Community Pharmacy Produce Prescriptions (CP3):

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

The Community Pharmacy Produce Prescriptions (CP3) project is a pioneering initiative designed to implement and evaluate a scalable Food is Medicine (FIM) program by leveraging the unique accessibility of community pharmacies. Spearheaded by the NACDS Foundation, in collaboration with the Food is Medicine Institute at Tufts University and major pharmacy chains including Hy-Vee, Kroger, and Walmart, the project aims to transform pharmacies into key access points for nutritional care.

Community pharmacies are among the most frequented healthcare settings, often visited more regularly than physicians. This high level of engagement and community trust positions them as ideal platforms for expanding access to nutrition interventions. Traditionally, FIM programs have been delivered through hospitals, clinics, or non-profits. CP3 seeks to shift this paradigm by integrating screening, referral, and produce prescriptions directly into pharmacy workflows.

Focusing on individuals with diabetes and/or hypertension who also experience nutrition insecurity, enrolled patients will receive produce prescriptions aiming to improve diet quality and clinical outcomes such as A1c levels and blood pressure. The study will also explore feasibility, sustainability, and payer engagement to support long-term integration of FIM programs in pharmacy settings. 

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 600 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.