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Onufrak SJ, Moore LV, Pierce SL, MacGowan CA, Galuska DA. Changes in Policy Supports for Healthy Food Retailers, Farmers Markets, and Breastfeeding Among US Municipalities, 2014-2021: National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living (CBS-HEAL). Prev Chronic Dis 2023; 20:E73. [PMID: 37590900 PMCID: PMC10457115 DOI: 10.5888/pcd20.230018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
INTRODUCTION Policies and practices at the local level can help reduce chronic disease risk by providing environments that facilitate healthy decision-making about diet. METHODS We used data from the 2014 and 2021 National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living to examine prevalence among US municipalities of policies to support access to healthier food in supermarkets, convenience stores, and farmers markets, as well as policies to support breastfeeding among government employees. Chi-square tests were conducted to compare prevalence estimates from 2021 to 2014 overall and according to municipal characteristics. RESULTS In 2021, 29% of municipalities had at least 1 policy to encourage full-service grocery stores to open stores, which was not significantly different from 31% in 2014. Prevalence of having at least 1 policy to help corner stores sell healthier foods declined significantly from 13% in 2014 to 9% in 2021. Prevalence of policies providing all local government employees who were breastfeeding breaktime and space to pump breast milk increased significantly from 25% in 2014 to 52% in 2021. The percentage of municipalities that provided 8 or more weeks of paid maternity leave for employees increased significantly from 16% in 2014 to 19% in 2021. CONCLUSION Prevalence of supports for supermarkets, convenience stores, and farmers markets generally did not increase among US municipalities from 2014 to 2021, while some supports for breastfeeding among municipal employees increased during this time. Opportunities exist to improve municipal-level policies that support healthy eating and breastfeeding among community residents and employees.
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Affiliation(s)
- Stephen J Onufrak
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 3679 Hermitage Dr, Berkeley Lake, Georgia 30096
| | - Latetia V Moore
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Samantha L Pierce
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carol A MacGowan
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Deborah A Galuska
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Rose DM, Donahoo S, McDaniel JT, Null D, McLernon M, Kruse-Diehr AJ. Perceptions of the double value coupon program in southern Illinois. Front Public Health 2023; 11:1125069. [PMID: 37483939 PMCID: PMC10359986 DOI: 10.3389/fpubh.2023.1125069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/12/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Purchasing produce at farmers markets represents one method by which individuals can purchase and have access to healthful and seasonal fruits. Despite the extension of nutrition assistance programs to local farmers markets, fruit and vegetables consumption has remained below the recommended guidelines, specifically in rural geographical locations. Statement of purpose The purpose of the study was to explore the aspects of the Link Up Illinois Double Value SNAP Nutrition Incentives Program (DVCP) and its effects on food selection at rural farmers markets for individuals enrolled in nutrition assistance programs. Methods/approach The current study uses a qualitative methodology in order to uncover barriers local health departments and farmers markets face to implementing the DVCP in their communities and to discover the perspectives of low-income individuals who utilize the DVCP. This paper explores the organizational and community member perceptions of the DVCP and its administration. Semi-structured interviews and one focus group were conducted with health educators from county health departments, DVCP stakeholders, farmers market managers, local farmers, and residents who used the DVCP. A purposeful sampling method was used, intentionally selecting individuals with lived experiences of the research objective. Data were analyzed using a three-cycle coding process, then categorized into overarching themes until thematic saturation was reached. Results There were a total of 19 individuals who participated in the study. Five themes and four subthemes emerged from data analysis, including organizational capacity, exposure to the DVCP, purchasing power, DVCP advancements, and values. Conclusion/implications These findings contextualize the facilitators and barriers of multiple stakeholders when implementing nutrition assistance programs at farmers markets. Other similar "double value" programs can utilize these lessons when seeking to increase participation of underrepresented populations at local farmers markets.
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Affiliation(s)
- Dominique M. Rose
- Nationwide Children’s Hospital, Center for Injury, Research and Policy, Abigail Wexner Research Institute, Columbus, OH, United States
| | - Saran Donahoo
- School of Education, Southern Illinois University, Carbondale, IL, United States
| | - Justin T. McDaniel
- School of Education, Southern Illinois University, Carbondale, IL, United States
- School of Human Sciences, Southern Illinois University, Carbondale, IL, United States
| | - Dawn Null
- School of Education, Southern Illinois University, Carbondale, IL, United States
- School of Human Sciences, Southern Illinois University, Carbondale, IL, United States
| | - Michelle McLernon
- School of Education, Southern Illinois University, Carbondale, IL, United States
- Center for Rural Health-SMC, Southern Illinois University, Carbondale, IL, United States
| | - Aaron J. Kruse-Diehr
- Department of Family and Community Medicine, Univeristy of Kentucky College of Medicine, Lexington, KY, United States
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Metoyer BN, Chuang RJ, Lee M, Markham C, Brown E, Almohamad M, Dave JM, Sharma SV. Fruit and Vegetable Shopping Behavior and Intake among Low-Income Minority Households with Elementary-Aged Children. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010082. [PMID: 36670633 PMCID: PMC9857335 DOI: 10.3390/children10010082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/03/2023]
Abstract
Low-income children and families do not meet the recommendations for fruit and vegetable (FV) intake. This study aimed to assess the association between FV shopping behavior and child FV intake through a cross-sectional study design analyzing self-reported surveys (n = 6074) from adult-child dyads of Hispanic/Latino and African American participants enrolled in the Brighter Bites co-op program. Through quantitative mixed effects linear regression models, accounting for school-level clustering and adjusting for covariates, child FV intake was positively associated with shopping for FV at large chain grocery stores (p < 0.001), natural/organic supermarkets (p < 0.001), warehouse club stores (p = 0.002), discount superstores (p < 0.001), small local stores/corner stores (p = 0.038), convenience stores (p = 0.022), ethnic markets (p = 0.002), farmers’ markets/co-op/school farm stands (p < 0.001), and gardens (p = 0.009) among Hispanic/Latinos participants. Among African American participants, there was significant positive association between child FV intake and shopping for FV at natural/organic supermarkets (p < 0.001), discount superstores (p = 0.005), and convenience stores (p = 0.031). The relationship between location and frequency of shopping for FV and child FV intake varied between races. Further research is needed to better understand the influence of cultural and physical environmental factors. Nutrition education programs are vital to encouraging families to make healthier food choices and purchases to improve child FV consumption.
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Affiliation(s)
- Brittni N. Metoyer
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Ru-Jye Chuang
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - MinJae Lee
- Department of Population and Data Sciences, Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center (UTSW), 5323 Harry Hines Blvd, Dallas, TX 75390, USA
| | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 7000 Fannin Street, Houston, TX 77030, USA
| | - Eric Brown
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Maha Almohamad
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Jayna M. Dave
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Ave, Houston, TX 77030, USA
| | - Shreela V. Sharma
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
- Correspondence: ; Tel.: +713-500-9344; Fax: +713-500-9264
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Understanding Impacts of SNAP Fruit and Vegetable Incentive Program at Farmers' Markets: Findings from a 13 State RCT. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127443. [PMID: 35742692 PMCID: PMC9223796 DOI: 10.3390/ijerph19127443] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/06/2022] [Accepted: 06/15/2022] [Indexed: 01/22/2023]
Abstract
Disparities in healthy food access and consumption are a major public health concern. This study reports the findings from a two-year randomized control trial conducted at 77 farmers' markets (FMs) in 13 states and the District of Columbia that sought to understand the impact of fruit and vegetable (FV) incentive vouchers, randomly issued at varied incentive levels to Supplemental Nutrition Assistance Program (SNAP) recipients, for use at FMs. Measures included FV and overall household food purchasing; FV consumption; food insecurity; health status; market expenditure; and demographics. A repeated-measures mixed-effects analysis and the Complier Average Causal Effect (CACE) were used to examine outcomes. Despite 82% reporting food insecurity in the prior year, the findings showed that financial incentives at FMs had statistically significant, positive effects on FV consumption; market expenditures increased with added incentives. SNAP recipients receiving an incentive of USD 0.40 for every USD 1.00 in SNAP spent an average of USD 19.03 per transaction, while those receiving USD 2 for every USD 1 (2:1) spent an average of USD 36.28 per transaction. The data showed that the incentive program at the highest level (2:1) maximally increased SNAP FM expenditure and FV consumption, increasing the latter by 0.31 daily cups among those who used their incentive (CACE model).
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A Produce Prescription Program in Eastern North Carolina Results in Increased Voucher Redemption Rates and Increased Fruit and Vegetable Intake among Participants. Nutrients 2022; 14:nu14122431. [PMID: 35745161 PMCID: PMC9229115 DOI: 10.3390/nu14122431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/31/2022] [Accepted: 06/09/2022] [Indexed: 02/04/2023] Open
Abstract
Few produce prescription programs have taken place in rural areas, in the context of existing public health programs. Thus, the purpose of this mixed-methods study was to examine voucher redemption rates, change in fruit and vegetable intake, and suggestions for improvement among participants enrolled in a produce prescription program occurring in existing public health programs throughout rural eastern North Carolina. We examined voucher redemption rates and conducted pre- (n = 125) and post-intervention surveys assessing fruit and vegetable intake. t-tests were used to examine changes in intake pre- versus post-intervention among 50 participants. Participants (n = 32) also completed a semi-structured, telephone interview. Qualitative data were thematically analyzed to determine potential improvements. The overall voucher redemption rate was 52%. There was a 0.29 (standard deviation = 0.91, p = 0.031) cup increase in self-reported fruit intake comparing post- to pre-intervention data. Qualitative analyses indicated that participants enjoyed the financial benefits of the program and wanted it to continue. The produce prescription program was successful in increasing self-reported fruit intake among participants. More research is needed to determine if changes in intake persist when measured objectively, and on best methods for the program’s financial sustainability.
