Texas Native Health Phase 2 Produce Prescription Pilot Program (P4) - Texas Native Health (TNH), the only Urban Indian Organization (UIO) in Texas, proposes the TNH Produce Prescription and Traditional Foods Wellness Program to address food insecurity, improve nutrition, and support whole-person health among American Indian and Alaska Native (AI/AN) individuals and families. TNH provides integrated medical, dental, behavioral health, nutrition, prevention, and community wellness services and serves AI/AN individuals representing more than 170 federally recognized tribes across the state. Food insecurity and nutrition-related chronic diseases, including diabetes, obesity, hypertension, and cardiovascular disease, disproportionately affect AI/AN communities. TNH's community needs assessments and social determinants of health screenings consistently identify food insecurity as one of the most significant barriers to health and wellness among patients and families. The proposed program will address these challenges through a culturally grounded produce prescription model that integrates healthcare services, food access, nutrition education, and traditional food knowledge. TNH will partner with Fresh Connect to provide produce prescription debit cards redeemable at participating grocery retailers, including Walmart, Kroger, Tom Thumb, and other approved vendors. Eligible participants will be identified through Hunger Vital Sign food insecurity screenings conducted by TNH medical, dental, behavioral health, nutrition, and community development staff. Individuals who screen positive for food insecurity and/or have nutrition-related chronic disease risk factors will be referred to TNH's Registered Dietitian for enrollment. The program will serve approximately 90 AI/AN households annually through twelve-month enrollment cycles. Participants will receive monthly produce prescription benefits, individualized nutrition counseling, culturally relevant nutrition education, traditional foods programming, cooking demonstrations, and community wellness activities. TNH will collaborate with Fresh Connect, Native culinary educators, and community partners to increase access to fruits, vegetables, and culturally relevant traditional foods while promoting healthy eating behaviors and chronic disease prevention. Expected outcomes include reduced food insecurity, increased access to nutritious foods, improved nutrition knowledge, increased consumption of fruits, vegetables, and traditional foods, improved participant well-being, and strengthened connections to traditional food practices. TNH will collect baseline, semiannual, and annual data to evaluate participant outcomes, prescription utilization, nutrition education participation, and program effectiveness. The long-term goal of the TNH Produce Prescription and Traditional Foods Wellness Program is to establish a sustainable, culturally responsive produce prescription model that improves food security, supports chronic disease prevention and management, strengthens traditional food knowledge, and advances whole-person health and well-being among AI/AN individuals and families throughout Texas
