122 research outputs found
A modified choice experiment to examine willingness to participate in a Community Supported Agriculture (CSA) program among low-income parents
There is a need to improve geographical and financial access to healthy foods for limited resource populations in rural areas. Community Supported Agriculture (CSA) programs can improve access to healthy foods in rural and limited-resource populations. However, research is needed to discern the most appealing conditions for a CSA (e.g. price, frequency, food quantity) among rural, low-income customers. The goal of this study was to understand low-income consumers' preferences related to participation in a CSA program, considering price, frequency, food quantity and accessibility (e.g. distance) conditions. A modified exploratory choice experiment exercise was embedded within in-depth interviews to examine willingness to participate in CSA under a variety of conditions among 42 low-income adults with at least one child in the household in North Carolina, New York, Vermont and Washington. Willingness to participate in a CSA under each condition was summed and compared across conditions. Results were stratified by race, number of children and household members and McNemar's test and Student's t-test were used to examine differences in willingness between conditions. Salient quotes were extracted to support themes related to each condition. Our analysis suggests that the ideal CSA would be a full-sized share of eight to nine items of mixed variety, distributed every other week, priced at less than US$15, no more than 10 min further than the supermarket (SM) from their home and preferably less expensive but no more than 20% more expensive than SM prices. CSAs interested in reaching rural low-income populations may benefit from considering these consumer-level preferences
Fruit and vegetable intake assessed by repeat 24 h recalls, but not by a dietary screener, is associated with skin carotenoid measurements in children
Accurate measurement of fruit and vegetable (FV) intake is important for nutrition surveillance and evaluation of dietary interventions. We compared two tools for reporting FV intake to objective measurement of skin carotenoids among children. FV cups/day was assessed by repeated 24 h dietary recalls (24H FV) and the National Cancer Institute’s All-Day Fruit and Vegetable Screener (NCI FV). Skin carotenoids were measured by repeated resonance Raman spectroscopy (RRS) of the palm. FV cups were regressed on RRS scores in unadjusted, field-based, and research-setting models with covariates feasible in each scenario. Data were baseline values from children aged 2–12 years in low-income households enrolled in a healthy eating randomized trial in four U.S. states (n = 177). Twenty-four-hour FV cups were associated with skin carotenoids in all models (p < 0.001) but NCI FV cups were not. Predicted RRS scores for discrete 24H FV cups provide a guide to interpretation of RRS in children (2 cups FV intake ~36,000 RRS units), with the research-setting scenario generally providing the narrowest prediction range (+/−1924). When self-reported data are required, 24 h recalls are more accurate than NCI FV screener data; and, when limited time, resources, or literacy must be considered, RRS scores can be quickly obtained and easily interpreted
Snacking, sugar-sweetened beverage consumption and child obesity in low-income households
Purpose: Snacking contributes to one-quarter of children’s total daily energy intake in the USA, with many snack foods being nutrient-poor and energy-dense. Snacking and sugary beverage consumption have been identified as potential contributors to childhood overweight and obesity and may play a particularly important role among children from socioeconomically disadvantaged households that generally display higher rates of obesity. This exploratory study investigated associations between consumption of snack foods, sugar-sweetened beverages (SSB) and overweight and obesity in children from low-income households. Design/methodology/approach: Data from households that participated in a multi-state cost-offset (CO-CSA) community supported agriculture intervention in 2016 and 2017 (n = 305) were analyzed. Fixed effect regression models were used to estimate associations between child monthly consumption of salty snack foods; sweet snack foods and SSBs; and child weight status, accounting for demographic characteristics. Findings: No associations were found between snack or SSB consumption and child overweight. However, household income was significantly, negatively related to all three consumption variables (Salty snacks: ß = −0.09, SE = 0.04, p = 0.02; Sweet snacks: ß= −0.10, SE = 0.04, p = 0.01; SSB: ß= −0.21, SE = 0.05, p = 0.0001). The results suggest that household income may play an important role in children’s snacking and SSB behaviors among more disadvantaged households. Practical implications: Factors beyond snack food and SSB consumption should be explored to better understand childhood overweight and obesity, and to inform future obesity interventions. Originality/value: Socioeconomic disparities in childhood obesity are an ongoing policy-relevant issue within the USA and internationally. This study provides new information about child snacking behaviors in a unique, low-income population and contributes to the evidence base regarding the role household context in shaping child consumption behaviors
Can a shift in the purchase of local foods by Supplemental Nutrition Assistance Program (SNAP) recipients impact the local economy?
