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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

THE ROLE OF THE URBAN ACADEMIC MEDICAL CENTER IN ADDRESSING FOOD JUSTICE: FROM FARM TO FAMILIES AND BEYOND

Carp, Julia Elizabeth 05 1900 (has links)
With food and nutrition insecurity driving diet-related chronic health conditions in urban settings, strategies that facilitate access to fresh fruits and vegetables are imperative. Food is Medicine is a philosophy that embraces the integration of nutrition education and food subsidies into health care. This thesis describes one example of a Food is Medicine program, food prescription programs (FRx), in chronic disease management. While FRx programs vary in length, there are no studies to our knowledge addressing the reasons why patients adhere to FRx long-term. Using a positive deviance approach, we sought to understand positive deviant patient (PDP) practices and characteristics influencing consistent, long-term participation in Temple University's Farm to Families (F2F) fruit and vegetable prescription program. Prior to introducing this case study, I share from an Urban Bioethics lens my reflections on study design, my positionality coordinating research with community members, and how Urban Bioethical principles relate to FRx. I present the F2F case study: we conducted semi-structured, in-depth interviews among 13 PDPs who participated for over three months between 2016 and 2021. Interview transcripts were coded for most common themes. Seven of the 13 PDPs opted to participate in photovoice interviews. I then examine lessons learned from the F2F case study. Lastly, I discuss the sustainability of FRx from an Urban Bioethics lens, starting with considerations of resource allocation of FRx, and ending with integrating FRx into clinical practice and health systems. Despite the complexity of risk factors and sociopolitical forces contributing to food and nutrition insecurity in the United States, food justice is both necessary and achievable. How we as Urban Bioethicists and clinicians choose to approach food insecurity determines our capacity to challenge the status quo and reconstruct the narratives that have perpetuated this issue for far too long. Through a collaborative effort that embraces the experiences of our patients and community members, my aspiration is for food justice to become a reality. / Urban Bioethics

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