Ko-Kwel Produce Prescription Program - The Coquille Indian Tribe proposes to implement the Ko‑Kwel Produce Prescription Pilot Program (P4), a clinic‑integrated initiative designed to improve access to healthy, culturally relevant foods and support chronic disease prevention among Tribal Citizens and other eligible American Indian and Alaska Native (AI/AN) patients. The program will be delivered through the Tribe’s Ko‑Kwel Wellness Centers in Coos Bay and Eugene, serving both rural and urban AI/AN populations in Coos and Lane Counties. AI/AN communities experience disproportionately high rates of diabetes, cardiovascular disease, and food insecurity, driven by social determinants of health and limited access to nutritious foods. Locally, more than 13% of residents in both Coos and Lane Counties experience food insecurity. Among Coquille Tribal Elders, 39% report diabetes, 89% report high blood pressure, and 21% report difficulty affording food. This data demonstrates a clear need for interventions that directly connect healthcare services with food access and nutrition support. The program will serve approximately 120 participants annually through a structured, integrated model. Healthcare providers will identify and refer eligible participants, who will receive produce prescriptions averaging $85 per month for six months. Participants will access fresh, frozen, and culturally relevant foods through grocery vendors, farmers markets, Tribal food sources, and alternative distribution options designed to reduce access barriers. Participants will receive ongoing support through monthly engagement with health educators or community health staff and quarterly visits with a Registered Dietitian providing nutrition assessment and Medical Nutrition Therapy. This integrated approach reinforces behavior change and supports improved dietary habits and health outcomes. The Coquille Indian Tribe has strong organizational capacity through its Health and Wellness Division, which integrates primary care, nutrition, behavioral health, and community programs. Most program activities will be delivered by existing staff supported through Tribal funding, with grant funds supporting a dedicated Project Coordinator (.5 FTE), food access, and required program operations. This approach ensures sustainability and efficient use of resources. The total Year 1 funding request is $250,000, with the majority of funds directed toward participant food support. Evaluation will include measures of food security, nutrition behaviors, clinical indicators, and participant engagement, supported by continuous quality improvement. By integrating healthcare, nutrition, and food access, this program addresses immediate food insecurity while advancing long-term health, resilience, and Tribal food sovereignty.
