07/02/2026
Food as Medicine initiatives like produce prescription (PRx) programs give participants vouchers to purchase free or reduced-cost fruits and vegetables. How often participants actually use these vouchers is central to program effectiveness, but predictors of voucher use are not well understood. Prior studies often excluded non-users, potentially overestimating effects. The researchers used an intent-to-treat (ITT) approach — including all enrolled participants regardless of participation level — to examine what factors predicted voucher redemption in a PRx program among primarily low-income Hispanic/Latino adults with type 2 diabetes.
In this single-arm, pre-post study, they enrolled 154 participants in a 7-month PRx program offering up to $90 in fruit and vegetable vouchers for attending monthly nutrition education sessions. They assessed predictors of redemption including transportation access, baseline fruit and vegetable intake, and knowledge of produce preparation.
The sample was majority female (66.2%), Hispanic/Latino (83.1%), and low-income (88.9% used public health insurance; 76.0% were food insecure). Most participants shared purchased produce with household members (61.2%). The ITT voucher redemption rate was 65.8%, compared to 84.3% when only active participants were counted. Access to a personal vehicle was associated with higher odds of redemption, while little or no knowledge of how to prepare fruits and vegetables was associated with lower odds.
These findings suggest that vouchers alone may not sustain engagement or dietary change. The authors conclude that future PRx programs may be more effective and equitable by pairing vouchers with strategies that address transportation barriers and build participants’ skills around fruit and vegetable preparation.
Read the full article from the Centers of Disease Prevention and Control
