Abstract：
Produce prescription programs within clinical care settings can address food insecurity by offering financial incentives through \"prescriptions\" for fruits and vegetables to eligible patients. The electronic health record (EHR) holds potential as a strategy to examine the relationship between these projects and participant outcomes, but no studies address EHR extraction for programmatic evaluations. We interviewed representatives of 9 grantees of the U.S. Department of Agriculture\'s Gus Schumacher Nutrition Incentive Grant Program\'s Produce Prescription Projects (GusNIP PPR) to understand their experiences with and capacity for utilizing EHR for evaluation. Five grantees planned to use EHR data, with 3 main strategies: reporting aggregate data from health clinics, contracting with external/third party evaluators, and accessing individual-level data. However, utilizing EHRs was prohibitive for others due to insufficient knowledge, training and/or staff capacity; lack of familiarity with the Institutional Review Board process; or was inappropriate for select target populations. Policy support for produce prescription programs requires a robust evidence base, deep knowledge of best practices, and an understanding of expected health outcomes. These insights can be most efficiently and meaningfully achieved with EHR data, which will require increased financial support and technical assistance for project operators.
摘要：
在临床护理环境中生产处方计划可以通过向符合条件的患者提供水果和蔬菜的“处方”来提供经济激励措施，从而解决粮食不安全问题。电子健康记录（EHR）具有潜力，可以作为检查这些项目与参与者结果之间关系的策略，但没有研究解决EHR提取方案评估。我们采访了美国农业部GusSchumacher营养激励资助计划的生产处方项目（GusNIPPPR）的9个受赠者的代表，以了解他们利用EHR进行评估的经验和能力。五个受赠人计划使用EHR数据，有3种主要策略：报告来自卫生诊所的汇总数据，与外部/第三方评估人员签订合同，并访问个人级别的数据。然而,由于知识不足，使用EHR对其他人来说是禁止的，培训和/或工作人员能力；不熟悉机构审查委员会的程序；或不适合选定的目标人群。对农产品处方计划的政策支持需要强大的证据基础，对最佳实践有深入的了解，以及对预期健康结果的理解。这些见解可以通过EHR数据最有效和有意义地实现，这将需要为项目运营商提供更多的财政支持和技术援助。