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Taylor DE, Lusuegro A, Loong V, Cambridge A, Nichols C, Goode M, McCoy E, Daupan SM, Bartlett M, Noel E, Pollvogt B. Racial, Gender, and Age Dynamics in Michigan's Urban and Rural Farmers Markets: Reducing Food Insecurity, and the Impacts of a Pandemic. THE AMERICAN BEHAVIORAL SCIENTIST 2022; 66:894-936. [PMID: 35645401 PMCID: PMC8107495 DOI: 10.1177/00027642211013387] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In recent decades, the number of farmers markets has increased dramatically across the country. Though farmers markets have been described as White spaces, they can play important roles in reducing food insecurity. It is particularly true in Michigan, where farmers markets were crucial collaborators in pioneering programs such as Double-Up Food Bucks that help low-income residents and people of color gain access to fresh, healthy, locally grown food. This article examines the questions: (1) What are the demographic characteristics of farmers market managers, vendors, and customers? (2) How do these influence market activities? (3) To what extent do farmers markets participate in programs to reduce food insecurity? (4) To what extent do farmers markets serve low-income residents and people of color? And (5) How has the Coronavirus Pandemic (COVID-19) affected farmers' markets? This article discusses the findings of a 2020 study that examined the extent to which Michigan's farmers markets served low-income customers and people of color, and participated in food assistance programs. The study examined 79 farmers markets and found that 87.3% of the farmers market managers are White. On average, roughly 79% of the markets' vendors are White, and almost 18% are people of color. Most of the vendors in the markets participate in nutrition assistance programs. Market managers estimate that about 76% of their customers are White, and about 23% are people of color. Farmers markets operated by people of color attract more customers and vendors of color than those administered by White market managers. Almost half of the farmers markets started operations later than usual in 2020 because of the pandemic. More than a third of the markets reported that their funding declined during the pandemic. Moreover, the number of vendors fell at two-thirds of the markets; customers dipped by more than 40%. On the other hand, the number of people requesting food assistance during the pandemic increased in more than half of the markets.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Erin Noel
- University of Massachusetts-Boston, Boston, MA, USA
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Greenwald HP, Tao E, Tilley G. Farmers' Market Incentives for Low-Income Families: Who Uses, How Much, and Why. Am J Prev Med 2022; 62:864-871. [PMID: 35597565 DOI: 10.1016/j.amepre.2021.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/22/2021] [Accepted: 11/30/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Focusing on participation and utilization, this research helps to assess the potential impact and contributions of farmers' market incentive programs, often seen as means for improving nutrition and preventing disease among low-income families. METHODS Evaluating the largest farmers' market incentive program in the U.S. (California Market Match), this study used (1) 3 administrative databases (n=1,469, 6,799, and 30,506), (2) a participant survey (n=2,723), and (3) longitudinal interviews (n=163) with active and former participants. Quantitative data were analyzed with contingency tables and multiple regression. Qualitative data were coded into analytically significant themes. Data were collected in 2015-2018 and analyzed in 2018-2021. RESULTS Participation was typically low and varied across localities (3.7%-19.8% of eligible families in a sample of ZIP codes). According to administrative records, market visits by participants in 2 California regions averaged 2.18 and 3.12 per season. However, 77.1% of participants in the shopper survey indicated that they were repeat customers, and 51.0% indicated that they were regular utilizers. Deterrents to utilization included perceptions of inconvenience and high prices but not availability of produce in the community or travel time to markets. Utilization was most frequent among Asian shoppers and residents of Southern California outside Los Angeles County. CONCLUSIONS Farmers' market incentive programs such as Market Match appear likely to benefit population health through a core of committed shoppers. Improvement in participation and utilization may be attained through a better understanding of the communities that the markets are intended to serve.
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Affiliation(s)
- Howard P Greenwald
- Sol Price School of Public Policy, University of Southern California, Los Angeles, California.
| | - Ernie Tao
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Gabrielle Tilley
- The Los Angeles Trust for Children's Health, Los Angeles, California
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8
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Caron-Roy S, Lee YY, Sayed SA, Lashewicz B, Milaney K, Dunn S, O'Hara H, Leblanc P, Prowse RJ, Fournier B, Raine KD, Elliott C, Lee Olstad D. Experiences and perceived outcomes of low-income adults during and after participating in the British Columbia Farmers’ Market Nutrition Coupon Program: a longitudinal qualitative study. J Acad Nutr Diet 2022; 122:2257-2266. [DOI: 10.1016/j.jand.2022.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 03/02/2022] [Accepted: 03/24/2022] [Indexed: 10/18/2022]
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Associations between farmers' market shopping behaviours and objectively measured and self-reported fruit and vegetable intake in a diverse sample of farmers' market shoppers: a cross-sectional study in New York City and rural North Carolina. Public Health Nutr 2022; 25:600-606. [PMID: 34789356 PMCID: PMC9991615 DOI: 10.1017/s1368980021004602] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To examine cross-sectional associations between farmers' market shopping behaviours and objectively measured and self-reported fruit and vegetable (FV) intake among rural North Carolina (NC) and New York City (NYC) shoppers. DESIGN Cross-sectional intercept surveys were used to assess self-reported FV intake and three measures of farmers' market shopping behaviour: (1) frequency of purchasing FV; (2) variety of FV purchased and (3) dollars spent on FV. Skin carotenoids, a non-invasive biomarker for FV intake, were objectively measured using pressure-mediated reflection spectroscopy. Associations between farmers' market shopping behaviours and FV intake were examined using regression models that controlled for demographic variables (e.g. age, sex, race, smoking status, education, income and state). SETTING Farmers' markets (n 17 markets) in rural NC and NYC. PARTICIPANTS A convenience sample of 645 farmers' market shoppers. RESULTS Farmers' market shoppers in NYC purchased a greater variety of FV and had higher skin carotenoid scores compared with shoppers in rural NC. Among all shoppers, there was a positive, statistically significant association between self-reported frequency of shopping at farmers' markets and self-reported as well as objectively assessed FV intake. The variety of FV purchased and farmers' market spending on FV also were positively associated with self-reported FV intake, but not skin carotenoids. CONCLUSION Those who shop for FV more frequently at a farmers' markets, purchase a greater variety of FV and spend more money on FV have higher self-reported, and in some cases higher objectively measured FV intake. Further research is needed to understand these associations and test causality.
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10
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Hanson KL, Meng X, Volpe LC, Jilcott Pitts S, Bravo Y, Tiffany J, Seguin-Fowler RA. Farmers’ Market Nutrition Program Educational Events Are Broadly Accepted and May Increase Knowledge, Self-Efficacy and Behavioral Intentions. Nutrients 2022; 14:nu14030436. [PMID: 35276793 PMCID: PMC8840006 DOI: 10.3390/nu14030436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/08/2022] [Accepted: 01/10/2022] [Indexed: 02/05/2023] Open
Abstract
The Farmers’ Market Nutrition Program (FMNP) in the U.S. provides coupons for the purchase of fruit and vegetables (FV) to pregnant women and children enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), and to income-eligible adults 60+ years of age. The New York State FMNP Education Event Guide was developed to support cooperative extension educators in providing information, food tastings, and cooking demonstrations at farmers’ markets (FM) to encourage consumption of FV. This paper describes implementation at seven FM in New York City, and shopping and eating behaviors in a cross-sectional survey of FM shoppers (n = 377). Three of nine lessons were implemented more than once, typically with food sampling (78.9%). FM shoppers were primarily women (81.5%), racially diverse (30.5% Black, 23.1% White), frequent shoppers (2.4 times/month), and had high FV consumption (2.24 cups fruit; 2.44 cups vegetables daily). Most FM shoppers participated in the FM education event (84%), and participants and non-participants had equivalent shopping and eating behaviors. More than 70% of FM education participants believed that the event positively impacted their knowledge, self-efficacy, and behavioral intentions. FMNP education events at FM were broadly accepted by FM shoppers of all characteristics, and may improve knowledge, self-efficacy, and behavioral intention.
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Affiliation(s)
- Karla L. Hanson
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853, USA; (X.M.); (L.C.V.)
- Correspondence: ; Tel.: +1-607-255-8075
| | - Xiangqi Meng
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853, USA; (X.M.); (L.C.V.)
| | - Leah C. Volpe
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853, USA; (X.M.); (L.C.V.)
| | | | - Yvonne Bravo
- Cornell University Cooperative Extension—New York City Programs, New York, NY 10022, USA; (Y.B.); (J.T.)
| | - Jennifer Tiffany
- Cornell University Cooperative Extension—New York City Programs, New York, NY 10022, USA; (Y.B.); (J.T.)
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Fultz AK, Sundermeir SM, Katz S, Robson SM. More Frequent Food Shopping May Promote Fruit and Vegetable Intake: A Systematic Review. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:957-965. [PMID: 34452830 DOI: 10.1016/j.jneb.2021.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 07/19/2021] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Food shopping frequency may be an important modifiable factor related to increasing fruit and vegetable (FV) intake. Because of mixed findings of individual studies of shopping frequency, a systematic review is needed to examine findings across studies and store types. OBJECTIVE To conduct a systematic review of articles examining the relationship between frequency of food shopping and FV intake including examination of participation in federal nutrition assistance programs on FV intake, if reported. METHODS A search, guided by the Preferred Reported Items for Systematic Reviews and Metanalyses, using terms related to FV consumption and food shopping across 4 online databases, was conducted. Studies conducted in the US and published through October, 2020, included adults, and had a cross-sectional, longitudinal, cohort, or randomized study design were eligible for inclusion. RESULTS Twenty-four articles were included. The majority of studies found at least 1 positive finding between the frequency of food shopping and FV intake, indicating that as the frequency of food shopping increased, FV intake increased. In studies with 100% participation in government/federal nutrition assistance programs, participation was associated with FV intake. Studies that included participation as a subset found participation not associated with FV intake. IMPLICATIONS FOR FUTURE RESEARCH AND PRACTICE The frequency of shopping may be modifiable to increase FV intake. Experimental research is needed to test the directionality and causality of the relationship. Federal nutrition assistance programs may be a logical place to test the relationship through the adjustment of fund disbursements.
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Affiliation(s)
- Amanda K Fultz
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE; Center for Health Behavior Research, University of Pennsylvania, Philadelphia, PA.
| | - Samantha M Sundermeir
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE; Department of International Health, Johns Hopkins University, Baltimore, MD
| | - Sarah Katz
- Health Science Librarian, University of Delaware Library, Museums and Press, Newark, DE
| | - Shannon M Robson
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE
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12
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Karpyn A, Pon J, Grajeda SB, Wang R, Merritt KE, Tracy T, May H, Sawyer-Morris G, Humphrey DL, Hunt A. Purchases, Consumption, and BMI of SNAP Farmers’ Market Shoppers. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2021. [DOI: 10.1080/19320248.2021.1997860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Allison Karpyn
- Center for Research in Education and Social Policy, University of Delaware, Newark, Delaware, USA
| | - Julia Pon
- Wholesome Wave, Berkeley, California, USA
| | - Sara Bernice Grajeda
- Center for Research in Education and Social Policy, University of Delaware, Newark, Delaware, USA
| | - Rui Wang
- Center for Research in Education and Social Policy, University of Delaware, Newark, Delaware, USA
| | | | - Tara Tracy
- Center for Research in Education and Social Policy, University of Delaware, Newark, Delaware, USA
| | - Henry May
- Center for Research in Education and Social Policy, University of Delaware, Newark, Delaware, USA
| | - Ginnie Sawyer-Morris
- Human Development & Family Sciences, The University of Delaware, Newark, Delaware, USA
| | - D. Layne Humphrey
- Center for Research in Education and Social Policy, University of Delaware, Newark, Delaware, USA
| | - Alan Hunt
- Wholesome Wave, Bridgeport, Connecticut, USA
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Kopetsky A, Brewer B, Steeves EA, Robson SM. Food Shopping Frequency of Rural Tennessee Adults With Comparisons by Federal Nutrition Assistance Participation. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:886-890. [PMID: 34112608 DOI: 10.1016/j.jneb.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 03/11/2021] [Accepted: 03/14/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To describe food shopping frequency across 7 store types in a rural context and compare food shopping frequency between federal nutrition assistance recipients and nonrecipients. METHODS This cross-sectional study was conducted at county fairs in rural Tennessee. RESULTS Reported overall mean food shopping frequency was 18.4 (SD, 13.9) times in the past 30 days. A mean of 3.1 (SD, 1.2) store types were visited, with supermarkets, convenience stores, and dollar stores the most frequented stores. Federal nutrition assistance program recipients shopped significantly less frequently than nonrecipients for overall shopping frequency (P = 0.02), supermarkets (P = 0.02), and farmers' markets (P = 0.04). CONCLUSIONS AND IMPLICATIONS Educating and counseling individuals on how food shopping frequency may promote nutrition and health may be important. Federal nutrition assistance programs that distribute benefits monthly may impact food shopping frequency.
