YMCA Produce Prescription Project (YPRx)

Change in body weight will be measured by change in absolute pounds and percent of body weight. Participants will provide self-reported weight in pounds via quarterly online surveys at baseline, 3 months, 6 months, 9 months, and 12 months (endline).

Change in physical activity will be measured by the change in absolute minutes of physical activity and percent change in time spent being physically active. Minutes spent being physically active over the past 7 days, self-reported via quarterly online surveys at baseline, 3 months, 6 months, 9 months, and 12 months (endline).

Change in food insecurity will be measured using the 6-question U.S. Household Food Security Screener Module which ask participants about food security within the household framed around personal and familial food consumption based on the ability to afford food in the past 30 days. Responses will be self-reported via online surveys at baseline and endline (12 months).

Change in dietary intake will be measured using the National Cancer Institute's Dietary Screener Questionnaire. Frequency of food and beverage consumption over the previous month will be self-reported by participants via online surveys at baseline and endline (12 months). Foods and beverages include: "Pure Fruit Juices", "Fruit", "Green Leafy or Lettuce Salad", "Fried Potatoes", "Other Kinds of Potatoes", "Cooked Beans", "Vegetables", "Salsa", "Pizza", and "Tomato Sauce". Responses to all questions will be measured using 11-point scale ranging from "Never" to "6 or more times per day" for "Pure Fruit Juices", a 9-point scale ranging from "Never" to "2 or more times per day" for all other food categories, plus an additional response option "Don't know/Prefer not to answer" for each question.

Change in food behavior will be measured as the change in number of days (0-7) the participant, or someone else in their family, cooked dinner at home during the preceding week. Frequencies will be self-reported by participants via online surveys at baseline and endline (12 months).

Change in self-rated health assessment will be measured by the change in participant's self-rated health assessment collected via online survey at baseline and 12 months using a five-point Likert scale ("Poor" to "Excellent") .

Change in healthcare utilization will be measured by the change in frequency of accessing healthcare during the three months preceding baseline and endline. This outcome will be measured by whether or not the participant accessed various types of medical attention ("Yes", "No" "Don't know/Prefer not to answer"), and if so, how many times ("None" to "16 or more" plus "Don't know/Prefer not to answer") as self-reported via online surveys at baseline and endline (12 months).

Change in healthcare utilization will be measured by comparing healthcare claims data at baseline and endline (12 months).

Change in participant HbA1c will be measured by the absolute change and percent change in HbA1c levels retrieved from healthcare claims data at baseline and endline (12 months).

Participant satisfaction with the YMCA Produce Rx program will be self-reported via online surveys at 4 weeks, 3 months, 6 months, 9 months, 12 months. Questions will include rating: the experience measured on a 6-point Likert scale ("Very negative" to "Very positive" plus "Don't know/Prefer not to answer"), the quality of produce measured on a 5-point Likert scale ("Very high quality" to "Very low quality"), familiarity with the produce measured on a 4-point Likert scale ("Very familiar, I received produce I already purchased and ate often" to "Very new, I received produce that was unfamiliar or new to me"), the quantity of produce measured on a 3-point Likert scale ("Not enough, I ran out and would have liked to have more" to "Too much, I often had leftover produce that I didn't use").

Participant satisfaction with the YMCA Produce Rx program will be self-reported via online surveys. One question asks about difficulties or challenges with the program and is presented at 4 weeks, 3 months, 6 months, 9 months, and 12 months (endline). A second question asks if there is anything else the participant would like to share and is presented at 12 months only. Both questions will be measured using written responses submitted in open text boxes.

Self-perceived impact of the YMCA Produce Rx program on participants will be self-reported via an online survey at endline (12 months). Four questions ask participants about the program's impact on their excitement toward learning about healthy eating, ability to eat healthier, and ability to save time and money, using a 5-point Likert scale from "Strongly Disagree" to "Strongly Agree".