Increasing Community Access to Fresh Fruits and Vegetables: A Case Study of the Farm Fresh Market Pilot Program in Cobb County, Georgia, 2014

Fruit and Vegetable Purchases in Farmer's Market Stands: Analysing Survey and Sales Data

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.

The introduction of new food retail opportunities in lower-income communities and the impact on fruit and vegetable intake: a systematic review

A lack of access to fresh fruits and vegetables (F&Vs) is associated with consumption of fewer F&Vs and higher risk of obesity, especially for lower-income individuals. It is widely believed that the addition of new food retail opportunities could improve F&V consumption and subsequently reduce the chronic disease burden. Observational studies provide some support for these hypotheses, but contradictions exist. In this study we sought to examine if the introduction of a food retailer affects F&V consumption in lower-income communities. We used a systematic PRISMA approach to conduct this study. We searched PubMed, EMBASE, and ProQuest Dissertations & Theses for academic journal references and gray literature published before August 2018. Included studies were those looking at the effect of the introduction of a new food retailer on F&V consumption. Studies were also categorized based on which dimensions of food access were targeted by the food retailer. We identified 15 studies meeting inclusion criteria: 11 studies reported a positive increase in F&V consumption attributable to the introduction of a new food retailer, of which 6 were statistically significant. The remaining 4 studies, all of which examined the impact of introducing a new retail supermarket, showed no change or a decrease in F&V intake. Results from studies which change the food environment generally support the idea that increased access to healthy food improves diet, but more studies are needed in order to assess the differences between the various types of retailers, and to identify strategies for improving impact. Understanding which types of new food retail programs are most likely to impact diet has implications for policies which incentivize new food retail.

Promoting access to fresh fruits and vegetables through a local market intervention at a subway station

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.

A systematic review of components of community-based organisation engagement

Community-based organisations (CBOs) are important for eliminating health disparities globally and translating research findings to inform interventions. Engagement is an integral part of partnerships between CBOs and community health researchers and impacts the quality and quantity of any desired outcome. Despite the acknowledged benefits of community-based organisation engagement (CBOE), there are variations in its operationalisation and paucity in the understanding of its use in community-scientific partnerships. To further understand CBOE, the aim of this study was to synthesise published literature relevant to the definitions and applications of CBOE and identify its key components. A systematic search was conducted in March 2017, and updated in June 2017. Keywords were varied to account for international differences in spelling and word usage. Five major databases, MEDLINE, PubMed, CINAHL, PsycINFO and Google Scholar, were used to identify potential research studies. A total of 32 studies were included in this review. Following the analysis of the literature, four salient themes emerged as components of CBOE: (1) Need (a consensus between all the parties in a partnership on the importance of a specified project and its proposed benefits to a target community); (2) Partnership Dynamics (the workings of a relationship between a CBO and a scientific/academic stakeholder); (3) Resources (include but are not limited to: personnel, money, work space, expertise and equipment); and (4) Outcomes (products of the partnership). This review provides a foundation for future research in applying CBOE to translational research and interventions. This analysis will assist community health researchers in planning partnerships with CBOs, and make necessary adjustments to improve study outcomes. Appropriate application of the components of CBOE in partnerships will assist researchers in addressing health disparities.

The dietary impact of introducing new retailers of fruits and vegetables into a community: results from a systematic review

OBJECTIVE

To investigate the potential dietary impact of the opening of new retailers of healthy foods.

DESIGN

Systematic review of the peer-reviewed research literature.

SETTING

References published before November 2015 were retrieved from MEDLINE, EMBASE and Web of Science databases using keyword searches.

SUBJECTS

The outcome of the review was change in fruit and vegetable consumption among adults.

RESULTS

Of 3514 references retrieved, ninety-two articles were reviewed in full text, and twenty-three articles representing fifteen studies were included. Studies used post-test only (n 4), repeated cross-sectional (n 4) and repeated measures designs (n 7) to evaluate the dietary impact of supermarket (n 7), farmers' market (n 4), produce stand (n 2) or mobile market (n 2) openings. Evidence of increased fruit and vegetable consumption was most consistent among adults who began shopping at the new retailer. Three of four repeated measures studies found modest, albeit not always statistically significant, increases in fruit and vegetable consumption (range 0·23-0·54 servings/d) at 6-12 months after baseline. Dietary change among residents of the broader community where the new retailer opened was less consistent.

CONCLUSIONS

The methodological quality of studies, including research designs, sampling methods, follow-up intervals and outcome measures, ranged widely. Future research should align methodologically with previous work to facilitate meta-analytic synthesis of results. Opening a new retailer may result in modest short-term increases in fruit and vegetable consumption among adults who choose to shop there, but the potential longer-term dietary impact on customers and its impact on the broader community remain unclear.