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A University at Buffalo randomized study found that food-insecure older adults used delivered produce at a much higher rate than food provided through vouchers requiring an in-person trip. Produce boxes and meal kits each had an 89.2% redemption rate, compared with 28.3% in the voucher group; the small, 12-week study does not establish whether the results apply to other populations or programs.
A University at Buffalo randomized study found that food-insecure older adults used fresh produce more often when it was delivered to their homes than when they had to collect it using vouchers. Over 12 weeks, produce use reached 89.2% in both delivery groups, compared with 28.3% among participants offered vouchers redeemable at local markets.
The study included 67 adults, mostly African American and over age 65, recruited through primary care clinics at Erie County Medical Center in Buffalo. Participants had reported experiencing food insecurity at times. Researchers randomly assigned them to one of three programs for 12 weeks: weekly produce boxes delivered at home, delivered meal kits containing produce and ingredients for three meals, or vouchers for produce at a mobile market or participating FeedMore Western New York markets.
For the produce-box group, participants could customize their deliveries if they wished. Meal-kit participants chose each week from five or six options. Researchers counted redemption as preparation and consumption of the delivered produce. By that measure, both delivery approaches reached 89.2%; the voucher group’s rate was 28.3%. The study was published in Frontiers in Public Health.
According to the study’s corresponding author, Lucia A. Leone, the delivery groups’ rate fell short of 100% partly because participants were sometimes away or felt they already had enough food. Participants rated both delivery programs highly, scoring them above 9 out of 10 and saying they would recommend them. The findings describe participation and produce use; the source does not report evidence that the programs improved specific health outcomes.
How Delivery Changed Program Use
The findings point to a practical obstacle in food assistance: providing a voucher does not mean a participant can readily reach the place where it can be used. Transportation barriers can make collection difficult, and some people may feel uncomfortable accessing markets run through food pantries, Leone said. Delivering food removes the need for a separate trip to redeem a benefit.
That difference may matter to clinics and organizations designing food prescription programs for older adults who face food insecurity. The study suggests that program access and delivery design can affect whether offered food is actually used. It does not establish that home delivery is affordable at a larger scale, or that the same approach will produce similar results in other communities.
The researchers found no additional increase in produce use from adding meal kits to deliveries. Leone suggested that participants, all over 65, may already have known how to prepare the produce. The meal kits did add food overall, and she said this helped improve food security; the provided report does not give a numerical measure of that change.
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Vouchers Versus Home Delivery
The researchers set out to compare two delivery options with the standard approach described in the study: giving participants vouchers to redeem at a mobile market. Earlier research cited in the report found that only 9% to 18% of voucher recipients used them. That figure comes from prior research, not the control group in this trial, where redemption was 28.3%; the rates should not be treated as a direct comparison from the same study.
In this trial, the home-delivery option was the default. Participants did not have to take an extra step to redeem the food, though they could customize produce orders. Leone said the researchers believe the low-effort delivery setup and ability to tailor orders may have contributed to the results. The study also involved a local delivery partner, FreshFix, whose driver made deliveries throughout the trial. The report notes positive participant comments about the driver, but does not isolate the effect of personal interaction from the effects of delivery or customization.
“The problem historically with food prescription programs is that people get the vouchers but don’t redeem them.”
— Lucia A. Leone, study corresponding author and University at Buffalo associate professor
Limits of the Buffalo Trial
The study was small, local and limited to 12 weeks, with 67 older adults recruited through clinics in Buffalo. The report does not establish whether its results would hold for larger programs, other regions, people of different ages, or delivery models without customization. It also does not provide a cost comparison between home delivery and vouchers.
It remains unclear how much of the difference in produce use came from avoiding travel, having food delivered by a familiar person, being able to customize orders, or other features of the program. Since the meal-kit group did not use more produce than the produce-box group, the trial also does not show an added effect on produce use from including recipes and meal ingredients. The report describes improved food security but provides no specific effect size in the supplied information.
Researchers Plan a Family Study
Leone and colleagues plan to test a similar program with a different group: families experiencing food insecurity who receive Medicaid and have children ages 2 to 6. The University at Buffalo team expects to work with local pediatric practices. The researchers have not yet reported results from that planned study.
That next project could help show whether delivery-based food prescriptions work for households with young children, whose needs may differ from those of older adults. Until those findings are available, the current results are best understood as evidence about food use in one small Buffalo trial, rather than a guarantee that every delivery program will achieve the same rate.
Key Questions
What did the study find?
In a 12-week trial, 89.2% of participants in each home-delivery group used the produce, compared with 28.3% in the voucher group. The trial included 67 food-insecure older adults in Buffalo.
What were the two delivery options?
One group received weekly produce boxes, which participants could customize. The other received meal kits with produce and ingredients for three meals, choosing from five or six options each week.
Did meal kits lead to more produce use?
No. Produce use was 89.2% in both delivery groups. The study did not find a higher redemption rate for meal kits than for produce boxes.
Does the study show that delivery improved health?
The report gives results on produce use and program ratings, and says the added food helped improve food security. It does not report specific health outcomes or show that delivery caused health improvements.
What research is planned next?
The University at Buffalo researchers plan a similar study with Medicaid families experiencing food insecurity who have children ages 2 to 6, in partnership with local pediatric practices.
Source: rss
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