Healthy Foods, Healthy Families: combining incentives and exposure interventions at urban farmers’ markets to improve nutrition among recipients of US federal food assistance

Abstract

Background: Healthy Foods, Healthy Families (HFHF) is a fruit and vegetable (F&V) exposure/incentive program implemented at farmers’ markets in low-income neighborhoods, targeting families receiving US federal food assistance. We examined program effects on participants’ diet and associations between attendance, demographics and dietary change. Methods: Exposure activities included F&V tastings and cooking demonstrations. Incentives included 40% F&V bonus for electronic benefit transfer (EBT) card users and $20 for use purchasing F&V at every third market visit. Self-report surveys measuring nutritional behaviors/literacy were administered to participants upon enrollment (n = 425, 46.2% Hispanic, 94.8%female). Participants were sampled for follow-up at markets during mid-season (n = 186) and at season end (n = 146). Attendance was tracked over 16 weeks. Results: Participants post-intervention reported significantly higher vegetable consumption(P = 0.005) and lower soda consumption (P = 0.005). Participants reporting largest F&V increases attended the market 6-8 times and received $40 in incentives. No change in food assistance spent on F&V (P = 0.94); 70% reported significant increases in family consumption of F&V,indicating subsidies increased overall F&V purchasing. Participants reported exposure activities and incentives similarly affected program attendance. Conclusion: Interventions combining exposure activities and modest financial incentives at farmers’ markets in low-income neighborhoods show strong potential to improve diet quality of families receiving federal food assistance.

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

“…Although awareness of PIUKP was not associated with the availability of recipe cards or food samples, awareness of PIUKP was associated with a willingness to prepare the recipe at home. Our findings are not consistent with previous research suggesting recipe samples, cooking ideas, and food demonstrations are ways to improve purchasing habits ( 8 ). Our study highlights how a community-based marketing campaign may be effective at influencing shopping behaviors of rural residents, especially when implemented over an extended period of time (our 2-year study period).…”

The behavioural constellation of deprivation: Causes and consequences

“…For example, mothers living in low-income neighbourhoods describe wanting to provide more fruits and vegetables for their children but not having the money to afford them or the time to prepare them (Jabs et al 2007). Qualitative interviews and preliminary outcome evaluations reveal that programmes that subsidise fruit and vegetable purchases can literally help mothers put fruit on the table (Bowling et al 2016;Cohen et al 2017;Lloyd 2014;McFadden et al 2014). These findings suggest that increasing the financial availability of healthier foods increases parents' ability to enact the choices they want to make.…”

Adults and Children in Low-Income Households that Participate in Cost-Offset Community Supported Agriculture Have High Fruit and Vegetable Consumption

“…Recent research suggests that shopping at farmers’ markets is positively associated with FVI [ 18 , 19 , 20 ], and that programs that facilitate access to farmers’ markets for families with low-incomes significantly increase self-reported vegetable consumption [ 21 , 22 , 23 , 24 ]. None of these studies, however, measured FVI among children.…”