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Author Notes:

Tracey L Henry, General Medicine and Geriatrics, Emory University, Atlanta, GA 30322, USA; henrytracey@hotmail.com

All authors listed have contributed sufficiently to the project to be included as authors, and all those who are qualified to be authors are listed in the author byline. Authors’ contributions: EC conducted the study and the analysis for the study, and helped to write up the study. SRS (MD) gave idea for study and helped plan and conduct the study and helped write up the study. TLH (MD, MPH, MS, FACP) helped plan, developed and conducted the study along with helping write up the study. SB helped plan, developed and conducted the study along with helping to write up the study. GK (MD) helped plan the study and write up the study. JB-J (MD, FACP) helped plan and developed the study. AWG (PhD) supervised and assisted EC in conducting the study and analysing the study and helped to write up the study.

We would like to acknowledge Wholesome Wave Georgia, Project Open Hand, and The Common Market for their contributions to the FVRx program at our site. We are appreciative to Grady Memorial Hospital and the Primary Care Center for their innovative role in implementing systems change by supporting patient-centred group classes and FVRx prescriptions at our site.

Competing interests: None declared.


Research Funding:

The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.


  • malnutrition
  • nutrition assessment
  • nutritional treatment

Qualitative research study on addressing barriers to healthy diet among low-income individuals at an urban, safety-net hospital


Journal Title:

BMJ Nutrition, Prevention and Health


Volume 3, Number 2


, Pages 383-386

Type of Work:

Article | Final Publisher PDF


Background Some American households experience food insecurity, where access to adequate food is limited by lack of money and other resources. As such, we implemented a free 6-month Fruit and Vegetable Prescription Program within a large urban safety-net hospital. Methods 32 participants completed a baseline and postintervention qualitative evaluation about food-related behaviour 6 months after study completion. Deductive codes were developed based on the key topics addressed in the interviews; inductive codes were identified from analytically reading the transcripts. Transcripts were coded in MAXQDA V.12 (Release 12.3.2). Results The information collected in the qualitative interviews highlights the many factors that affect dietary habits, including the environmental and individual influences that play a role in food choices people make. Participants expressed very positive sentiments overall about their programme participation. Conclusions A multifaceted intervention that targets individual behaviour change, enhances nutritional knowledge and skills, and reduces socioeconomic barriers to accessing fresh produce may enhance participant knowledge and self-efficacy around healthy eating. However, socioeconomic factors remain as continual barriers to sustaining healthy eating over the long term. Ongoing efforts that address social determinants of health may be necessary to promote sustainability of behaviour change.

Copyright information:

© 2020 BMJ Publishing Group. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/).
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