Fresh produce prescription programs aim to improve health outcomes for people facing food insecurity by providing free fruits, vegetables, and other nutritious foods. However, traditional voucher-based systems have struggled with low participation, with only 9% to 18% of recipients actually using their benefits.
A new study from the University at Buffalo has identified a potential solution: home delivery of fresh produce increases redemption rates dramatically. The findings, published in Frontiers in Public Health, show that when foods are delivered directly to participants’ homes, nearly 90% of recipients actually use the benefits—compared to just 28.3% in traditional voucher programs.
The 12-week randomized controlled trial involved 67 adults over age 65, primarily African-American, who had experienced food insecurity. Participants were recruited from primary care clinics at Erie County Medical Center in Buffalo. The study tested three different approaches to food prescription delivery.
Home Delivery Boosts Participation
One group of participants received weekly fresh produce boxes delivered to their homes through FreshFix, a local food delivery company co-founded by lead researcher Dr. Lucia A. Leone. Recipients could customize their produce selections if they chose. Another group received home deliveries of healthy meal kits that included produce plus all ingredients needed to prepare three meals.
The third group served as the control arm received vouchers redeemable at the ECMC mobile market or at FeedMore Western New York markets across Buffalo. This standard approach mirrors how most food prescription programs operate.
Researchers chose this design to test whether delivery eliminates common barriers to participation. Many people cannot access food pantries or mobile markets due to transportation challenges or concerns about being seen receiving assistance. These locations can also carry stigma for some recipients.
“We wanted to overcome those barriers,” explained Dr. Leone, corresponding author and associate professor of community health and health behavior. “We wanted to find out, does delivery improve redemption of food prescriptions? Does having a meal kit mean that people would use more produce?”
The results were striking. Both home delivery groups achieved an 89.2% redemption rate, defined as preparation and consumption of the delivered produce. The control group’s redemption rate was only 28.3%. Redemption fell short of 100% when participants were away from home or already had sufficient food supplies.
Interestingly, adding meal kits did not significantly improve produce usage among seniors, who already knew how to prepare fresh vegetables. However, the larger quantity of food provided through meal kits did help improve overall food security for participants.
Participants in both intervention arms rated the program highly, with scores above 9 out of 10, and nearly all said they would recommend it to others. They also praised their delivery driver, Charles Humphrey, describing him as a “wonderful, personable person” who ensured smooth delivery throughout the study period.
The UB study’s success stemmed from two key design features: making home delivery the default option rather than requiring action from participants, and offering customization through the partnership with FreshFix. Most delivery programs send identical boxes to all recipients, but this approach allowed tailoring to individual preferences and needs.
The study was funded by the American Heart Association and involved partners including FreshFix, FeedMore Western New York, and the UB Veggie Van. Dr. Leone and her team have since received National Institutes of Health funding to replicate this research with families on Medicaid experiencing food insecurity and young children ages 2-6.
Design Innovations and Future Research
Dr. Leone emphasized that making delivery the default option removed participant burden. Unlike typical programs requiring recipients to act, this model required no additional steps beyond receiving the boxes. Customization through FreshFix allowed recipients to select preferred produce, avoiding waste and increasing satisfaction. The partnership with a local delivery company enabled this tailored approach, which researchers noted is rare in larger-scale programs.