Nutrition prescriptions

There is some evidence that nutrition prescriptions that include access to fresh produce increase consumption of healthy foods including fruits and vegetables and reduce food insecurity (Haslam 2022, Little 2022, Bhat 2021). Healthy eating and nutrition counseling, advice, and information given by physicians and other health care providers influences patient behavior (Bhattarai 2013, Dorsey 2011). Nutrition prescriptions increase access to healthy foods when they provide vouchers for fresh fruits and vegetables, redeemable at local farmers markets or grocery stores, or pre-selected food for pick up or delivery (Haslam 2022, Bhat 2021, Little 2022, Muleta 2024). In general, subsidies and financial incentives for healthy foods have been shown to increase healthy food purchases (Gittelsohn 2017, Grech 2015, Jaime 2009, Kocken 2012, An 2013, AHA-Mozaffarian 2012), which enables increased healthy food consumption (Gittelsohn 2017, An 2013, AHA-Mozaffarian 2012). Additional evidence is needed to determine the long-term effects of enrollment in nutrition prescription programs (Cafer 2023).

Nutrition prescriptions may improve health outcomes (Kerr 2020, York 2020, Bhat 2021), improve quality of life (Joseph 2023), reduce stress (Stroud 2023), improve mental and physical health (PCORE-Royal 2016), and improve sleep, mood, and pain (Kerr 2020). Pediatric nutrition prescription programs may increase fruit and vegetable consumption among children (Muleta 2024), increase food security (Muleta 2024, Hager 2023), and improve self-reported health outcomes among children and adults in the household (Hager 2023).

Nutrition prescriptions may increase fresh produce consumption and cooking from scratch, which may reduce emissions from fossil fuels used to produce, process, and transport food (Ringling 2020, Stone 2021, CCAFS-Campbell 2012). Nutrition prescriptions may also reduce the energy intensity of an individual’s diet if more plant-based foods are consumed in place of animal products (Ringling 2020).

Nutrition prescription programs may focus on helping populations with diet-related diseases or with managing chronic diseases (Haslam 2022). Nutrition prescriptions may generate community co-benefits, for example, nutrition prescriptions can increase demand for fresh produce, so community grocery stores may increase the amount of fresh produce available (Virudachalam 2023). Family members of nutrition prescription recipients may experience dietary improvements when shared meals include more healthy foods (Virudachalam 2023). Farmers markets, often locations for voucher redemption or food pick up, may offer additional opportunities to increase social connection and reduce isolation (Joseph 2023).

Interviews with health care providers suggest that participation in nutrition prescription programs changes the way providers talk with patients about healthy eating (Stotz 2022), improves patient health outcomes (Stotz 2022), improves provider knowledge of the burden of food insecurity (Johnson 2023a), and increases provider desires to screen for food insecurity (Johnson 2023a). Several challenges for implementing these programs in a medical setting were identified by providers and patients, including limited time with patients, limited training, and the need for follow-up to encourage continued patient engagement (Stotz 2022). Additional barriers to the implementation of nutrition prescription programs include limited transportation to clinics or farmers markets (Stroud 2023, Thomson 2022, Newman 2022), communication issues between retailers, providers, and patients (Little 2022), potential for patients to feel stigmatized (Johnson 2023, Little 2022), and difficulty sustaining changes to lifestyle or diet after the program ends or when farmers markets seasonally close (Newman 2022).

Nutrition prescriptions and supports for access to healthy foods may be a cost-effective way to manage chronic diseases (Haslam 2022), for example, among adults with diabetes (Wang 2023).

It is unclear what impact nutrition prescriptions alone may have on disparities in healthy food consumption and health outcomes.

Some nutrition prescription programs have increased fruit and vegetable consumption (Saxe-Custack 2021a), reduced food insecurity (Saxe-Custack 2021a), and improved health outcomes among Black participants with low incomes (Cook 2021, Cook 2023). Programs targeting Latino/a adults have reduced food insecurity and improved health outcomes (York 2020). Participant interviews suggest that nutrition prescription programs in these communities may be more effective if they include trust building efforts (Suh 2024), culturally relevant education (Suh 2024), culturally relevant dietary choices (Suh 2024, Jones 2020), and bidirectional feedback (Suh 2024). One theoretical model of national implementation of nutrition prescriptions for adults with diabetes and low incomes suggests that targeted nutrition prescriptions may have the potential to reduce racial disparities in cardiovascular disease, since they could prevent more cases of cardiovascular disease among Hispanic and Non-Hispanic Black populations under 65 years old than among Non-Hispanic white populations (Wang 2023). Black and rural communities are also typically underserved by farmers markets, one of the more common redemption points for vouchers (Cafer 2023).

