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A University at Buffalo randomized study found that food-insecure adults over 65 used 89.2% of produce in home-delivery programs, compared with 28.3% in a voucher program requiring pickup. The 12-week study tested produce boxes and meal kits; adding meal kits did not further increase produce use.
A 12-week randomized study of 67 food-insecure adults over 65 found that participants used substantially more prescribed produce when it was delivered to their homes than when they had to collect it through a market voucher program. The University at Buffalo researchers reported produce use of 89.2% in both delivery groups, compared with 28.3% in the standard voucher group.
The study compared three food prescription approaches among patients recruited from primary care clinics at Erie County Medical Center in Buffalo. Most participants were African American, and all had reported experiencing food insecurity at least some of the time. One group received weekly boxes of fresh produce delivered by FreshFix, with an option to customize the contents. A second group received home-delivered meal kits containing produce and ingredients for three meals, with five or six weekly menu choices.
The third, standard-of-care group received vouchers to collect produce at the hospital’s mobile market or at participating FeedMore Western New York markets. Researchers defined redemption as preparing and eating the delivered produce. By that measure, both home-delivery programs reached 89.2% redemption; the voucher group reached 28.3%. The results were published in Frontiers in Public Health in a paper titled “A randomized controlled study comparing three food prescription programs for older adults: program design, implementation, and utilization.”
The researchers found that meal kits did not raise produce use beyond the level achieved by produce boxes alone. Participants nevertheless reported positive views of both delivery programs, rating them above 9 out of 10 and saying they would recommend them. The report says greater food availability helped improve food security, but it does not provide a quantified health outcome or establish that the programs reduced illness.
Home Delivery Removes Pickup Barriers
The findings point to access and convenience as practical factors that may affect whether a food prescription gets used. The study’s lead researcher, Lucia A. Leone, said people may not collect vouchers because they lack transportation or feel uncomfortable seeking assistance at places associated with food pantries. In this trial, bringing food to participants’ homes was linked to much higher use than requiring a trip to a market.
That difference matters to health and social-service programs that provide food support but need recipients to be able to obtain and use it. A prescription that goes uncollected may not address limited access to fresh food. The study offers evidence for a delivery model with this small group of older adults, while leaving open whether the same results would hold in larger programs or other communities.
Delivery also involved more than the food itself. Participants praised the driver, Charles Humphrey, and Leone said a consistent, positive contact can help a program succeed. The study does not isolate the driver’s role from the effect of delivery, however, so it cannot establish how much that relationship contributed to the high use.
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Three Programs Tested in Buffalo
Food prescription programs provide free or subsidized food, often through vouchers for produce. The Medical Xpress report says prior research has found that only 9% to 18% of voucher recipients use them. That reported range refers to earlier work; it is not the comparison rate in this trial. In the Buffalo study, voucher redemption was 28.3%.
The researchers tested two delivery formats against that market-based approach. Produce-box participants could adjust their orders, while meal-kit participants chose from weekly options that included ingredients for three meals. Leone said the program made delivery the default and did not require participants to take an extra step to redeem the food. The study was conducted with a local delivery company co-founded by Leone, a detail relevant to the model’s implementation and potential replication.
The study’s authors said the older participants may already have known how to prepare produce, which could help explain why meal kits did not increase use compared with produce boxes. That is the researchers’ interpretation, not a tested explanation of the difference. The trial’s small sample and single-city setting also limit how broadly its results can be applied.
“The problem historically with food prescription programs is that people get the vouchers but don’t redeem them.”
— Lucia A. Leone, corresponding author and associate professor at the University at Buffalo
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Limits of the Buffalo Trial
The trial included only 67 participants recruited through clinics in Buffalo, and most were African American adults over 65. The results do not establish whether home delivery would produce comparable use among other age groups, in rural areas, or at a larger scale. Nor does the reported redemption measure show whether participants’ health improved; the study assessed use of the produce and program experience.
It is also unclear how much each element contributed to the outcome. The delivery groups did not have to travel or complete a separate redemption step, and participants could customize or select food options. The study does not show whether convenience, customization, the relationship with the driver, or a combination of factors accounted for the difference. Researchers also did not report a cost comparison in the source material.
Leone said redemption was not 100% because some participants were away or felt they already had enough food. The report does not specify how many fell into either situation. The 89.2% figure therefore describes produce preparation and consumption in this trial, not a guaranteed result for every delivery program.
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Researchers Turn to Families
Leone and colleagues plan a similar study involving families enrolled in Medicaid who experience food insecurity and have children ages 2 to 6. The research is expected to be conducted with local pediatric practices. That population presents a different test of whether delivery and food choices can support participation, because the recipients and household needs differ from those in the older-adult trial.
The next study may help researchers assess whether the Buffalo findings apply beyond older adults and how a food prescription program can be designed for families. The source report does not give a start date, expected completion date, or details of the planned program arms, so those points remain unannounced.
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Key Questions
What did the study find?
In a 12-week trial, produce use reached 89.2% in both home-delivery groups, compared with 28.3% in the group that had to collect produce using vouchers.
Did meal kits work better than produce boxes?
No difference in produce use was reported between the two delivery approaches. Adding meal kits did not increase use beyond the level seen with delivered produce boxes.
Who took part in the study?
The study included 67 adults over 65 recruited from primary care clinics at Erie County Medical Center in Buffalo. Most participants were African American, and they had reported experiencing food insecurity at times.
Does the study show that food delivery improved health?
The report describes produce use, program ratings and food-security findings, but it does not establish that delivery improved participants’ health or reduced illness.
What research is planned next?
The University at Buffalo team plans a similar study with food-insecure Medicaid families who have children ages 2 to 6, working with local pediatric practices. No timetable was provided in the report.
Source: rss
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