Food prescription programs are a growing trend across the retail industry, promoting produce through partnerships with health care and non-profit organizations. During this podcast, Jillian Griffith MSPH, RDN, LDN, In-store Nutritionist at Giant and Lorena Kaplen, RDN, LDN, West Regional Dietitian for H-E-B will discuss their retailers’ experiences with food prescription programs. Hosted by RDBA Executive Director Annette Maggi, MS, RDN, LD, FAND, topics discussed will include funding strategies and partnerships, retail logistics for program implementation, scalability and longevity of programs, and the value of food Rx programs.
Welcome to today's Lost in the Supermarket podcast. My name is Annette Maggi, the executive director of the Retail Dietitians Business Alliance. Today's topic of our podcast is food distribution programs. Are they truly a prescription for success that retail food prescription programs? They're growing friend across the retail industry, promoting produce the partnerships with healthcare and nonprofit organization. Many produce prescription programs, Target budget conscious stoppers or those who participate in federal programs like the Supplemental Nutrition Assistance Program. Some are focused on consumers with health conditions, including heart disease or diabetes. Wholesome Wave operates a program with $1.5 million in funding from Target. Grover launched a pilot project where doctors refer patients to nutrition experts at the retailer. Today, we're fortunate to have two retail dietitians with us, those who have experience with food prescription programs. Gillian Griffith is an in store nutritionist, that giant and Loretta Kaplan is the West Regional dietitian for a TV in Texas. Today they'll share their insight and experience with produce perspective programs. Jillian and Lorena thanks for being with us today.
Thanks for having me.
So I'd love to kick off with both of you just really giving a description of your retailers Food, prescription programs. Jillian, do you wanna start us off?
Yeah, sure. So in March of 2019 Giant Food We actually launched our produce prescription program in March 2019. The process for developing it started way before, but it's in partnership with a nonprofit D. C. Greens easy Department of Health and Amar'e Health care. A task. And through the program, we offer Ward eight residents in Washington, D. C. Who are Medicaid beneficiaries through mere health care, a task D. C. And currently experiencing diet related chronic illness and who also are experiencing food and security. They are eligible for the program and essentially receive a prescription for fruits and vegetables from their health care provider. And those prescriptions are filled at the pharmacy in my store giant one album Avenue in Southeast D. C. Though the patient who has now met with their physician and was written a prescription, they check in at the pharmacy and are able to receive prescription in the in the form of up the coupon or a voucher for $20 a week and fresh produce, and they can either redeem their one week for $20 or get two weeks at a time till $40 totalling $80 a month and fresh produce. And then I want to be connected with me and the instant nutritionist, or either individual consultations or I have. I have a variety of different classes that offer in the store. We have a wellness space in the store that we also opened up at the same time is launching this program. So and my wellness based idea weekly diabetes classes as well as other other classes and store tours and things along those lines.
And Jillian, how many people do you have participating in the program today?
So I'm not sure the latest numbers, but a little over 400. I believe this is a pilot program, and I think their goal of 600 for the pilot DC Greens is working hard. Thio get additional funding to expand the program, so I know that they're hoping expanded beyond that the initial pilot numbers
And it's just that you're one store, right?
Right now? Yes, right now, it is just that my one store I'm so there is five clinics in Ward eight that are participating. So you know you'll be eligible for the program. You have to be seeing a medical brighter at one of those clinics, and then you also have to have a mirror health insurance to be enrolled in the program. So it's a pilot for right now.
Loretta, do you want to share a little bit of background on the program at 80 B?
Absolutely. So our program at H E. B was called Prescription from Produce and just let you know what we come in more from a perspective of what we attempted on the program no longer exist, but I think there's gonna be some really great findings once we finish going through all of our data that we collected to be able to make sure whatever we do, try this program again, that it just becomes successful because there was a lot of great learnings through what we offered, and so through prescription for priorities. This was a program that was actually offered to pregnant or expecting moms. They were sourced from a local O b G y n. We partner with a couple of of doctors that could identify the need for assistance for parties. And with this demographic, basically, you were eligible. If you are eligible for snap and those air basically the qualifications you need it to be, at least in your first trimester and eligible for snap to be considered for the program. We then did have 1/3 party help with sponsorship and funding for the program. And so logistically it was managed through h e B on are partnering o b g y n ds, and we'd be both played a part in making sure we were gonna have participants to come through the program. And so the way the program was laid out is once we identified our participants, they were they were invited to come to a TV to have a grocery store tour, and then that was gonna be followed by a cooking demo. The cooking demo was good. Incorporate all of these wonderful vegetables forces. So the funding did cover vegetable sourcing, vegetable fruit sourcing from the first parties from our frozen department and then are in aisle camps. And so we went through the store gathered. These items came to a teaching room to be would have put these items together. What was really great about this program was how interactive we could get with the participants. And they really drove the show for a cooking demo in terms of picking out what they wanted to try and picking out seasonings and and really trying to get a feel for Okay, this is something I can start to incorporate in my everyday cooking. So that was a really fun piece about that being able to interact with these women. And so the program ended up running about six months, in my opinion, definitely not long enough to be able to get something off the road. I think we needed to do it a little bit longer. But like I said right now, with all of the data that we collected, we're currently going through the learnings and we do it. Expect those those signings to be published so more to come.
