Trends and disparities in prevalence of cardiometabolic diseases by food security status in the United States.

BACKGROUND: Previous studies have demonstrated the association between food security and cardiometabolic diseases (CMDs), yet none have investigated trends in prevalence of CMDs by food security status in the United States (US). METHODS: Serial cross-sectional analysis of the US nationally representative data from National Health and Nutrition Examination Survey (1999-2018) was conducted among adults aged 20 years or older. Food security status was defined by the US Household Food Security Survey Module (full, marginal, low, and very low food security). We estimated the age-adjusted prevalence of CMDs including obesity, hypertension, diabetes, and coronary heart disease by food security status. Racial and ethnic disparities in age-adjusted prevalence of CMDs by food security status were also assessed. RESULTS: A total of 49,738 participants were included in this analysis (weighted mean age 47.3 years; 51.3% women). From 1999 to 2018, the age-adjusted prevalence of CMDs was lower in full food secure group as compared with other groups. For example, trends in hypertension decreased from 49.7% (47.5-51.8%) to 45.9% (43.8-48.0%) (P-trend = 0.002) among the full and from 54.2% (49.9-58.5%) to 49.7% (46.8-52.6%) (P-trend = 0.02) among the marginal but remained stable among the low at 49.7% (47.9-51.6%) and among the very low at 51.1% (48.9-53.3%) (P-interaction = 0.02). Prevalence of diabetes increased from 8.85% (8.15-9.60%) to 12.2% (11.1-13.5%) among the full (P-trend < 0.001), from 16.5% (13.2-20.4%) to 20.9% (18.6-23.5%) (P-trend = 0.045) among the marginal and from 14.6% (11.1-19.0%) to 20.9% (18.8-23.3%) (P-trend = 0.001) among the low but remained stable at 18.8% (17.0-20.9) among the very low (P-trend = 0.35) (P-interaction = 0.03). Racial and ethnic differences in prevalence of CMD by food security status were observed. For example, among individuals with full food secure status, the prevalence of diabetes was 9.08% (95% CI, 8.60-9.59%) for non-Hispanic whites, 17.3% (95% CI, 16.4-18.2%) for non-Hispanic blacks, 16.1% (95% CI, 15.0-17.4%) for Hispanics and 14.9% (95% CI, 13.3-16.7%) for others. CONCLUSIONS AND RELEVANCE: Prevalence of CMDs was greatest among those experiencing food insecurity, and food insecurity disproportionately affected racial/ethnic minorities. Disparities in CMD prevalence by food security status persisted or worsened, especially among racial/ethnic minorities.

Influence of biopsychosocial factors on self-reported anxiety/depression symptoms among first-generation immigrant population in the U.S.

BACKGROUND: Despite increasing studies on mental health among immigrants, there are limited studies using nationally representative samples to examine immigrants' mental health and its potential biopsychosocial contributing factors, especially during the COVID-19 pandemic. We explored and estimated the influence of life satisfaction, social/emotional support, and other biopsychosocial factors on self-reported anxiety/depression symptoms among a nationally representative sample of first-generation immigrants in the U.S. METHODS: We conducted a secondary data analysis using the 2021 National Health Interview Survey among first-generation adults aged ≥ 18 years (n = 4295). We applied survey weights and developed multivariable logistic regression model to evaluate the study objective. RESULTS: The prevalence of daily, weekly, or monthly anxiety/depression symptoms was 10.22% in the first-generation immigrant population. There were 2.04% daily, 3.27% weekly, and 4.91% monthly anxiety/depression among the population: about 8.20%, 9.94%, and 9.60% experienced anxiety symptoms, whereas 2.49%, 3.54%, and 5.34% experienced depression symptoms daily, weekly, and monthly, respectively. The first-generation population aged 26-49 years were less likely to experience anxiety/depression daily, weekly, or monthly compared to those aged 18-25. Females (versus males) were more likely to experience anxiety/depression daily, weekly, or monthly. Those who identified as gay/lesbian had higher odds of experiencing anxiety/depression daily, weekly, or monthly compared to heterosexual persons. Relative to non-Hispanic White individuals, non-Hispanic Asian, Black/African American, and Hispanic individuals had lower odds, while other/multi-racial/ethnic groups were more likely to experience anxiety/depression daily, weekly, or monthly. A higher life satisfaction score was associated with lower odds of experiencing anxiety/depression daily, weekly, or monthly. Having social/emotional support sometimes/rarely or using healthcare within the past one/two years was associated with experiencing anxiety/depression daily, weekly, or monthly. CONCLUSIONS: The findings reveal significant burden of anxiety and depression among first-generation population in the U.S., with higher risks among subgroups like young adults, females, sexual minorities, and non-Hispanic White and other/multi-racial individuals. Additionally, individuals with lower life satisfaction scores, limited social/emotional support, or healthcare utilization in the past one or two years present increased risk. These findings highlight the need for personalized mental health screening and interventions for first-generation individuals in the U.S. based on their diversity and health-related risks.