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Affiliation(s)
- Amanda Kopetsky
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE.
| | - Ben Brewer
- College of Health Sciences, University of Delaware, Newark, DE
| | | | - Shannon M Robson
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE
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Bhat S, Coyle DH, Trieu K, Neal B, Mozaffarian D, Marklund M, Wu JHY. Healthy Food Prescription Programs and their Impact on Dietary Behavior and Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis. Adv Nutr 2021; 12:1944-1956. [PMID: 33999108 PMCID: PMC8483962 DOI: 10.1093/advances/nmab039] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/21/2020] [Accepted: 03/11/2021] [Indexed: 12/11/2022] Open
Abstract
The enormous burden of diet-related chronic diseases has prompted interest in healthy food prescription programs. Yet, the impact of such programs remains unclear. The aim of this study was to conduct a systematic review of healthy food prescription programs and evaluate their impact on dietary behavior and cardiometabolic parameters by meta-analysis. A systematic search was carried out in Medline, Embase, Scopus, and Cochrane Central Register of Controlled Trials databases since their inception to 3 January, 2020 without language restriction. A systematic search of interventional studies investigating the effect of healthy food prescription on diet quality and/or cardiometabolic risk factors including BMI, systolic (SBP) and diastolic blood pressure (DBP), glycated hemoglobin (HbA1c), or blood lipids was carried out. Thirteen studies were identified for inclusion, most of which were quasi-experimental (pre/post) interventions without a control group (n = 9). Pooled estimates revealed a 22% (95% CI: 12, 32; n = 5 studies, n = 1039 participants; I2 = 97%) increase in fruit and vegetable consumption, corresponding to 0.8 higher daily servings (95% CI: 0.2, 1.4; I2 = 96%). BMI decreased by 0.6 kg/m2 (95% CI: 0.2, 1.1; I2 = 6.4%) and HbA1c by 0.8% (95% CI: 0.1, 1.6; I2 = 92%). No significant change was observed in other cardiometabolic parameters. These findings should be interpreted with caution in light of considerable heterogeneity, methodological limitations of the included studies, and moderate to very low certainty of evidence. Our results support the need for well-designed, large, randomized controlled trials in various settings to further establish the efficacy of healthy food prescription programs on diet quality and cardiometabolic health.
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Affiliation(s)
- Saiuj Bhat
- School of Medicine, The University of Western Australia, Crawley, Australia
| | - Daisy H Coyle
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Kathy Trieu
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Bruce Neal
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- School of Public Health, Imperial College London, London, United Kingdom
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Matti Marklund
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jason H Y Wu
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
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Volz K, Wyckoff E, Medina TH, Denmat Z, Field C, LaRose J, Gorin A, Leahey T. Impact of income and perceived stress on engagement and weight loss outcomes in an online behavioral weight loss program. J Behav Med 2021; 44:853-859. [PMID: 34160724 DOI: 10.1007/s10865-021-00238-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 06/10/2021] [Indexed: 02/07/2023]
Abstract
Lower income is associated with greater stress, and stress has been shown to undermine treatment engagement and weight loss outcomes in face-to-face interventions. The present study examined whether lower income predicts treatment engagement and weight loss outcomes during an online behavioral weight loss (BWL) intervention. A total of N = 260 participants (79.2% female; 50.7 ± 11.9 years of age; 60.3% non-Hispanic White) were enrolled into an online BWL program and had their income, stress, program engagement, and weight measured. Results showed that stress fully mediated the effect of income on engagement in the online program. Further, lower income predicted poorer weight loss outcomes, and this effect was partially mediated by perceived stress. This is the first study to demonstrate that lower income is associated with poorer engagement and weight loss outcomes in an online weight loss program, underscoring the need for systems-level stress reduction programs and individual level stress management tools, particularly for individuals with lower income.
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Affiliation(s)
| | | | | | | | | | | | - Amy Gorin
- University of Connecticut, Storrs, CT, USA
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Di Noia J, Monica D, Sikorskii A. Process Evaluation of a Farm-to-WIC Intervention. J Acad Nutr Diet 2021; 121:2021-2034. [PMID: 34144918 DOI: 10.1016/j.jand.2021.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Despite the promise of farm-to-institution interventions for addressing limited vegetable access as a barrier to intake, programs designed for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are lacking. As such, little is known about the implementation of, and mechanisms of action through which, farm-to-WIC interventions affect vegetable intake and participant satisfaction with such programs. OBJECTIVE To examine whether a farm-to-WIC intervention to promote vegetable intake was implemented as intended, differences between participants who received the intervention relative to those in a usual-care control group in intermediate outcomes of vegetable-related knowledge, attitudes, and behaviors, and secondary outcomes of physical activity and weight status; and participant satisfaction with the intervention. DESIGN A process evaluation encompassing descriptive and comparative analyses of implementation fidelity logs and survey data collected as part of a pilot study was conducted. PARTICIPANTS/SETTING The setting was a large, New Jersey-based, urban WIC agency. Recruited between June 3 and August 1, 2019 through 3 of the agency's 17 sites (1 intervention and 2 control sites), participants were 297 primarily Hispanic adults (160 enrolled at the intervention site and 137 at control sites). INTERVENTION The intervention combined behaviorally focused instruction and handouts with the introduction of a WIC-based farmers' market, field trips to an area farmers' market, telephone coaching and support, and recipe demonstrations and tastings. MAIN OUTCOME MEASURES Primary outcomes were vegetable intake (measured via self-report and objectively using dermal carotenoids as a biomarker of intake) and the redemption of vouchers provided by WIC for fruit and vegetable purchases at farmers' markets (measured objectively using data provided by WIC). For the process evaluation, logs were used to document program activities. Vegetable-related knowledge, attitudes, and behaviors, physical activity, and satisfaction with the intervention were assessed with participant questionnaires. Weight status was assessed with direct measures of height and weight. Data were collected at baseline and at mid- and post-intervention (3 and 6 months post-baseline, respectively). STATISTICAL ANALYSES PERFORMED Descriptive statistics were used to characterize implementation fidelity. Associations between intermediate and secondary outcomes and vegetable intake were examined at baseline with Pearson correlations. Post-baseline between-group differences in the outcomes were examined with linear mixed-effects models adjusted for baseline values and covariates. Satisfaction with the intervention was assessed with inferential and thematic analyses. RESULTS Post-intervention, measures of vegetable intake were higher in the intervention relative to the control study group. Receipt of the intervention was also associated with a greater likelihood of voucher redemption. Nearly all participants (≥94%) received the intervention as intended at the WIC-based farmers' market; smaller percentages completed 1 or more planned trips to the area farmers' market (28%) and telephone coaching and support calls (88%). Although most intermediate and secondary outcomes were associated with measures of vegetable intake at baseline, the variables did not differ between study groups post-intervention. Mean satisfaction ratings were ≥6.8 on a 7-point scale. Recipe demonstrations, learning about vegetables, field trips, and the rapport with staff were liked most about the program. Although adding days and times for field trips was suggested, limited market days and hours of operation limited the ability to do so. CONCLUSIONS Preliminary data highlight the promise of this well-received intervention. Intermediate outcome findings suggest that other potential intervention mechanisms of action should be considered in future large-scale trials of this program. Broad-scale initiatives are needed to improve access to farmers' markets in underserved communities.
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Strome S, Johns T, Scicchitano M, Shelnutt K. The Effects of Mealtime Behaviors and Beliefs on Fresh Fruit and Vegetable Consumption in Food Deserts. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2021. [DOI: 10.1080/19320248.2019.1649778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Stuart Strome
- Florida Survey Research Center, University of Florida, Gainesville, Florida, USA
| | - Tracy Johns
- Florida Survey Research Center, University of Florida, Gainesville, Florida, USA
| | - Michael Scicchitano
- Florida Survey Research Center, University of Florida, Gainesville, Florida, USA
| | - Karla Shelnutt
- Department of Family, Youth, and Community Sciences, University of Florida, Gainesville, Florida, USA
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Abstract
Food’s place on the urban, municipal agenda has become an increasing focus in the emergent fields of food policy and food planning, whose leaders argue that food needs to be more explicitly added to the urban agenda. Yet, public food markets are a food system activity that municipal governments have been long engaged in. Reports from leading health, planning, and food organizations assert that farmers markets—the dominant form of public retail food markets in the US today—should be explicitly included in zoning and other municipal codes to ensure that they can be created and sustained. Despite their popularity as a local sustainable food system and healthy food access strategy, it is unclear whether markets have been codified through municipalities’ planning and policy instruments, and research has largely not addressed this topic. This study aims to elicit whether markets have been codified into law, focusing on US municipal charters, codes and zoning ordinances, using Michigan, an upper Midwest state, as a case. After analyzing municipal documents to determine whether and where markets have been codified into law in ninety Michigan cities, this study concludes that markets are highly underrepresented in municipal policy, rarely defined in code, and mostly absent from zoning ordinances, even among those cities with currently operating markets. Market presence in code is, however, associated with the presence of historically operated markets. These findings raise questions about why markets are missing from codified food policy and what risks this poses to the future of markets. They also highlight the need to better document the market sector and underline the importance of including historic perspectives when examining the efficacy of current food policy efforts.
