Prevention Produce educates on the value of healthy eating

John Chan, a medical student who helped develop the Prevention Produce program, helps a participant choose vegetables.

Lisa Brown was on mission to find fresh basil. The only problem was that she didn’t really know what it looked, smelled, or tasted like. And Harrisburg’s Broad Street Market had so many leafy green vegetables that she didn’t know where to start.

As a participant in Penn State Hershey’s Prevention Produce program serving women in transitional housing, she was excited to try a new recipe, even though it called for an herb she wasn’t familiar with.

“I never bought that before,” she said.

When she finally found a bunch, Brown wrinkled up her nose, but conceded the basil might taste better than it smelled – especially in a recipe.

Prevention Produce is part of a larger Food as Medicine program led by medical students and was launched by students at Penn State College of Medicine last year. Food as Medicine – or FAM as it is known – also oversees a plot in the community garden on the Penn State Hershey campus that is used for donations to charitable initiatives, and is developing efforts to change the hospital inpatient food menu, among other projects.

Last summer, students developed Prevention Produce, which is modeled after a national program called “Prescription Produce” that allows doctors to write prescriptions for fruits and vegetables for at-risk patients that can be reimbursed at farmers markets. The students innovated upon this model by not only providing “produce prescriptions” to patients but also training a team of their fellow students as “nutrition liaisons” to provide nutritional mentoring to families at market.

Last summer, the group worked with two physicians to identify underserved, at-risk families who they invited to participate in weekly shopping and nutrition education at the farmer’s market with student mentors. Each family was provided with four fruit and vegetable “prescriptions” for $50 of produce redeemable weekly at Farmer’s Market in Hershey, located across from the Penn State Hershey campus. Students shopped alongside participants and modeled how to prepare foods in simple recipes. They also allowed children to pick fresh produce from the FAM community garden plot.

“It’s not a novel thing to subsidize produce, but research consistently shows that without coupling access with education, we’re not making much of a difference,” said Wib Beachy, a second-year medical student who is president of the Food as Medicine group. “That is the unique thing that our program does – pairing participants with someone who can provide education of value to them.”

This year, the students forged a connection with Angela Wise, who works with the Harrisburg YWCA’s Safe Haven permanent supportive housing program to help homeless women. Wise had attended a medical school class to speak about the health needs of homeless populations in the region, and students from Food as Medicine saw an opportunity to extend the Prevention Produce model to people who could really benefit from increased access to healthy foods and nutrition education. This summer, they partnered with Penn State Hershey community outreach nurse Judy Dillon to develop a six-week Prevention Produce program at Harrisburg’s Broad Street Market, located in an area designated as a “food desert” by the U.S. Department of Agriculture for its lack of access to fresh produce.

“We wanted to apply this intervention to a patient population of a lower socioeconomic status so that the free produce and education would really make a difference,” said Beachy, who helped establish the program with fellow FAM members John Chan, Cameron Forbes and Jane Trinkkeller.

Each week at Broad Street, nurse Anna Biser taught the women about important health topics such as smoking cessation, heart health, making exercise fun, first aid and medication safety. Nurse Jodi Hawley followed it up with food-related education on how to modify recipes to make them healthier, how to make one-pot meals, cook on a budget and use portion control.

Then, tokens worth $10 would be given to the women to use on produce with guidance from medical student mentors who shopped alongside them. Each person would go home with bags of fresh fruits and vegetables, while advice and suggestions from the student mentors and nurse educators help them put the produce to good use. The program was a success – so much so that it resumed in September and will run weekly through the rest of the academic year.

“Right now, it’s about establishing our Prevention Produce model, showing its feasibility, developing relationships and gaining trust with our various clinical and community partners,” said Danny George, assistant professor of humanities, who is an advisor for the Food as Medicine group. “Then the next step would be to reach out to different at-risk populations and possibly partner with schools and food banks to refer people to the program.”

To date the program has been funded by small grants, but George says more funding is needed to expand the program’s reach and evaluate how it is improving long-term health outcomes.

According to Wise, this summer’s program has already had significant benefit for her Safe Haven residents. “This experience has exposed them to a lot of fruits and vegetables they didn’t know about,” she said. “Plus, they learn how to budget their money for groceries for the week, they’re using pedometers and some of the smokers are thinking about trying to quit.”

Participant Loretta McCall was excited to win a drawing for a slow cooker during the final session of the program. “They have really helped me get a healthier look on my eating,” she said. Substituting soy, cutting fat, reading nutrition labels and using food preparation methods that don’t involve frying have brought her blood pressure down.

Participant Angela Watson said she now has the information she needs to consider some lifestyle changes, even though they might not happen all at once. “Quitting smoking is something to think about, and I like fresh fruit, but I would rather have chips and soda,” she said. “I haven’t quit those yet, but I eat and drink less of it now. It was like a habit for me.”

As for Lisa Brown, she is excited to share with her seven grandchildren what she has learned about making healthy, fun foods for kids. “I’d like for them to eat healthy, and I think if I start them off good, it will become a habit.”

-Jennifer Vogelsong

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