School climate-related determinants of physical activity among high school girls and boys.

INTRODUCTION: In the United States, physical activity (PA) among adolescents is declining; 75% of high school students do not meet daily PA guidelines. Low rates of PA are more prevalent among high school girls. Schools provide an optimal environment to target and promote PA. However, school climate has not yet been studied for its importance in promoting PA among high school students, particularly girls. METHODS: A cross-sectional analysis was conducted using the Georgia Student Health Survey (GSHS) 2.0 data on perceptions of different school climate measures and self-reported weekly PA levels to study gender differences in the association of PA with school climate. RESULTS: Data from a total of 362,926 students (48% males and 52% females) were analyzed. For both genders, the odds of being physically active increased with a more positive report of supportive school environments, school connectedness, peer social support, school physical environments, cultural acceptance, school safety, and adult social support. Peer victimization was associated with increased odds of PA among females but lower odds for males. CONCLUSION: Results suggest that improving school climate can increase PA among adolescents. As new or existing school-based interventions and policies are considered by states and local governments, improving the school climate should be part of the overall strategy. Future research is needed on peer victimization among physically active females. IMPLICATIONS AND CONTRIBUTIONS: This study evaluated gender differences in the association between measures of school climate and PA among high school students. School climate or policies fostering positive environments including feelings of safety, connectedness, and peer support may increase adolescent PA; addressing peer victimization and fights may reduce gender disparities in PA.

Narrowing but persisting gender pay gap among employees of the US Department of Health and Human Services during 2010-2018.

BACKGROUND: The gender pay gap in the United States (US) has narrowed over the last several decades, with the female/male earnings ratio in the US increased from about 60% before the 1980s to about 79% by 2014. However, the gender pay gap among the healthcare workforce persists. The objective of this study is to estimate the gender pay gap in the US federal governmental public health workforce during 2010-2018. METHODS: We used an administrative dataset including annual pay rates and job characteristics of employees of the US Department of Health and Human Services. Employees' gender was classified based on first names. Regression analyses were used to estimate the gender pay gap using the predicted gender. RESULTS: Female employees of the DHHS earned about 13% less than men in 2010, and 9.2% less in 2018. Occupation, pay plan, and location explained more than half of the gender pay gap. Controlling for job grade further reduces the gap. The unexplained portion of the gender pay gap in 2018 was between 1.0 and 3.5%. Female employees had a slight advantage in terms of pay increase over the study period. CONCLUSIONS: While the gender pay gap has narrowed within the last two decades, the pay gap between female and male employees in the federal governmental public health workforce persists and warrants continuing attention and research. Continued efforts should be implemented to reduce the gender pay gap among the health workforce.

Implementation of a Statewide Policy Mandating School-Based Fitness Assessment Screening, Georgia: 2018.

Objectives. To evaluate the statewide implementation of childhood fitness assessment and reporting in Georgia.Methods. We collected survey data from 1683 (919 valid responses from a random-digit-dialed survey and 764 valid responses from a Qualtrics panel) parents of public school students in Georgia in 2018.Results. Most parents reported that their child participated in fitness assessments at school, yet only 31% reported receiving results. If a child was identified as needing improvement, parents were significantly more likely to change the diet and exercise of both the child and the family.Conclusions. A state-level mandatory fitness assessment for children may be successful in state-level surveillance of fitness levels; parental awareness of the policy, receipt of the fitness assessment information, and action on receiving the screening information require more efforts in implementation.

Gender differential impact of bereavement on health outcomes: evidence from the China Health and Retirement Longitudinal Study, 2011-2015.