Yeah, first are in Lorraine. It's interesting because your program really focused on all forms of fruits and vegetables, not just fresh produce. It sounds like
correct, Yes, And so we definitely highlighted all those sources, which made it a little challenging from from some of the other pieces. I think we'll get into it a little bit, but you know T include all forms and different. Accused of what would be eligible to be purchased with this with this gift card was, and that's one thing I didn't imagine. The participants were given a gift card to Mabel to purchase their items.
Well, in Llorona, that's a great Segway into a discussion around. Obviously there some logistical things that have to be managed at the retail company for implementation of any kind of food or produce prescription program. Llorente. Do you want to talk about that a little bit?
Yeah, absolutely. A cheapie took on the logistical piece of making sure that on the front end, you know, these participants wouldn't have any trouble coming to the registry to be able to ring out these things with their gift cards. With that being said, on the back end of that, there's a
whole lot of work
being done by our teen to include all those he'll use and items that can be purchased. Aside from that, you know, that was that was mostly a TV's part playing this aside from that myself, making sure that I have everything ready to logistically for rooms and course my time to be able to provide these classes classes what would have always been led by one of our dietitians. Mean So then the other piece of that is sourcing these sourcing these participants, right from retails template, definitely working really closely with with the folks who helped to create the gift card to, ah, source all this cues and make sure that they were included, not it was a big, big piece.
Dylan. What would you add from your perspective related to logistics for the retailer?
So from our end, we've had such a great partnership with D. C. Green Suit is, and they've really been kind of like the pipe work in the background, connecting all the different partners and really, you know, helping to manage everything happening when the clinical side, where participants are engaging with their medical providers and just raising awareness about the program and helping with training when the clinic cipher and rolling into the program as well as in with their health care tax, they've really been leading the efforts From that end, essentially, we've been responsible for the process is dining at the pharmacy counter, ending a checkout. So that includes our pharmacists or pharmacy team up keeping the redemption logs. So, you know, training for the pharmacy team and then keeping what? That to date husband a manual log at the pharmacy counter connecting the the patient i D codes. Because this is ah, this is, ah, pilot programming. There's data being collected, and so everything's kind of hip are protected. So, you know, mashing the codes with the participant i d. Numbers and all that's been Emmanuel process. And that's, you know, being shared back Toa Giant and then kind of well, Arena was talking about but updating the u. P. C code. So with all of our produce, you know, which is ever changing on the shelves. So updating the different produces its hatch to the voucher, Um, as new produce items are added to the shells and then also just associate education at the store level. So making off, making sure all of our store associates are where the program and what items are eligible of being able to just help with customer service. And, you know, at the beginning of the program there were a lot of glitches, so making sure that we're still serving our customers in, you know, making them happy. If there there was a hick up with the voucher, not working or you know there's question. So there's There's been a lot of support needed, hands on support needed from not only our in store associates, but time from our corporate associates to to make sure that everything's running smoothly and we're lifting all the learnings. And we started off with weekly Falls. So it's definitely been a learning process when a lot of logistics in the background then also for me. So as the Install Nutrition is trying to connect with all the participants in the program, make sure I'm providing classes that are relevant for their needs. I'm connecting with the Ardis that are in the clinical, based in seeing what they're providing in that space to make sure that I'm providing, you know, needed information from the groceries for So it's It's been a lot of moving pieces and a lot of learnings over the past year. We, um you know, the program's been around a year now, and who happened so quickly?
Yeah, and it's interesting, you know, both of you are kind of bringing up that point for my perspective that it's not just really about the cost of the produce, especially in the upfront setup of you know, there's changes that have to be made to pos systems and to your point your situation, 1,000,000,000 in the pharmacy and then bowls of your time. And so, as we kind of evaluate these programs, I think there is a key piece around looking at what's the total cost right of not just that cost of the gift card or the produce itself, but the total cost, really, to the retailer as well as the partners. You both talked a little bit about the partners that you had in these programs, but I think that funding sources is a really important topic as other retailers, maybe centering doing who prescription or produce prescription programs. Can you talk about how funding sources are identified and then secured for these programs?
