Fruit and Vegetable Programs

What are they?

Produce prescription (PRx) programs allow health care workers to prescribe fruits and vegetables to patients who meet specific criteria. Depending on the healthcare facility, patient eligibility may be based on chronic disease status or their lack of access to nutritious food.

Produce prescriptions may be used in health care settings, local farmers markets, brick-and-mortar or online grocery stores, or mobile markets. Patients also typically receive vouchers to buy produce or receive produce.

Voucher incentive programs for fruits and vegetables provide consumers with vouchers, coupons, or cash incentives to use at the point of purchase. These vouchers can be physical, such as paper or wood coins, or electronic, such as loyalty or debit cards.

Incentives may be redeemed at participating food pantries, farmers markets, brick-and-mortar or online grocery stores, and mobile markets. Vouchers may also be used in community-supported agriculture (CSA). A CSA enables people to buy a subscription or “share” of a farm’s produce. This allows growers and consumers to share the risks and benefits of food production. In Ohio, these coupons are often distributed by Produce Perks Midwest.

Strategy Components

Led by Case Western's Swetland Center

The Fruit and Vegetable Programs aim to:

1. Improve access to healthier foods by promoting and expanding existing programs and creating new fruit and vegetable programs in the County.
2. Increase the number of people using these programs and the number of sites providing services.
3. Improve community health behaviors, such as healthier food consumption, and reduce the rates of diet-related chronic diseases, including diabetes, obesity, and high blood pressure.

Strategy activities from the Swetland Center Staff include:

• Increasing the awareness and utilization of Produce Path, an app that connects community members to farmers’ markets in their area.
• Recruiting local food justice leaders to participate in a 6-month fellowship program that ensures PRx programs in the County will reach those with the highest risk or burden of chronic diseases.
• Connecting PRx programs with local farmers and growers to support the local economy and provide patients with freshly harvested fruits and vegetables.
• Helping local healthcare providers identify funding sources to develop and implement PRx programs.
• Convening local food justice leaders and other essential stakeholders in the HIP-Cuyahoga Nutrition Equity Committee to support PRx programming in Cuyahoga County.

Produce Prescription Landscape Analysis

Overview

In partnership with Cleveland Fresh, LLC, our partners at the Swetland Center conducted a produce prescription landscape analysis in 2024 to identify assets and gaps related to produce prescription programs. The researchers interviewed:

• Active produce prescription program implementers
• Patients who have participated in a produce prescription or other food as medicine program in the past year
• Local growers, nutrition educators, and food product makers

Who participated?

Sixteen people were interviewed, including five local food leaders (nutrition educators, farmers, and chefs) and 11 PRx implementers (hospital-based and community-based) in Ohio.

Of the programs surveyed…

• 50% partner with Black and CDC’s REACH program focuses on eliminating chronic diseases in communities nationwide by facilitating healthy eating and physical activity for those at the highest risk or burden of these diseases. food leaders to culturally tailor their programming.
• 70% offer additional services (e.g., education, deliveries, and equipment for food preparation).
• Most programs (n=8) see patients for 7-12 months.
• On average, PRx programs in Cuyahoga County serve 82 patients per week.

Read the Full Report

REACH Fellowship

What is the REACH Fellowship?

Modeled after the Nourishing Power Fellowship, the REACH Fellowship is a 6-month program that partners food system leaders with clinical providers to co-develop a produce prescription (PRx) program. This initiative aims to enhance the availability and access to nutrition programs specifically designed for Cuyahoga County residents at the highest risk or burden of chronic diseases. By implementing tailored PRx programs, we can enhance food freedom and promote wealth-building among at-risk communities, while also achieving healthcare savings for providers and insurers.

Interested in connecting with the Swetland Center facilitators or connecting with the fellows? Email reach@case.edu

See the 2025 Fellowship Graduation Photos         Watch the Graduation Ceremony  

Meet the 2025 Fellows