Good nutrition is essential across the lifespan — supporting healthy growth early on and helping people maintain strength and independence in later life. Reflecting that need, WashU School of Public Health’s first Cultivate Grants will improve access to nourishing food in two high-impact settings: early-childhood programs and clinical care for older adults.
Cultivate is the first funding initiative of the school’s Food and Agriculture Research Mission (FARM), which invests in practical, scalable solutions that connect agriculture, nutrition and public health to build healthier, more resilient communities. The initiative invests in projects with near-term potential to change practice and policy. Track 1 awards up to $40,000 for one year to help early-career investigators test promising ideas. Track 2 provides up to $250,000 over two to three years for established interdisciplinary teams advancing pilot studies that can scale.
The Track 1 project — Growing Minds, Growing Communities — strengthens Farm to Early Care and Education (Farm to ECE) programs, a national approach that connects child care settings to gardening, farm visits, nutrition education and locally grown foods. The Track 2 project launches a Missouri-based Food is Medicine hub that integrates medically tailored meals into clinical care for older adults recovering from illness.
Growing Minds, Growing Communities
Endorsed by the Centers for Disease Control and Prevention (CDC) and the National Academy of Sciences, Farm to ECE programs operate across the country, reaching 12 million children up to age 5 in child care. Such programs have been shown to promote healthier eating habits, enhance understanding of food systems, and support local farmers, said principal investigator Stephanie L. Mazzucca-Ragan, PhD, an assistant professor in the School of Public Health. Other team members include the School of Public Health’s Ross C. Brownson, PhD, the Steven H. and Susan U. Lipstein Distinguished Professor; Maura M. Kepper, MPH, PhD, an assistant professor; and Cheryl Valko, MPH, RD, the associate director of WashU’s Prevention Research Center.
Yet implementation varies widely across settings. Some child-care centers build gardens or visit farms. Others integrate nutrition lessons or serve locally sourced foods. Without a shared framework, it’s difficult to evaluate benefits or sustain funding.
Mazzucca-Ragan’s team will conduct a national scoping review of existing literature, convene an expert advisory panel and use concept mapping to identify the core components of successful programs and define metrics to capture broader benefits, such as stronger local economies and community well-being. The goal: standardize practices, enhance implementation, and strengthen the evidence base to increase support from policymakers and funders — especially as federal public health funding remains uncertain.
These programs face real barriers: limited funding, high staff turnover, competing priorities in childcare, and weak connections to local food producers.
“This work is important,” said Mazzucca Ragan. “Farm to ECE interventions are a practical, scalable, evidence-based approach to food system transformation and improved public health, specifically for the youngest members of our communities. By strengthening how these programs are defined and evaluated, we can help more children develop healthy habits while supporting the communities that feed them.”
NOURISH — A Food is Medicine hub for Missouri
The Track 2 project, NOURISH (Network for Operationalizing Upstream Responses to Improve Systems and Food), will build a regional Food is Medicine hub that links hospitals and health systems, community food organizations and a university-based research team to deliver medically tailored nutrition services as part of routine care — starting with older adults at risk of malnutrition at Mercy Hospital Jefferson in rural Jefferson County, Mo.
Patient screenings at Mercy Hospital Jefferson — the only hospital serving Jefferson County — have revealed that one in five older adults admitted for inpatient care is malnourished, leading to worse health and care outcomes.
No coordinated regional network exists to address food insecurity at scale. Research has shown that Food is Medicine programs can improve health, but they remain difficult to replicate, sustain and integrate into standard care. “Missouri reflects both the urgency and opportunity to connect health care and food systems,” said principal investigator Dan Ferris, PhD, an associate professor of practice in the Brown School. Other WashU team members are Todd B. Combs, MA, PhD, a research assistant professor and the co-principal investigator; Rachel G. Tabak, PhD, RD, an associate professor; and Sarah M. Moreland-Russell, MPH, PhD, an associate professor — all faculty of the School of Public Health. The WashU team collaborates with Sydney Gosik, MPH, MSW, at Food Outreach and a team at Mercy Jefferson.
Led by WashU, Food Outreach and Mercy, the initiative brings together expertise in medically tailored meals, clinical care, nutrition education, philanthropy, research and policy to drive systems change and build scalable care models.
Patients will receive medically tailored meals that are high in protein and designed for convenience through Food Outreach and Mercy Jefferson, along with nutrition counseling and care coordination. Partners will share data and insights to refine and expand the model. The program also will explore ways to redirect surplus nutritious food from farms and food providers to patients and community members.
“In the first year, we hope to see tangible benefits for older adults at risk of malnutrition: improved nutrition security, better continuity of care, and stronger community connections,” Ferris said.
The team will track health outcomes, refine logistics and identify what’s needed for long-term sustainability, including expanded partnerships and new funding streams, such as philanthropic support, government grants, hospital community-benefit spending, and emerging Medicaid and Medicare coverage models.
Comparison groups will be identified from nonparticipating local patients and other Mercy sites. A final report summarizing findings will be shared widely across the region, including a summit planned for early 2028.
Early success would mean creating a blueprint that hospitals and community partners can easily use to connect food and health care. The long-term goal is to expand across under-resourced communities in the St. Louis region, involving more sites, health conditions and populations.
“Our vision is a sustainable regional model that shows Food is Medicine is not just a program but a better way to deliver care, shape policy and invest in health,” Ferris said.