Need: A tangible way for providers to increase patients' access to affordable healthy food.
Intervention: With Wholesome Rx, a fruit and vegetable prescription program, providers prescribe vouchers for patients to redeem for fruits and vegetables at local healthy food retailers.
Results: Over 10,000 people have received Wholesome Rx prescriptions in rural and urban areas across 10 states.
Rx (formerly known as the Fruit and Vegetable
Prescription Program - FVRx) was started by Wholesome Wave, a
national program that makes fresh, locally grown fruits
and vegetables affordable and available to communities.
Wholesome Rx's evidence-based model offers a tangible
solution to providers looking to help patients who are at
risk of diet-related illness and cannot afford, or
access, healthy food.
WholesomeRx has specifically benefited those living in
medically underserved areas and food deserts.
Participating providers prescribe vouchers to their
patients to be redeemed for produce at local food
retailers such as grocery stores and farmers markets. The
vouchers are typically equivalent to $1 per day and help
to lower the cost of healthy foods, creating incentives
for a more balanced diet.
In 2010, several Wholesome Rx pilot projects were
launched, including one in the rural town of Skowhegan,
Maine. Since then, the program has become
nationally-recognized, successful in 10 rural healthcare
sites and Navajo Nation locations.
Wholesome Rx programs have typically been funded through
private foundations like the Laurie M. Tisch Illumination
Fund; however, state and federal agencies such as the
U.S. Department of
Agriculture have also started to invest in Wholesome
Rx projects. Excitement for this new model has also
created leverage for funding on local levels.
This video highlights the benefits of Wholesome Rx
prescriptions from a provider, a patient, and Wholesome
Wave's Founder and CEO Michel Nischan:
When a patient receives a Wholesome Rx prescription, it
is typically accompanied by nutrition education from a
provider, nutritionist, or dietitian. Depending upon the
care needs of the patient, providers determine a schedule
of checkups in order to measure their progress and write
new Wholesome Rx prescriptions.
Part of this program's purpose is to empower providers
with resources and tools to inspire healthier food
choices in their patients. The National Nutrition
Incentive Network, run by Wholesome Wave, equips new and
existing prescription programs through the following
Technical assistance and capacity building for
practitioners to deliver high-quality, high-impact
Assistance, resources, and training sessions
regarding program development
A community to network and share experiences, ideas,
resources, and solutions
Opportunities to contribute to fruit and vegetable
prescription data collection and evaluation
Opportunities to advocate for the expansion and
adoption of clinic-community nutrition incentives through
To date, Wholesome Rx has achieved the following:
Over 240 retailers have participated as redemption
sites for these prescriptions
Over 2,2824 patients have been enrolled in the
Over 13,000 people have received the benefits of
Wholesome Rx prescriptions
Over $790,000 in fruit and vegetable sales have been
69% increased their fruit and vegetable consumption
45% decreased their BMI
91% agreed or strongly agreed they were happier with
their healthy weight or diabetes care because of
45% of patient households reported an increase in
food security over program period
Articles highlighting the Fruit and Vegetable
Winter months can make fresh produce hard to come by,
especially as farmers markets are closed. Because of
this, some locations extend their program over winter
months by partnering with other local healthy food
Skepticism leads some local food retailers to be
hesitant about participating. Convenience stores may also
be hesitant to participate since the majority of their
profit comes from packaged foods.
Keeping the price of fresh produce low is difficult
in some locations where cost is driven by wholesale food
Some patients who are eligible for Wholesome Rx prescriptions
do not want to be associated with a program that is
related to obesity and other diet-related diseases.
Develop strong partnerships with healthcare
organizations, local food retailers, farm businesses,
local government, and community organizations.
Identify program "champions" who are capable of
motivating staff and dedicate adequate time to designing
and implementing the prescription program.
Design a program to work within existing healthcare,
clinical practices, and retail practices to limit
administrative staff time and healthcare expenses for
Ensure that the program is designed so that
participants can easily access redemption locations by
walking, cycling, or using public transportation. If
possible, choose retail sites where participants are able
to redeem prescription incentives multiple times per
week, or during more convenient hours of the day and
Consider including those without diet-related
diseases in the Wholesome Rx program so as not to deny
healthy food access to those who could greatly benefit
from the prescriptions.
Please contact the models and innovations contact directly for the most complete and current information
about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The
programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural
community should consider whether a particular project or approach is a good match for their community’s
needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep
in mind that changes to the program design may impact results.