Produce Prescriptions and Veggie Meter Scores for College Food Security

Skin carotenoid levels are measured using the Veggie Meter, a non-invasive device that utilizes reflection spectroscopy to provide an objective biomarker of fruit and vegetable intake. The Veggie Meter score is measured on a continuous scale ranging from 0 to 800 units. A higher score indicates a higher concentration of carotenoids in the skin, which serves as a proxy for increased consumption of carotenoid-rich fruits and vegetables. The study will evaluate the change in these scores to determine the impact of the produce box intervention.

Food insecurity is assessed using the 2-item Hunger Vital Sign screener. This validated tool identifies individuals at risk of food insecurity based on concerns about food running out and the inability to afford more food. Responses are categorized as "food secure" or "food insecure." A participant is considered food insecure if they identify as "often true" or "sometimes true" to either of the two statements. The study will evaluate the change in the proportion of participants categorized as food insecure from the beginning to the end of the intervention.

Fruit and vegetable intake is assessed using the 2-item NIH (National Institutes of Health) All-Day Fruit and Vegetable Screener. This tool asks participants to report the frequency of their consumption of 100% fruit juice and fruit, as well as vegetables (excluding fried potatoes), over the past month. Responses are converted into an estimated score of daily servings of fruits and vegetables. The study will evaluate the mean change in daily servings from baseline to the end of the intervention.

Diet quality is assessed using the 21-item Prime Diet Quality Score (PDQS). The PDQS measures the consumption frequency of 21 distinct food groups, which are categorized into 12 "healthy" food groups (e.g., green leafy vegetables, legumes, whole grains) and 9 "unhealthy" food groups (e.g., processed meats, sugar-sweetened beverages, fried foods).

Scoring logic: > * For healthy food groups, higher consumption frequency receives a higher point value.

For unhealthy food groups, higher consumption frequency receives a lower point value (points are penalized).

The total score ranges from 0 to 42, where a higher score indicates better overall diet quality and higher alignment with a nutrient-dense dietary pattern. The study will evaluate the mean change in the total PDQS score from baseline to study completion.

Subjective well-being and quality of life are assessed using the 5-item World Health Organization Well-Being Index (WHO-5). This validated scale asks participants to rate their well-being over the past two weeks using five positively phrased statements (e.g., "I have felt cheerful and in good spirits").

Scoring logic: > * Each item is scored on a 0 to 5 scale, where 0 is "at no time" and 5 is "all of the time."

The raw score ranges from 0 to 25.

The raw score is multiplied by 4 to generate a final percentage score from 0 (worst imaginable well-being) to 100 (best imaginable well-being).

The study will evaluate the mean change in the transformed (0-100) score from baseline to study completion.