Evaluating Appalachian Farmacy: A Qualitative Process Evaluation of a Rural Produce Prescription Program

Abstract

Introduction: Food insecurity remains a critical public health concern, particularly in rural, low-income communities. Produce prescription programs have emerged as a strategy to improve food access and promote healthier eating behaviors. This study presents a qualitative process evaluation of Appalachian Farmacy, a produce prescription program in Northeast Tennessee designed to increase fruit and vegetable consumption among individuals receiving Medicaid, Medicare, or Supplemental Nutrition Assistance Program (SNAP) benefits. Methods: Semi-structured interviews were conducted with program participants to explore their experiences, perceptions of the program, and barriers to participation. Transcripts were analyzed using rapid coding in Microsoft Excel to identify common themes. Results: Themes that emerged included inconsistent treatment and rules across grocery store locations, easy experiences for exchanging vouchers at farmer’s markets, desired changes for smaller voucher increments, barriers to attending educational events, suggestions for additional education topics, expanding sites and times for voucher accessibility, knowledge gained from educational classes, financial relief, increased socialization, overall health benefits, emotional and mental health benefits, changes in eating behaviors, improved access to fruits and veggies, increased variety of produce intake, and desired program expansion. Conclusion: These findings suggest that increasing accessibility—through expanded distribution sites, flexible voucher options, and enhanced educational support—could strengthen the program’s impact. Addressing these gaps can help optimize produce prescription programs as an effective strategy to combat food insecurity and promote healthier eating habits in rural communities.

Start Time

16-4-2025 9:00 AM

End Time

16-4-2025 11:30 AM

Presentation Type

Poster

Presentation Category

Health

Student Type

Graduate Student - Doctoral

Faculty Mentor

Bethesda O'Connell

Faculty Department

Community and Behavioral Health

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Apr 16th, 9:00 AM Apr 16th, 11:30 AM

Evaluating Appalachian Farmacy: A Qualitative Process Evaluation of a Rural Produce Prescription Program

Introduction: Food insecurity remains a critical public health concern, particularly in rural, low-income communities. Produce prescription programs have emerged as a strategy to improve food access and promote healthier eating behaviors. This study presents a qualitative process evaluation of Appalachian Farmacy, a produce prescription program in Northeast Tennessee designed to increase fruit and vegetable consumption among individuals receiving Medicaid, Medicare, or Supplemental Nutrition Assistance Program (SNAP) benefits. Methods: Semi-structured interviews were conducted with program participants to explore their experiences, perceptions of the program, and barriers to participation. Transcripts were analyzed using rapid coding in Microsoft Excel to identify common themes. Results: Themes that emerged included inconsistent treatment and rules across grocery store locations, easy experiences for exchanging vouchers at farmer’s markets, desired changes for smaller voucher increments, barriers to attending educational events, suggestions for additional education topics, expanding sites and times for voucher accessibility, knowledge gained from educational classes, financial relief, increased socialization, overall health benefits, emotional and mental health benefits, changes in eating behaviors, improved access to fruits and veggies, increased variety of produce intake, and desired program expansion. Conclusion: These findings suggest that increasing accessibility—through expanded distribution sites, flexible voucher options, and enhanced educational support—could strengthen the program’s impact. Addressing these gaps can help optimize produce prescription programs as an effective strategy to combat food insecurity and promote healthier eating habits in rural communities.