BackgroundChildhood obesity persists in the United States and is associated with serious health problems. Higher rates of obesity among children from disadvantaged households may be, in part, attributable to disparities in access to healthy foods such as fruits and vegetables. Community supported agriculture can improve access to and consumption of fresh produce, but the upfront payment structure, logistical barriers, and unfamiliarity with produce items may inhibit participation by low-income families. The aim of this project is to assess the impact of subsidized, or “cost-offset,” community supported agriculture participation coupled with tailored nutrition education for low-income families with children.Methods/designThe Farm Fresh Foods for Healthy Kids community-based, randomized intervention trial will build on formative and longitudinal research to examine the impact of cost-offset community supported agriculture on diet and other health behaviors as well as the economic impacts on local economies. The intervention will involve reduced-price community supported agriculture shares which can be paid for on a weekly basis, nine skill-based and seasonally-tailored healthy eating classes, and the provision of basic kitchen tools. Low income families with at least one child aged 2–12 years will be recruited to join existing community supported agriculture programs in New York, North Carolina, Vermont, and Washington. In each program, families will be randomized 1:1 to intervention or delayed intervention groups. Data will be collected at baseline, and in the fall and spring for 3 years. The primary outcomes are children’s intake of fruits and vegetables and foods high in sugar and/or (solid) fat, as well as diet quality; secondary outcomes include physical, behavioral, psychosocial, and environmental variables. Cost-effectiveness and economic impact at the farm and community levels also will be assessed.DiscussionThis integrated project will provide important information and contribute to the evidence base regarding the use of local agricultural interventions to improve children’s dietary behaviors and weight maintenance. Findings also will inform the development of a toolkit for farmers and education modules related to local food system innovations for undergraduate and graduate students.Trial registration ClinicalTrials.gov NCT02770196. Registered 5 April 2016. Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4202-2) contains supplementary material, which is available to authorized users.

This paper describes two related studies. Study 1 is a literature review of existing adult partner domestic violence assessment scales. Results of the review revealed that the scales varied on the available amount of empirical evidence for validity and reliability. More importantly, results showed that the content of the scales focused most heavily on the physical abuse aspects of domestic violence. Study 2 is a factor analysis performed on the results of 64 items taken from the Artemis Intake Questionnaire, a clinically relevant tool constructed by treatment providers used in working with the victims of domestic violence. Results indicate that reported humiliation and blame of the victim accounted for the largest amount of variance, followed by controlling the victim, and then physical violence. Results of this factor analysis suggest that greater emphasis must be put on factors other than physical violence in the construction of future domestic violence scales.KEY WORDS: domestic violence; emotional abuse; assessment; literature review. INTRODUCTIONIn the last 10-15 years, domestic violence against an adult partner (DV) has been identified as a major health and safety concern (Browne & Williams, 1993;Campbell, 1995a;Walker, 1994). Consequently, research in this area has exploded and, as seen in a literature review addressed in this paper, numerous DV assessment scales have been created (e.g., Dutton & Golant, 1995;Dwyer, 1999;Kropp & Hart, 2000;Marshall, 1992;Shepard & Campbell, 1992;Straus et al., 1996). This paper presents two related studies. The overall purpose of these studies is two-fold: (a) to determine the type of psychometric evidence employed in the development of these current domestic violence measurement techniques and the constructs that are commonly incorporated, and (b) to determine whether the constructs of intimidation, power, and control (in addition to physical violence) are supported by victims' responses and should thus be emphasized in future domestic violence scales and models. The first study consisted of a literature review of existing domestic violence scales in order to examine what constructs are commonly incorporated into the scales, and whether they had been psychometrically evaluated. The review focused on two issues: (a) the types of psychometric support used during the development of these scales, and (b) the overall content of these scales to determine what constructs were most heavily represented. There were two general hypotheses. The first hypothesis concerning the review of these scales was that the majority would focus psychometrically on demonstrating construct validity (convergent, divergent, factor analytic), with some providing evidence for content validity and only a few using predictive validity (concurrent and/or future). Further, we expected that the majority of scales (probably greater than 60%) would provide evidence of 340Strauchler, McCloskey, Malloy, Sitaker, Grigsby, and Gillig reliability consisting of internal consistency and/or temporal stability. The ...

Although CO-CSA may facilitate increased access to fruits and vegetables for low-income families, perceptions of positive diet change may be limited by the ability to incorporate share pick-up into regular travel patterns and meal planning. Food waste concerns may be particularly acute for families with constrained resources. Future research should examine whether CO-CSA with flexible logistics and produce self-selection are sustainable for low-income families and CSA farms.

