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A randomized study of 67 food-insecure older adults found that produce delivered to participants’ homes was prepared and consumed at a higher rate than produce available through vouchers for market pickup. Redemption was 89.2% in both delivery groups, compared with 28.3% in the voucher group. The small, local study does not establish whether the results will hold for other populations or larger programs.
A randomized study of 67 food-insecure older adults in Buffalo found that participants used fresh produce at a higher rate when it was delivered to their homes than when they had to collect it with vouchers. Produce redemption—defined as preparation and consumption—was 89.2% in both delivery groups, compared with 28.3% in the voucher group, according to University at Buffalo researchers.
The 12-week study, published in Frontiers in Public Health, recruited participants through primary care clinics at Erie County Medical Center. Most were African American adults over age 65 who reported experiencing food insecurity at times. Researchers assigned participants to one of three program approaches.
One delivery group received weekly boxes of fresh produce from FreshFix, with the option to customize the contents. A second received meal kits with produce and ingredients for three meals, choosing from five or six options each week. The standard-of-care group received vouchers to collect produce at the hospital’s mobile market or participating FeedMore Western New York markets. Researchers report that both home-delivery approaches had the same redemption rate; adding meal kits did not raise produce use beyond delivery alone.
Participants in the two delivery groups rated the program at more than 9 out of 10 and said they would recommend it to others. Study author Lucia A. Leone said some deliveries went unused when participants were away or already had enough food. The researchers also reported that the added amount of food helped improve food security, though the supplied report does not give a specific measure or effect size for that finding.
Delivery Removes a Pickup Barrier
The findings point to a practical obstacle in food prescription programs: a voucher has little value if a participant cannot or does not want to travel to redeem it. The researchers said transportation difficulties and discomfort about being seen seeking assistance may deter people from using markets, some of which operate out of food pantries. In this study, home delivery made receipt of food the default, rather than requiring participants to take a separate step to collect it.
That distinction matters for health and social-service programs trying to connect food-insecure patients with fresh food. The study suggests that how food is provided can affect whether it is used, while the lack of a higher redemption rate for meal kits suggests that extra cooking guidance may not be necessary for every older-adult population. These are findings from a small trial, however, not proof that delivery will produce the same results at larger scale or in other groups.
Leone also pointed to the role of a familiar delivery worker. Participants spoke positively about driver Charles Humphrey, and the research team said a consistent, personable contact may support engagement. The trial did not isolate the driver’s influence, so it cannot show how much that relationship contributed to the redemption results.
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How the Three Programs Compared
The report describes food prescriptions as programs that provide free food, often fruits and vegetables, to people facing food insecurity. The conventional approach in this study was a voucher redeemable at a designated market. Leone said earlier research has reported that just 9% to 18% of voucher recipients use their vouchers, though that range comes from prior research and is not the control-group result in this trial.
For this study’s comparison, the voucher group had a 28.3% produce redemption rate. Participants in both delivery arms reached 89.2%. The figures measure use of food within the study’s program design; they are not a direct measure of long-term diet, health outcomes or the effectiveness of every food prescription program.
The paper, by Lucia A. Leone and colleagues, is titled “A randomized controlled study comparing three food prescription programs for older adults: program design, implementation, and utilization.” It appeared in Frontiers in Public Health in 2026 (DOI: 10.3389/fpubh.2026.1855988). FreshFix, a local delivery company co-founded by Leone, supplied the produce delivery service.
“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 trial included 67 people at one medical center and lasted 12 weeks. The supplied report does not provide enough detail to determine whether the redemption difference would persist over longer periods, in other locations, or among older adults with different circumstances. It also does not establish that higher produce use led to specific health improvements.
It remains unclear which parts of the delivery model mattered most. The study found equal redemption rates for produce boxes and meal kits, but it did not establish whether customization, the default delivery arrangement, reduced travel, the relationship with the driver, or other factors drove the difference from voucher pickup. The study also does not report the program’s cost or whether delivery can be maintained at scale.
The report says participants’ greater food supply helped improve food security, but it does not specify the measure used or the size of that change. That result should not be read as evidence of a particular health outcome.
Researchers Plan a Family Study
Leone and colleagues plan to test a similar food prescription approach with families enrolled in Medicaid who experience food insecurity and have children ages 2 to 6. The planned study will be conducted with local pediatric practices, according to the report. That work could show whether delivery and program design have similar effects for a population with different food needs and practical barriers.
The next study will not, by itself, answer whether the Buffalo model is affordable or workable for large public programs. The researchers said customization may be more difficult in programs operating at a broader scale, including Medicaid-based efforts. Further evidence on costs, sustained use and outcomes beyond redemption would be needed to assess how widely the approach could be applied.
Key Questions
What did the study find?
In a 12-week trial, 89.2% of produce was prepared and consumed in each home-delivery group, compared with 28.3% in the voucher group, whose participants collected food at markets.
Did meal kits lead to more produce use?
No difference in redemption was reported between the produce-box and meal-kit delivery groups: both reached 89.2%. The study therefore did not find that adding meal kits increased produce use beyond the delivery approach.
Who took part in the trial?
The study included 67 adults recruited through Erie County Medical Center clinics in Buffalo. Most were African American, older than 65 and had reported experiencing food insecurity at times.
Does the study prove home delivery improves health?
No. The reported main comparison was food redemption, defined as preparation and consumption. The study does not establish specific long-term health effects or show that the same results would occur in larger or different populations.
What research is planned next?
The University at Buffalo researchers plan a similar study involving Medicaid families with food insecurity and children ages 2 to 6, in partnership with local pediatric practices.
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