BACKGROUND: Bereavement is the experience of an individual following the death of a person of significance to the individual, most often referring to the spouse. Increased morbidity, health care utilization, and mortality are known to be associated with bereavement. Given China's growing population of older adults, there is a critical need to assess the health consequences of bereavement. METHOD: We use data from the China Health and Retirement Longitudinal Study to examine the impact of bereavement on mental health and quality of life among a sample of mid- and older-aged adults. We use propensity score matching to construct a matching sample and difference-in-differences method to estimate the impact of bereavement on mental health and self-assessed health. RESULTS: We find bereavement is associated with increased depression symptoms among women (1.542 point or 0.229 standard deviations of Center for Epidemiologic Studies Depression (CES-D) 10 score) but not consistently for men over time. No statistically significant effect of bereavement on self-assessed health is found. CONCLUSIONS: Our results show a harmful impact of bereavement on mental health among older women in China and point to the need for a comprehensive policy on survivor benefits in China, particularly for rural older women.

Non-communicable diseases are key to further narrow gender gap in life expectancy in Shanghai, China.

BACKGROUND: To address change in the gender gap of life expectancy (GGLE) in Shanghai from 1973 to 2018, and to identify the major causes of death and age groups associated with the change over time. METHODS: The temporal trend in GGLE was evaluated using retrospective demographic analysis with Joinpoint regression. Causes of death were coded in accordance with the International Classification of Diseases and mapped with the Global Burden of Disease (GBD) cause list. The life table technique and decomposition method were used to express changes in GGLE. RESULTS: The trend of GGLE in Shanghai experienced two phases, i.e., a decrease from 8.4 to 4.2 years in the descent phase (1973-1999) and a fluctuation between 4.0 and 4.9 years in the plateau phase (1999-2018). The reduced age-specific mortality rates tended to concentrate to a narrower age range, from age 0-9 and above 30 years in the descent phase to age above 55 years in the plateau phase. Gastroesophageal and liver cancer, communicable, chronic respiratory, and digestive diseases were once the major contributors to narrow GGLE in the descent phase. While, importance should be attached to a widening effect on GGLE by lung cancer, cardiovascular diseases, other neoplasms like colorectal and pancreatic cancer, and diabetes in the recent plateau phase. CONCLUSIONS: Non-communicable diseases (NCDs) have made GGLE enter a plateau phase from a descent phase in Shanghai, China. Public efforts to reduce excess mortalities for male NCDs, cancers, cardiovascular diseases, chronic respiratory diseases, and diabetes in particular and health policies focused on the middle-aged and elderly population might further narrow GGLE. This will also ensure improvements in health and health equity in Shanghai China.

Weekend Effect on in-Hospital Mortality for Ischemic and Hemorrhagic Stroke in US Rural and Urban Hospitals.

INTRODUCTION: Previous studies have reported a "weekend effect" on stroke mortality, whereby stroke patients admitted during weekends have a higher risk of in-hospital death than those admitted during weekdays. AIMS: We aimed to investigate whether patients with different types of stroke admitted during weekends have a higher risk of in-hospital mortality in rural and urban hospitals in the US. METHODS: We used data from the 2016 National Inpatient Sample and used logistic regression to assess in-hospital mortality for weekday and weekend admissions among stroke patients aged 18 and older by stroke type (ischemic or hemorrhagic) and rural or urban status. RESULTS: Crude stroke mortality was higher in weekend admissions (p <0.001). After adjusting for confounding variables, in-hospital mortality among hemorrhagic stroke patients was significantly greater (22.0%) for weekend admissions compared to weekday admissions (20.2%, p = 0.009). Among rural hospitals, the in-hospital mortality among hemorrhagic stroke patients was also greater among weekend admissions (36.9%) compared to weekday admissions (25.7%, p = 0.040). Among urban hospitals, the mortality of hemorrhagic stroke patients was 21.1% for weekend and 19.6% for weekday admissions (p = 0.026). No weekend effect was found among ischemic stroke patients admitted to rural or urban hospitals. CONCLUSIONS: Our results help to understand mortality differences in hemorrhagic stroke for weekend vs. weekday admissions in urban and rural hospitals. Factors such as density of care providers, stroke centers, and patient level risky behaviors associated with the weekend effect on hemorrhagic stroke mortality need further investigation to improve stroke care services and reduce weekend effect on hemorrhagic stroke mortality.

Neighborhood immigrant density and population health among native-born Americans.