Yeah, I can start. So for our program, the funding really, Like I said, D. C Greens has really been the pipe work on behind it in securing the funding and bringing on different partners. So they've done. They've definitely done the legwork on this and are continuing to do so. So one of the biggest funders has been the D. C. Department of Health, as well as a mayor Health Caritas. And then they've also over the last couple of months have been able to bring on private funders or corporations through their philanthropic legs. So in their continuing Tino speak funders and and use this as a case study to, you know, hopefully in the future used health care dollars for programs and like this across the country.
Yeah, statements seem at h e B. If you're looking for, you know, where should even start to look for funding For this, of course, within our communities, we all have those health aloneness minded individuals that won t be able to help with cases like this. And, you know, we talk about the need almost on a daily basis within our communities on the need for more parties, more consumption of parties. And so, you know, just seeking out those health and wellness minded folks toe be able t get that sponsorship. There's going to be, you know, several for each community. Ours. Luckily they have been and I won't. I won't share their their name right now, but they have been ho kash for many years. I would say over 10 years great partnership within the community within the San Antonio community to be able to provide funding for different initiatives within health and wellness. Definitely grateful for them. But, you know, look out for those folks. Their health and wellness focus.
Right? Loretta, you bring up a good point that we all know in the three of us are dietitians, right? But I think in general, people know that eating more fruits and vegetables is probably the singularly most important thing that all Americans could do to live happier, healthier lives. Right. But how do you look at success from the retail perspective in these programs as well as I think from the partner perspective. Llorente, do you wanna start?
I'll tell you, I'm specifically for the program that we did. There's two areas that we were looking out to see if this program would be success. Well, one of them was Were we changing that basket behavior? Was this consumer purchasing more parties even after they use their gift card to purchase their produce where they continue to just really increase that basket number. So we did look into that. The other thing that you think of just being more simplistic is Did we have participation? You know, I'll tell you that every class that we said we had about 10 to 15 participants sign up. But our show up was always so low would go down to about Rita. Four people showing up. And so that peace we were just we could never figure out was still mind boggling to us. Why aren't they coming there were going to give them some free produce. We get excited about that, and sharing those really fine ideas that we have is dieticians. But part of what? We were measuring this, How many people were actually interested in this and how many people would actually utilize it? And so, unfortunately, within our program, that was a big piece that we saw. Wow, this is just not being, you know, it's not successful because we're not getting the head count that we like. And so just untidy. And I thought to put out there as to all right, if we offer something like this, what are we gonna do to make sure that we're getting the head. Countless people in the seats to be ableto feel that slots that have been been secured. And so it was just two things that was participation for us. And it was taking a look at that basket increase of produce. And so those were two measurements, please.
Yeah. And you have to really hope right like that. You're building a new habit for people that they've started to really enjoy that increased consumption of fruits and vegetables and so that it will continue even if the program ends. Two billion. Is there anything your dad?
Yeah. So, I mean for us and I don't have data specific data to share right now, but success for us, You know, we're tracking new customers that we've seen new customers through this program. You traffic into our store change in baskets, eyes looking at the helpfulness of the basket, or increased consumption of vegetables dollars spent in the produce section. And, well, I don't have a specific data, but I can say that the impact of the program in addition toe just the other changes in the or, like I said, we added the wellness face week. We had a total store refreshed, simultaneous to this program launching. But all of that together has been very positive for the store in comparison. Other similar stores in Our friend serving, you know, somewhere demographic. But also for us, I would say successes increased engagement in community. So do the program. I'm offering the Wellness Basin engagement with the partners that we would measure success that way, too.
Yeah, which is a really good point. You know, retailers have historically been especially grocery retailers have been kind of a central part of any community, and I think this is definitely a wave to extend that region. Really build partnerships that are meaningful
One of the things that's interesting to me is if, if you look at published research, there is public research on these types of programs. Most of it focused on programs that are riding produce prescriptions for snap participants. I'm curious from both your perspectives of Do you think these programs can work with a variety of groceries, sappers? Or how are these programs reaching a greater variety of shoppers?
