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The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time
Published on: February 19, 2021
Evaluating the impact of an implementation blueprint on a produce prescription program's implementation outcomes
Emily S Fu1,2, Alison Tovar3, Nadia Tsado3
1Departments of Medicine & Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, United States.
Background:
"Food is Medicine (FIM)" programs can improve diet-related health outcomes. Produce prescription programs (PRxs), a type of FIM program, entail healthcare providers "prescribing" free or reduced-cost vegetables. Previous studies have identified multilevel barriers to implementing FIM programs. However, there is scant research examining how implementation strategies can influence FIM implementation outcomes.
Purpose:
Assess changes in implementation outcomes following the introduction of tailored implementation strategies to support the delivery and uptake of a PRx in four participating clinics.
Methods:
VeggieRx is a 6-month PRx in Rhode Island. This single-arm pilot study measured implementation outcomes according to the Consolidated Framework for Implementation Research Outcomes Addendum before and after tailored implementation strategies were applied for the 2023 VeggieRx season. Adoption was measured as the number of VeggieRx referrals. Implementation was measured by the number of individuals and households receiving produce. Patient acceptability was measured via text message after each delivery. Patient food security status and vegetable intake were assessed before and after VeggieRx participation.
Results:
From 2022 to 2023, following the introduction of the implementation strategies, VeggieRx referrals increased by 57.9% and the number of households receiving vegetables increased by 86.2%. Study participants (n = 44) used Most to all vegetables in each delivery (median = 88.6% of weekly responses, interquartile range = 78.4%, 95.5%). The proportion of participants classified as High or marginal food security increased from 18.2% at baseline to 36.6% at follow-up (Cohen's h = 0.42).
Conclusion:
This study demonstrates the value of tailored implementation strategies and their potential to expand the delivery of future PRx programs.
Clinical Trial Information:
The Clinical Trials Registration #NCT05941403.
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