The healthy immigrant effect-whereby immigrants are on average healthier than the native-born-have been well studied. However, little is known about the relationship between immigration and the health of the native-born. This study fills this important research gap by examining the association between neighborhood immigrant density and several population health measures among native-born Americans. We used data from the Los Angeles County Health Survey to analyze four individual-level health behaviors and outcomes, including regular fast food consumption, fruit and vegetable consumption, body mass index, and hypertension. We conducted multilevel logistic regressions to assess the association between neighborhood immigrant density and the four health behaviors and outcomes. The results showed that neighborhood immigrant density was negatively associated with regular fast food consumption (OR = 0.33; 95% CI, 0.18-0.59), BMI (ß = -2.16, 95% CI, -3.13 to -1.19), and hypertension (OR = 0.58; 95% CI, 0.38-0.89), and positively associated with fruit/vegetable consumption (OR = 1.64; 95% CI, 1.01-2.66) among native-born Americans. In conclusion, native-born Americans who lived in a neighborhood with a high density of immigrants had healthier behaviors and better health outcomes compared to those who lived in a neighborhood with a low density of immigrants.

Physical activity and its correlates among higher secondary school students in an urban district of Nepal.

BACKGROUND: Data on adolescents' physical activity and determinants are scarce in Nepal. In this study, we aim to assess the level of physical activity, its correlates and the sedentary behavior of high school students in an urban district of Nepal. METHODS: This is a cross-sectional study. Participants were selected using two-stage cluster sampling technique. We used Global Physical Activity Questionnaire (GPAQ) to collect information regarding physical activity and sedentary behavior. We also collected information about socio-demographic, academic, environmental and lifestyle-related factors. Data from 945 high school students from 23 randomly selected schools were analyzed. Logistic regression was used to identify correlates of low physical activity separately for male and female students. RESULTS: Based on GPAQ classification, one out of five respondents reported low physical activity. The prevalence of low physical activity was 8% for males and 31% for females. About 31% of the adolescents and 14% of young adults did not meet the WHO recommendations of physical activity. Forty-seven percent of the total physical activity was borne by recreational activities. Correlates of low physical activity included school type and mode of transport among females, family support and drinking among males, and playground/park around home among both. CONCLUSIONS: The prevalence estimate of low physical activity among adolescents is high, with higher odds among females. Several different factors are associated with physical activity among males and females, therefore, interventions to promote physical activity in school may need to weigh these factors prior to/during implementation.

Opioid-Related Hospitalization and Its Association With Chronic Diseases: Findings From the National Inpatient Sample, 2011-2015.

Chronic disease and opioid-related hospitalizations in the United States are increasing. We analyzed nationally representative data on patients aged 18 years or older from the 2011-2015 National Inpatient Sample to assess the association between opioid-related hospitalization and chronic diseases. We found that most patients with opioid-related hospitalization were white, aged 35-54 years, in urban hospitals, and had 2 or more comorbid conditions. Patients with 2 or more chronic conditions accounted for more than 90% of opioid-related hospitalizations in all years. The results suggest a need for targeted interventions to prevent opioid misuse in patients with multiple chronic conditions.

Experiences With Work-Family Conflict, Breastfeeding, and Perinatal Mental Health Among Women Returning to Work After Giving Birth: A Mixed Methods Study.

OBJECTIVE: This study aimed to examine working mothers' experiences with returning to work after giving birth, work-family conflict, breastfeeding, and mental health. METHODS: A sequential, mixed methods design was used to administer an online survey to capture job characteristics and perceptions of work-family conflict among first-time mothers in Georgia who gave birth within the previous year ( N = 26). Then, interviews were conducted to understand their experiences with returning to work, work-family conflict, breastfeeding, and mental health. RESULTS: Many participants worked in educational settings and returned to full-time work after giving birth. Qualitative themes from 12 interviews captured the context of participants' work environments, types of work-family conflict, and factors that alleviated work-family conflict. CONCLUSIONS: Employers need to incorporate support for work-family conflict and perinatal mental health into workplace breastfeeding programs and maternity leave policies.

The Association Between Type of Insurance Plan, Out-of-Pocket Cost, and Adherence to Antihypertensive Medications in Medicare Supplement Insurance Enrollees.

