'A community supported agriculture produce prescription pilot in the Northern Black Hills: Dakota Food Rx

One in eight South Dakota residents faces food insecurity, which has been linked to increased prev­alence of chronic diseases such as heart disease and diabetes. Produce prescription (PRx) programs have proliferated to ameliorate food insecurity and prevent chronic disease exacerbation through pro­vision of fresh produce to clinically eligible patients. This study conducted a preliminary pro­cess and impact evaluation of Dakota Food Rx, a pilot community-supported agriculture PRx pro­gram in the Northern Black Hills of South Dakota. Healthcare providers (Prescribers) referred adults with low income and/or food insecurity and diet-related chronic disease (Patients) to receive weekly produce boxes from a local specialty producer (Growers). Evaluation measures included Patient pre-post surveys and key informant interviews with Prescribers, Growers, and Patients. Thirty Patients participated in the program, picking up 434 pro­duce boxes (mean 14.5 per patient) valued at over US$14,000 from June-November 2024. Ten pre- and eight post-surveys were completed (seven completed pre-only, five completed post-only, and three completed both); nine interviews were con­ducted. Overall, program satisfaction was high among all participants. Patients responding at post-test had higher food security and sense of commu­nity than those at pre-test. Thematic analysis of the key informant interviews indicated that Patients improved their diet, food access, and overall health; moreover, relationships were built between Patients and other Dakota Food Rx actors. Pre­scribers, Growers, and Patients all reported ways in which they had to adapt to the program, and future considerations included increased communication, improved workflow, and additional resources. The Dakota Food Rx pilot showed promise for improv­ing diet, food security, and sense of community belonging for Patients in rural South Dakota with low income and experiencing or at risk of diet-related chronic disease.