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19
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Zhao Y, Sawicki M, Kelly P, Kress K. Consumer Attitudes Towards Accepting SNAP Benefits at Farmers’ Markets. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2020. [DOI: 10.1080/19320248.2019.1668324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Yiwei Zhao
- Department of Nutrition and Dietetics, Saint Louis University, Saint Louis, MO, USA
| | - Marjorie Sawicki
- Department of Nutrition and Dietetics, Saint Louis University, Saint Louis, MO, USA
| | - Patrick Kelly
- Office of Institutional Research, Saint Louis University, St. Louis, MO, USA
| | - Kathleen Kress
- Department of Nutrition and Dietetics, Saint Louis University, Saint Louis, MO, USA
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20
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Drisdelle C, Kestens Y, Hamelin AM, Mercille G. Disparities in Access to Healthy Diets: How Food Security and Food Shopping Behaviors Relate to Fruit and Vegetable Intake. J Acad Nutr Diet 2020; 120:1847-1858. [DOI: 10.1016/j.jand.2020.03.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 03/25/2020] [Indexed: 11/29/2022]
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21
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Garner JA, Coombs C, Savoie-Roskos MR, Durward C, Seguin-Fowler RA. A Qualitative Evaluation of Double Up Food Bucks Farmers' Market Incentive Program Access. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:705-712. [PMID: 31924558 PMCID: PMC7338242 DOI: 10.1016/j.jneb.2019.11.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 11/13/2019] [Accepted: 11/18/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Explore factors affecting access to and use of Double Up Food Bucks (DUFB), a farmers' market program that doubles Supplemental Nutrition Assistance Program benefits for use toward the purchase of fruits and vegetables (FV). DESIGN Focus groups. SETTING Metro and nonmetro counties in Utah and western Upstate New York. PARTICIPANTS Nine groups composed of 62 low-income adults (3-9/group). PHENOMENA OF INTEREST Satisfaction with, barriers to, and facilitators of program use; suggestions for improvement. ANALYSIS Transcribed verbatim and coded thematically in NVivo 11 software according to template analysis. RESULTS Program satisfaction was high and driven by FV affordability, perceived support of local farmers, positive market experiences, and high-quality FV. Primary barriers to using DUFB were lack of program information and inconvenient accessibility. Insufficient program communication was a consistent problem that elicited numerous suggestions regarding expansion of program marketing. Emergent topics included issues related to the token-based administration of DUFB and debate regarding stigma experienced during DUFB participation. CONCLUSIONS AND IMPLICATIONS Results suggest that although DUFB elicits many points of satisfaction among users, program reach may be limited owing to insufficient program marketing. Even among satisfied users, discussion of barriers was extensive, indicating that program reach and impact may be bolstered by efforts to improve program accessibility.
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Affiliation(s)
- Jennifer A Garner
- School of Health and Rehabilitation Sciences, Ohio State University, Columbus, OH; John Glenn College of Public Affairs, Ohio State University, Columbus, OH.
| | - Casey Coombs
- Department of Nutrition, Dietetics, and Food Science, Utah State University, Logan, UT
| | | | - Carrie Durward
- Department of Nutrition, Dietetics, and Food Science, Utah State University, Logan, UT
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22
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Saxe-Custack A, Sadler R, LaChance J, Hanna-Attisha M, Ceja T. Participation in a Fruit and Vegetable Prescription Program for Pediatric Patients is Positively Associated with Farmers' Market Shopping. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124202. [PMID: 32545578 PMCID: PMC7344709 DOI: 10.3390/ijerph17124202] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 12/16/2022]
Abstract
Objectives: The primary objective was to investigate the association between participation in a farmers’ market fruit and vegetable prescription program (FVPP) for pediatric patients and farmers’ market shopping. Methods: This survey-based cross-sectional study assessed data from a convenience sample of 157 caregivers at an urban pediatric clinic co-located with a farmers’ market. Prescription redemption was restricted to the farmers’ market. Data were examined using chi-square analysis and independent samples t-tests. Results: Approximately 65% of respondents participated in the FVPP. Those who received one or more prescriptions were significantly more likely to shop at the farmers’ market during the previous month when compared to those who never received a prescription (p = 0.005). Conclusions: This is the first study to demonstrate that participation in a FVPP for pediatric patients is positively associated with farmers’ market shopping.
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Affiliation(s)
- Amy Saxe-Custack
- Department of Food Science and Human Nutrition, Division of Public Health, Michigan State University-Hurley Children’s Hospital Pediatric Public Health Initiative, Flint, MI 48502, USA
- Correspondence:
| | - Richard Sadler
- Department of Family Medicine, Division of Public Health, Michigan State University College of Human Medicine, Flint, MI 48502, USA;
| | - Jenny LaChance
- Division of Public Health, Michigan State University-Hurley Children’s Hospital Pediatric Public Health Initiative, Flint, MI 48502, USA; (J.L.); (T.C.)
| | - Mona Hanna-Attisha
- Department of Pediatrics and Human Development, Division of Public Health, Michigan State University-Hurley Children’s Hospital Pediatric Public Health Initiative, Flint, MI 48502, USA;
| | - Tiffany Ceja
- Division of Public Health, Michigan State University-Hurley Children’s Hospital Pediatric Public Health Initiative, Flint, MI 48502, USA; (J.L.); (T.C.)
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Russo R, Li Y, Chong S, Siscovick D, Trinh-Shevrin C, Yi S. Dietary policies and programs in the United States: A narrative review. Prev Med Rep 2020; 19:101135. [PMID: 32551216 PMCID: PMC7289763 DOI: 10.1016/j.pmedr.2020.101135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/14/2020] [Accepted: 05/23/2020] [Indexed: 01/18/2023] Open
Abstract
School-based and youth targeted programs and policies were most frequently studied. Research has rather neglected older adult, Asian, Native Hawaiian and American Indian populations. Despite existing research indicating effectiveness, faith-based were understudied.
Prior reviews describing approach, methodological quality and effectiveness of dietary policies and programs may be limited in use for practitioners seeking to introduce innovative programming, or academic researchers hoping to understand and address gaps in the current literature. This review is novel, assessing the “where, who, and in whom” of dietary policies and programs research in the United States over the past decade – with results intended to serve as a practical guide and foundation for innovation. This study was conducted from October 2018 to March 2019. Papers were selected through a tailored search strategy on PubMed as well as citation searches, to identify grey literature. A total of 489 papers were relevant to our research objective. The largest proportion of papers described school-based strategies (31%) or included economic incentives (19%). In papers that specified demographics, the study populations most often included children, adults and adolescents (54%, 46%, and 42% respectively); and White, Black and Hispanic populations (77%, 76% and 70%, respectively). Results highlight opportunities for future research within workplace and faith-based settings, among racial/ethnic minorities, and older adults.
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Affiliation(s)
- Rienna Russo
- NYU School of Medicine, Department of Population Health, New York, NY, United States
| | - Yan Li
- Icahn School of Medicine at Mount Sinai, Department of Population Health Science and Medicine, New York, NY, United States
| | - Stella Chong
- NYU School of Medicine, Department of Population Health, New York, NY, United States
| | - David Siscovick
- New York Academy of Medicine, Center for Health Innovation, New York, NY, United States
| | - Chau Trinh-Shevrin
- NYU School of Medicine, Department of Population Health, New York, NY, United States
| | - Stella Yi
- NYU School of Medicine, Department of Population Health, New York, NY, United States
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Aktary ML, Caron-Roy S, Sajobi T, O'Hara H, Leblanc P, Dunn S, McCormack GR, Timmins D, Ball K, Downs S, Minaker LM, Nykiforuk CI, Godley J, Milaney K, Lashewicz B, Fournier B, Elliott C, Raine KD, Prowse RJ, Olstad DL. Impact of a farmers' market nutrition coupon programme on diet quality and psychosocial well-being among low-income adults: protocol for a randomised controlled trial and a longitudinal qualitative investigation. BMJ Open 2020; 10:e035143. [PMID: 32371514 PMCID: PMC7228519 DOI: 10.1136/bmjopen-2019-035143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 02/19/2020] [Accepted: 04/02/2020] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Low-income populations have poorer diet quality and lower psychosocial well-being than their higher-income counterparts. These inequities increase the burden of chronic disease in low-income populations. Farmers' market subsidies may improve diet quality and psychosocial well-being among low-income populations. In Canada, the British Columbia (BC) Farmers' Market Nutrition Coupon Programme (FMNCP) aims to improve dietary patterns and health among low-income participants by providing coupons to purchase healthy foods from farmers' markets. This study will assess the impact of the BC FMNCP on the diet quality and psychosocial well-being of low-income adults and explore mechanisms of programme impacts. METHODS AND ANALYSIS In a parallel group randomised controlled trial, low-income adults will be randomised to an FMNCP intervention (n=132) or a no-intervention control group (n=132). The FMNCP group will receive 16 coupon sheets valued at CAD$21/sheet over 10-15 weeks to purchase fruits, vegetables, dairy, meat/poultry/fish, eggs, nuts and herbs at farmers' markets and will be invited to participate in nutrition skill-building activities. Overall diet quality (primary outcome), diet quality subscores, mental well-being, sense of community, food insecurity and malnutrition risk (secondary outcomes) will be assessed at baseline, immediately post-intervention and 16 weeks post-intervention. Dietary intake will be assessed using the Automated Self-Administered 24-hour Dietary Recall. Diet quality will be calculated using the Healthy Eating Index-2015. Repeated measures mixed-effect regression will assess differences in outcomes between groups from baseline to 16 weeks post-intervention. Furthermore, 25-30 participants will partake in semi-structured interviews during and 5 weeks after programme completion to explore participants' experiences with and perceived outcomes from the programme. ETHICS AND DISSEMINATION Ethical approval was obtained from the University of Calgary Conjoint Health Research Ethics Board, Rutgers University Ethics and Compliance, and University of Waterloo Office of Research Ethics. Findings will be disseminated through policy briefs, conference presentations and peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT03952338.
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Affiliation(s)
- Michelle L Aktary
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | | | - Tolulope Sajobi
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Heather O'Hara
- British Columbia Association of Farmers' Markets, Vancouver, British Columbia, Canada
| | - Peter Leblanc
- British Columbia Association of Farmers' Markets, Vancouver, British Columbia, Canada
| | - Sharlette Dunn
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Gavin R McCormack
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
- School of Architecture, Planning and Landscape, University of Calgary, Calgary, Alberta, Canada
| | - Dianne Timmins
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Kylie Ball
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Victoria, Australia
| | - Shauna Downs
- School of Public Health, Rutgers University, Newark, New Jersey, USA
| | - Leia M Minaker
- School of Planning, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Jenny Godley
- Department of Sociology, University of Calgary, Calgary, Alberta, Canada
| | - Katrina Milaney
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Bonnie Lashewicz
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Bonnie Fournier
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Charlene Elliott
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Communication Media and Film, University of Calgary, Calgary, Alberta, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Rachel Jl Prowse
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Dana Lee Olstad
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
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25
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Singleton CR, Kessee N, Chatman C, Spreen C. Racial/Ethnic Differences in the Shopping Behaviors and Fruit and Vegetable Consumption of Farmers' Market Incentive Program Users in Illinois. Ethn Dis 2020; 30:109-118. [PMID: 31969790 DOI: 10.18865/ed.30.1.109] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction Farmers' market incentive programs, such as Link Match, provide monetary incentives to Supplemental Nutrition Assistance Program (SNAP) participants to promote their use of local farmers' markets. Information on racial/ethnic differences in the shopping behaviors and fruit and vegetable (FV) consumption of farmers' market incentive program users is scarce. This research aimed to address this need by examining users of the Link Match incentive program in Illinois. Methods A cross-sectional survey of 328 Link Match users (39.6% non-Hispanic White; 45.4% non-Hispanic Black; and 15.0% other) was conducted in 2016 and 2017. Information on each participant's demographics, farmers' market shopping behaviors, and monthly frequency of FV consumption was collected from Link Match users. Chi-square and ANOVA tests were used to assess differences in farmers' market shopping measures by race/ethnicity. Logistic regression models were used to examine the association between race/ethnicity and frequency of FV consumption. Results A significantly higher percentage of non-Hispanic Black participants reported being an infrequent farmers' market user (ie, shopping ≤ once a month) compared with non-Hispanic White and other participants (P=.01). After adjusting for covariates, non-Hispanic Black participants had lower odds of consuming fruit daily (OR: .44; 95% CI:.22-.86) compared with non-Hispanic White participants. Other participants had lower odds of consuming both fruit and vegetables compared with non-Hispanic White participants (OR: .30; 95% CI:.12-.71). Conclusions Differences in shopping behaviors and FV consumption were observed by race/ethnicity among Link Match users. Future research should examine the nutritional implications of these differences.
