To evaluate a Produce Prescription Programme’s utilisation and its effects on healthy food purchasing and diabetes control among participants with type 2 diabetes.

Prospective cohort study using participants’ electronic health records and food transaction data. Participants were categorised as ‘Frequent Spenders’ and ‘Sometimes Spenders’ based on utilisation frequency. Multivariate regressions assessed utilisation predictors and programme effects on fruit/vegetable purchasing (spending, expenditure share and variety) and on diabetes-related outcomes (HbA1c, BMI and blood pressure).

Patients enrolled by clinics in Durham, North Carolina, USA. Participants received $40 monthly for fruits and vegetables at a grocery store chain.

A total of 699 food-insecure participants (353 with diabetes).

Being female and older was associated with higher programme utilisation; hospitalisations were negatively associated with programme utilisation. Frequent Spender status was associated with $8·77 more in fruit/vegetable spending (P < 0·001), 3·3 % increase in expenditure share (P = 0·007) and variety increase of 2·52 fruits and vegetables (P < 0·001). For $10 of Produce Prescription Dollars spent, there was an $8·00 increase in fruit/vegetable spending (P < 0·001), 4·1 % increase in expenditure share and variety increase of 2·3 fruits/vegetables (P < 0·001). For the 353 participants with diabetes, there were no statistically significant relationships between programme utilisation and diabetes control.

Programme utilisation was associated with healthier food purchasing, but the relatively short study period and modest intervention prevent making conclusions about health outcomes. Produce Prescription Programmes can increase healthy food purchasing among food-insecure people, which may improve chronic disease care.

Mobile produce markets (MPM) offering Supplemental Nutrition Assistance Program (SNAP) incentive programmes have the potential to provide accessible and affordable fruits and vegetables (FV) to populations at risk of food insecurity. The objective of this study is to characterise the customer base of an MPM and describe their participation at twelve market sites serving low-income seniors.

In 2018, customers from an MPM in Rhode Island (RI) participated in a cross-sectional survey (n 330; 68 % response rate), which measured dietary patterns, food security and food shopping behaviours. We compared the shopping habits and market experiences of customers who currently received SNAP benefits with those who did not currently receive SNAP benefits.

An MPM in RI which offers a 50 % discount for FV purchased with SNAP benefits.

This study describes current market customers at twelve market sites serving low-income seniors.

Market customers were mostly low-income, female, over the age of 50 years and Hispanic/Latino. Most customers received SNAP benefits, and almost half were food insecure. In addition, three quarters of SNAP customers reported their SNAP benefits last longer since shopping at the markets. Mixed logistic regression models indicated that SNAP customers were more likely to report buying and eating more FV than non-SNAP customers.

MPM are critical resources of affordable produce and have been successful in improving access to FV among individuals of low socio-economic status in RI. This case study can inform policy and programme recommendations for MPM and SNAP incentive programmes.