Higher produce prescriptions improved food security Larger monthly fruit and vegetable benefits led to better redemption, food security, and intake than smaller benefits.
*Randomized community trial; Level 2 (OCEBM).

Citation

Kane RM, Perez-Velazco X, Levi R, et al. Produce Prescription Dose Response: A Randomized Community Trial. Journal of General Internal Medicine. 2026. doi:10.1007/s11606-026-10773-0

Background

Produce prescription programs help people buy fruits and vegetables, but the best monthly benefit amount is unclear. This trial tested whether higher monthly benefits produced better use and diet-related outcomes.

Patients

242 adult clients of a nonprofit social service provider in California; 83% Hispanic and 97% female. Excluded: people already receiving another produce prescription card.

Intervention

Monthly electronic benefits of $80 or $110 for 6 months, redeemable only for fruits and vegetables at major grocery stores.

Control

$40 monthly produce prescription benefit for 6 months.

Outcome

Primary: percent of benefit redeemed. Secondary: food insecurity using the 18-item Household Food Security Survey Module (0 to 18) and fruit and vegetable intake in cups per day.

Follow-up Period

3 months primary endpoint; 6 months total follow-up.

Results

Outcome $40 group $110 group Significant comparison
Food insecurity at 3 months 74.3% (95% CI 62.0 to 86.6) 47.4% (95% CI 31.6 to 63.1) Absolute reduction 26.9 percentage points (CI not reported); NNT≈4
Benefit redeemed over 6 months 58.0% (95% CI 50.1 to 65.9) 69.4% (95% CI 61.9 to 76.8) Absolute increase 11.4 percentage points (CI not reported)
Fruit and vegetable intake at 3 months 2.51 cups/day (95% CI 2.31 to 2.72) 2.89 cups/day (95% CI 2.61 to 3.17) Mean difference 0.38 cups/day (CI not reported)

Analyses were intention-to-treat. The control was a lower-dose benefit, not usual care. No established minimum clinically important difference was reported.

Limitations

Open-label single-community trial with about 30% survey loss to follow-up. Participants were mostly young Hispanic women, limiting generalizability. Diet was self-reported, and health outcomes were not improved or powered for definitive testing.

Funding

American Heart Association; limited commercial bias concern.

Clinical Application

Consider higher produce prescription amounts; $110 monthly improved food security and intake versus $40, but generalizability and health outcomes remain uncertain.