Evaluation of the 2021–2024 Implementation of the Fresh Start Enhanced Food Is Medicine Intervention Among Rural, Underinsured People With Type 2 Diabetes

07/23/26

This study evaluated the feasibility, acceptability, and impact of the Fresh Start produce prescription (FSPRx) intervention among rural, underinsured adults with type 2 diabetes across 15 counties in eastern North Carolina. Over 20 weeks, 414 enrolled participants received 5–7 pounds of produce at group classes and through individual telephone-based health coaching. Approximately half completed pre-post measures. Among active participants — majority female and racially diverse — program satisfaction was high (96.5%), and significant improvements were observed in food literacy, fruit and vegetable intake, and glycemic control, with mean HbA1c decreasing by 0.44% among those with the highest class and coaching attendance. Group class participation was the strongest predictor of improved HbA1c, though overall attendance was limited. The authors conclude that while the program showed strong acceptability and meaningful health impact, feasibility was moderate, and further research is needed to identify the optimal balance of educational and behavioral support in Food Is Medicine programs for rural populations.

Read the full article from the US Centers for Disease Control and Prevention or access the PDF here 

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