BACKGROUND: Medicare supplement insurance, or Medigap, covers 21% of Medicare beneficiaries. Despite offsetting some out-of-pocket (OOP) expenses, remaining OOP costs may pose a barrier to medication adherence. This study aims to evaluate how OOP costs and insurance plan types influence medication adherence among beneficiaries covered by Medicare supplement plans. METHODS: We conducted a retrospective analysis of the Merative MarketScan Medicare Supplement Database (2017-2019) in Medigap enrollees (≥65 years) with hypertension. The proportion of days covered (PDC) was a continuous measure of medication adherence and was also dichotomized (PDC ≥0.8) to quantify adequate adherence. Beta-binomial and logistic regression models were used to estimate associations between these outcomes and insurance plan type and log-transformed OOP costs, adjusting for patient characteristics. RESULTS: Among 27,407 patients with hypertension, the average PDC was 0.68 ±â€…0.31; 47.5% achieved adequate adherence. A mean $1 higher in 30-day OOP costs were associated with a 0.06 (95% confidence intervals [CIs]: -0.09 to -0.03) lower probability of adequate adherence, or a 5% (95% CI: 4%-7%) decrease in PDC. Compared with comprehensive plan enrollees, the odds of adequate adherence were lower among those with point-of-service plans (odds ratio [OR]: 0.69, 95% CI: 0.62-0.77), but higher among those with preferred provider organization (PPO) plans (OR: 1.08, 95% CI: 1.01-1.15). Moreover, the association between OOP costs and PDC was significantly greater for PPO enrollees. CONCLUSIONS: While Medicare supplement insurance alleviates some OOP costs, different insurance plans and remaining OOP costs influence medication adherence. Reducing patient cost-sharing may improve medication adherence.

Disparities in Successful Discharge to the Community Following Use of Medicare Home Health by Level of Neighborhood Socioeconomic Disadvantage.

Considering the importance of social and structural support and resources in recovering health, where people reside could lead to differences in health outcome in Medicare home health care. We used the 2019 Outcome and Assessment Information Set and Area Deprivation Index to examine the association between neighborhood context and successful discharge to community among older Medicare home health care users. Based on the multivariable logistic regression (OR: 0.84; 95% CI, 0.83-0.85) and conditional logistic regression models stratified by home health agency (OR: 0.95; 95% CI, 0.94-0.95), patients living in the most disadvantaged neighborhoods were less likely to experience successful discharge to community than others. Furthermore, the predicted probability of successful discharge to community decreased as the percentage of patients from the most disadvantaged neighborhoods within a home health agency increased. Policymakers should consider using area-level interventions and supports to reduce disparities in Medicare home health care.

Adverse childhood experiences, risk of opioid misuse and its pathway among students at a public university.

OBJECTIVE:  We examine role of ACEs and pathways to risk of opioid misuse among young adults. Participants and Methods: A cross-sectional survey of validated measures of ACEs, risk of opioid misuse, and health conditions with a sample of 1,402 students from a large public university followed by multivariate logistic regression and pathway analysis. Results: Majority (61%) of participants reported at least one ACE. A dose-response relationship between numbers of ACEs with risk for opioid misuse was present. Compared to participants with no ACEs, participants with ≥4 ACEs and 0-3 ACEs were 2.93 (95% CI: 1.95, 4.39; p < 0.001) and 1.96 (95% CI: 1.46, 2.65; p < 0.001) times more likely to be at risk for opioid misuse, respectively. Having at least one existing or past health condition significantly mediated the association. Conclusions: Our findings suggest need to include assessment of ACEs as a screening criterion for opioid prescription and administration among college-aged individuals.

Utilization of Counseling Services by Pediatric Patients With Obesity Using MarketScan Data (2017-2019).

The United States has implemented policy efforts for public and private insurance to cover counseling services related to the treatment of obesity. However, no research has yet studied counseling service utilization among pediatric patients with obesity. We used 3 years (2017-2019) of IBM MarketScan Commercial Claims and Encounters Database and IBM MarketScan Multi-State Medicaid Data to examine such utilization patterns. We found the proportion of patients receiving any counseling services to be low among both privately insured (7.06%-7.97%) and Medicaid patients (9.51%-11.61%) within 6 months from diagnosis of obesity. This underutilization is concerning as many pediatric patients go undiagnosed, as evidenced in this research. Among the utilized services, nutrition counseling and face-to-face counseling were utilized the most by privately and Medicaid-insured patients over 6- and 12-month follow-ups. Our study underscores the need for implementing policies and programs to promote the utilization of counseling services among pediatric patients.

Depression and anxiety among college students at Historically Black and Predominantly White universities during the COVID-19 pandemic: A cross-sectional study.

