Maternal Produce Prescription Program - The University of California San Diego Center for Community Health (UC San Diego CCH), in partnership with Family Health Centers of San Diego (FHCSD), and Foodshed Cooperative, proposes the Maternal Produce Prescription Program. The program is an innovative Food is Medicine initiative designed to address critical maternal and infant health disparities among low-income pregnant and postpartum women experiencing nutrition insecurity in San Diego County by integrating food access into the continuum of prenatal and postpartum care. Despite the region's economic vitality, access to healthy foods remains a significant challenge in San Diego County, with one in four residents experiencing nutrition insecurity. These disparities are especially concerning during pregnancy and postpartum, when nutrition insecurity can contribute to poor maternal health and adverse birth outcomes. While programs such as WIC and CalFresh provide essential support to pregnant and postpartum women, an estimated 40% of households with children facing nutrition insecurity in San Diego County do not qualify for these programs, and many who do still lack consistent access to fresh fruits and vegetables and the resources needed to implement nutrition recommendations provided during healthcare visits. The Maternal Produce Prescription Program addresses this critical gap in maternal care. The program will serve approximately 500 low-income pregnant and postpartum women over four years through three annual cohorts. Participants will be recruited through maternal health clinics and community-based organizations. Eligible participants will be at risk for nutrition or food insecurity; priority given to women enrolled at or before 16 weeks gestation. Each participant will receive a standardized 12-month intervention including four integrated components: (1) biweekly home delivery of 10-20 pounds of fresh fruits and vegetables sourced from local farms; (2) monthly culturally and linguistically appropriate nutrition education focused on healthy pregnancy nutrition, breastfeeding, meal planning, fruit and vegetable consumption, and family nutrition; (3) individualized healthy lifestyle coaching and patient navigation to support behavior change and connect participants with healthcare, behavioral health, breastfeeding, housing, transportation, WIC, Healthy Start, and other community resources; and (4) continuous quality improvement informed by participants, providers, community partners, and a multi-sector Community Advisory Board. The project team will evaluate program reach, effectiveness, adoption, implementation, and sustainability using the RE-AIM framework. Key outcomes include improvements in fruit and vegetable consumption, diet quality, food and nutrition security, healthy eating behaviors, maternal well-being, mental health, gestational weight gain, birth outcomes, and healthcare-community integration. UC San Diego CCH will provide overall program leadership, coordination, and evaluation, building on an established Food is Medicine infrastructure and longstanding healthcare, public health, food system, and community partnerships. FHCSD, as a leading provider of maternal health services in the region, will facilitate participant enrollment and integrate the intervention into clinical care. Foodshed Cooperative, a local community-based organization, will ensure access to local farm-fresh produce, coordinating bi-weekly home deliveries to participants. Together, these partners combine clinical, community, and food system resources to create a coordinated, participant-centered, scalable model capable of addressing both maternal healthcare needs and social drivers of health. By linking healthcare delivery with healthy food access and supportive services, the Maternal Produce Prescription Program advances health equity, strengthens local food systems, and improves outcomes for mothers and infants across San Diego County.
