Monetary Matched Incentives to Encourage the Purchase of Fresh Fruits and Vegetables at Farmers Markets in Underserved Communities

Lindsay, Suzanne P.; Lambert, J.; Penn, Tanya; Hedges, Susan; Ortwine, Kristine; Mei, Anchi; Delaney, Tracy; Wooten, Wilma

doi:10.5888/pcd10.130124

Cited by 56 publications

(75 citation statements)

References 10 publications

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“…14,31,32 This study also had higher retention rates compared with several prior longitudinal incentive interventions, 30,33–35 which may augment generalizability and help mitigate potential selection bias.…”

Section: Discussionmentioning

confidence: 85%

Increasing Use of a Healthy Food Incentive: A Waiting Room Intervention Among Low-Income Patients

Cohen

Richardson

Heisler

et al. 2017

American Journal of Preventive Medicine

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Introduction Diet-related disease is disproportionally concentrated in low-income communities where fruit and vegetable consumption is far below guidelines. To address financial barriers, Double Up Food Bucks (DUFB)—a statewide healthy food incentive—matches Supplemental Nutrition Assistance Program (SNAP) funds spent at farmers markets. However, incentive use is limited. This study examined the impact of a brief waiting room–based intervention about DUFB on program utilization and produce consumption. Study design Longitudinal, repeated measures, quasi-experimental trial. Setting/participants SNAP—enrolled adults at a health center in a low-income, racially and ethnically diverse area of Southeast Michigan. Intervention Participants received a brief explanation of DUFB, written program materials, a map highlighting market locations and hours, and an initial $10 market voucher. DUFB use and produce consumption were measured through four surveys over 5 months (August 2014–January 2015). Main outcome measures Outcome measures included DUFB use and fruit and vegetable consumption (analyses conducted in 2015–2016). Results A total of 302 eligible adults were identified, and 177 (59%) enrolled. One hundred twenty-seven (72%) completed all surveys. At baseline, 57% of participants reported shopping at a farmers market within the last year; 18% had previously used DUFB. By the end of the DUFB season, participants were significantly more likely to report DUFB use than at baseline (AOR=19.2, 95% CI=10.3, 35.5, p<0.001), with 69% of participants reporting use of DUFB at least once, and 34% reporting use of DUFB three or more times. Adjusted fruit and vegetable consumption increased from baseline by 0.65 servings/day (95% CI=0.37, 0.93, p<0.001) at 3 months, and remained 0.62 servings/day (95% CI=0.32, 0.92, p<0.001) higher than baseline 2 months post-DUFB season. Conclusions A brief clinic-based intervention was associated with a nearly fourfold increase in uptake of a SNAP incentive, as well as clinically significant increases in produce consumption. Results suggested sustained behavior change even once the financial incentive was no longer available. Providing information about healthy food incentives is a low-cost, easily implemented intervention that may increase produce consumption among low-income patients.

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Section: Discussionmentioning

confidence: 85%

Increasing Use of a Healthy Food Incentive: A Waiting Room Intervention Among Low-Income Patients

Cohen

Richardson

Heisler

et al. 2017

American Journal of Preventive Medicine

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“…For instance, studies evaluating financial incentive programs (e.g., coupons or vouchers), demonstrate at least modestly greater intent to purchase or consume—or reportedly increased purchasing or consumption—of fruits and vegetables among FM incentive recipients (Baronberg, Dunn, Nonas, Dannefer, & Sacks, 2013; Freedman, et al, 2011; Freedman, Choi, Hurley, Anadu, & Hebert, 2013; Jones & Bhatia, 2011; Kropf, Holben, Holcomb, & Anderson, 2007; Lindsay, et al, 2013; McCormack, Laska, Larson, & Story, 2010; Racine, et al, 2010; Webber, Balsam, & Oehlke, 1995; Weinstein, Galindo, Fried, Rucker, & Davis, 2014; Wheeler & Chapman-Novakofski, 2014; Young, et al, 2013). Other studies suggest that living near a FM is associated with greater produce intake (Gustafson, et al, 2013; Park, et al, 2011; Ruelas, et al, 2012) and that introducing FMs to communities may minimally increase reported consumption of select fruits and vegetables (Evans, et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Urban farmers' markets: Accessibility, offerings, and produce variety, quality, and price compared to nearby stores

et al. 2015

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Most food-environment research has focused narrowly on select stores and restaurants. There has been comparatively less attention to non-storefront food sources like farmers' markets (FMs), particularly in urban communities. The objective of the present study was to assess FMs' potential contribution to an urban food environment in terms of specific foods offered, and compare FM accessibility as well as produce variety, quality, and price to that of nearby stores. Investigators conducted a detailed cross-sectional assessment of all FMs in Bronx County, NY, and of the nearest store(s) selling produce within a half-mile walking distance (up to two stores per FM). The study included 26 FMs and 44 stores. Investigators assessed accessibility (locations of FMs and stores relative to each other, and hours of operation for each), variety (the number and type of all food items offered at FMs and all fresh produce items offered at stores), quality (where produce items were grown and if they were organic), and price (including any sales prices or promotional discounts). Analyses included frequencies, proportions, and variable distributions, as well as mixed-effect regressions, paired t-tests, and signed rank tests to compare FMs to stores. Geographic information systems (GIS) allowed for mapping of FM and store locations and determining street-network distances between them. The mean distance between FMs and the nearest store selling fresh produce was 0.15 miles (range 0.02-0.36 miles). FMs were open substantially fewer months, days, and hours than stores. FMs offered 26.4 fewer fresh produce items on average than stores (p values <0.02). FM produce items were more frequently local and organic, but often tended towards less-common/more-exotic and heirloom varieties. FMs were more expensive on average (p values <0.001 for pairwise comparisons to stores)—even for more-commonplace and “conventional” produce—especially when discounts or sales prices were considered. Fully, 32.8% of what FMs offered was not fresh produce at all but refined or processed products (e.g., jams, pies, cakes, cookies, donuts, juice drinks). FMs may offer many items not optimal for good nutrition and health, and carry less-varied, less-common fresh produce in neighborhoods that already have access to stores with cheaper prices and overwhelmingly more hours of operation.

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“…38 In North Carolina, Jilcott Pitts et al (2015) in WIC. 39 Comparatively, a study in San Diego, California reported that 82% of a mostly Hispanic or Latino (49.5%) and Caucasian (18.0%) had never shopped at a FM (prior to intervention). 39 Collectively, these findings provide further evidence that the Healthy Roots For You pilot study must promote FM use by first considering cultural aspects of the target population, including communication channels and messages, sociodemographic factors and dietary habits.…”

Section: Discussionmentioning

confidence: 99%

Farmers' Market Utilization among Supplemental Nutrition Assistance Program Recipients in New Orleans, Louisiana: Preliminary Findings

et al. 2017

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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.Ethn Dis. 2017;27(Suppl 1):295-302; doi:10.18865/ed.27.S1.295.

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Monetary Matched Incentives to Encourage the Purchase of Fresh Fruits and Vegetables at Farmers Markets in Underserved Communities

Cited by 56 publications

References 10 publications

Increasing Use of a Healthy Food Incentive: A Waiting Room Intervention Among Low-Income Patients

Increasing Use of a Healthy Food Incentive: A Waiting Room Intervention Among Low-Income Patients

Urban farmers' markets: Accessibility, offerings, and produce variety, quality, and price compared to nearby stores

Farmers' Market Utilization among Supplemental Nutrition Assistance Program Recipients in New Orleans, Louisiana: Preliminary Findings

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