ABSTRACT
People with low incomes suffer disproportionately from diet-related chronic diseases and may have fewer resources to manage their diseases. The "food as medicine" movement encourages healthcare systems to address these inequities while controlling escalating healthcare costs by integrating interventions such as produce prescriptions, in which healthcare providers distribute benefits for fruit and vegetable purchases. The purpose of this study was to identify perceived facilitators and barriers for designing and implementing produce prescriptions within the healthcare system. Nineteen semi-structured in-depth interviews were conducted with experts, and interviews were analyzed using thematic analysis. Overall, interviewees perceived that produce prescriptions could impact patients' diets, food security, disease management, and engagement with the healthcare system, while reducing healthcare costs. Making produce prescriptions convenient to use for patients, while providing resources to program implementers and balancing the priorities of payers, will facilitate program implementation. Integrating produce prescriptions into the healthcare system is feasible but requires program administrators to address implementation barriers such as cost and align complex technology systems (i.e., electronic medical records and benefit/payment processing). Engaging patients, clinics, retailers, and payers in the design phase can improve patient experience with a produce-prescription program; enhance clinic and retail processes enrolling patients and redeeming benefits; and ensure payers can measure outcomes of interest.
