Investigating the barriers of a healthy diet among low-income individuals who suffer from diet-related illnesses living in Atlanta, GA Open Access

Cahill, Erin (Spring 2018)

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Introduction: In Atlanta Georgia, the ninth-largest metropolis of the world’s richest country, thousands of people have limited or no access to fresh food and many are suffering from nutrition-related illnesses like diabetes and heart disease. Within Grady Memorial Hospital, a large, urban safety net hospital providing care to low-income, uninsured and vulnerable populations, food insecurity appears to be more prevalent than in the general metro-Atlanta area. To better understand, and address the barriers that low-income individuals face towards adopting healthier nutrition habits, Grady Hospital implemented a Fruit and Vegetable Prescription Program (FVRx) within their primary care center. During the 6-month program, participants met with a clinician as part of the Healthy Living Group Class, received a prescription to eat more fruits and vegetables, and attended monthly cooking classes offered by a local non-profit organization.

Objective: The purpose of this thesis project was to conduct a post-intervention qualitative evaluation among participants of the FVRx implemented at Grady Hospital from July 2016- December 2016.

Methods: FVRx participants were contacted by phone in June 2017, approximately six months after completing the program. Phone interviews were conducted that focused on program evaluation and capacity to sustain behavior change after completion of the program. Interviews were recorded, transcribed, and a constant comparative analysis was used to compare experiences and perspectives among participants.

Results: Of the original 32 program enrollees, 18 were able to be contacted and agreed to participate in this qualitative evaluation. Overall, participants expressed positive sentiments about their experience, and reported continued use of lessons learned. Those who did not finish the program cited reasons for not continuing as their own or a family member’s poor health, out of pocket costs i.e. co-pays, and lack of affordable transportation or parking. When asked what they believed to be the biggest barrier to healthy eating, the most commonly reported answer was cost of healthier options, including fresh produce.

Conclusions: The skills and knowledge gained through the FVRX program seemed to sustain positive behavior change in many of the participants; however, socioeconomic factors remain as continual barriers to sustaining healthy eating over the long term.



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