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Affiliation(s)
- Chelsea R Singleton
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Nicollette Kessee
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
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26
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Hamilton DL, Walkinshaw LP, Quinn EL, Johnson DB. Increasing farmers market access among low-income shoppers in Washington state: understanding the role of peer-to-peer programs. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2020. [DOI: 10.1080/19320248.2018.1544527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Danielle L. Hamilton
- Department of Public Health, University of Washington Nutritional Sciences Program
| | - Lina P. Walkinshaw
- Department of Public Health, University of Washington Center for Public Health Nutrition
| | - Emilee L. Quinn
- Department of Public Health, University of Washington Center for Public Health Nutrition
| | - Donna B. Johnson
- Department of Public Health, University of Washington Center for Public Health Nutrition
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27
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Rebouillat P, Bonin S, Kestens Y, Chaput S, Drouin L, Mercille G. Fruit and Vegetable Purchases in Farmer's Market Stands: Analysing Survey and Sales Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:E88. [PMID: 31877682 PMCID: PMC6981572 DOI: 10.3390/ijerph17010088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 12/06/2019] [Accepted: 12/15/2019] [Indexed: 11/16/2022]
Abstract
Farmers' market implementation holds promise for increasing access to healthy foods. Although rarely measured, purchase data constitute an intermediate outcome between food environment and actual consumption. In a study conducted with two seasonal Fruits and Vegetables (FV) stands in a disadvantaged area of Montréal (Canada), we analysed how accessibility, perception, and mobility-related factors were associated with FV purchase. This analysis uses a novel measure of FV purchasing practices based on sales data obtained from a mobile application. A 2016 survey collected information on markets' physical access, perceived access to FV in the neighbourhood, usual FV consumption and purchases. Multivariate models were used to analyse three purchasing practice indicators: number of FV portions, FV variety and expenditures. Average shoppers purchased 12 FV portions of three distinct varieties and spent 5$. Shoppers stopping at the market on their usual travel route spent less (p = 0.11), bought fewer portions (p = 0.03) and a lesser FV variety (p < 0.01). FV stands may complement FV dietary intake. Individuals for whom the market is on their usual travel route might make more frequent visits and, therefore, smaller purchases. The novel data collection method allowed analysis of multiple purchase variables, is precise and easy to apply at unconventional points of sales and could be transposed elsewhere.
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Affiliation(s)
- Pauline Rebouillat
- Institut de Santé Publique d’Épidémiologie et de Développement (ISPED), Université de Bordeaux, 33000 Bordeaux, France
- Centre de recherche du Centre hospitalier de l’Université de Montréal, 850 St-Denis, Montréal, QC H2X 0A9, Canada
| | - Sarah Bonin
- Département de médecine sociale et préventive, École de Santé Publique de l’Université de Montréal, 7101 Avenue du Parc, Montréal, QC H3N 1X9, Canada
| | - Yan Kestens
- Centre de recherche du Centre hospitalier de l’Université de Montréal, 850 St-Denis, Montréal, QC H2X 0A9, Canada
- Département de médecine sociale et préventive, École de Santé Publique de l’Université de Montréal, 7101 Avenue du Parc, Montréal, QC H3N 1X9, Canada
| | - Sarah Chaput
- Centre de recherche du Centre hospitalier de l’Université de Montréal, 850 St-Denis, Montréal, QC H2X 0A9, Canada
- Département de médecine sociale et préventive, École de Santé Publique de l’Université de Montréal, 7101 Avenue du Parc, Montréal, QC H3N 1X9, Canada
| | - Louis Drouin
- Direction régionale de santé publique, Centre intégré universitaire de santé et services sociaux du Centre-Sud-de-l’Ile-de-Montréal, Montréal, QC H2L 1M3, Canada
| | - Geneviève Mercille
- Département de nutrition, Université de Montréal, 2450 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1A8, Canada
- Centre de recherche en santé publique, 1301 Sherbrooke Est, Montréal, QC H2L 1M3, Canada
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Ball L, Andrews J, Gruber K, Dharod J. Implementation of a WIC clinic farmers’ market improves accessibility and consumption of fresh fruits and vegetables among WIC farmers’ market nutrition program participants. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2019. [DOI: 10.1080/19320248.2018.1491364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Lanae Ball
- Department of Nutrition, Health, and Human Performance, Meredith College, Raleigh, NC, USA
| | - Jesse Andrews
- Department of Geography, Oklahoma State University, Stillwater, OK, USA
| | - Kenneth Gruber
- Center for Family, Youth, and Community Partnerships, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Jigna Dharod
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC, USA
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A Systematic Review on Socioeconomic Differences in the Association between the Food Environment and Dietary Behaviors. Nutrients 2019; 11:nu11092215. [PMID: 31540267 PMCID: PMC6769523 DOI: 10.3390/nu11092215] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/06/2019] [Accepted: 09/09/2019] [Indexed: 12/25/2022] Open
Abstract
Little is known about socioeconomic differences in the association between the food environment and dietary behavior. We systematically reviewed four databases for original studies conducted in adolescents and adults. Food environments were defined as all objective and perceived aspects of the physical and economic food environment outside the home. The 43 included studies were diverse in the measures used to define the food environment, socioeconomic position (SEP) and dietary behavior, as well as in their results. Based on studies investigating the economic (n = 6) and school food environment (n = 4), somewhat consistent evidence suggests that low SEP individuals are more responsive to changes in food prices and benefit more from healthy options in the school food environment. Evidence for different effects of availability of foods and objectively measured access, proximity and quality of food stores on dietary behavior across SEP groups was inconsistent. In conclusion, there was no clear evidence for socioeconomic differences in the association between food environments and dietary behavior, although a limited number of studies focusing on economic and school food environments generally observed stronger associations in low SEP populations. (Prospero registration: CRD42017073587)
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Saxe-Custack A, Lofton HC, Hanna-Attisha M, Tata Z, Ceja T, LaChance J. Caregiver Experiences With an Innovative Farmers' Market Incentive Program for Children in Flint, Michigan. Glob Pediatr Health 2019; 6:2333794X19870989. [PMID: 31489342 PMCID: PMC6712753 DOI: 10.1177/2333794x19870989] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/26/2019] [Accepted: 07/29/2019] [Indexed: 01/21/2023] Open
Abstract
An innovative farmers’ market incentive program designed specifically for children was implemented to address persistent challenges with accessing fresh, nutrient-rich foods in a food desert community. The current study sought to qualitatively examine caregiver perceptions of the incentive program. Following distribution of farmers’ market incentives to all children (ages 0 to 15 years) at 43 Flint-area early childcare facilities and elementary schools, researchers conducted semistructured interviews with 37 caregivers (mean age = 39.59 ± 11.73 years). The majority were female (87%) and African American (53%). Through these interviews, researchers explored family experiences with the farmers’ market incentive program, as well as changes in environmental factors that may have resulted from program participation. Interviews were audio recorded and transcribed verbatim for textual analysis. Thematic analysis was used to identify patterns across transcripts and formulate emerging themes. Four recurrent themes emerged during interviews: (1) fruit and vegetable access, (2) child influence, (3) autonomous grocery shopping, and (4) program expansion. Interview participants indicated that the farmers’ market incentive program was an effective tool to both encourage families to visit the farmers’ market and purchase fresh foods there. Program design, particularly distribution to children, was credited with introducing families to the local farmers’ market. The current study suggests that a farmers’ market incentive program targeting children who reside in a food desert community may have meaningful impacts on access to fresh, nutrient-rich foods.
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Affiliation(s)
| | | | - Mona Hanna-Attisha
- Michigan State University, Flint, MI, USA.,Hurley Children's Hospital at Hurley Medical Center, Flint, MI, USA
| | | | - Tiffany Ceja
- Michigan State University, Flint, MI, USA.,Hurley Research Center, Hurley Medical Center, Flint, MI, USA
| | - Jenny LaChance
- Michigan State University, Flint, MI, USA.,Hurley Research Center, Hurley Medical Center, Flint, MI, USA
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Abstract
AbstractObjective:To examine whether an intervention consisting of a WIC-based farmers’ market, nutrition education, recipe demonstrations and tastings, and handouts could be implemented as intended and the acceptability of the programme to recipients. The availability, variety and prices of fruits and vegetables (F&V) and the Farmers’ Market Nutrition Program voucher redemption rate at the site with market (relative to the rate among fourteen other WIC agency sites) also were examined.Design:Site-level data were used to evaluate programme implementation. Acceptability was assessed with participant data.Setting:A large, New Jersey-based, urban WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) agency.Participants:Fifty-four women who purchased F&V at the market.Results:Gaps in stakeholder communication and coordination, F&V selling out by midday and staffing levels affected implementation fidelity. On average, 12 (sd 3) F&V were available daily at the market (twenty-five unique F&V in total). For thirteen of nineteen items, prices were lower at the WIC-based market than area farmers’ markets. The voucher redemption rate at the site with the market (46 %) was higher than the rate among the fourteen other sites (39 %; P < 0·01). The mean rating of satisfaction with the programme was 6·9 (sd 0·6) on a 7-point scale. All participants reported intending to purchase F&V again at the market, owing to the convenient location, quality of the F&V and helpfulness of the staff. Improving F&V availability and variety were recommended.Conclusions:The intervention is feasible with improved stakeholder communication and coordination, F&V availability and variety, and staffing.
