P056 Challenges and Successes of a Pediatric Produce Prescription Program During COVID-19

BACKGROUND: A large pediatric clinic in Flint, Michigan, a low-income, urban community, implemented a fruit and vegetable prescription program for youth to address enduring challenges with food access and food insecurity. Approximately 18 months after this prescription program was introduced, the State of Michigan issued a “stay home, stay safe” executive order in response to the COVID-19 pandemic. OBJECTIVE: This study sought to investigate perceived changes to access and utilization of fruit and vegetable prescriptions as well as general changes in the food environment that resulted from the pandemic and related executive order. STUDY DESIGN, SETTING, PARTICIPANTS: Data were collected using semi-structured telephone interviews with caregivers of children (8-18 years of age) who received at least one fruit and vegetable prescription. MEASURABLE OUTCOME/ANALYSIS: Interview recordings were transcribed verbatim for textual analysis. Using thematic analysis, qualitative data was examined to identify patterns across transcripts and formulate common themes. Interviews concluded when data saturation was reached. RESULTS: Fifty-six caregivers participated in interviews (mean age, 41.3 ± 10.3 years). The majority were female (91%), African American (70%), and residents of Flint (75%). Four recurrent themes, centered around changes in the food environment resulting from COVID-19, emerged: produce prescription access and utilization; food access constraints; food shopping adjustments; and food insecurity stress. CONCLUSIONS: The current study highlights stark ramifications of COVID-19, particularly among vulnerable families, many of whom were at elevated risk for food insecurity and hunger prior to the pandemic. Perceived consequences of COVID-19 included increased anxiety related to food shopping and food insecurity alongside challenges with access and utilization of a fruit and vegetable prescription program as pediatric clinics moved to virtual healthcare visits and farmers’ markets closed. FUNDING: Michigan Health Endowment Fund