AHA (American Heart Association) Food is Medicine Test of Choice Architecture and Salience of Incentives
The goal of this interventional study is to test ways to improve the effectiveness of a healthy foods prescription program in increasing the purchase of healthy foods for patients who have both obesity (BMI > 30) and diabetes (last A1C>8 in the last 90 days). The main questions it aims to answer are:

Aim 1: Examine feasibility and engagement among participants by assessing percent enrollment among those identified as eligible, rates of Instacart platform use, amount of the subsidy used each week, and amounts of healthy foods ordered.

Aim 2: Examine strategies to optimize the user experience of trial participation, including communication strategies and on-boarding, to increase uptake and engagement in this and subsequent studies.

Usual Care (Control): Participants in the usual care arm will not receive weekly subsidies on Instacart, and they will not receive any modifications to the virtual storefront on Instacart. They will have access to the standard Instacart platform and Instacart + memberships with $5 per week to cover service and delivery fees and delivery tips for 3 months.

Intervention Arms: The four treatment groups will also each receive a $160 subsidy per month for 3 months to be used on produce (fruits and vegetables).
- EligibilityCriteria: Inclusion Criteria:  Between the ages of 30 and 70 Patients in the Penn Medicine system who have obesity (BMI>30) and diabetes (last A1C>8 in the last 90 days) Have internet access and self-report using online shopping at least three times in the past year Have a backup payment option available to use in registering for Instacart  Exclusion Criteria:  Not fluent in English Participating in another food and nutrition study Opted out of research The patient does not have a Primary care provider assigned The patient is part of a Penn primary care practice engaged with the Healthy Heart Program - HealthyVolunteers: No - Gender: All - MinimumAge: 30 Years - MaximumAge: 70 Years - StdAgeList: Adult, Older Adult