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Forbes JM, Forbes CR, Lehman E, George DR. "Prevention Produce": Integrating Medical Student Mentorship into a Fruit and Vegetable Prescription Program for At-Risk Patients. Perm J 2019; 23:18-238. [PMID: 30939289 PMCID: PMC6443358 DOI: 10.7812/tpp/18-238] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Fruit and vegetable prescription (FVRx) programs provide increased access to produce to food-insecure, at-risk populations, yet many lack the educational and social components to support long-term disease prevention. OBJECTIVES To address these barriers, students at Penn State College of Medicine designed "Prevention Produce"-a modified FVRx program that integrated a community-based, month-long educational curriculum-and undertook preliminary evaluation. METHODS Nine families deemed by clinicians as at risk of chronic disease and food insecurity received weekly $40 "prescriptions" for produce at partnering farmers markets. Participants were paired with medical student mentors who delivered weekly nutrition education modules and assisted in produce shopping. Preprogram and postprogram surveys were administered, categorizing perceptions and practices of healthy eating. All participants were interviewed by phone 3 years later to assess long-term impact. Medical students provided written reflections via online survey. RESULTS Postprogram fruit and vegetable consumption increased, and more patients expressed efforts to include produce in every meal. More participants strongly agreed that fruits and vegetables prevented chronic diseases. In reflective interviews, participants praised the program's ease of use, mentor-patient relationship, and increased access to produce. Student mentors expressed gratitude for one-on-one interaction and felt empowered to learn and deliver nutrition education. CONCLUSION Integration of an FVRx program with education, mentorship, and community-based focus may increase produce consumption and improve opinions about healthy eating. This program serves as a model for integrating preventive strategies within larger health care systems. Additionally, the model can facilitate early clinical interventions that may benefit medical trainees' professional development.
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Affiliation(s)
| | | | - Erik Lehman
- Public Health Sciences at Penn State College of Medicine in Hershey, PA
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Ritter G, Walkinshaw LP, Quinn EL, Ickes S, Johnson DB. An Assessment of Perceived Barriers to Farmers' Market Access. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:48-56. [PMID: 30249521 PMCID: PMC7416758 DOI: 10.1016/j.jneb.2018.07.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/27/2018] [Accepted: 07/31/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To explore whether Supplemental Nutrition Assistance Program-Education (SNAP-Ed) stakeholders (individuals involved in work to increase access to farmers' markets [FMs] for low-income populations) perceive the same barriers to shopping at FMs as those reported by SNAP participants in Washington State. DESIGN Descriptive study; data included a stratified clustered random sample of SNAP participants and stakeholder interviews. SETTING Washington State. PARTICIPANTS A total of 400 SNAP participants and 51 SNAP-Ed stakeholders. MAIN OUTCOME MEASURES The SNAP participants' reported barriers to accessing FMs and the SNAP-Ed stakeholders' perceptions of FM access barriers. ANALYSIS Thematic content analysis, descriptive statistics, 2-sample tests of proportion, and Pearson chi-square tests (P < .025). RESULTS A majority of SNAP participants reported they did not shop at an FM because it is inconvenient (n = 193; 51%) and not financially viable (n = 84; 22%). Moreover, 9% of SNAP participants (n = 34) stated that they experienced no barriers. The SNAP-Ed stakeholders placed increased emphasis on transportation and cost barriers compared with the SNAP participants. CONCLUSIONS AND IMPLICATIONS Comprehensive, multilevel strategies that reflect the perspectives of SNAP participants could increase SNAP use at FMs. Opening FMs in diverse locations at variable operating times may address convenience barriers while engaging the targeted populations' communities to promote FMs, and FM incentive programs may address financial and awareness barriers.
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Affiliation(s)
- Gaelen Ritter
- Department of Health Services, Nutritional Sciences Program, Center for Public Health Nutrition, University of Washington, Seattle, WA.
| | - Lina P Walkinshaw
- Department of Health Services, Nutritional Sciences Program, Center for Public Health Nutrition, University of Washington, Seattle, WA
| | - Emilee L Quinn
- Department of Health Services, Nutritional Sciences Program, Center for Public Health Nutrition, University of Washington, Seattle, WA
| | - Scott Ickes
- Department of Health Services, Nutritional Sciences Program, Center for Public Health Nutrition, University of Washington, Seattle, WA; Department of Applied Health Sciences, Wheaton College, Wheaton, IL
| | - Donna B Johnson
- Department of Health Services, Nutritional Sciences Program, Center for Public Health Nutrition, University of Washington, Seattle, WA
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Promoting access to fresh fruits and vegetables through a local market intervention at a subway station. Public Health Nutr 2018; 21:3258-3270. [PMID: 30101730 DOI: 10.1017/s1368980018001921] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Alternative food sources (AFS) such as local markets in disadvantaged areas are promising strategies for preventing chronic disease and reducing health inequalities. The present study assessed how sociodemographic characteristics, physical access and fruit and vegetable (F&V) consumption are associated with market use in a newly opened F&V market next to a subway station in a disadvantaged neighbourhood. DESIGN Two cross-sectional surveys were conducted among adults: (i) on-site, among shoppers who had just bought F&V and (ii) a telephone-based population survey among residents living within 1 km distance from the market. SETTING One neighbourhood in Montreal (Canada) with previously limited F&V offerings. SUBJECTS Respectively, 218 shoppers and 335 residents completed the on-site and telephone-based population surveys. RESULTS Among shoppers, 23 % were low-income, 56 % did not consume enough F&V and 54 % did not have access to a car. Among all participants living 1 km from the market (n 472), market usage was associated (OR; 95 % CI) with adequate F&V consumption (1·86; 1·10, 3·16), living closer to the market (for distance: 0·86; 0·76, 0·97), having the market on the commute route (2·77; 1·61, 4·75) and not having access to a car (2·96; 1·67, 5·26). CONCLUSIONS When implemented in strategic locations such as transport hubs, AFS like F&V markets offer a promising strategy to improve F&V access among populations that may be constrained in their food acquisition practices, including low-income populations and those relying on public transportation.
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Bradford VA, Quinn EL, Walkinshaw LP, Rocha A, Chan NL, Saelens BE, Johnson DB. Fruit and vegetable access programs and consumption in low-income communities. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2018. [DOI: 10.1080/19320248.2018.1498819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Victoria A. Bradford
- University of Washington Department of Health Services, Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
| | - Emilee L. Quinn
- University of Washington Department of Health Services, Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
| | - Lina P. Walkinshaw
- University of Washington Department of Health Services, Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
| | - Anita Rocha
- Data Manager and Research Analyst, SSW: West Coast Poverty Center, University of Washington, Seattle, Washington, USA
| | - Nadine L. Chan
- Assessment, Policy Development, and Evaluation Unit Public Health, Seattle, King County, Washington, USA
- Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA
| | - Brian E. Saelens
- Pediatrics and Psychiatry & Behavioral Sciences, University of Washington and Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Donna B. Johnson
- University of Washington School of Public Health, Nutritional Sciences Program, Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
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Walkinshaw LP, Quinn EL, Rocha A, Johnson DB. An Evaluation of Washington State SNAP-Ed Farmers' Market Initiatives and SNAP Participant Behaviors. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:536-546. [PMID: 29478951 DOI: 10.1016/j.jneb.2018.01.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 12/21/2017] [Accepted: 01/07/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To describe Supplemental Nutrition Assistance Program-Education (SNAP-Ed)-supported farmers' market (FM) access activities in Washington State communities and identify associations between participation in these activities and SNAP participants' FM shopping and fruit and vegetable consumption. DESIGN Descriptive study; data included stakeholder interviews and surveys with FM managers and a stratified clustered random sample of SNAP participants. SETTING Washington State. PARTICIPANTS A total of 51 SNAP-Ed stakeholders, 400 SNAP participants, and 94 FM managers participated. MAIN OUTCOME MEASURE(S) Partnership measures and SNAP-Ed FM access activities; SNAP participants' participation in FM access activities, FM shopping frequency, and fruit and vegetable consumption. ANALYSIS Thematic content analysis, descriptive statistics, and 0-inflated Poisson and ordinary least-squares regression models. RESULTS A total of 343 FM access activities and strong multi-sector partnerships were identified. Fifty percent of SNAP participants shopped at an FM in the past year, and 30% at least monthly. The SNAP participants participating in FM access activities shopped at FMs more frequently (P=.005). The SNAP participants shopping at FMs ate fruit and vegetables more frequently than did non-FM shoppers (P<.001). CONCLUSIONS AND IMPLICATIONS Through nutrition education and systems and environmental changes, Washington SNAP-Ed developed effective programming and multi-sector partnerships. These efforts are associated with SNAP participants' FM shopping and fruit and vegetable consumption.
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Affiliation(s)
- Lina Pinero Walkinshaw
- Center for Public Health Nutrition, University of Washington School of Public Health, Seattle, WA.
| | - Emilee L Quinn
- Center for Public Health Nutrition, University of Washington School of Public Health, Seattle, WA
| | - Anita Rocha
- Center for Studies in Demography and Ecology, University of Washington, Seattle, WA
| | - Donna B Johnson
- Center for Public Health Nutrition, University of Washington School of Public Health, Seattle, WA
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Martinez O, Tagliaferro B, Rodriguez N, Athens J, Abrams C, Elbel B. EBT Payment for Online Grocery Orders: a Mixed-Methods Study to Understand Its Uptake among SNAP Recipients and the Barriers to and Motivators for Its Use. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:396-402.e1. [PMID: 29187304 DOI: 10.1016/j.jneb.2017.10.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 10/09/2017] [Accepted: 10/12/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To examine Supplemental Nutrition Assistance Program (SNAP) recipients' use of the first online supermarket accepting Electronic Benefit Transfer (EBT) payment. METHODS In this mixed-methods study, the authors collected EBT purchase data from an online grocer and attempted a randomized controlled trial in the South Bronx, New York City, followed by focus groups with SNAP beneficiaries aged ≥18 years. Participants were randomized to shop at their usual grocery store or an online supermarket for 3 months. Focus groups explored barriers and motivators to online EBT redemption. RESULTS Few participants made online purchases, even when incentivized in the randomized controlled trial. Qualitative findings highlighted a lack of perceived control over the online food selection process as a key barrier to purchasing food online. Motivators included fast, free shipping and discounts. CONCLUSIONS AND IMPLICATIONS Electronic Benefit Transfer for online grocery purchases has the potential to increase food access among SNAP beneficiaries, but challenges exist to this new food buying option. Understanding online food shopping barriers and motivators is critical to the success of policies targeting the online expansion of SNAP benefits.
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Affiliation(s)
- Olivia Martinez
- Department of Population Health, New York University School of Medicine, New York, NY
| | - Barbara Tagliaferro
- Department of Population Health, New York University School of Medicine, New York, NY
| | - Noemi Rodriguez
- Department of Population Health, New York University School of Medicine, New York, NY; New York City College of Technology, City University of New York, New York, NY
| | - Jessica Athens
- Department of Population Health, New York University School of Medicine, New York, NY
| | - Courtney Abrams
- Department of Population Health, New York University School of Medicine, New York, NY
| | - Brian Elbel
- Department of Population Health, New York University School of Medicine, New York, NY.
