I appreciated the recent Viewpoint by Virudachalam et al1 highlighting the critical need to expand produce prescription programs to children as a means to advance food equity. As the principal investigator of Food for Health, a randomized clinical trial of a produce prescription program for children at New York City Health + Hospitals, the nation’s largest public health care system, I wholeheartedly agree with the authors’ sentiments. However, I regret that they overlooked the rapidly growing modality of home delivery of fruits and vegetables, which eliminates multiple barriers to inequitable fruit and vegetable access and stands to play an important role in advancing food and health equity. [JAMA Pediatrics}
Providing vouchers or on-site pickup for prescribed produce is often a substantial barrier to fruit and vegetable access among both rural and urban populations, who often face inequitable access to healthy foods. Studies of produce prescription programs have found that, in addition to limited proximity to prescription redemption locations, barriers to redeeming produce prescriptions include limited mobility, limited or unreliable transportation, and lack of childcare.2 In recent years, produce prescription programs have begun to deliver fruits and vegetables to participants’ homes, but these have been pilot studies or serve adults.3,4
To our knowledge, Food for Health is the first large study of a produce prescription program for children that delivers locally grown produce directly to participants’ homes.5 Our team chose home delivery to eliminate barriers to fruit and vegetable access, which we know are many among the population we serve, and to thereby advance food and health equity. Although this is more costly than vouchers or on-site pickup, we feel strongly that the benefit of overcoming barriers to fruit and vegetable access is worth the cost.
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