Effectiveness of Fresh to You, a Discount Fresh Fruit and Vegetable Market in Low-Income Neighborhoods, on Children’s Fruit and Vegetable Consumption, Rhode Island, 2010–2011

Abstract

IntroductionEating fruits and vegetables is associated with lowered risk for many chronic diseases. However, most Americans, especially members of low-income and minority populations, do not eat adequate amounts. Fresh to You is a public–private partnership program that brings discount fresh produce markets into low-income neighborhoods. We conducted a mixed-methods evaluation of Fresh to You to assess the effect of the program on children’s consumption of fruits and vegetables.MethodsA local produce distributor brought the Fresh to You markets to 6 community organizations serving low-income families in Rhode Island. The markets, held weekly for 5 months at each site, sold fresh produce at below-retail prices. Parents (N = 480) of children aged 3 to 13 years were recruited at the markets to participate in a 5-month cohort study. The primary outcome was change in children’s fruit and vegetable intake, measured by a validated screener. We also conducted postintervention focus groups at each site with parents and qualitative interviews with site contacts to collect feedback about Fresh to You.ResultsFrom baseline to 5 months, there was a significant increase in children’s daily fruit and vegetable consumption of 0.48 cups (t = 4.16, P < .001). Data from follow-up parent surveys, focus groups, and site contact interviews provided positive feedback about Fresh to You and recommendations for improvement.ConclusionFresh to You was effective at increasing consumption of fruits and vegetables among racially and ethnically diverse low-income children aged 3 to 13 years whose parents shopped at the markets. The intervention could serve as a model program for replication in other cities. Refinements and a more rigorous evaluation are needed.

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

“…This limits our ability to differentiate the effects of market use per se from those of the incentive programs, reducing the transferability of findings to other contexts [24]. A few studies conducted either in the USA or in other countries considered a broader population that did not have access to such incentives [34,39,42,[51][52][53][54][55]. Those that focus on farmers' market interventions without financial incentives report an increase in FV intake [34,55], including certain types of FV [42,53] or a perceived increase in intake [34,39,51,52,54].…”

“…A few studies conducted either in the USA or in other countries considered a broader population that did not have access to such incentives [34,39,42,[51][52][53][54][55]. Those that focus on farmers' market interventions without financial incentives report an increase in FV intake [34,55], including certain types of FV [42,53] or a perceived increase in intake [34,39,51,52,54]. Study designs include a longitudinal pre-post study [42], a mixed-method cohort study [55], a repeated cross-sectional study [34], two cross-sectional studies [51,52], a case study [39] and a one-group post-intervention study [54].…”

A multi-level intervention in worksites to increase fruit and vegetable access and intake: Rationale, design and methods of the ‘Good to Go’ cluster randomized trial

“…These FTY markets are not local farmer's markets, but rather mobile markets selling both local and non-local produce on a year-round basis at prices at or below local supermarket prices [79]. The best times and locations for the weekly markets are identified through a negotiation process with worksite contact personnel and market staff.…”

Cluster randomized controlled trial of a mobile market intervention to increase fruit and vegetable intake among adults in lower-income communities in North Carolina

“…Given the challenges with opening new grocery stores in lower-income areas (e.g., high start-up costs, zoning ordinances, perceived lack of customer demand or buying power), there is a need for alternative food sources; Farmer’s markets, Community-Supported Agriculture (CSA; i.e., commitment to a farm to purchase a share of their produce for a set period of time), and mobile markets generally focus exclusively or predominately on F&V and provide fresh (often locally grown), affordable produce. While these strategies are promising [ 11 – 16 ], there are few studies examining their efficacy and at the time of this study there were no randomized controlled trials. Experts have noted the need for stronger study designs to better understand the relationship between the food environment and diet, and identify scalable solutions [ 6 ].…”