The Chickasaw Nation's Produce Prescription Pilot Program - The Chickasaw Nation (CN) Department of Health's (CNDH) Empowered Living program proposes the implementation of a Produce Prescription Pilot Program to improve healthy food access, nutrition and whole-person wellness amongst First American youth and families. Empowered Living is an interdisciplinary pediatric, healthy lifestyle and obesity management program serving children and adolescents ages 2-to-18 years with overweight, obesity and related health risks through coordinated medical, nutrition, physical activity and behavioral health services. The Produce Prescription Pilot Program will be integrated into Empowered Living's existing longitudinal care model and will serve pediatric patients with a body mass index (BMI) at or above the 85th percentile who may also experience food insecurity, obesity-related comorbidities, prediabetes or diabetes risk. Eligible participants may also include non-First American children residing within a First American household meeting program criteria. Participants will receive recurring healthy food support through a combination model that will include produce boxes and traditional or community-relevant food opportunities. The program will emphasize culturally responsive nutrition education and support incorporation of traditional foods when available and appropriate. This will be completed through sessions with registered dietitians surrounding traditional Chickasaw and First American foods, culturally relevant meal planning strategies, seasonal food opportunities and food preparation techniques that support healthy lifestyle goals while honoring cultural food traditions. Approximately 50 participants will be served during the first year of the project, with capacity anticipated to increase throughout the project period. Participants will be identified through the existing Empowered Living referral and enrollment process and will receive routine food insecurity screenings utilizing the Hunger Vital Sign screening tool. Participants will engage in ongoing interdisciplinary care that includes medical management, nutrition counseling, physical activity programming, behavioral health support, family education and group-based programming. During year one of the project period, partnerships will be established with local grocery stores, farmers markets, Chickasaw farms and gardens, tribal food programs and other community vendors to improve access to nutritious foods. Program evaluations will include tracking food insecurity status, nutrition knowledge, produce prescription utilization and redemption, participant retention, healthy eating behaviors and objective clinical outcomes, including body composition measures and other health indicators routinely collected through Empowered Living. Empowered Living is uniquely positioned to implement this project due to its established interdisciplinary care model, demonstrated success in improving health outcomes and existing infrastructure for longitudinal patient engagement. Grant funding will support participant food assistance, nutrition education, community partnerships, program implementation, evaluation activities and dedicated project coordination to support successful program delivery and reporting. The project is expected to improve access to healthy foods, reduce food insecurity, increase nutrition knowledge and support healthier lifestyle behaviors among participating youth and families while establishing a sustainable model for integrating food access interventions into pediatric obesity management.
