Community Pharmacy Produce Prescriptions (CP3):

Design, Implementation, and Evaluation of a Produce Prescription Program in Community Pharmacies

This project, Community Pharmacy Produce Prescriptions (CP3):  will design, implement, and evaluate a scalable Food is Medicine (FIM) program that leverages the community pharmacy setting as a key access-to-care point for patients. Community pharmacy is a unique healthcare setting, as individuals often visit pharmacies more frequently than they see their physicians or other healthcare providers. As such, this setting presents an opportunity to expand access to nutritional care for patients through screening and referral activities for FIM programming. Pharmacies routinely engage in vital screening and referral services, including monitoring blood glucose, blood pressure, cholesterol levels, and administering vaccinations, among other patient care services.

However, the community pharmacy setting has remained a largely underutilized and understudied platform for advancing FIM. Historically, FIM interventions have been designed and delivered through hospitals, medical clinics, or community non-profit organizations. The next phase of FIM efforts involves expanding screening and referral for such programs to community pharmacies, including those affiliated or co-located with grocery stores, which are common in various locations across the U.S.

This project will leverage the potential of community pharmacies to advance FIM, utilizing them for their high level of engagement and community trust, and generate valuable evidence on the feasibility and impact of FIM interventions in the community pharmacy setting.

Aim 1

To design and implement screening, referral, and delivery of a produce prescription (PRx) program in the community pharmacy setting, in collaboration with pharmacy partners, among 400 U.S. adults with cardiometabolic risk factors and food and/or nutrition insecurity.

Aim 2

To evaluate the impact of the program on nutrition-relevant outcomes, including (a) food security, (b) nutrition security, and (c) diet quality as assessed by a brief dietary screener questionnaire.

Aim 3

To explore the impact of the program on health outcomes, including (a) HbA1c and CGM-based time-in-range among people with diabetes, if applicable (b) blood pressure among people with hypertension, and (c) body mass index (BMI) among people with obesity.

Aim 4

To perform a process evaluation of the program including reach, effectiveness, adoption or dose, implementation, and maintenance, from both community pharmacy and participant perspectives.

Aim 5

To explore sustainability models with the aim to engage payer partners to support the intervention directly, but at minimum, to explore payer interest in covering food prescriptions for their beneficiaries broadly.