OBJECTIVE: To assess depression and anxiety among college students during the COVID-19 pandemic and its association with race. PARTICIPANTS: Using a cross-sectional survey, depression and anxiety among college students at a Predominantly White (PWU) and a Historically Black University (HBU) during 2021 were evaluated. METHODS: The patient health questionnaire-9 (PHQ-9), general anxiety disorder-7 (GAD-7), and self-reported sociodemographic characteristics were collected. Chi-square and logistic regression tests examined differences in depression and anxiety based on race. RESULTS: Depression and anxiety among 3,102 students (87% female) were analyzed. Minority racial groups were associated with anxiety (p < 0.01) but not depression in the PWU. Moderately severe and severe depression was higher among the minority race at both the universities (1.76% compared to 0.53% at PWU, and 11.1% compared to 2.4% at HBU). CONCLUSIONS: Depression and anxiety among college students is influenced by racial status. First-generation students were more likely to report depression in both HBU and PWU.

Social Determinants of Cardiovascular Health: A Longitudinal Analysis of Cardiovascular Disease Mortality in US Counties From 2009 to 2018.

Background Disparities in cardiovascular disease (CVD) outcomes persist across the United States. Social determinants of health play an important role in driving these disparities. The current study aims to identify the most important social determinants associated with CVD mortality over time in US counties. Methods and Results The authors used the Agency for Healthcare Research and Quality's database on social determinants of health and linked it with CVD mortality data at the county level from 2009 to 2018. The age-standardized CVD mortality rate was measured as the number of deaths per 100 000 people. Penalized generalized estimating equations were used to select social determinants associated with county-level CVD mortality. The analytic sample included 3142 counties. The penalized generalized estimating equation identified 17 key social determinants of health including rural-urban status, county's racial composition, income, food, and housing status. Over the 10-year period, CVD mortality declined at an annual rate of 1.08 (95% CI, 0.74-1.42) deaths per 100 000 people. Rural counties and counties with a higher percentage of Black residents had a consistently higher CVD mortality rate than urban counties and counties with a lower percentage of Black residents. The rural-urban CVD mortality gap did not change significantly over the past decade, whereas the association between the percentage of Black residents and CVD mortality showed a significant diminishing trend over time. Conclusions County-level CVD mortality declined from 2009 through 2018. However, rural counties and counties with a higher percentage of Black residents continued to experience higher CVD mortality. Median income, food, and housing status consistently predicted higher CVD mortality.

Spatiotemporal Optimization for the Placement of Automated External Defibrillators Using Mobile Phone Data.

With over 350,000 cases occurring each year, out-of-hospital cardiac arrest (OHCA) remains a severe public health concern in the United States. The correct and timely use of automated external defibrillators (AEDs) has been widely acknowledged as an effective measure to improve the survival rate of OHCA. While general guidelines have been provided by the American Heart Association (AHA) for AED deployment, the lack of detailed instructions hindered the adoption of such guidelines under dynamic scenarios with various time and space distributions. Formulating the AED deployment as a location optimization problem under budget and resource constraints, we proposed an overlayed spatio-temporal optimization (OSTO) method, which accounted for the spatiotemporal heterogeneity of potential OHCAs. To highlight the effectiveness of the proposed model, we applied the proposed method to Washington DC using user-generated anonymized mobile device location data. The results demonstrated that optimization-based planning provided an improved AED coverage level. We further evaluated the effectiveness of adding additional AEDs by analyzing the cost-coverage increment curve. In general, our framework provides a systematic approach for municipalities to integrate inclusive planning and budget-limited efficiency into their final decision-making. Given the high practicality and adaptability of the framework, the OSTO is highly amenable to different healthcare facilities' deployment tasks with flexible demand and resource restraints.

Current Landscape of Produce Prescription Programs in the US.

OBJECTIVE: To understand the design and implementation models of US produce prescription programs. METHODS: In a mixed-methods study, program providers completed an online survey and an individual phone interview regarding their 2019 programming. RESULTS: Twenty-three programs completed surveys; 20 completed interviews. Program locations included the mid-Atlantic (26%), Northeast (9%), Midwest (30%), Southwest (17%), and Western regions (17%). Although program models varied, programs generally included a health care visit, usually at a safety-net clinic, and nutrition education, typically counseling, advice, or classes. Prescriptions tended to be farmers market vouchers worth a median of $15 a week (interquartile range, $7.81-$20.00). Transportation was a problem for nearly half of the programs. CONCLUSIONS AND IMPLICATIONS: Current produce prescription program characteristics and operations can serve as a blueprint for new and existing programs. Future research should determine program best practices and the opportunity cost between program standardization and local flexibilities.