An Implementation Blueprint for a Pilot Produce Prescription Program in a Northeastern U.S. State.

Food insecurity increases the risk of chronic disease, yet scalable approaches to address nutrition-related needs remain limited. Produce prescription programs, in which healthcare providers refer patients to receive subsidized fruits and vegetables, are expanding but lack clear implementation guidance to support long-term delivery. We partnered with an accountable care organization, a nonprofit produce supplier, and primary care clinics in a Northeastern United States state to develop a practical implementation blueprint. Guided by the Consolidated Framework for Implementation Research, we conducted qualitative interviews with patients and providers to identify barriers related to clinic workflows, patient participation, and resource availability. A community advisory board then reviewed and prioritized these barriers and selected strategies to address them, including workflow integration, provider training, and creation of patient education materials in English and Spanish. We describe the process of operationalizing these strategies into a context-specific blueprint to inform adaptation and scale-up. This work provides a structured example of how health systems can design and refine produce prescription programs to strengthen implementation efforts.