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A University at Buffalo randomized study found that food-insecure older adults used delivered produce far more often than vouchers they had to redeem at a market. Produce boxes and meal kits each had an 89.2% redemption rate, compared with 28.3% in the market-voucher group; the small, 12-week study does not establish whether results will hold for other populations or larger programs.
A 12-week randomized study by University at Buffalo researchers found that food-insecure older adults used fresh produce more often when it was delivered to their homes than when they had to redeem vouchers at a market. Produce use reached 89.2% in both delivery groups, compared with 28.3% in the voucher group, according to the study published in Frontiers in Public Health.
The study enrolled 67 adults, mostly African Americans over age 65, recruited through primary care clinics at Erie County Medical Center in Buffalo. Participants had reported experiencing food insecurity at times. Researchers randomly assigned them to one of three programs for 12 weeks: weekly home-delivered produce boxes, home-delivered meal kits containing produce and ingredients for three meals, or vouchers redeemable at a mobile market or participating food markets.
In each delivery group, researchers recorded 89.2% redemption, defined in the report as preparation and consumption of the delivered produce. In the standard-care voucher group, where participants had to travel to a market, that figure was 28.3%. The study compared program designs and use; the reported figures do not by themselves establish how much participants’ health changed.
Participants could customize produce orders if they wanted. Meal-kit recipients chose from five or six weekly options. The researchers reported that meal kits did not raise produce use beyond the level seen with produce boxes. According to the study’s corresponding author, Lucia A. Leone, the meal kits may not have changed cooking behavior because participants already knew how to prepare the food. She said that receiving a greater quantity of food did help improve food security.
Why Home Delivery Raised Use
The findings point to access barriers as one reason food prescriptions may go unused. Leone told Medical Xpress that participants can have difficulty getting to a redemption site, and some may feel uncomfortable seeking assistance at locations associated with food pantries. A delivery model removes the trip and makes receipt of the food the default, rather than asking participants to take an extra step to claim it.
That design difference matters to organizations deciding how to deliver food assistance. A voucher can offer a choice of where to shop, but its value depends on recipients being able and willing to reach a participating market. Home delivery may make a program easier to use for some older adults, while requiring delivery capacity and coordination. The study suggests that, for this group and program, making delivery automatic was associated with substantially higher produce use.
The results also caution against assuming that adding more program components necessarily improves uptake. Meal kits did not produce a higher redemption rate than produce boxes in this trial. The finding does not mean meal kits lack value for other groups or goals; it shows only that they did not further increase measured produce use among these participants.
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How the Three Programs Differed
Food prescription programs provide food, often fruits and vegetables, to people experiencing food insecurity. The Buffalo researchers compared two delivery options with a market-voucher approach described as the standard-of-care model in their study. Under that approach, participants received vouchers to use at the ECMC mobile market or at participating FeedMore Western New York markets.
One intervention delivered weekly produce boxes through FreshFix, a local food delivery company. The other delivered meal kits with produce and the ingredients needed to make three meals. Leone, an associate professor of community health and health behavior at UB, said the program made delivery the default while allowing participants to customize orders. The study was published as “A randomized controlled study comparing three food prescription programs for older adults: program design, implementation, and utilization,” with DOI 10.3389/fpubh.2026.1855988.
The research team also reported that participants rated both delivery programs above 9 out of 10 and said they would recommend them. The article highlighted positive comments about the delivery driver, but those participant ratings and comments are separate from the study’s redemption measure.
“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, speaking to Medical Xpress
Limits of the Buffalo Trial
The results come from 67 participants in one city over 12 weeks. The study does not establish whether the same redemption rates would occur in larger programs, other regions or groups with different needs. Nor does the reported comparison establish whether higher produce use leads to lasting health improvements; the figures supplied describe program utilization.
Researchers did not report a specific explanation for every instance of unused food. Leone said redemption fell short of 100% when participants were away or felt they already had enough food. The source also does not provide detailed cost comparisons between delivery and market vouchers, or show whether programs can maintain customization and reliable delivery at larger scale. Those questions matter for organizations considering how to apply the results.
Researchers Plan a Family Study
Leone and her colleagues plan a similar study involving a different population: families experiencing food insecurity who are enrolled in Medicaid and have children ages 2 to 6. The team expects to work with local pediatric practices. The source material does not give a start date or further details about that trial’s design.
That research may test whether delivery and program customization have similar effects for households with young children. For now, the Buffalo study offers evidence about program use among older adults in a specific setting, while questions about cost, scalability and outcomes beyond food redemption remain open.
Key Questions
What did the study find?
The study recorded 89.2% produce redemption in both home-delivery groups, compared with 28.3% in the group that received vouchers to redeem at markets.
Who took part in the trial?
It included 67 adults, mostly African Americans over age 65, recruited through primary care clinics at Erie County Medical Center in Buffalo. Participants had reported experiencing food insecurity at times.
Did meal kits work better than produce boxes?
No higher redemption rate was reported for meal kits. Both delivery approaches had a reported rate of 89.2%. The study’s author suggested meal kits may not have changed use because participants already knew how to prepare the produce.
Does the study show that home delivery improved health?
The reported results focus on produce preparation and consumption, which the study defined as redemption. The supplied findings do not establish long-term health effects.
What research is planned next?
The researchers plan a similar study with Medicaid families experiencing food insecurity who have children ages 2 to 6, in partnership with local pediatric practices. A start date was not provided.
Source: rss