Some nutrition prescription programs have targeted rural areas where poverty and food insecurity rates are higher than in urban areas (Joseph 2023). At the beginning of the Partnerships to Improve Community Health (PICH) Produce Rx program in rural eastern North Carolina, 48.0% of participants reported that they did not have fresh fruits and vegetables available in their neighborhood (Lyonnais 2022). Nutrition prescription programs that support farmers markets in rural areas can provide community opportunities to strengthen existing connections, build new ones, and prevent individuals from experiencing severe social isolation (Joseph 2023). Local farmers markets also provide a space to celebrate community resources and change the narrative of scarcity in rural areas with limited access to grocery stores (Joseph 2023).

Throughout U.S. history, discriminatory housing, lending, and exclusionary zoning policies entrenched racial residential segregation and concentrated poverty (Zdenek 2017, Kaplan 2007). This systemic disinvestment and exclusion by both government and private entities created and maintains community environments with limited resources, deteriorating infrastructure, hazardous industries and waste disposal sites, and many other factors that lead to poorer health outcomes for people of color and people with low incomes (Braveman 2022, Prochnow 2022, McAndrews 2022, Brookings-Semmelroth 2020). Communities shaped by discriminatory policies are often areas that have limited access to healthy and affordable food, formerly known as “food deserts” (Beaulac 2009, Walker 2010b). Individuals who live in these communities face higher food costs, fewer store options, and must travel further to purchase healthy food than those who live in well-resourced communities (Beaulac 2009). Residents also have increased exposure to high calorie foods that have little nutritional value which often leads to worse health outcomes (Walker 2010b).

Disparities in access to health care are associated with delays in disease diagnosis and treatment of health conditions, fewer preventive health visits, shortages of behavioral health clinicians, and larger Medicaid or uninsured populations in neighborhoods that are primarily Black and low income (Lee 2023). People with one or more chronic diseases are at greater risk for disability, death, poor functional status, unnecessary hospitalizations, and many other challenges (Bleich 2015). Individuals from minoritized racial backgrounds (Price 2013), from rural areas (RHIhub-Chronic Disease), and those with low incomes are disproportionately more likely to have one or more chronic diseases (Eyler 2019). Rural areas also lack adequate access to physicians; approximately 20% of the U.S. population resides in rural areas, but only 10% of physicians provide care there (Arredondo 2023).

Nutrition prescription programs have evolved as part of the growing Food is Medicine movement, an approach that centers access to nutritious food as an essential part of health and well-being (Food is Medicine). Food is Medicine programs, including nutrition prescriptions, facilitate access to and support the production of healthy foods in a variety of settings across the country (Food is Medicine). Food is Medicine programs are working to overcome existing structural barriers that have created communities where access to nutritious food is limited and improve the health of individuals who are disproportionately living in areas where access to healthcare is limited. In 2023, the U.S. Department of Health and Human Services began organizing a federal Food is Medicine strategy through the funding established by the 2023 Omnibus Appropriations Bill, with the goals of reducing food insecurity and nutrition-related chronic disease (US DHHS-FIM).

• What populations are you aiming to enroll in your nutrition prescription program? Have you adequately invested time in this community to build a culture of trust and an open line of communication? Have you considered cultural norms when choosing the food or education you want to include in the program?
• What barriers exist that might impede a nutrition prescription program in your community? Are there adequate spaces (e.g. farmers markets, grocery stores) that will partner with you to provide access to fresh produce? Will transportation be an issue for your population? How could your program support local healthcare providers so healthy food boxes could be offered on-site or establish food delivery programs to make program participation easier?
• Are there local coalitions or partnerships that can champion expanded appointment times so health care providers can offer counseling and follow-up care with nutrition prescriptions? Which groups have the power to influence health insurance policies to pay for physician’s time and any additional costs associated with nutrition prescriptions?

