As a family nurse practitioner for more than two decades, Heather Ward, MSN, FNP-BC, knows how diet-related chronic diseases like diabetes and heart disease affect health and quality of life. While many of these conditions can be prevented with a well-balanced diet, access to fruits, vegetables and other nutritious foods is out of reach for some. Food insecurity, combined with the rising costs of produce, is a real concern in Whitley County, Indiana, where Ward grew up and has practiced for most of her career.
“Ninety-one percent of the counties in the U.S. with high food insecurity are rural communities,” said Ward, a third-year student in the IU School of Nursing Doctor of Nursing Practice program. “It’s something that hits close to my heart when I see patients who can’t afford nutritious food.”
Committed to making a positive impact for her patients and others facing similar barriers, Ward is focusing on food insecurity as her Doctor of Nursing Practice project. To earn the doctoral degree, IU School of Nursing Doctor of Nursing Practice students use evidence-based solutions to engage in a project that impacts patient care, optimizes systems or creates new policies. For Ward, it’s looking at how produce prescription programs like Parkview Health’s successful VeggieRx program in Fort Wayne can be implemented in rural areas like nearby Whitley County.
“Parkview gathered data about those enrolled in VeggieRx after the first three years of the program, and the outcomes are pretty impressive. On average patients’ A1C dropped by almost a point, and they lost weight,” Ward said. “Even things we don’t think about being connected to diet, like hospital readmissions and ER visits, dropped during that time.”
With such encouraging results, Ward was surprised there weren’t more people from rural areas enrolled given the prevalence of chronic disease there. That’s when she decided to focus her Doctor of Nursing Practice project on learning about barriers to enrollment in rural communities. VeggieRx enrollment requires referral from a primary care provider, and Ward is meeting with fellow providers in Whitley County to discuss produce prescription program models and gain insights.
“Providers are integral to this program—they place the referrals and encourage their patients to try it, and we know from research that patients are more likely to take action when a provider suggests something,” Ward explained. “We need to find out what’s holding back enrollment in rural communities and where barriers exist so that we can have a more successful launch in these counties.”
Ward, who is set to graduate from the IU School of Nursing’s Doctor of Nursing Practice program in May 2025, plans to report her findings early next year.
“I think we’re going to show that before you start a program, it’s important to talk to the providers so that they are on board and know they’re the primary stakeholders in the program’s success,” Ward said.
For Ward, the Doctor of Nursing Practice program’s emphasis on leadership and public policy was a huge benefit not only in completing her final project, but in preparing her for the next step in her career.
“After being a one-on-one provider for 21 years, I think I’m ready to step into a role where I can make a bigger difference for a larger group of people,” Ward said. “I’ve been making a difference with my patients every day but having an impact on a macro level through program leadership—I believe I’m ready for that.”
