{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T21:16:06Z","timestamp":1780607766137,"version":"3.54.1"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Nutrition during pregnancy significantly impacts maternal and birth outcomes. A key factor contributing to the rise in adverse maternal and birth outcomes is poor nutrition. Produce prescription programs have the potential to address pregnancy-related adverse outcomes such as hypertensive disorders and gestational diabetes, but scientific evidence is limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To conduct qualitative interviews to gain an in-depth understanding of how, why, and in what context should produce prescriptions be implemented to best meet the needs of pregnant women in a clinical setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted interviews with 11 patients with low incomes and\/or experiencing food insecurity and 11 clinic staff from a major metropolitan OB\/GYN clinic. Interview questions were designed to understand attitudes toward participating in or helping implement a produce prescription program. We analyzed the data using a deductive qualitative content analysis approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both patients and clinic staff perceived many benefits to this type of program, including easing financial strain, removing barriers to access, and addressing nutrition security during pregnancy. Both groups described a need to consider participants\u2019 autonomy in the program design. Patients also perceived some drawbacks to the home delivery aspect, such as limited participation by patients due to unstable housing. Staff expressed some concerns about the staff time needed to implement this type of program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There was strong support for produce prescription programs for this population; however, results indicate that they may best meet needs if patient autonomy and delivery-related barriers are considered in the design. Designating screening and enrollment tasks for ancillary staff may facilitate implementation in clinics.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2024.1462908","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T06:13:48Z","timestamp":1736921628000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Gaining stakeholder perspectives to shape a produce prescription program to improve maternal and birth outcomes: a qualitative study"],"prefix":"10.3389","volume":"12","author":[{"given":"Helene","family":"Vilme","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang Fang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Perrie","family":"O\u2019Tierney-Ginn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenchen H.","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oyedolapo A.","family":"Anyanwu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rukhshan","family":"Fahmi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara C.","family":"Folta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"100657","DOI":"10.1016\/j.eclinm.2020.100657","article-title":"Concerning trends in maternal risk factors in the United States: 1989-2018","author":"Bornstein","year":"2020","journal-title":"EClinicalMedicine"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1414","DOI":"10.3390\/jcm9051414","article-title":"Racial disparity in pregnancy risks and complications in the US: temporal changes during 2007-2018","volume":"9","author":"Bornstein","year":"2020","journal-title":"J Clin Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e009227","DOI":"10.1136\/bmjgh-2022-009227","article-title":"Racial discrimination and adverse pregnancy outcomes: a systematic review and meta-analysis","volume":"7","author":"Van Daalen","year":"2022","journal-title":"BMJ Glob Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1093\/advances\/nmaa156","article-title":"Associations between maternal dietary patterns and perinatal outcomes: a systematic review and meta-analysis of cohort studies","volume":"12","author":"Abdollahi","year":"2021","journal-title":"Adv Nutr"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1093\/advances\/nmy123","article-title":"Maternal dietary patterns and birth outcomes: a systematic review and meta-analysis","volume":"10","author":"Chia","year":"2019","journal-title":"Adv Nutr"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1016\/j.ajog.2021.12.035","article-title":"The importance of nutrition in pregnancy and lactation: lifelong consequences","volume":"226","author":"Marshall","year":"2022","journal-title":"Am J Obstet Gynecol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"132","DOI":"10.2174\/18756212MTA1DNTgkw","article-title":"Lifestyle, maternal nutrition and healthy pregnancy","volume":"19","author":"Mate","year":"2021","journal-title":"Curr Vasc Pharmacol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1434","DOI":"10.1007\/s10995-022-03440-3","article-title":"Experiences of food-insecure pregnant women and factors influencing their food choices","volume":"26","author":"Zinga","year":"2022","journal-title":"Matern Child Health J"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e2324005","DOI":"10.1001\/jamanetworkopen.2023.24005","article-title":"Patterns in food insecurity during pregnancy, 2004 to 2020","volume":"6","author":"Hinkle","year":"2023","journal-title":"JAMA Netw Open"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1007\/s11606-018-4716-z","article-title":"Medically tailored meal delivery for diabetes patients with food insecurity: a randomized cross-over trial","volume":"34","author":"Berkowitz","year":"2019","journal-title":"J Gen Intern Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.jcjd.2022.11.001","article-title":"The effect of food is medicine interventions on diabetes-related health outcomes among low-income and food-insecure individuals: a systematic review and meta-analysis","volume":"47","author":"Gao","year":"2023","journal-title":"Can J