You know, you automatically think well, who's who's in greater need, right? Who gets less exposure or who saves their dollars for certain types of spending. And then that's when our snap participants come to mind. But reaching a variety of grocery shoppers? You know, just working aside from this program that we tried working with the individual from from all demographics on a day to day seeing patients within Nutrition Service's at H E B. You know, it's not discriminated just to just snap people that need it's not participants that need a greater intake of produce. So how do we really get that reach greater and, you know, see if it could be helpful for other folks. It really just comes down to making sure that, you know, you're placing that importance on what you know what that consumer needs. And so across the board, I would say, from the day to day at HP what we do Nutrition Service's We are trying to reach every individual that we know for the most part, needs to increase their produce consumption.
And I guess tomorrow and I would definitely echo that. So this program isn't specific force? Nah, protest defense, um, are porters prescription program? Essentially, you know that when you're meeting with your position, you would just need to screen positive. They have, ah, screener on for food and security. And then also you would need tohave hypertension, pre diabetes or diabetes. It was not just specific for, um snapped.
So you're really tying in the health conditions as well. And you know, those health conditions to where we know higher produce consumption can make a big difference
Yeah, and that's very similar. I think what Kroeber is trying to do is to tie it to I think, diabetes in particular right now, and they may expand that later on.
Yeah, it's kind of that food is medicine mentality or approach,
right? Right. Absolutely. So if you had to say what the top three factors are to make these programs successful, Gillian, what would you say those top three things are,
I think, first and foremost would just be the strong partnership between Giant and the participating organizations. So DC greens, I guess that has been, you know, just the leader in this and pulling everyone together so strong partnerships that private public partnership is definitely key. I would say patience. So patients as we worked on all the different kinks in the program and implementing the different processes at this door level. So definitely like leadership by in, as you may have hit roadblocks and just, you know, needed additional time or assistance from Inter organization to get this program off the ground. And then also, I would say, this program, it's unique, has a mayor Health care task is sharing their claims to show that programs like this could have an impact on health outcomes and the health care dollars can be used for this program tohave it impact on health outcomes. So that's what's so I think he was. This program is that the claim is being used and we have Our DC Greens is in partnership with 1/3 party evaluator who is looking, who is combing through all that claims data and connecting it on with the data that giants sharing, which I will say took, you know sometime that get through all the legal prophecies for that. So that's where that patient something's play. I think that would be the third is definitely that claims data that we have, or that the evaluator has access to to prove out this concept
well, and I think Gillian that'll be impactful and being able to justify extensions of these programs and to secure other funders to mean
Yeah, that's really impressive, Morena. What would you say are the factors that are most essential to make these programs successful?
And I'll really kind of take some of the learnings that we found in our program and what things that I felt would have helped a little bit to continue the program? Um, number one is ownership. So we've got all of these folks coming in and and really excited to play, right? Yeah. We want to help. We want to be a part of this. This sounds fantastic. Let's do it. But the partnership really needs to be owned by at least one person, right? One overarching entity. I think that's really important to keep things moving and driving. Otherwise, you're gonna get sucked back into your everyday real job, right? Cause I feel like things like this become a they become kind of like a side job from your real job. And so you have to have that one piece of owner that one owner that's gonna help drive this ship. The second thing I saw that we really needed some work on with marketing marketing's of a big piece, which is really tough, right? Because we're talking about individuals and making sure we're protecting hip and and all the things they think about it in, ah, in the health studying professional world on. I don't know the answer to this actually, how you do this, uh, that, but But the marketing piece is really being able to make sure that people are where the program is there, making sure that they're utilizing it and then just really making it attractive to them. Right? And then that last piece, really central first successful program is the data collection, like Julian mentioned to what you But they're doing the great work they're doing that peace is essential. Because if you, you know, spend all your time and energy in Julian, Really? This is a really big, you know, take on here. You want to be able to support your efforts and then get your learnings from your efforts. And so I think those to me just come really top of mind would be really important to making a program like this successful.
