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A 12-week University at Buffalo randomized study found that food-insecure older adults used delivered produce more often than produce vouchers they had to redeem at a market. Produce use was 89.2% in both home-delivery groups and 28.3% in the voucher group; adding meal kits did not raise use beyond produce delivery alone.
A 12-week randomized study of 67 food-insecure older adults in Buffalo found that participants used fresh produce more often when it was delivered to their homes than when they had to visit a market to redeem vouchers. Produce preparation and consumption reached 89.2% in each delivery group, compared with 28.3% in the voucher group, according to University at Buffalo researchers reporting the findings in Frontiers in Public Health.
The study compared three food prescription approaches: weekly boxes of fresh produce delivered to participants, delivered meal kits containing produce and ingredients for three meals, and vouchers redeemable at a mobile market or participating FeedMore Western New York markets. Participants in the two delivery groups could receive food without traveling to a redemption site. People receiving produce boxes could also customize their selections, while meal-kit participants chose from five or six options each week.
Researchers counted redemption as preparing and consuming the delivered produce. That measure reached 89.2% for both the produce-box and meal-kit groups. In the standard-care voucher group, where participants had to go to a market, the figure was 28.3%. The study therefore found a difference associated with delivery, but it did not find that meal kits increased produce use beyond delivery of produce alone.
The 67 participants were recruited through primary care clinics at Erie County Medical Center. Most were African American adults over 65 who said they had experienced food insecurity at times. The researchers also reported that participants in both delivery groups rated the program above nine out of 10 and said they would recommend it. These results reflect the small study group and its specific Buffalo program, rather than all food prescription programs or older adults.
Removing the Market-Visit Barrier
The results point to a practical challenge for food prescription programs: providing a voucher does not necessarily mean a person can or will collect the food. Researchers said transport difficulties may prevent some participants from reaching a redemption site. Others may feel uncomfortable going to a food pantry or being seen as needing assistance. Home delivery removes the required trip, which may help explain the higher use recorded in the delivery arms.
For health care providers and program administrators, the finding suggests that the way food assistance is delivered can shape whether participants use it. It does not show that delivery improves health outcomes, and the study was not described as testing such outcomes. Nor does the comparison establish which costs or delivery models are practical at a larger scale. It offers evidence about program participation and produce use, not a complete measure of long-term effectiveness.
The study also found that adding meal kits did not improve produce use compared with produce boxes. Lucia A. Leone, the study’s corresponding author, suggested that participants in this older group may already have known how to prepare the produce. That explanation is the researcher’s interpretation, not a separate finding measured by the trial. The comparison may help programs weigh extra meal-kit support against simpler delivery, while recognizing that other populations could respond differently.
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How the Three Programs Compared
Food prescription programs provide free or subsidized food, often through vouchers intended to make fresh produce more accessible to people experiencing food insecurity. The report says earlier research found that only 9% to 18% of voucher recipients used their vouchers. The Buffalo study’s control-group result was 28.3%; those figures come from different research contexts and should not be treated as a direct like-for-like comparison.
In this trial, one intervention group received weekly produce boxes through FreshFix, a local delivery company. A second received meal kits containing produce and ingredients for three meals. The control group received vouchers for existing market options. The report says delivery was the default in both intervention arms, while participants could customize their produce orders if they wished. The researchers said that combination may have contributed to use, but the study did not isolate the effects of customization from delivery.
The findings were published in a 2026 paper by Lucia A. Leone and colleagues, titled “A randomized controlled study comparing three food prescription programs for older adults: program design, implementation, and utilization,” in Frontiers in Public Health. The researchers plan a related study with families experiencing food insecurity who are enrolled in Medicaid and have children ages 2 to 6, working with local pediatric practices.
“The problem historically with food prescription programs is that people get the vouchers but don’t redeem them.”
— Lucia A. Leone, corresponding author and University at Buffalo associate professor
Limits of the Buffalo Trial
The study included 67 people at one health system, mostly older African American adults in Buffalo. The report does not establish whether the same use rates would hold in other locations, among different age groups, or in larger programs. It also does not provide, in the supplied findings, a comparison of program costs or longer-term health effects.
The trial found higher produce use in both delivery arms than in the voucher arm, but it cannot show from these figures alone which element drove the difference. Delivery was the default, and participants could customize orders; the report says both features may have helped. It is also unclear how much the delivery driver’s relationship with participants influenced participation, despite positive participant comments about the driver. Reasons for unconsumed food included being out of town or feeling that enough food was already available, according to Leone.
A Planned Study With Families
Leone and colleagues plan to conduct a similar study with Medicaid-enrolled families experiencing food insecurity and children ages 2 to 6, in partnership with local pediatric practices. That research will test the approach in a population and setting different from the older adults in the Buffalo trial. The supplied report does not give a start date, planned sample size or expected publication date.
For now, the study’s clearest result is limited to program use: in this trial, home-delivered produce and meal kits were associated with more participants preparing and consuming the food than vouchers requiring a market visit. Whether that advantage can be reproduced at scale, and how delivery costs and customization affect implementation, remains to be determined.
Key Questions
What did the study find?
In a 12-week trial of 67 food-insecure older adults, researchers recorded 89.2% produce preparation and consumption in both home-delivery groups, compared with 28.3% in the group that had to redeem vouchers at a market.
Did meal kits lead participants to use more produce?
No. Produce use was 89.2% in both the meal-kit group and the produce-box delivery group. The study did not find an additional increase from including meal ingredients.
Who took part in the trial?
The study recruited 67 adults through Erie County Medical Center clinics in Buffalo. Most were African American, over 65 and had reported experiencing food insecurity at times.
Do the findings prove that delivery improves health?
No. The reported outcome was produce preparation and consumption, along with participant ratings. The supplied report does not say the trial established improvements in health outcomes or tested long-term effects.
What research is planned next?
The University at Buffalo researchers plan a similar study with food-insecure families enrolled in Medicaid who have children ages 2 to 6, working with local pediatric practices. A timeline was not provided in the report.
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