VCU research in action: Filling a prescription for nutrition

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Curtis McClendon used to rely on fast food for his meals, which was a bad match for his high blood pressure and diabetes. Now he cooks for himself, thanks to a Virginia Commonwealth University initiative.

For two years, McClendon has been participating in the Prescription Produce Program, which is incorporated in the School of Nursing's Mobile Health and Wellness Program.

"It's helped me in a lot of ways," said McClendon, who lives in an area of Richmond with few options for fresh groceries. "In the program, we get a bag of food, and we have a menu that we follow. It's just a splendid idea."

The PPP screens participants for food insecurity, enhances food access and promotes nutrition by providing healthy fruits and vegetables to individuals with limited access to them. Such programs are increasingly implemented in clinical settings, in light of the clear links between diet and chronic medical conditions.

Ana Diallo, Ph.D., assistant professor in the Department of Adult Health and Nursing Systems and Building Interdisciplinary Research Careers in Women's Health Scholar, has been researching the effects of the VCU program, which she has led since implementation in 2022. Her recent study explored the effectiveness of the PPP program over six- and 12-week intervals.

"At first, we were evaluating and addressing the need for healthy food access. At the moment, we are focusing on the effectiveness of the program. Starting this year, with funding from a Centene Foundation Grant, we will measure impact," Diallo said.

"I also hope this type of research provides the evidence needed to build strong policies to support Food is Medicine interventions, like the PPP, as an integral part of the management of chronic diseases."

The study also determined that a strength of the PPP is its partnerships with community members and nonprofit organizations Shalom Farms, which grows and distributes produce, and The Underground Kitchen Community First, which addresses food insecurity in Richmond communities.

The PPP started partnering with Shalom Farms in 2021, but the Mobile Health and Wellness Program had been working with the organization since 2016 through the former Healthy Meal Program. This year, the PPP began working with The Underground Kitchen, too.

"They are providing a recipe bag with vegetables, spices and ingredients to pair with some shelf-stable protein such as beans and grains," said Katherine Falls, director of clinical operations for the Mobile Health and Wellness Program.

VCU's Virginia Center on Aging provides funding to the PPP to purchase the food bags, with six given out every week or every other week to each participant. Funding is in place through 2026.

"Shalom Farms and The Underground Kitchen are wonderful partners. They do such a great job of helping to address nutrition insecurity, and they are doing it with such dignity," Falls said.

PPP participants report a higher frequency of fruit and vegetable consumption and a higher sense of self-sufficiency in being able to cook their meals.

"Participants want to eat more vegetables and expand the different foods they cook," Falls said. "We monitor their health, measure their blood pressure, weight, blood sugar and the person's self-efficacy to manage chronic disease."

The study found evidence that a PPP may help individuals facing food insecurity and difficulties managing complex chronic diseases. The findings also support the need for more research to establish rigorous standards of program implementation that will effectively measure the short- and long-term benefits of the PPP among diverse population groups.

Since the PPP started, it has focused on serving communities in Richmond - "we have served 80 to 90 adults at five different clinical sites in Richmond, mainly the East End," Diallo said. This September, the Mobile Health and Wellness Program started a 12-month pilot program at two clinical sites in Petersburg. It will follow 30 individuals for one year.

"They will receive lifestyle behavior counseling, social needs referrals and food bags every two weeks for one year," Diallo said, with the program slated to end in August 2026. "Our program has shown great results with food and nutrition security, but we didn't have outcomes for the efficiency of the program in impacting health outcomes. With this program, we will measure with a more rigorous approach to health outcomes, food and diet quality."

Research in food and nutrition insecurity is ongoing, Falls added.

"The complex nature of nutrition security is difficult to assess," she said, "but is essential when trying to implement interventions that will have a positive impact on our participants."