In recent years, several initiatives have sought to encourage redemption of food assistance benefits at direct-to-consumer (DTC) market venues such as community supported agriculture programs and farmers' markets in the USA, with the dual goal of increasing access to healthy foods for low-income families and sales of locally-grown foods for farmers. Proponents of these interventions assert that these programs have a positive impact on local economies yet there is limited evidence to validate this argument. This research project used a customized input-output model to simulate potential economic impacts of programs and policies that enable Supplemental Nutrition Assistance Program (SNAP) recipients to shift purchases from traditional food retailers to DTC venues in four states. Two different scenarios were explored: (1) increased outreach to low-income consumers and (2) financial support for using SNAP benefits at DTC market channels. We found a positive, though modest, economic impact at the state level under both scenarios when accounting for (a) business losses in the food retail and wholesale sectors, (b) a shift in acreage from commodity to specialty crops and (c) the cost to taxpayers. Since most of the increased economic activity would be in the produce farming sector, we discuss the opportunities and challenges for this sector along with potential policy implications
Fruit and Vegetable Preferences and Practices May Hinder Participation in Community-Supported Agriculture Among Low-Income Rural Families
Objective: Describe fruit and vegetable (FV) preferences and other factors that may influence participation in community-supported agriculture (CSA). Design: In-depth, semi-structured interviews. Setting: Eight rural/micropolitan communities in 4 US states. Participants: There were 41 caregivers and 20 children (8–12 years of age) from low-income, English-speaking households. Phenomena of Interest: Knowledge, attitudes, and behaviors regarding FVs; perceived barriers to CSA participation. Analysis: Transcribed verbatim and iteratively coded. Results: Caregivers and children believed FVs were important to health, yet FVs were not featured in dinners or snacks and consumption was challenged by limited preferences and neophobia. Few caregivers and children knew about the seasonality of FV. Most caregivers were unfamiliar with CSA and had concerns about CSA cost, accessibility, produce quality, and selection. Conclusions and Implications: These qualitative data support improvements in: 1) CSA distribution practices to offer flexible payment and pick-up options, more fruits, and self-selection of FV; 2) public awareness of produce seasonality and the CSA distribution model as necessary precursors to participation, and lower cost for low-income families who highlighted this barrier; and 3) capacity to prepare FV by enhancing skills and providing time-saving kitchen tools. Approaches to aligning CSA practices with the needs and preferences of low-income families warrant further research
Gaining and maintaining a competitive edge: Evidence from CSA members and farmers on local food marketing strategies
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 pick-up were very important; thus, farmers tried to offer convenient sites or an enriched pick-up 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
The perceived influence of cost-offset community-supported agriculture on food access among low-income families
Objective To examine perspectives on food access among low-income families participating in a cost-offset community-supported agriculture (CO-CSA) programme.Design Farm Fresh Foods for Healthy Kids (F3HK) is a multicentre randomized intervention trial assessing the effect of CO-CSA on dietary intake and quality among children from low-income families. Focus groups were conducted at the end of the first CO-CSA season. Participants were interviewed about programme experiences, framed by five dimensions of food access: Availability, accessibility, affordability, acceptability and accommodation. Transcribed data were coded on these dimensions plus emergent themes.Setting Nine communities in the US states of New York, North Carolina, Washington and Vermont.Subjects Fifty-Three F3HK adults with children.Results CSA models were structured by partner farms. Produce quantity was abundant; however, availability was enhanced for participants who were able to select their own produce items. Flexible CSA pick-up times and locations made produce pick-up more accessible. Despite being affordable to most, payment timing was a barrier for some. Unfamiliar foods and quick spoilage hindered acceptability through challenging meal planning, despite accommodations that included preparation advice.Conclusions 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
Knowledge, attitudes, beliefs and behaviors regarding fruits and vegetables among cost-offset community-supported agriculture (csa) applicants, purchasers, and a comparison sample
