One of Amy Sapola’s main beliefs is that food is central to health. And as a pharmacist at Gundersen St. Elizabeth’s in Wabasha, Minnesota, she has been able to promote fresh food and healthy living using innovative programs that expand the idea of health and health care.
Hospital garden, Gundersen St. Elizabeth’s in Wabasha
The first project began five years ago when a conversation at a St. Elizabeth’s Wellness Committee meeting led to the creation of a hospital garden. The original aim was to grow herbs that could be used to add flavor and reduce salt consumption in meals served to long term care residents and to staff and visitors in the cafeteria. The project began with just two garden beds and has grown over the years to include more beds full of herbs, greens and other vegetables, a drip irrigation system, and a sensory garden for residents and visitors to enjoy. St. Elizabeth’s has been able to expand this project through Statewide Health Improvement Partnership (SHIP) grants from the Minnesota Department of Health, as well as donations from the families who appreciated how much the garden has added to the lives of patients.
As the garden at St. Elizabeth’s continued to grow, the Wellness Committee was presented with another opportunity to address health through access to fresh food. In 2020, the St. Elizabeth’s Hospital Foundation donated $1,000 in tokens that could be given to patients to buy fresh produce at the local farmers market. After learning that primary care providers were struggling to distribute all of the tokens during patient visits, Sapola proposed taking a different approach, and used her role as a pharmacist to launch a “Veggie Rx” food prescription program.
The Veggie Rx Program began as a pilot with 10 participants. Each participant received a “prescription” with four refills for $10 a week that could be used to buy produce at the local farmers market. After four weeks the group attended a midpoint meeting to share their experiences, and then received a prescription for four more weeks of farmer’s market credits. Sapola received great feedback from the first group of participants. Buoyed by encouragement from patients and a grant from the St. Elizabeth's Foundation, St. Elizabeth’s expanded the program the following year, enrolling four times as many patients and increasing the amount they were given to spend each week from $10 to $20.
"Eat yourself healthy" garden, Gundersen St. Elizabeth’s in Wabasha,
After two summers of running a Veggie Rx program, Sapola and St. Elizabeth’s are excited to expand the program further using key learnings from these first two experiences. One change they made between the first and second year was to allow participants to self-refer into the program. They advertised the program through flyers at locations such as the local food share and social services center, but did not require formal referrals to participate. This kept membership open to people who may not perceive themselves as having the highest need for food assistance, but who were interested in learning more and getting support accessing these foods. The program also was designed with a strong emphasis on exploration and peer-to-peer learning, and no focus on weight loss or diets. St. Elizabeth’s Veggie Rx program favors promoting an experience that helps people feel good while learning more about fresh food and how to use it.
In addition to patients sharing positive feedback, St. Elizabeth’s learned that local farmers appreciate the Veggie Rx program, too. Giving patients money to spend on fruits and vegetables at the farmers market drove up produce purchases throughout the summer, which in turn increased enthusiasm among the farming community for participating in the farmer’s market.
Sensory Garden, Gundersen St. Elizabeth’s in Wabasha
Sapola is working to increase access to fresh food through other initiatives with the local food share. For example, the pharmacy students she precepts pick vegetables from the Wabasha city gardens, bring them to the food share, and talk with customers about why they picked that produce and what they could do with it. She has asked these students to design their own meal kits by picking fresh produce, packaging all the necessary ingredients, and including a recipe. These kits are donated to the food share, and the recipes can be replicated by the community members who receive them.
As winter begins, Sapola and St. Elizabeth’s are looking forward to continuing to next season. They plan to expand whole person care through the garden, Veggie Rx program, and other initiatives that focus on health and wellness both inside and outside the healthcare facilities
For more examples of rural projects focusing on wellness, health promotion, and disease prevention, visit the Rural Health Information Hub’s webpage of models and innovations focusing on this topic, accessed December 2021.
For more information on the Minnesota Statewide Health Improvement Partnership (SHIP), please visit the MN SHIP Program’s webpage
Articles:
Doheny, Kathleen. Prescriptions for Fruits and Vegetables a Blossoming Program (webmd.com), WebMD, July 2021, accessed December 2021.
Yang, Nancy. Hmong farmers, HealthEast write prescription for better health: Veggie boxes, MPR News, July 2019, accessed December 2021
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