For decades, it's been known that poor nutrition during pregnancy has negative impacts on maternal and child outcomes both in the short and long term. Unfortunately, due to socioeconomic and food access issues, likely secondary to structural racism in populations of color, nutrition in pregnancy is also an issue of health equity. Few interventions have addressed this public health issue through a food as medicine approach. The concept of food as medicine is a reaffirmation that food and nutrition play a role in sustaining health, preventing disease, and as a therapy for those with conditions responsive to changes in their diet.
MIRI's Executive Director Dr. Perrie O'Tierney-Ginn is the study's co-PI. Her collaborator, Dr. Fang Fang Zhang of the Friedman School of Nutrition Science and Policy at Tufts University, has experience leading food is medicine studies in the non-pregnant population. Together with colleagues from Tufts Medicine and the Friedman School, Drs. O'Tierney-Ginn and Zhang designed a study piloting the delivery of Produce Prescriptions (Rx) to pregnant patients at Tufts Medical Center, targeting its food insecure patients.
The study, "Produce prescriptions on maternal and birth outcomes: A food is medicine intervention among pregnant women," aims to evaluate the feasibility of implementing produce prescriptions in our prenatal care clinics at Tufts Medical Center, and is supported by a Tufts Springboard Grant, Tufts Health Plan, and Blue Cross Blue Shield of Massachusetts.
Patients that are eligible to enroll in the study are identified by the clinical social worker. Subjects can enroll up to 24 weeks into their pregnancy. Once enrolled, a subject will first take a survey that aims to assess their diet during pregnancy. Approximately two weeks after enrolling in the study, they will begin to receive boxes of produce on a weekly basis for 16 consecutive weeks, delivered directly to the doorstep of the address of their choice throughout the study.
At the prenatal appointment closest to the fourth week of the study, a participant will be given a survey that asks how they like the produce being delivered. The same survey is given approximately 10 weeks into the study. When the 16 weeks are over, subjects will fill out a survey to collect theiroverall thoughts about the Produce Prescription program.
In addition, the study offers participants recorded video classes that give insight into the nutritional value of the produce that is being delivered and the importance of nutrition during pregnancy. It also offers a colorful booklet of fun and easy recipes for participants to prepare.
As a pilot study, the Produce Rx Program is limited by the number of patients it can provide produce to, so only 20 pregnant patients will be enrolled in the pilot. Surveys will provide valuable information on participant satisfaction with the program, and on how to adjust the program to better suit their needs and health benefits. This will help in designing a larger program that will hopefully be rolled out across Tufts Medicine.