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, selfefficacy, 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
Community supported agriculture plus nutrition education improves skills, self-efficacy, and eating behaviors among low-income caregivers but not their children: a randomized controlled trial
Background: Adults and children in the U.S. consume inadequate quantities of fruit and vegetables (FV), in part, due to poor access among households with lower socioeconomic status. One approach to improving access to FV is community supported agriculture (CSA) in which households purchase a ‘share’ of local farm produce throughout the growing season. This study examined the effects of cost-offset (half-price) CSA plus tailored nutrition education for low-income households with children. Methods: The Farm Fresh Foods for Healthy Kids (F3HK) randomized controlled trial in New York, North Carolina, Vermont, and Washington (2016–2018) assigned caregiver-child dyads (n = 305) into cost-offset CSA plus education intervention or control (delayed intervention) groups. Following one growing season of CSA participation, changes in children’s diet quality, body mass index (BMI), and physical activity; caregivers’ nutrition knowledge, attitudes, behaviors, and diet quality; and household food access and security were examined using multiple linear or logistic regression, with adjustment for baseline value within an intent-to-treat (ITT) framework in which missing data were multiply imputed. Results: No significant net effects on children’s dietary intake, BMI, or physical activity were observed. Statistically significant net improvements were observed after one growing season for caregivers’ cooking attitudes, skills, and self-efficacy; FV intake and skin carotenoid levels; and household food security. Changes in attitudes and self-efficacy remained one-year after baseline, but improvements in caregiver diet and household food security did not. The number of weeks that participants picked up a CSA share (but not number of education sessions attended) was associated with improvements in caregiver FV intake and household food security. Conclusions: Cost-offset CSA plus tailored nutrition education for low-income households improved important caregiver and household outcomes within just one season of participation; most notably, both self-reported and objectively measured caregiver FV intake and household food security improved. Households that picked up more shares also reported larger improvements. However, these changes were not maintained after the CSA season ended. These results suggest that cost-offset CSA is a viable approach to improving adult, but not child, FV intake and household food security for low-income families, but the seasonality of most CSAs may limit their potential to improve year-round dietary behavior and food security. Trial registration: ClinicalTrials.gov. NCT02770196. Registered 5 April 2016. Retrospectively registered
Perceptions of nutrition education classes offered in conjunction with a community-supported agriculture intervention among low-income families
Abstract Objective: To examine participants' experiences with nutrition education classes that were implemented with and designed to complement a cost-offset community-supported agriculture (CSA) programme. Design: Qualitative analysis of data from twenty-eight focus groups with ninety-six participants enrolled in Farm Fresh Foods for Healthy Kids (F3HK). Transcribed data were coded and analysed by a priori and emergent themes. Setting: Rural and micropolitan communities in New York, North Carolina, Vermont and Washington (USA). Participants: Ninety-six F3HK participants. Results: Participants found recipes and class activities helpful and reported improvements in nutrition knowledge, food preservation skills and home cooking behaviours for themselves and their children; they also reported that classes promoted a sense of community. Some educators better incorporated CSA produce into lessons, which participants reported as beneficial. Other obligations and class logistics were barriers to attendance; participants recommended that lessons be offered multiple times weekly at different times of day. Other suggestions included lengthening class duration to encourage social engagement; emphasising recipes to incorporate that week's CSA produce and pantry staples and offering additional strategies to incorporate children in classes. Conclusion: Complementing a cost-offset CSA with nutrition education may enhance programme benefits to low-income families by improving nutrition knowledge and cooking behaviours. However, future interventions will benefit from ongoing coordination between educators and local growing trajectories to maximise timely coverage of unfamiliar produce in lessons; synchronous scheduling of CSA pick-up and classes for participant convenience and creative strategies to engage children and/or provide childcare
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