Impact of COVID-19 Pandemic on the Fruit and Vegetable Prescription Program in a Pediatric Clinic

Hurley Children's Clinic's novel fruit and vegetable prescription program aims to improve nutrition intake, household food security, and nutrition access. Children receive $15 prescriptions for fruits and vegetables redeemable at the Flint Farmers’ Market or through the mobile market, Flint Fresh, for a home delivered produce box. The COVID-19 pandemic has spread worldwide, resulting in a national decrease in pediatric visits. Children missed routine well-child and health maintenance visits, including necessary vaccinations and screenings. The aim of this evaluation is to better understand how the pandemic impacted the distribution and redemption of fruit and vegetable prescriptions. Using descriptive statistics and chi-square analysis, rates of prescription and redemption before and during the waves of pandemic will be examined at two participating Hurley clinics. Prescription rates reflect provider-driven EMR orders, and redemption rates reflect patient-driven prescriptions submitted in that month to vendors in exchange for produce. Surge one of the pandemic will be defined as March 2020-June 2020; surge two will be defined as November 2020-February 2021. Additionally, change in clinic visit volume will be analyzed. Well-child visits decreased by 21% during the pandemic period. Preliminary results reveal prescription rate decreased from 74.9% the year before the pandemic (March 2019-February 2020) to 59.4% (p < 0.001) the year following the start of the pandemic (March 2020-February 2021). Redemption through Flint Fresh delivered produce boxes increased by 64.7%. Surge-specific time period analysis and redemption rate statistics are being finalized. Rates of fruit and vegetable prescriptions significantly decreased during the pandemic, with a likely associated decrease in redemption rates. This is concerning as Flint's pre-existing nutrition insecurity was exacerbated by the pandemic due to the concomitant economic crisis resulting from rise in unemployment and poverty. Efforts to improve rates should be considered including targeted outreach to patients who missed visits, enhanced telehealth prescribing, provider education, and promotion of COVID-safe home delivered produce boxes. Further analysis will examine impact of case surges and quality improvement strategies. Hurley.