The 5-2-1-0 childhood obesity prevention program is an example of a program that allows health care provider partners to give patients nutrition and physical activity prescriptions. Prescriptions encourage daily habits that include five servings of fruits and vegetables, two hours or less of screen time, one hour or more of physical activity, zero sugary drinks, and increased water consumption. Providers also administer healthy habits questionnaires and monitor patients’ BMI. The 5-2-1-0 program started in Maine (MH-Let's go) and has expanded to cities and states all over the country, including Florida (FL DOH-5210); New Hampshire (FHC-5210); and Palo Alto, California (PAMF-5210 resources).

Through Gorge Grown Food Network’s Veggie Rx program participating health care providers prescribe $30 worth of vouchers for one month to families who screen positive for food insecurity to redeem at 30 local groceries, farms stands, or farmers markets (GGFN-Veggie Rx). Wholesome Wave’s produce prescription (Rx) programs allow doctors and other providers around the country to prescribe fruits and vegetables to prevent or manage diet-related illnesses (WW-Rx), with programs including Augusta Georgia Food for Health (Augusta-Rx), the FARM Rx program of Athens, GA (FARM-Rx), and the Food4Moms program in Hartford, CT (Food4Moms-Rx). In New York, the Choosing Healthy & Active Lifestyles for Kids (CHALK) obesity prevention program connects patients facing food insecurity with healthy groceries and social services (NYP-CHALK).

The Navajo Fruit & Vegetable Prescription (FVRx) program enrolls Navajo families with pregnant parents or children under six to attend monthly health classes and receive prescriptions with whole food vouchers (Navajo-FVRx). COPE (Community Outreach & Patient Empowerment), a Native-controlled non-profit organization, reports 53% of health facilities serving the Navajo Nation have implemented this FVRx program (Navajo-FVRx).

GGFN-Veggie Rx - Gorge Grown Food Network (GGFN). Veggie Rx Program.

ISU-Food and sustainability resources - Iowa State University (ISU), Sustainable Food Processing Alliance. Online resources for food and sustainability.

MBC-Health care toolkit - Mary Bridge Children’s (MBC) Hospital-Clinics-Foundation. Family wellness toolkit: Ready, set, go! 5210.

WW-Rx - Wholesome Wave (WW). What we do: Produce prescription (Rx) program, healthy choice initiatives, and SNAP doubling.

* Journal subscription may be required for access.

AHA-Mozaffarian 2012 - Mozaffarian, D., Afshin, A., Benowitz, N.L., Bittner, V., Daniels, S.R., Franch, H.A., Jacobs, D.R., Kraus, W.E., Kris-Etherton, P.M., Krummel, D.A., Popkin, B.M., Whitsel, L.P., & Zakai, N.A. (2012). Population approaches to improve diet, physical activity, and smoking habits: A scientific statement from the American Heart Association (AHA). Circulation, 126(12), 1514-1563.

An 2013* - An, R. (2013). Effectiveness of subsidies in promoting healthy food purchases and consumption: A review of field experiments. Public Health Nutrition, 16(7), 1215-1228.

Arredondo 2023 - Arredondo K, Touchett HN, Khan S, Vincenti M, Watts BV. Current programs and incentives to overcome rural physician shortages in the United States: A narrative review. Journal of General Internal Medicine. 2023;38:916-922.

Augusta-Rx - Augusta Georgia Food for Health Program. (n.d.). The Georgia Food for Health Program: Augusta’s vegetable prescription program. Retrieved October 21, 2024.

Beaulac 2009 - Beaulac J, Kristjansson E, Cummins S. A systematic review of food deserts, 1966-2007. Preventing Chronic Disease. 2009;6(3):A105.

Bhat 2021 - Bhat, S., Coyle, D. H., Trieu, K., Neal, B., Mozaffarian, D., Marklund, M., & Wu, J. H. Y. (2021). Healthy food prescription programs and their impact on dietary behavior and cardiometabolic risk factors: A systematic review and meta-analysis. Advances in Nutrition, 12(5), 1944–1956.

Bhattarai 2013 - Bhattarai, N., Prevost, A.T., Wright, A.J., Charlton, J., Rudisill, C., & Gulliford, M.C. (2013). Effectiveness of interventions to promote healthy diet in primary care: Systematic review and meta-analysis of randomised controlled trials. BMC Public Health, 13, 1203.

Bleich 2015 - Bleich SN, Sherrod C, Chiang A, et al. Systematic review of programs treating high-need and high-cost people with multiple chronic diseases or disabilities in the United States, 2008–2014. Preventing Chronic Disease. 2015;12:150275.