BackgroundPolicies that improve access to healthy, affordable foods may improve population health and reduce health disparities. In the United States most food access policy research focuses on urban communities even though residents of rural communities face disproportionately higher risk for nutrition-related chronic diseases compared to residents of urban communities. The purpose of this study was to (1) identify the factors associated with access to healthy, affordable food in rural communities in the United States; and (2) prioritize a meaningful and feasible rural food policy research agenda.MethodsThis study was conducted by the Rural Food Access Workgroup (RFAWG), a workgroup facilitated by the Nutrition and Obesity Policy Research and Evaluation Network. A national sample of academic and non-academic researchers, public health and cooperative extension practitioners, and other experts who focus on rural food access and economic development was invited to complete a concept mapping process that included brainstorming the factors that are associated with rural food access, sorting and organizing the factors into similar domains, and rating the importance of policies and research to address these factors. As a last step, RFAWG members convened to interpret the data and establish research recommendations.ResultsSeventy-five participants in the brainstorming exercise represented the following sectors: non-extension research (n = 27), non-extension program administration (n = 18), “other” (n = 14), policy advocacy (n = 10), and cooperative extension service (n = 6). The brainstorming exercise generated 90 distinct statements about factors associated with rural food access in the United States; these were sorted into 5 clusters. Go Zones were established for the factors that were rated highly as both a priority policy target and a priority for research. The highest ranked policy and research priorities include strategies designed to build economic viability in rural communities, improve access to federal food and nutrition assistance programs, improve food retail systems, and increase the personal food production capacity of rural residents. Respondents also prioritized the development of valid and reliable research methodologies to measure variables associated with rural food access.ConclusionsThis collaborative, trans-disciplinary, participatory process, created a map to guide and prioritize research about polices to improve healthy, affordable food access in rural communities.

This paper examines fruit and vegetable intake (FVI) in low-income households that participated in a cost-offset (CO), or 50% subsidized, community-supported agriculture (CSA) program. CSA customers paid farms upfront for a share of the harvest, and received produce weekly throughout the growing season. A cohort of adults and children 2–12 y in a summer CO-CSA were surveyed online twice: August 2015 (n = 41) and February 2016 (n = 23). FVI was measured by the National Cancer Institute’s (NCI) Fruit and Vegetable Screener (FVS) and an inventory of locally grown fruits and vegetables. FVI relative to United States (US) recommendations and averages, and across seasons, were tested with non-parametric tests and paired t-tests (p < 0.05). Both adults and children in the CO-CSA had higher FVI than the US averages, and more often met recommendations for vegetables. Some summer fruits and vegetables were more often eaten when locally in-season. The CO-CSA model warrants further examination as an avenue for improving vegetable consumption among adults and children in low-income households. However, causality between CO-CSA participation and FVI cannot be inferred, as CO-CSA participants may be positive deviants with respect to FVI. A multi-state randomized controlled trial is currently underway to evaluate impacts of CO-CSAs on FVI and related outcomes.

Community-supported agriculture (CSA) is a widely-used approach for farmers to sell directly to consumers. We used the product, place, price, and promotion (4P) marketing mix framework to examine characteristics that help farms offering CSA maintain member satisfaction and thus competitiveness. We conducted semi-structured interviews with 20 CSA members and 24 CSA farmers in four states. CSA members additionally completed a modified choice experiment. Qualitative data were coded iteratively, and choice experiment data were summarized and compared across scenarios. CSA members and farmers were motivated by a range of personal, social, environmental, and economic objectives. Members favored high-quality staple vegetables (e.g., lettuce, green beans), ideally produced organically. Trust and a sense of personal connection with the farmer comprised part of the "value added" of CSA participation. Time and location of share pickup were very important; thus, farmers tried to offer convenient sites or an enriched pickup experience. Small changes in price appeared unlikely to impact participation among current members. Social networks and word-of-mouth were powerful for marketing, but may limit the ability to reach diverse populations. Future research should examine the ability of CSAs to meet the needs of those who do not currently participate.

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Community-supported agriculture (CSA) participation has been associated with high fruit and vegetable (FV) consumption, which may be due to better access to FV for CSA purchasers, or to positive knowledge, attitudes, and beliefs (KAB) regarding healthy eating among CSA applicants. The objective of this study was to examine KAB and consumption, in association with application to a cost-offset CSA (CO-CSA) program, and with CO-CSA purchase among applicants. We conducted a cross-sectional survey of CO-CSA applicants and a comparison sample in August 2017. All respondents were English-reading adults with a child 2–12 years old and household income of ≤185% of the federal poverty level. Among CO-CSA applicants, some were CO-CSA purchasers (n = 46) and some were not (n = 18). An online comparison sample met equivalent eligibility criteria, but had not participated in CSA for three years (n = 105). We compared CO-CSA applicants to the comparison sample, and compared purchasers and non-purchaser sub-groups, using Mann-Whitney U tests and chi-square analysis. CO-CSA applicants reported better knowledge, self-efficacy, home habits, and diet than the comparison sample. Among applicants, CO-CSA purchasers and non-purchasers had equivalent KAB, but children in purchaser households had higher FV consumption than in non-purchaser households (4.14 vs. 1.83 cups, p = 0.001). Future research should explore associations between CO-CSA participation and diet using experimental methods.