P0213 - Prescribing Health with 5210 and Produce Rx: A Pilot Study for Obesity Prevention

Introduction: In West Virginia (WV), 16.6% of the children ages 2-4 who participate in the Women, Infants, and Children (WIC) program and 20.9% of adolescents ages 10-17 suffer from obesity. WV is one of three states whose obesity rates in young WIC participants continue to increase. Contributing factors related to poverty include food desserts with lack of access to healthy food. Historically, medical systems haven’t commonly engaged with community organizations to improve access to and consumption of healthful foods.

Objective: To increase healthy lifestyle counseling and access to healthy foods for low-income children with overweight or obesity by a collaboration between the medical home and the community.

Methods: The study was a non-randomized prospective pilot, approved by the IRB. Children 2-18 years on Medicaid with a BMI > 85th percentile seen at a pediatrician’s office were eligible for enrollment. Standard of care included following the 5-2-1-0 Pediatric Obesity Clinical Decision Support Chart with the 5-2-1-0 Healthy Habits Questionnaire and tracking BMI and healthy lifestyle goals. Patients were offered monthly follow-up visits for four months. Patients received lifestyle counseling, goal setting with the 5-2-1-0 Rx, and an attached $20 produce prescription (Rx). A local farmer set up a “pop up” farmers market on-site monthly during the pilot. Outcome measures were participation with the 5210 office visits, the number of Produce Rx issued and redeemed, and patient BMI.

Data Analysis: The population’s data were analyzed with descriptive statistics. Analyses were conducted with SAS (version 9.4) for BMI (kg/m2) and BMI percent over 95th percentile (BMI%95). Subgroup analysis, with Fischer’s exact test, were conducted to determine the effect of produce prescriptions and office visits on change in BMI percentile.

Results: A total of 44 patients were consented with 59.1% males, 81.8% white and 18.2% black. Seventeen patients did not attend any study visits and were excluded. The remaining 27 patients who attended two, three, and four visits were 59 %, 26 %, and 11%, respectively. Table 1 indicates the BMI%95 results by age group. Figure 1 indicates a scatterplot of baseline to final visit BMI%95. There were 97 Produce Rx’s issued with 45.4% of those redeemed. A BMI percentile decrease was not associated with the number of Rx redeemed or office visits attended.

Conclusion: Even though the small sample size prohibited any statistical significant results, patients had increased access to office visits and utilized produce Rx valued at $880. The 5210 Rx with a Produce Rx is an innovative clinical-community intervention that created a link between clinical and community systems, which is a vital step in establishing an obesity prevention framework.