Braveman 2022 - Braveman PA, Arkin E, Proctor D, Kauh T, Holm N. Systemic and structural racism: Definitions, examples, health damages, and approaches to dismantling. Health Affairs. 2022;41(2):171-178.

Brookings-Semmelroth 2020 - Semmelroth L. How Wilmington, Del. is revitalizing vacant land to rebuild community trust. Washington, D.C.: Brookings Institution; 2020.

Cafer 2023* - Cafer, A., Rosenthal, M., Smith, P., McGrew, D., Bhattacharya, K., Rong, Y., Salkar, M., Yang, J., Nguyen, J., & Arnold, A. (2023). Examining the context, logistics, and outcomes of food prescription programs: A scoping review. Research in Social and Administrative Pharmacy, 19(1), 57–68.

CCAFS-Campbell 2012 - Campbell B. Is eating local good for the climate? Thinking beyond food miles. Research Program on Climate Change, Agriculture and Food Security (CCAFS), CGIAR Research Programs. 2012.

Cook 2021* - Cook, M., Ward, R., Newman, T., Berney, S., Slagel, N., Bussey-Jones, J., Schmidt, S., Sun Lee, J., & Webb-Girard, A. (2021). Food security and clinical outcomes of the 2017 Georgia fruit and vegetable prescription program. Journal of Nutrition Education and Behavior, 53(9), 770–778.

Cook 2023 - Cook, M. A., Taylor, K., Reasoner, T., Moore, S., Mooney, K., Tran, C., Barbo, C., Schmidt, S., Stein, A. D., & Webb Girard, A. (2023). Participation in the Georgia food for health programme and CVD risk factors: A longitudinal observational study. Public Health Nutrition, 26(11), 2470–2479.

Dorsey 2011 - Dorsey R, Songer T. Lifestyle behaviors and physician advice for change among overweight and obese adults with prediabetes and diabetes in the United States, 2006. Preventing Chronic Disease, 2011;8(6):A132.

Eyler 2019 - Eyler AA, Valko CA, Marti M, et al. Adjusting the equity lens: Gaps in addressing health equity in state chronic disease prevention. Health Equity. 2019;3(1):86-91.

FARM-Rx - Athens Farmers Market. (n.d.). The FARM Rx Program. Retrieved October 21, 2024.

FHC-5210 - Foundation for Healthy Communities (FHC). 5-2-1-0 Healthy NH.

FL DOH-5210 - Florida Department of Health (FL DOH), FloridaHealth Lee County. The 5-2-1-0 plan for a healthier active lifestyle.

Food is Medicine - U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (n.d.). Food is Medicine. Retrieved October 21, 2024.

Food4Moms-Rx - Wholesome Wave. (n.d.). Empowering Latina moms: The Food4Moms Produce Prescription Program. Retrieved October 21, 2024.

GGFN-Veggie Rx - Gorge Grown Food Network (GGFN). Veggie Rx Program.

Gittelsohn 2017 - Gittelsohn J, Trude ACB, Kim H. Pricing strategies to encourage availability, purchase, and consumption of healthy foods and beverages: A systematic review. Preventing Chronic Disease. 2017;14(E107):170213.

Grech 2015* - Grech A, Allman-Farinelli M. A systematic literature review of nutrition interventions in vending machines that encourage consumers to make healthier choices. Obesity Reviews. 2015;16(12):1030-1041.

Hager 2023 - Hager, K., Du, M., Li, Z., Mozaffarian, D., Chui, K., Shi, P., Ling, B., Cash, S. B., Folta, S. C., & Zhang, F. F. (2023). Impact of produce prescriptions on diet, food security, and cardiometabolic health outcomes: A multisite evaluation of 9 produce prescription programs in the United States. Circulation: Cardiovascular Quality and Outcomes, 16(9).

Haslam 2022 - Haslam, A., Gill, J., Taniguchi, T., Love, C., & Jernigan, V. B. (2022). The effect of food prescription programs on chronic disease management in primarily low-income populations: A systematic review and meta-analysis. Nutrition and Health, 28(3), 389–400.

Jaime 2009* - Jaime PC, Lock K. Do school based food and nutrition policies improve diet and reduce obesity? Preventive Medicine. 2009;48(1):45-53.

Johnson 2023 - Johnson, J. K., Vingilis, E., & Terry, A. L. (2023). Patients’ experiences with a community fruit and vegetable box program prescribed by their health provider. BMC Public Health, 23(1), 869.