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Beckerman JP, Alike Q, Lovin E, Tamez M, Mattei J. The Development and Public Health Implications of Food Preferences in Children. Front Nutr 2017; 4:66. [PMID: 29326942 PMCID: PMC5741689 DOI: 10.3389/fnut.2017.00066] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 12/05/2017] [Indexed: 12/17/2022] Open
Abstract
Food preferences are a primary determinant of dietary intake and behaviors, and they persist from early childhood into later life. As such, establishing preferences for healthy foods from a young age is a promising approach to improving diet quality, a leading contributor to cardiometabolic health. This narrative review first describes the critical period for food preference development starting in utero and continuing through early childhood. Infants’ innate aversion to sour and bitter tastes can lead them to initially reject some healthy foods such as vegetables. Infants can learn to like these foods through exposures to their flavors in utero and through breastmilk. As solid foods are introduced through toddlerhood, children’s food preferences are shaped by parent feeding practices and environmental factors such as food advertising. Next, we discuss two key focus areas to improve diet quality highlighted by the current understanding of food preferences: (1) promoting healthy food preferences through breastfeeding and early exposures to healthy foods and (2) limiting the extent to which innate preferences for sweet and salty tastes lead to poor diet quality. We use an ecological framework to summarize potential points of intervention and provide recommendations for these focus areas, such as worksite benefits that promote breastfeeding, and changes in food retail and service environments. Individuals’ choices around breastfeeding and diet may ultimately be influenced by policy and community-level factors. It is thus crucial to take a multilevel approach to establish healthy food preferences from a young age, which have the potential to translate into lifelong healthy diet.
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Affiliation(s)
- Jacob P Beckerman
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Queen Alike
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Erika Lovin
- Harvard Kennedy School of Government, Cambridge, MA, United States.,Wharton School of the University of Pennsylvania, Philadelphia, PA, United States
| | - Martha Tamez
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Skizim M, Sothern M, Blaha O, Tseng TS, Griffiths L, Joseph J, Nuss H. Social marketing for a farmer's market in an underserved community: A needs assessment. J Public Health Res 2017; 6:815. [PMID: 29441329 PMCID: PMC5806034 DOI: 10.4081/jphr.2017.815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 10/27/2017] [Accepted: 10/30/2017] [Indexed: 11/30/2022] Open
Abstract
The aim of the present paper is to assess local residents' awareness of utilizing Supplemental Nutrition Assistance Program (SNAP) benefits to purchase fresh produce at local farmers' markets, and to determine internet use and media preferences of study participants prior to implementation of a social marketing campaign. A needs assessment was conducted to collect baseline data in an underserved neighbourhood in New Orleans (La, USA). The study was carried out August 2014-May 2015. The assessment revealed that 73% of the respondents were unaware that the SNAP benefits could be used to purchase food in farmers' markets; 63% of low-income participants never attended a farmers' market compared to 27% of mid/high-income. Over 50% of the low-income respondents have access to the internet at least once per day. The results show the potential of raising awareness among a wide range of members in the community. This needs assessment will serve as the foundation for a social marketing intervention, which will be disseminated city-wide.
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Affiliation(s)
- Meg Skizim
- Louisiana State University Health Sciences Center, New Orleans School of Public Health, LA, USA
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40
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Nuss H, Skizim M, Afaneh H, Miele L, Sothern M. Farmers' Market Utilization among Supplemental Nutrition Assistance Program Recipients in New Orleans, Louisiana: Preliminary Findings. Ethn Dis 2017; 27:295-302. [PMID: 29158654 PMCID: PMC5684773 DOI: 10.18865/ed.27.s1.295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective Farmers' markets are increasingly being promoted as a means to provide fresh produce to poor and underserved communities. However, farmers' market (FM) use remains low among low-income patrons. The purpose of our study was to examine FM awareness and use, grocery shopping behaviors, and internet use among Supplemental Nutrition Assistance Program (SNAP) recipients. Design A descriptive analysis of preliminary data was performed to evaluate quantitative baseline data among SNAP recipients between June and August 2016 in New Orleans, Louisiana (N=51). Data were collected via a 42-item online survey that included demographics, internet use, FM awareness and use, health information seeking behaviors and fruit and vegetable purchasing behaviors. Results Less than half of the survey respondents (n=24) had ever been to a FM. Local grocery stores and Wal-Mart were most used for purchasing fruits and vegetables (88% and 84%, respectively). The most common sources of healthy eating information were Women, Infants and Children (WIC) and the internet, frequently accessed via smartphones. More than 80% of participants were not aware that local FMs accepted electronic benefit transfer payments as a form of payment. Conclusion These results support the incorporation of promotional methodology that combines internet-based mobile technology and existing services (eg, WIC) as a viable strategy to improve farmers' market use among low-income populations. As most participants were not aware that participating FMs accept electronic benefit transfer payments, this fact should be emphasized in promotional material.
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Affiliation(s)
- Henry Nuss
- Louisiana State University Health, School of Public Health, New Orleans, LA
| | - Meg Skizim
- Louisiana State University Health, School of Public Health, New Orleans, LA
| | - Hasheemah Afaneh
- Louisiana State University Health, School of Public Health, New Orleans, LA
| | - Lucio Miele
- Louisiana State University School of Medicine, New Orleans, LA
| | - Melinda Sothern
- Louisiana State University Health, School of Public Health, New Orleans, LA
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Fruit and vegetable intake among participants in a District of Columbia farmers’ market incentive programme. Public Health Nutr 2017; 21:601-606. [DOI: 10.1017/s1368980017003020] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Objective
Limited research is available on whether participation in healthy food incentive programmes is associated with higher fruit and vegetable intake. The objective of the present study was to determine fruit and vegetable intake among participants in the Produce Plus Program, a farmers’ market-based healthy food incentive programme in Washington, DC, and identify demographic and behavioural factors associated with higher fruit and vegetable intake.
Design
Using a cross-sectional survey, programme participants were interviewed at markets across DC between June and September 2015. Questions included the Behavioral Risk Factor Surveillance System (BRFSS) fruit and vegetable module. Fruit and vegetable intake among 2013 DC BRFSS participants reporting annual household incomes of ≤$US 35 000 was calculated for context.
Setting
Washington, DC, USA.
Subjects
Participants (n 288) in the Produce Plus Program.
Results
On average, participants reported consuming both fruits (interquartile range: 1·0–3·0) and vegetables (interquartile range: 1·3–3·5) two times/d. Participants who reported eating home-cooked meals ≥3 times/week also reported higher median fruit (2·0 v. 0·8) and vegetable (2·3 v. 1·3) intake compared with those eating home-cooked meals less frequently. No statistically significant differences in reported median fruit or vegetable intake were observed over the course of the farmers’ market (June v. August/September) season.
Conclusions
Produce Plus Program participants reported higher median fruit and vegetable intake compared with DC BRFSS respondents with similar incomes, but still below recommended levels. More frequent home-cooked meals were associated with higher fruit and vegetable intake. Thus, efforts to increase home cooking may represent an opportunity to increase fruit and vegetable intake among healthy food incentive participants.
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DeWitt E, McGladrey M, Liu E, Peritore N, Webber K, Butterworth B, Vail A, Gustafson A. A Community-Based Marketing Campaign at Farmers Markets to Encourage Fruit and Vegetable Purchases in Rural Counties With High Rates of Obesity, Kentucky, 2015-2016. Prev Chronic Dis 2017; 14:E72. [PMID: 28858607 PMCID: PMC5580727 DOI: 10.5888/pcd14.170010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Availability of farmers markets may increase fruit and vegetable consumption among rural residents of the United States. We conducted a community-based marketing campaign, Plate it Up Kentucky Proud (PIUKP), in 6 rural communities over 2 years to determine the association between exposure to the campaign and fruit and vegetable purchases, adjusted for Supplemental Nutrition Assistance Program recipient status. Logistic regression was used to examine the odds of the PIUKP campaign influencing purchases. Awareness of the PIUKP marketing campaign was significantly associated with a willingness to prepare fruits and vegetables at home. Using marketing strategies at farmers markets may be an effective way to improve fruit and vegetable purchases in rural communities.
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Affiliation(s)
- Emily DeWitt
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky
| | | | - Emily Liu
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky
| | - Nicole Peritore
- Family and Consumer Sciences Extension, University of Kentucky, Lexington, Kentucky
| | - Kelly Webber
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky
| | - Brooke Butterworth
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky
| | - Ann Vail
- School of Human Environmental Sciences, Family and Consumer Sciences, University of Kentucky, Lexington, Kentucky
| | - Alison Gustafson
- Department of Dietetics and Human Nutrition, University of Kentucky, 206G Funkhouser Bldg, Lexington, KY 40506.
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Factors associated with continued participation in a matched monetary incentive programme at local farmers' markets in low-income neighbourhoods in San Diego, California. Public Health Nutr 2017; 20:2786-2795. [PMID: 28756784 DOI: 10.1017/s1368980017001549] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The Farmers' Market Fresh Fund Incentive Program is a policy, systems and environmental intervention to improve access to fresh produce for participants on governmental assistance in the USA. The current study examined factors associated with ongoing participation in this matched monetary incentive programme. DESIGN Relationship of baseline factors with number of Fresh Fund visits was assessed using Poisson regression. Mixed-effects modelling was used to explore changes in consumption of fruits and vegetables and diet quality. SETTING San Diego, California. SUBJECTS Recipients of Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Supplemental Security Income (SSI) who attended participating farmers' markets from 2010 to 2012 (n 7298). RESULTS Among those with participation for ≤6 months, factors associated with increased visits included reporting more daily servings of fruits and vegetables (F&V) at baseline, being Vietnamese or Asian/Pacific Islander, and eligibility because of SNAP/CalFresh or SSI (v. WIC). Among those who came for 6-12 months, being Asian/Pacific Islander, eligibility because of SNAP/CalFresh and enrolling in the autumn, winter or spring were associated with a greater number of Fresh Fund visits. Among those who came for >12 months, being male and eligibility because of SSI were associated with a greater number of visits. Overall, the odds of increasing number of servings of F&V consumed increased by 2 % per month, and the odds of improved perception of diet quality increased by 10 % per month. CONCLUSIONS Sustaining and increasing Fresh Fund-type programme operations should be a top priority for future policy decisions concerning farmers' market use in low-income neighbourhoods.
