be collected from chart reviews as these measures are routinely collected for all pediatric patients in this weight classification based on the American Association of Pediatric recommendations.
Time frame: baseline , post intervention (32 weeks after baseline)
Change in diastolic blood pressure
This will be collected from chart reviews as these measures are routinely collected for all pediatric patients in this weight classification based on the American Association of Pediatric recommendations.
Time frame: baseline , post intervention (32 weeks after baseline)
Change in hemoglobin A1c as assessed by blood work
This will be collected from chart reviews as these measures are routinely collected for all pediatric patients in this weight classification based on the American Association of Pediatric recommendations.
Time frame: baseline , post intervention (32 weeks after baseline)
Change in Aspartate transaminase (AST) assessed by blood work
This will be collected from chart reviews as these measures are routinely collected for all pediatric patients in this weight classification based on the American Association of Pediatric recommendations.
Time frame: baseline , post intervention (32 weeks after baseline)
Change in Alanine transaminase (ALT) assessed by blood work
This will be collected from chart reviews as these measures are routinely collected for all pediatric patients in this weight classification based on the American Association of Pediatric recommendations.
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Time frame: baseline , post intervention (32 weeks after baseline)
Change in lipid panels assessed by blood work
This will be collected from chart reviews as these measures are routinely collected for all pediatric patients in this weight classification based on the American Association of Pediatric recommendations.
Time frame: baseline , post intervention (32 weeks after baseline)
Change in household food insecurity prevalence among participants (measured as a percentage) as assessed by the two item Hunger Vital Sign screening tool
This is a 2 item questionnaire and each is categorically scored as often true, sometimes true or never true, higher number indicating higher prevalence of household food insecurity
Time frame: baseline , post intervention (32 weeks after baseline)
Change in household food insecurity as assessed by the U.S. Household Food Security Survey Module: Six-Item Short Form Economic Research Service
This is a 6 item questionnaire and raw scores range from 0-6, higher score indicating worse outcome
Time frame: baseline , post intervention (32 weeks after baseline)
Change in nutrition security as assessed by the self reported Perceived Limited Ability validated screener
This is a 4 item questionnaire, each is scored from 0-4, higher score indicating better outcome
Time frame: baseline , post intervention (32 weeks after baseline)
Change in amount of fruit and vegetable intake
Time frame: baseline , post intervention (32 weeks after baseline)
Change in amount of junk food consumed
Time frame: baseline , post intervention (32 weeks after baseline)
Change in number of times subject eats out at restaurants
Time frame: baseline , post intervention (32 weeks after baseline)
Change in parent feeding practices as assessed by the number of times parent has cooked food from scratch
Time frame: baseline , post intervention (32 weeks after baseline)
Change in parent feeding practices as assessed by the number of times parent has used nutrition facts labels to make purchasing decisions
Time frame: baseline , post intervention (32 weeks after baseline)
Change in parent feeding practices as assessed by the number of times parent has eaten meals with their referent child
Time frame: baseline , post intervention (32 weeks after baseline)
Change in impact of the Produce Prescription intervention on adolescent patients' behavioral and emotional health as assessed by the Patient Health Questionnaire for Adolescents (PHQ-A)
This is a 9 item questionnaire and each is scored from 0(not at all) to 3(nearly every day), for a maximum score of 27, higher score indicating worse outcome
Time frame: baseline , post intervention (32 weeks after baseline)
Healthcare usage as assessed by the number of well-visits
Time frame: post intervention (32 weeks after baseline)
Healthcare usage as assessed by the number of visits due to illness
Time frame: post intervention (32 weeks after baseline)
Healthcare usage as assessed by the number of no shows to clinic appointments
Time frame: From 6 months prior to the intervention to two months post-intervention