Diabetes"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e009520","DOI":"10.1161\/CIRCOUTCOMES.122.009520","article-title":"Impact of produce prescriptions on diet, food security, and Cardiometabolic health outcomes: a multisite evaluation of 9 produce prescription programs in the United States","volume":"16","author":"Hager","year":"2023","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"3","DOI":"10.58464\/2155-5834.1356","article-title":"Prescriptions for produce: an intervention with nutrition education, cooking instruction and produce vouchers to increase fruit and vegetable consumption","volume":"10","author":"La Barba","year":"2019","journal-title":"J Appl Res Child Inform Policy Child Risk"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1080\/19320248.2016.1227749","article-title":"Mixed methods evaluation of a produce prescription program for pregnant women","volume":"12","author":"Trapl","year":"2017","journal-title":"J Hunger Environ Nutr"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1017\/S1368980017000180","article-title":"Brief assessment of food insecurity accurately identifies high-risk US adults","volume":"20","author":"Gundersen","year":"2017","journal-title":"Public Health Nutr"},{"key":"ref16","doi-asserted-by":"crossref","DOI":"10.4135\/9781483328126","volume-title":"Developing questions for focus groups","author":"Krueger","year":"1998"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/1748-5908-4-50","article-title":"Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science","volume":"4","author":"Damschroder","year":"2009","journal-title":"Implement Sci"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1186\/s13012-022-01245-0","article-title":"The updated consolidated framework for implementation research based on user feedback","volume":"17","author":"Damschroder","year":"2022","journal-title":"Implement Sci"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"122","DOI":"10.2307\/3380029","article-title":"A competing values approach to organizational effectiveness","volume":"5","author":"Quinn","year":"1981","journal-title":"Public Prod Rev"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"E960","DOI":"10.1001\/amajethics.2018.960","article-title":"Produce Rx programs for diet-based chronic disease prevention","volume":"20","author":"Swartz","year":"2018","journal-title":"AMA J Ethics"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1080\/10852352.2014.973251","article-title":"Food Rx: a community-university partnership to prescribe healthy eating on the south side of Chicago","volume":"43","author":"Goddu","year":"2015","journal-title":"J Prev Interv Community"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.sapharm.2022.09.007","article-title":"Examining the context, logistics, and outcomes of food prescription programs: a scoping review","volume":"19","author":"Cafer","year":"2023","journal-title":"Res Soc Adm Pharm"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1016\/j.jneb.2023.08.006","article-title":"A rural delivery-based produce prescription intervention improves glycemic control and stress","volume":"55","author":"Stroud","year":"2023","journal-title":"J Nutr Educ Behav"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"2409","DOI":"10.1093\/jn\/nxac152","article-title":"Testing the feasibility and dietary impact of a \u201cproduce prescription\u201d program for adults with undermanaged type 2 diabetes and food insecurity in Australia","volume":"152","author":"Wu","year":"2022","journal-title":"J Nutr"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"e13141","DOI":"10.1111\/mcn.13141","article-title":"Guilt, shame, and postpartum infant feeding outcomes: a systematic review","volume":"17","author":"Jackson","year":"2021","journal-title":"Matern Child Nutr"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1251912","DOI":"10.3389\/fpubh.2023.1251912","article-title":"Food is medicine intervention shows promise for engaging patients attending a safety-net hospital in the Southeast United States","volume":"11","author":"Owens","year":"2023","journal-title":"Front Public Health"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e10201","DOI":"10.1002\/lrh2.10201","article-title":"CFIR simplified: pragmatic application of and adaptations to the consolidated framework for implementation research (CFIR) for evaluation of a patient-centered care transformation within a learning health system","volume":"4","author":"Safaeinili","year":"2020","journal-title":"Learn Health Syst"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1186\/s12889-021-12407-y","article-title":"An embedded multiple case study: using CFIR to map clinical food security screening constructs for the development of primary care practice guidelines","volume":"22","author":"Taher","year":"2022","journal-title":"BMC Public Health"},{"key":"ref29","author":"Garfield","year":"2021"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"2633489520988258","DOI":"10.1177\/2633489520988258","article-title":"Provider self-efficacy in delivering evidence-based psychosocial interventions: a scoping review","volume":"2","author":"Shapiro","year":"2021","journal-title":"Implement Res Pract"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1007\/s10488-007-0144-9","article-title":"Interventions in organizational and community context: a framework for building evidence on dissemination and implementation in health services research","volume":"35","author":"Mendel","year":"2008","journal-title":"Admin Pol Ment Health"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1462908\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T06:13:53Z","timestamp":1736921633000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1462908\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,15]]},"references-count":31,"alternative-id":["10.3389\/fpubh.2024.1462908"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2024.1462908","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,15]]},"article-number":"1462908"}}