"You Guys Really Care About Me...": a Qualitative Exploration of a Produce Prescription Program in Safety Net Clinics
"You Guys Really Care About Me...": a Qualitative Exploration of a Produce Prescription Program in Safety Net Clinics
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DOI：
10.1007/s11606-019-05326-7
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发表时间：
2019-11-01
影响因子：
5.7
通讯作者：
Bolen, Shari
中科院分区：
文献类型：
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作者：
Schlosser, Allison V.;Smith, Samantha;Bolen, Shari
背景虽然研究表明，生产处方（PRx）计划增加水果和蔬菜（FV）的消费，很少有人知道参与者如何体验them.ObjectiveTo更好地了解参与者如何体验PRx计划的高血压成人在3个安全网诊所与20个农贸市场（FM）在克利夫兰，OH。设计我们进行了半结构化访谈5计划提供者，23名患者参与者，接受访谈的患者主要是中年人（平均年龄62岁）、非洲裔美国人（100%）和女性（78%）。提供者主要是中年男性和女性的不同种族/ethnics.InterventionHealthcare提供者招募成年患者谁是食物不安全和诊断为高血压。参与患者每月参加一次门诊访视，持续3个月。每次访视包括血压（BP）检查，BP控制的饮食咨询，生产处方，并在当地FM兑换的生产券。方法患者访谈集中在（1）对食物，健康饮食和FM的信念;（2）基于诊所的计划经验;（3）FM的经验。供应商和市场经理的访谈侧重于计划提供。所有的采访录音，转录，并分析thematically.Key ResultsWe确定了四个中心主题。首先，提供者和患者报告在计划活动中的积极互动，但提供者努力将计划整合到他们的工作流程中。第二，患者报告更大的FV摄入量和FM购物过程中的程序。第三，社交互动增强了节目体验。第四，经济困难影响患者的购物和饮食模式，但这些困难被最小化在一些参与者的病人deservingness为program inclusion.ConclusionsOur的研究结果突出的承诺和挑战的PRx计划，为经济上处于不利地位的慢性病患者。患者参与者报告说，由于该计划，他们与供应商的互动得到改善，FV消费增加，健康饮食融入了他们的社交网络。未来的工作重点应该是将PRx有效地整合到临床工作流程中，利用患者社交网络，并包括维持行为改变的经济支持。
BackgroundAlthough research shows produce prescription (PRx) programs increase fruit and vegetable (FV) consumption, little is known about how participants experience them.ObjectiveTo better understand how participants experience a PRx program for hypertensive adults at 3 safety net clinics partnered with 20 farmers' markets (FMs) in Cleveland, OH.DesignWe conducted semi-structured interviews with 5 program providers, 23 patient participants, and 2 FM managers.ParticipantsPatients interviewed were mainly middle-aged (mean age 62 years), African American (100%), and women (78%). Providers were mainly middle-aged men and women of diverse races/ethnicities.InterventionHealthcare providers enrolled adult patients who were food insecure and diagnosed with hypertension. Participating patients attended monthly clinic visits for 3 months. Each visit included a blood pressure (BP) check, dietary counseling for BP control, a produce prescription, and produce vouchers redeemable at local FMs.ApproachPatient interviews focused on (1) beliefs about food, healthy eating, and FMs; (2) clinic-based program experiences; and (3) FM experiences. Provider and market manager interviews focused on program provision. All interviews were audio-taped, transcribed, and analyzed thematically.Key ResultsWe identified four central themes. First, providers and patients reported positive interactions during program activities, but providers struggled to integrate the program into their workflow. Second, patients reported greater FV intake and FM shopping during the program. Third, social interactions enhanced program experience. Fourth, economic hardships influenced patient shopping and eating patterns, yet these hardships were minimized in some participants' views of patient deservingness for program inclusion.ConclusionsOur findings highlight promises and challenges of PRx programs for economically disadvantaged patients with a chronic condition. Patient participants reported improved interactions with providers, increased FV consumption, and incorporation of healthy eating into their social networks due to the program. Future efforts should focus on efficiently integrating PRx into clinic workflows, leveraging patient social networks, and including economic supports for maintenance of behavior change.