Implementing a Produce Prescription Program for Hypertensive Patients in Safety Net Clinics

Abstract

Introduction. Although community–clinical linkages can improve chronic disease management, little is known regarding strategies for program implementation. We describe implementation of a unique produce prescription program for patients with hypertension (PRxHTN) involving 3 safety net clinics and 20 farmers’ markets (FMs). Strategy. Safety net clinics were invited to participate, and provider-leads received assistance in (1) developing a process flow to screen for food insecurity among hypertensive adults for program referral, (2) integrating the program into their electronic health record for scheduling, and (3) counseling patients on PRxHTN/FM use. Research staff met with clinics twice monthly. FM managers were trained on maintaining PRxHTN voucher redemption logs. Discussion. A total of 7 diverse providers screened 266 patients over 3 months; 224 were enrolled. Twelve FM, including one newly established at a clinic through provider–FM manager collaboration, redeemed over $14,500 of the $10 PRxHTN vouchers. We describe several strategies that can be used to prepare for and overcome implementation challenges including organizational and staff selection, facilitative administration, and clinical training and consultation. Conclusion. The PRxHTN program offers a flexible implementation process allowing clinics to successfully adapt their workflow to suit their staffing and resources.