Yeah, and there's a lot of parts and pieces, and I think to comment you both made. There's a lot of players, from the partner to the participants, to the retail employees that all have to be educated and some level marketed to about the program. You know, even with Internal Employee is you've got a market, the benefit of the retailer. So they're committed to their part in all of this. So, yeah, I mean, those are really great tips from both of you on what it'll take if someone's interested in pursuing this type of a program. I'm curious from your perspective of whether these programs truly are scalable and and their longevity be secured. You know, can we have produce per se option programs that are lasting for five years, you know, to really make an impact on people's lives. But, Llorente, do you wanna if your thoughts on that
gosh, you know I will, I will give my thoughts on that, and I'm just thinking of what it took. It's a partner with just a couple of medical offices and that in that wood that took the energy that took the time that it took, I think it would be scalable if it was approached from medical groups that already have a large amount of providers. And so and there's there's plenty here in San Antonio, where we could go into offices where there's going to be, you know, 10 15 plus providers. But so again, it's it's really thinking through the stakeholders, the team players that really need to be all in on this. In order to scale something like this, we would need to probably ah, look for partners like that that have a larger entity, the weight of a TV does. All right, so we're talking about 400 stores here, So we need to think of those partners in that sense to is who has those numbers that I could really match ours too. And it's been a long gravity of it. I think definitely is something with the learnings with the continued learnings and fixing all the little intricate pieces that you take more time or not efficient. I definitely lee thing that that would be something that that can, um, could be something that we can think through for long term.
Really. And what are your thoughts?
So for us, we have best in something of focus recently how to make the scalable. So as we had said earlier, this program right now is just at my one store and we're hoping to, you know, expanded to other giant stores and no D. C. Greens has hopes of expanding. This could be on Giant because there is such a need for programs like this. So right now we're trying to figure out how to streamline the program. So right now everything has been manual. So, like the log that the pharmacy has is a manual log that big, then go use essentially like a Google L sheet and a sharing, you know, And I think stuff in manually. So we're the next phase of this is running a digital and attaching, attaching everything. Thio are essential to like our loyalty card to help with the processes and help us to be able to now do this at other stores and then also just continued funding. So I know DC Breen is working really hard on getting more funding for the program so that we can keep it going with the participants that we currently have. We can expand it. You know, two other participants, even beyond those that just having their health care task. So I think streamlining it making a digital and then funding is what would be necessary to make a scalable and to assist with longevity of the program.
You know, one of the things I think about often times is across the time. You know, it's been eight years now that I've been the executive director of the Retail Dietitians Business Alliance. And I always love talking to retail dietitians because all of you have varied roles and take on responsibilities really well outside the normal scope of what a dietitian does. So, Justin, wrap up today, I'd love to hear from both of you. Of what new skill do you feel you gained or a skill you had, But you honed and working on this are outed. Working on this type of program help you to develop professionally.
I gotta definitely give thanks to our great leadership about HCB for helping me learn through this. But you know, dietitian ever goes in learning toe faked to financials or look at financials. And that's one of the things that through my years with H e. B. I have learned to speak a little bit better to financials. And I also my my mindset has changed and that, you know, I need to think profitability, right? So how how are we not gonna are we not gonna bring those profits down by all these grand ideas that we have cause I would admit most dietitians that I know we have fantastic ideas, right on howto incorporate this and howto really inspire people. But bottom line comes down to is that gonna be profitable? And that was hard for me to understand and really taken as, hey, this is important because I came into dietetics working with low income individuals, and so the mighty brain, I just thought, Oh, I just I'm gonna I gotta give away all of the information I have to help these people. But I quickly learned that if I continue to do that, I wasn't going to get anywhere, and I definitely wasn't gonna help H e. D. Or Nutrition Service's be successful. And so the great leadership like I mentioned in our nutrition service's team, I learned how important it is to understand financials in tow and to be able to speak to them and relate them to my everyday activity, being able to connect them with the things that should be driving me every day, right? So what? We need to drive my energy every day? And so those air, those are things I never
thought I would have learned
as a dietitian. And
so we've got to be able to say to that in recent biotech, and I would just go that So, you know, with the dietetics background. And also I come from a public health background, too, and dietitians air this public health nutritionist or what? What have you we always we do how grand ideas, things that we want to implement, things that we want to see done. But now, working in a retail space, I have had to kind of step back and really understand the business. And I'm continuing to learn and which has been, you know, it's been really great experience so far, and just understanding what Giant does need to meet its bottom line and out of kind of, you know, foresees a public private partnership by in helping both parties, you know, reach their goal. And so that's been a learning for sure. But then also, I think, with this program as well as others you know, just me with my service is that I'm offering a giant marketing and the importance of marketing and marketing to different communities. How I'm marketing to health care providers in the community and observing versus working directly food community, those in the community or residents of the local community, you know, participate in my programming or talking about this program in general. But I think that's another. Still, that I have really had to hone in on is marketing of service is learning how to communicate with different different groups or different stakeholders.
Yeah, makes sense. Yeah, well, Loretta and Jillian, I can't thank you enough for being with us today to really share your insights on food description programs on the lost in this people market past. This has really been great. And thank you so much for your time today.
Thank you for having us.
Yes, Thank you. It's been fun. Thanks so much