A possible dose–response association between distance to farmers’ markets and roadside produce stands, frequency of shopping, fruit and vegetable consumption, and body mass index among customers in the Southern United States

Background: The association between farmers’ market characteristics and consumer shopping habits remains unclear. Our objective was to examine associations among distance to farmers’ markets, amenities within farmers’ markets, frequency of farmers’ market shopping, fruit and vegetable consumption, and body mass index (BMI). We hypothesized that the relationship between frequency of farmers’ market shopping and BMI would be mediated by fruit and vegetable consumption. Methods: In 15 farmers’ markets in northeastern North Carolina, July–September 2015, we conducted a crosssectional survey among 263 farmers’ market customers (199 provided complete address data) and conducted farmers’ market audits. To participate, customers had to be over 18 years of age, and English speaking. Dependent variables included farmers’ market shopping frequency, fruit and vegetable consumption, and BMI. Analysis of variance, adjusted multinomial logistic regression, Poisson regression, and linear regression models, adjusted for age, race, sex, and education, were used to examine associations between distance to farmers’ markets, amenities within farmers’ markets, frequency of farmers’ market shopping, fruit and vegetable consumption, and BMI. Results: Those who reported shopping at farmers’ markets a few times per year or less reported consuming 4.4 (standard deviation = 1.7) daily servings of fruits and vegetables, and those who reported shopping 2 or more times per week reported consuming 5.5 (2.2) daily servings. There was no association between farmers’ market amenities, and shopping frequency or fruit and vegetable consumption. Those who shopped 2 or more times per week had a statistically significantly lower BMI than those who shopped less frequently. There was no evidence of mediation of the relationship between frequency of shopping and BMI by fruit and vegetable consumption. Conclusions: More work should be done to understand factors within farmers’ markets that encourage fruit and vegetable purchases.ECU Open Access Publishing Support Fun

A Produce Prescription Program in Eastern North Carolina Results in Increased Voucher Redemption Rates and Increased Fruit and Vegetable Intake among Participants

Few produce prescription programs have taken place in rural areas, in the context of existing public health programs. Thus, the purpose of this mixed-methods study was to examine voucher redemption rates, change in fruit and vegetable intake, and suggestions for improvement among participants enrolled in a produce prescription program occurring in existing public health programs throughout rural eastern North Carolina. We examined voucher redemption rates and conducted pre- (n = 125) and post-intervention surveys assessing fruit and vegetable intake. t-tests were used to examine changes in intake pre- versus post-intervention among 50 participants. Participants (n = 32) also completed a semi-structured, telephone interview. Qualitative data were thematically analyzed to determine potential improvements. The overall voucher redemption rate was 52%. There was a 0.29 (standard deviation = 0.91, p = 0.031) cup increase in self-reported fruit intake comparing post- to pre-intervention data. Qualitative analyses indicated that participants enjoyed the financial benefits of the program and wanted it to continue. The produce prescription program was successful in increasing self-reported fruit intake among participants. More research is needed to determine if changes in intake persist when measured objectively, and on best methods for the program’s financial sustainability

Examining Shopping Patterns, Use of Food-Related Resources, and Proposed Solutions to Improve Healthy Food Access Among Food Insecure and Food Secure Eastern North Carolina Residents

In the Southern United States (U.S.), food insecurity rates are higher in rural (20.8%) versus urban communities (15%). Food insecurity can exacerbate diet-related disease. Thus, the purpose of this study was to examine differences in the use of food-related community resources and potential solutions proposed among food insecure versus food secure residents. A community survey (n = 370) was conducted in rural eastern North Carolina, with questions pertaining to food security status and food-related resources. The IBM SPSS Statistics software and SAS software were used to examine differences in food-related resources, and qualitative data analysis was used to examine differences in solutions offered between food insecure and food secure participants. Of the 370 respondents, forty-eight-point-six percent were classified as food insecure. Food insecure participants were more likely to report shopping for groceries at a convenience/discount store, less likely to use their own vehicle for transportation, and less likely to purchase food from local producers. Food insecure participants were more likely to suggest solutions related to reducing the cost of healthy food, while food secure participants were more likely to suggest educational or convenience-related interventions

A possible dose–response association between distance to farmers’ markets and roadside produce stands, frequency of shopping, fruit and vegetable consumption, and body mass index among customers in the Southern United States

Background: The association between farmers’ market characteristics and consumer shopping habits remains\r\nunclear. Our objective was to examine associations among distance to farmers’ markets, amenities within farmers’\r\nmarkets, frequency of farmers’ market shopping, fruit and vegetable consumption, and body mass index (BMI). We\r\nhypothesized that the relationship between frequency of farmers’ market shopping and BMI would be mediated by\r\nfruit and vegetable consumption.\r\nMethods: In 15 farmers’ markets in northeastern North Carolina, July–September 2015, we conducted a crosssectional\r\nsurvey among 263 farmers’ market customers (199 provided complete address data) and conducted\r\nfarmers’ market audits. To participate, customers had to be over 18 years of age, and English speaking. Dependent\r\nvariables included farmers’ market shopping frequency, fruit and vegetable consumption, and BMI. Analysis of\r\nvariance, adjusted multinomial logistic regression, Poisson regression, and linear regression models, adjusted for\r\nage, race, sex, and education, were used to examine associations between distance to farmers’ markets, amenities\r\nwithin farmers’ markets, frequency of farmers’ market shopping, fruit and vegetable consumption, and BMI.\r\nResults: Those who reported shopping at farmers’ markets a few times per year or less reported consuming 4.4\r\n(standard deviation = 1.7) daily servings of fruits and vegetables, and those who reported shopping 2 or more times\r\nper week reported consuming 5.5 (2.2) daily servings. There was no association between farmers’ market amenities,\r\nand shopping frequency or fruit and vegetable consumption. Those who shopped 2 or more times per week had a\r\nstatistically significantly lower BMI than those who shopped less frequently. There was no evidence of mediation of\r\nthe relationship between frequency of shopping and BMI by fruit and vegetable consumption.\r\nConclusions: More work should be done to understand factors within farmers’ markets that encourage fruit and\r\nvegetable purchases