Johnson 2023a* - Johnson, S., Fischer, L., Gupta, S., Lazerov, J., Singletary, J., & Essel, K. (2023). “I felt like I had something I could do about it”: Pediatric clinician experiences with a food insecurity-focused produce prescription program. Clinical Pediatrics, 62(9), 1018–1026.

Jones 2020 - Jones, L. J., VanWassenhove-Paetzold, J., Thomas, K., Bancroft, C., Ziatyk, E. Q., Kim, L. S.-H., Shirley, A., Warren, A. C., Hamilton, L., George, C. V., Begay, M.-G., Wilmot, T., Tsosie, M., Ellis, E., Selig, S. M., Gall, G., & Shin, S. S. (2020). Impact of a fruit and vegetable prescription program on health outcomes and behaviors in young Navajo children. Current Developments in Nutrition, 4(8), nzaa109.

Joseph 2023* - Joseph, C. A., & Seguin, M. L. (2023). “Something fun to look forward to”: Lessons from implementing the prescription for health farmers’ market initiative in rural Upper Michigan. Health Promotion Practice, 24(5), 903–910.

Kaplan 2007* - Kaplan J, Valls A. Housing discrimination as a basis for Black reparations. Public Affairs Quarterly. 2007;21(3):255-273.

Kerr 2020 - Kerr, D., Barua, S., Glantz, N., Conneely, C., Kujan, M., Bevier, W., Larez, A., & Sabharwal, A. (2020). Farming for life: Impact of medical prescriptions for fresh vegetables on cardiometabolic health for adults with or at risk of type 2 diabetes in a predominantly Mexican American population. BMJ Nutrition, Prevention & Health, 3(2), 239–246.

Kocken 2012* - Kocken PL, Eeuwijk J, Van Kesteren NMC, et al. Promoting the purchase of low-calorie foods from school vending machines: A cluster-randomized controlled study. Journal of School Health. 2012;82(3):115-122.

Lee 2023* - Lee EK, Donley G, Ciesielski TH, Freedman DA, Cole MB. Spatial availability of federally qualified health centers and disparities in health services utilization in medically underserved areas. Social Science and Medicine. 2023;328:116009.

Little 2022 - Little, M., Rosa, E., Heasley, C., Asif, A., Dodd, W., & Richter, A. (2022). Promoting Healthy Food Access and Nutrition in primary care: A systematic scoping review of food prescription programs. American Journal of Health Promotion, 36(3), 518–536.

Lyonnais 2022 - Lyonnais, M. J., Rafferty, A. P., Spratt, S., & Jilcott Pitts, S. (2022). A produce prescription program in eastern North Carolina results in increased voucher redemption rates and increased fruit and vegetable intake among participants. Nutrients, 14(12), 2431.

McAndrews 2022* - McAndrews C, Schneider RJ, Yang Y, et al. Toward a gender-inclusive Complete Streets movement. Journal of Planning Literature. 2022;38(1):3-18.

MH-Let's go - MaineHealth (MH). Let's go!

Muleta 2024 - Muleta, H., Fischer, L. K., Chang, M., Kim, N., Leung, C. W., Obudulu, C., & Essel, K. (2024). Pediatric produce prescription initiatives in the U.S.: A scoping review. Pediatric Research, 95(5), 1193–1206.

Navajo-FVRx - COPE (Community Outreach & Patient Empowerment). (n.d.). Food access: Navajo Fruit & Vegetable Prescription Program. Retrieved October 21, 2024.

Newman 2022* - Newman, T., Lee, J. S., Thompson, J.J., & Rajbhandari-Thapa, J. (2022). Current landscape of produce prescription programs in the U.S. Journal of Nutrition Education and Behavior, 54(6), 575–581.

NYP-CHALK - New York-Presbyterian Ambulatory Care Network. (n.d.). CHALK Choosing Healthy & Active Lifestyles for Kids. Retrieved October 21, 2024.

PAMF-5210 resources - Sutter Health Palo Alto Medical Foundation (PAMF). 5-2-1-0 Resources.

PCORE-Royal 2016 - Royal N, Brown K, Rodriguez F, Fernandez B, Valle L, Bello E. Harvesting health: A community-based participatory evaluation of the Veggie Rx program. Providence Center for Outcomes Research & Education (PCORE), The Next Door, Inc. 2016.