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Savoie Roskos MR, Wengreen H, Gast J, LeBlanc H, Durward C. Understanding the Experiences of Low-Income Individuals Receiving Farmers’ Market Incentives in the United States: A Qualitative Study. Health Promot Pract 2017; 18:869-878. [DOI: 10.1177/1524839917715438] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective. The objective of this study was to identify benefits and barriers to using a farmers’ market (FM) incentive program among program participants. Design. In qualitative semistructured interviews, participants were asked about their experiences with shopping at FM, using FM incentives, barriers to fruit and vegetable (F&V) intake, and changes in dietary intake. Interviews were recorded and transcribed. Inductive content analysis was used to code, categorize, and develop themes based on the transcriptions. Setting. A FM in Northern Utah. Subjects. A convenience sample of participants ( n = 14) completed a 45- to 60-minute interview after receiving FM incentives for an 8-week intervention period. Results. FM incentives reduced barriers associated with shopping at FM such as cost and accessibility among program participants. Incentives provided participants with greater spending flexibility, allowing parents to provide children with F&V that previously did not fit into their food budget. Participants reported greater family and community involvement when shopping at FM. However, the limited hours and days of operation were factors that reduced the use of FM among participants, even when incentives were provided. Conclusions. The perceived benefits and barriers to shopping at FM and receiving FM incentives should be considered by future programmers and funding agencies.
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Shopping pattern and food purchase differences among Supplemental Nutrition Assistance Program (SNAP) households and Non-supplemental Nutrition Assistance Program households in the United States. Prev Med Rep 2017; 7:152-157. [PMID: 28660124 PMCID: PMC5484978 DOI: 10.1016/j.pmedr.2017.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/08/2017] [Accepted: 06/12/2017] [Indexed: 11/20/2022] Open
Abstract
SNAP households are influenced by proximity to stores in predicting store choice. Store choice among SNAP households predicted beverage purchases. SNAP households are more likely to purchase sugar-sweetened beverages at supercenters and convenience stores.
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O'Dare Wilson K. Community food environments and healthy food access among older adults: A review of the evidence for the Senior Farmers' Market Nutrition Program (SFMNP). SOCIAL WORK IN HEALTH CARE 2017; 56:227-243. [PMID: 28271967 DOI: 10.1080/00981389.2016.1265631] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Although an array of federal, state, and local programs exist that target food insecurity and the specific nutritional needs of seniors, food insecurity among older adults in the United States remains a persistent problem, particularly in minority and rural populations. Food insecurity is highly predictive of inadequate fresh fruit and vegetable (FFV) consumption in particular. The Senior Farmers' Market Nutrition Program (SFMNP) is a community-based program to help seniors purchase FFVs at farmer's markets in their neighborhoods. The SFMNP continues to grow; however, little is known about the effectiveness of the program. The purposes of this article are to (1) highlight the importance of community and neighborhood based food insecurity programs, specifically emphasizing the importance of FFV access for seniors, (2) review the current state of the evidence on the SFMNP, and (3) provide recommendations for researchers and policy-makers wishing to continue to advance the knowledge base in neighborhood-based food security among older adults.
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Affiliation(s)
- Kellie O'Dare Wilson
- a Department of Social Work , University of West Florida , Pensacola , Florida , USA
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Jilcott Pitts SB, Hinkley J, Wu Q, McGuirt JT, Lyonnais MJ, Rafferty AP, Whitt OR, Winterbauer N, Phillips L. A possible dose-response association between distance to farmers' markets and roadside produce stands, frequency of shopping, fruit and vegetable consumption, and body mass index among customers in the Southern United States. BMC Public Health 2017; 17:65. [PMID: 28077113 PMCID: PMC5225609 DOI: 10.1186/s12889-016-3943-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 12/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The association between farmers' market characteristics and consumer shopping habits remains unclear. Our objective was to examine associations among distance to farmers' markets, amenities within farmers' markets, frequency of farmers' market shopping, fruit and vegetable consumption, and body mass index (BMI). We hypothesized that the relationship between frequency of farmers' market shopping and BMI would be mediated by fruit and vegetable consumption. METHODS In 15 farmers' markets in northeastern North Carolina, July-September 2015, we conducted a cross-sectional survey among 263 farmers' market customers (199 provided complete address data) and conducted farmers' market audits. To participate, customers had to be over 18 years of age, and English speaking. Dependent variables included farmers' market shopping frequency, fruit and vegetable consumption, and BMI. Analysis of variance, adjusted multinomial logistic regression, Poisson regression, and linear regression models, adjusted for age, race, sex, and education, were used to examine associations between distance to farmers' markets, amenities within farmers' markets, frequency of farmers' market shopping, fruit and vegetable consumption, and BMI. RESULTS Those who reported shopping at farmers' markets a few times per year or less reported consuming 4.4 (standard deviation = 1.7) daily servings of fruits and vegetables, and those who reported shopping 2 or more times per week reported consuming 5.5 (2.2) daily servings. There was no association between farmers' market amenities, and shopping frequency or fruit and vegetable consumption. Those who shopped 2 or more times per week had a statistically significantly lower BMI than those who shopped less frequently. There was no evidence of mediation of the relationship between frequency of shopping and BMI by fruit and vegetable consumption. CONCLUSIONS More work should be done to understand factors within farmers' markets that encourage fruit and vegetable purchases.
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Affiliation(s)
- Stephanie B. Jilcott Pitts
- Department of Public Health, Brody School of Medicine East Carolina University, 600 Moye Blvd, MS 660, Lakeside Annex 7, Greenville, NC 27834 USA
| | - Jedediah Hinkley
- Healthy Foods Coordinator Partnerships to Improve Community Health, Albemarle Regional Health Services, Elizabeth City, NC USA
| | - Qiang Wu
- Department of Biostatistics, East Carolina University, 2435D Health Sciences Building, Greenville, NC 27834 USA
| | - Jared T. McGuirt
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Mary Jane Lyonnais
- Department of Public Health, Brody School of Medicine East Carolina University, 600 Moye Blvd, MS 660, Lakeside Annex 7, Greenville, NC 27834 USA
| | - Ann P. Rafferty
- Department of Public Health, Brody School of Medicine East Carolina University, 600 Moye Blvd, MS 660, Lakeside Annex 7, Greenville, NC 27834 USA
| | - Olivia R. Whitt
- Department of Public Health, Brody School of Medicine East Carolina University, 600 Moye Blvd, MS 660, Lakeside Annex 7, Greenville, NC 27834 USA
| | - Nancy Winterbauer
- Department of Public Health, Brody School of Medicine East Carolina University, 600 Moye Blvd, MS 660, Lakeside Annex 7, Greenville, NC 27834 USA
| | - Lisa Phillips
- Department of Public Health, Brody School of Medicine East Carolina University, 600 Moye Blvd, MS 660, Lakeside Annex 7, Greenville, NC 27834 USA
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Strome S, Johns T, Scicchitano MJ, Shelnutt K. Elements of Access: The Effects of Food Outlet Proximity, Transportation, and Realized Access on Fresh Fruit and Vegetable Consumption in Food Deserts. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2016; 37:61-70. [PMID: 28038499 DOI: 10.1177/0272684x16685252] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study surveys 900 supplemental nutrition assistance program recipient or eligible households and 300 supplemental nutrition assistance program ineligible households in local food deserts to identify the effects of different dimensions of access on fresh fruit and vegetables (FFV) consumption. While proximity and access to one's own car were not significant predictors of FFV consumption, realized access to nonsupermarket outlets did have a positive effect on fresh vegetable consumption. Among food insecure respondents, limited car access had a negative effect on FFV consumption. This research underlines the importance of focusing on dimensions of access other than proximity when considering interventions designed to improve nutrition and health outcomes in food deserts.
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Affiliation(s)
- Stuart Strome
- 1 Department of Family, Youth and Community Sciences, University of Florida, Gainesville, FL, USA
| | - Tracy Johns
- 2 Florida Survey Research Center, University of Florida, Gainesville, FL, USA
| | | | - Karla Shelnutt
- 1 Department of Family, Youth and Community Sciences, University of Florida, Gainesville, FL, USA
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Hulbrock E, Otten JJ, Quinn E, Johnson DB, Lerman S. Exploring the Use of Seattle's Farmers' Market Incentive Program ("Fresh Bucks") by Household Food Security Levels. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2016; 12:362-374. [PMID: 34354790 DOI: 10.1080/19320248.2016.1255696] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The objective of this study was to explore Seattle's farmers' market incentive program, known as Fresh Bucks, and associated shopping behaviors based on participants' food security status. Researchers surveyed a convenience sample of Fresh Bucks users and classified subjects as high/marginal, low, or very low food security. Investigators analyzed for differences in demographics and farmers' market shopping behaviors by food security levels. Study findings suggest that once present at the farmers' market, Fresh Bucks users across all food security levels experience the market and the Fresh Bucks program in similar ways. These relationships should be explored in a larger and more diverse population.
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Affiliation(s)
| | - Jennifer J Otten
- University of Washington Nutritional Sciences, Seattle, Washington, USA
| | - Emilee Quinn
- University of Washington Nutritional Sciences, Seattle, Washington, USA
| | - Donna B Johnson
- University of Washington Nutritional Sciences, Seattle, Washington, USA
| | - Sharon Lerman
- City of Seattle Office of Sustainability and Environment, Seattle, Washington, USA
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Robles B, Montes CE, Nobari TZ, Wang MC, Kuo T. Dietary Behaviors among Public Health Center Clients with Electronic Benefit Transfer Access at Farmers' Markets. J Acad Nutr Diet 2016; 117:58-68. [PMID: 27618576 DOI: 10.1016/j.jand.2016.07.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 07/15/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND Although increasing access to electronic benefit transfer (EBT) at farmers' markets has become a popular strategy for encouraging healthy eating, its relationships to a number of dietary behaviors in low-income populations are not well understood. OBJECTIVE To describe the frequency of and relationships between EBT access, fruit and vegetable intake, and sugar-sweetened beverage (SSB) consumption among public health center (PHC) clients with access to EBT at farmers' markets during 2011-2012. DESIGN Cross-sectional. PARTICIPANTS/SETTING Low-income participants recruited from the waiting rooms of five multipurpose PHCs operated by the Los Angeles County Department of Public Health. MAIN OUTCOME MEASURES Fruit and vegetable and SSB consumption (number per week). STATISTICAL ANALYSIS Data from the 2012 Los Angeles County Health and Nutrition Examination Survey were analyzed using multivariable regressions, with EBT access at farmers' markets as the primary independent variable. Covariates included EBT use, transportation behaviors, neighborhood attributes, and sociodemographic characteristics. RESULTS A total of 1,503 adults participated in the survey (response rate=69%). Of these, 529 reported receiving EBT benefits. Among these benefits recipients, 64% were women, 54% were aged 25 to 44 years, 62% were black, and 75% were unemployed or part-time employed. In multivariable regression analyses, EBT access at farmers' markets was positively associated with higher fruit and vegetable consumption; however, an association to SSB consumption was not demonstrated. CONCLUSIONS EBT access at farmers' markets is related to higher fruit and vegetable consumption among PHC clients in Los Angeles County. However, the finding of no association to SSB consumption raises important questions about the need for strategies to discourage EBT recipients' purchase of foods of minimal nutritional value in other venues that accept nutrition assistance program benefits.
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