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Caregiver-reported barriers to engagement in a paediatric fresh fruit and vegetable prescription programme
Amy Saxe-Custack1, Sarah Egan1, Bridget Farmer1
1Charles Stewart Mott Department of Public Health, Michigan State University-Hurley Children's Hospital Pediatric Public Health Initiative, Flint, MI, USA.
Insights
Fruit and vegetable prescription programs can improve youth nutrition, but caregiver engagement is key. This study identified environmental barriers and caregiver-suggested solutions for better program participation.
Area of Science:
- Public Health
- Nutrition Science
- Community Health
Background:
- Paediatric fruit and vegetable prescription programs aim to enhance food security and dietary habits in youth.
- Caregiver and family engagement are critical factors for the success of these health initiatives.
- Understanding participant-level barriers is essential for optimizing program effectiveness.
Purpose of the Study:
- To investigate environmental barriers to caregiver engagement in a paediatric fruit and vegetable prescription program.
- To gather caregiver perspectives and recommendations for improving program participation in a low-income urban community.
Main Methods:
- Conducted thirty-two semi-structured interviews with caregivers of children in a fruit and vegetable prescription program.
- Utilized thematic analysis to identify patterns and emerging themes from transcribed qualitative data.
- Focused on a specific low-income, urban community in Flint, Michigan, USA.
Main Results:
- Five key themes emerged: nutrition security, prescription distribution, prescription redemption, educational support, and program modifications.
- Caregivers reported that the program addressed food insecurity but faced environmental engagement barriers.
- Identified barriers included issues with prescription distribution and redemption processes.
Conclusions:
- Environmental barriers significantly impact caregiver engagement in paediatric fruit and vegetable prescription programs.
- Caregivers proposed practical solutions, including partnerships with large grocery stores and digital prescription options.
- Addressing these identified barriers is crucial for enhancing the success and reach of such health programs.
Abstract:
Paediatric fruit and vegetable prescription programmes hold promise in improving food security and dietary patterns among youth. However, programme success is largely dependent upon caregiver and family engagement. The current study sought to gain a better understanding of environmental barriers to engagement in a paediatric fruit and vegetable prescription programme in one low-income, urban community (Flint, Michigan, USA). Following the implementation of a paediatric fruit and vegetable prescription programme, researchers conducted thirty-two semi-structured interviews with caregivers. Researchers explored caregivers' understanding of the fruit and vegetable prescription programme, barriers to programme engagement, and recommendations for improvement. Telephone interviews were transcribed for textual analysis. Researchers used thematic analysis to examine qualitative data, determine patterns across transcripts, and develop emerging themes. Researchers concluded interviews when data saturation was reached. The majority of participants were female (94%), African American (66%), and residents of Flint (72%). Five recurrent themes emerged: (1) nutrition security; (2) prescription distribution; (3) prescription redemption; (4) educational supports; and (5) programme modifications. Although caregivers indicated that the prescription programme addressed household food insecurity, environmental barriers to engagement were apparent. Caregivers provided suggestions, such as partnering with large grocery stores and developing digital prescriptions, to address programme engagement challenges. Fundamental to the success of fruit and vegetable prescription programmes is the understanding of barriers to engagement from the perspective of participants. This study explores challenges with one paediatric fruit and vegetable prescription programme and provides actionable solutions, from the viewpoint of caregivers, to address these challenges.
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