Price 2013 - Price JH, Khubchandani J, McKinney M, Braun R. Racial/ethnic disparities in chronic diseases of youths and access to health care in the United States. BioMed Research International. 2013:787616.

Prochnow 2022* - Prochnow T, Valdez D, Curran LS, et al. Multifaceted scoping review of Black/African American transportation and land use expert recommendations on activity-friendly routes to everyday destinations. Health Promotion Practice. 2022.

RHIhub-Chronic Disease - Rural Health Information Hub (RHIhub). Chronic disease in rural America.

Ringling 2020 - Ringling KM, Marquart LF. Intersection of diet, health, and environment: Land grant universities’ role in creating platforms for sustainable food systems. Frontiers in Sustainable Food Systems. 2020;4(70).

Saxe-Custack 2021a - Saxe-Custack, A., LaChance, J., Jess, J., & Hanna-Attisha, M. (2021). Influence of a pediatric fruit and vegetable prescription program on child dietary patterns and food security. Nutrients, 13(8), 2619.

Stone 2021 - Stone, T., Thompson, J., Rosentrater, K., & Nair, A. (2021). A life cycle assessment approach for vegetables in large-, mid-, and small-scale food systems in the midwest U.S. Sustainability, 13(20).

Stotz 2022 - Stotz, S. A., Budd Nugent, N., Ridberg, R., Byker Shanks, C., Her, K., Yaroch, A. L., & Seligman, H. (2022). Produce prescription projects: Challenges, solutions, and emerging best practices – perspectives from health care providers. Preventive Medicine Reports, 29, 101951.

Stroud 2023* - Stroud, B., Jacobs, M. M., Palakshappa, D., & Sastre, L. R. (2023). A rural delivery-based produce prescription intervention improves glycemic control and stress. Journal of Nutrition Education and Behavior, 55(11), 803–814.

Suh 2024* - Suh, C. K., Huliganga, A., Collymore, J., Desai, N., Mora, M., & Hatchett, L. (2024). Participants’ experiences with a community based participatory research produce prescription program: Findings from a qualitative study. American Journal of Health Promotion, 38(4), 522–527.

TFAH-Levi 2014 - Levi J, Segal L, St. Lauren R, Rayburn J. The state of obesity: Better policies for a healthier America 2014. Washington, D.C.: Trust for America's Health (TFAH); 2014.

Thomson 2022* - Thomson, S., Ugwuegbu, J., Montez, K., Langdon, S., Best, S., Sostaita, D., Franklin, M., & Zimmer, R. (2022). Qualitative perceptions of an anticipated fresh food prescription program. Health Behavior and Policy Review, 9(1).

US DHHS-DG - U.S. Department of Health and Human Services (U.S. DHHS). The dietary guidelines for Americans.

US DHHS-FIM - U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (n.d.). Food is Medicine: A project to unify and advance collective action. Retrieved October 21, 2024.

Virudachalam 2023* - Virudachalam, S., Kim, L. S.-H., & Seligman, H. (2023). Produce prescriptions and a path toward food equity for children. JAMA Pediatrics, 177(3), 225.

Walker 2010b - Walker RE, Keane CR, Burke JG. Disparities and access to healthy food in the United States: A review of food deserts literature. Health and Place. 2010;16(5):876-884.

Wang 2023 - Wang, L., Lauren, B. N., Hager, K., Zhang, F. F., Wong, J. B., Kim, D. D., & Mozaffarian, D. (2023). Health and economic impacts of implementing produce prescription programs for diabetes in the United States: A microsimulation study. Journal of the American Heart Association, 12(15), e029215.

WHA-FVRx - Wisconsin Hospital Association. (n.d.). Aspirus Health, 2022 Community Benefits: Aspirus Health expands Fruit and Vegetable Prescription (FVRx) Program. Retrieved October 21, 2024.

WW-Rx - Wholesome Wave (WW). What we do: Produce prescription (Rx) program, healthy choice initiatives, and SNAP doubling.

York 2020 - York, B., Kujan, M., Conneely, C., Glantz, N., & Kerr, D. (2020). Farming for Life: Pilot assessment of the impact of medical prescriptions for vegetables on health and food security among Latino adults with type 2 diabetes. Nutrition and Health, 26(1), 9–12.

Zdenek 2017 - Zdenek RO, Walsh D. Navigating community development: Harnessing comparative advantages to create strategic partnerships. Chapter: The background and history of community development organizations. New York: Palgrave Macmillan; 2017.