O37 Fruit and Vegetable Preparation Changes During and After Cost-Offset Community Supported Agriculture and Nutrition Education

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.

Download Full-text

Making community-supported agriculture accessible to low-income families: findings from the Farm Fresh Foods for Healthy Kids process evaluation

Translational Behavioral Medicine ◽

10.1093/tbm/ibaa080 ◽

2020 ◽

Author(s):

Jennifer A Garner ◽

Stephanie B Jilcott Pitts ◽

Karla L Hanson ◽

Alice S Ammerman ◽

Jane Kolodinsky ◽

...

Keyword(s):

Mixed Methods ◽

Nutrition Education ◽

Process Evaluation ◽

Diet Quality ◽

Low Income ◽

Community Supported Agriculture ◽

Geographically Dispersed ◽

Cost Offset ◽

Low Income Families ◽

Fresh Foods

Abstract A randomized trial of Farm Fresh Foods for Healthy Kids (F3HK) was initiated across 4 states and 12 farms to test whether cost-offset community-supported agriculture (CO-CSA) could improve diet quality among children in low-income families. Intervention households purchased a 50% subsidized share of local produce and were invited to nine complimentary nutrition classes. The purpose of this study was to assess F3HK reach, dose, and fidelity via a mixed methods process evaluation. Screening and enrollment records indicated reach; study records and postlesson educator surveys tracked dose delivered; CSA pickup logs, lesson sign-in sheets, postseason participant surveys, and postlesson caregiver surveys assessed dose received; and coordinator audits and educator surveys tracked fidelity. Educator interviews contextualized findings. The results of this study were as follows. Reach: enrolled caregivers (n = 305) were older (p = .005) than eligible nonenrollees (n = 243) and more likely to be female (p < .001). Dose: mean CSA season was 21 weeks (interquartile range [IQR]: 19–23). Median CSA pickup was 88% of the weeks (IQR: 40–100). All sites offered each class at least once. Most adults (77%) and children (54%) attended at least one class; few attended all. Eighty-two percent of caregivers indicated that their household consumed most or all produce. Median lesson activity ratings were 5/5 (“very useful”). Fidelity: CSA locations functioned with integrity to project standards. Educators taught 92% of activities but frequently modified lesson order. This study demonstrates the feasibility of pairing a CO-CSA intervention with nutrition education across geographically dispersed sites. Greater integration of intervention elements and clearer allowance for site-level modifications, particularly for educational elements, may improve intervention dose and, ultimately, impact.

Download Full-text

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

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-021-01168-x ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Rebecca A. Seguin-Fowler ◽

Karla L. Hanson ◽

Stephanie B. Jilcott Pitts ◽

Jane Kolodinsky ◽

Marilyn Sitaker ◽

...

Keyword(s):

Food Security ◽

Nutrition Education ◽

Low Income ◽

Self Efficacy ◽

Controlled Trial ◽

Growing Season ◽

Household Food Security ◽

Community Supported Agriculture ◽

Cost Offset ◽

Household Food

Abstract 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.

Download Full-text

P147 Cost-offset Community-Supported Agriculture plus Nutrition Education Improves Household Food Security and Nutrition Attitudes and Self-efficacy: A Randomized Controlled Trial

Journal of Nutrition Education and Behavior ◽

10.1016/j.jneb.2020.04.194 ◽

2020 ◽

Vol 52 (7) ◽

pp. S86

Author(s):

Rebecca Seguin-Fowler ◽

Alice Ammerman ◽

Karla Hanson ◽

Stephanie Jilcott Pitts ◽

Jane Kolodinsky ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Food Security ◽

Nutrition Education ◽

Controlled Trial ◽

Household Food Security ◽

Community Supported Agriculture ◽

Randomized Controlled ◽

Cost Offset ◽

Household Food ◽

Food Security And Nutrition

Download Full-text

Farm Fresh Foods for Healthy Kids: Innovative Cost-Offset Community Supported Agriculture Intervention to Prevent Childhood Obesity and Strengthen Local Agricultural Economies

Journal of Nutrition Education and Behavior ◽

10.1016/j.jneb.2017.05.108 ◽

2017 ◽

Vol 49 (7) ◽

pp. S120 ◽

Cited By ~ 1

Author(s):

Rebecca A. Seguin ◽

Alice S. Ammerman ◽

Karla L. Hanson ◽

Jane Kolodinsky ◽

Stephanie B. Jilcott Pitts ◽

...

Keyword(s):

Childhood Obesity ◽

Community Supported Agriculture ◽

Cost Offset ◽

Fresh Foods ◽

Agricultural Economies

Download Full-text

Fruit and vegetable consumption: marketing data to inform nutrition education and policy

The FASEB Journal ◽

10.1096/fasebj.20.4.a619-b ◽

2006 ◽

Vol 20 (4) ◽

Author(s):

Mary Katherine Hoy ◽

Barbara Berry ◽

Linda Brugler ◽

Elizabeth Pivonka

Keyword(s):

Nutrition Education ◽

Vegetable Consumption ◽

Fruit And Vegetable Consumption ◽

Fruit And Vegetable ◽

Marketing Data

Download Full-text

Impact of a Fruit and Vegetable Prescription Program on Diet Quality and Cardio-Metabolic Risk Factors in Healthy Adults in a Worksite Setting: A Randomized Controlled Trial (OR16-07-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz051.or16-07-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Beth Comerford ◽

Kimberly Doughty ◽

Valentine Njike ◽

Rockiy Ayettey ◽

Audra Weisel ◽

...

Keyword(s):

Blood Pressure ◽

Dietary Intake ◽

Nutrition Education ◽

Diet Quality ◽

Hemoglobin A1c ◽

Healthy Adults ◽

Grocery Store ◽

Control Group ◽

Fruit And Vegetable ◽

The Impact

Abstract Objectives Community- and clinic-based fruit and vegetable “prescription” (FVRx) programs, which include nutrition education and subsidies to reduce the cost of fruits and vegetables have improved dietary intake and some clinical outcomes, such as hemoglobin A1c (HbA1c) and blood pressure. However, few if any studies have investigated the impact of an FVRx program in a worksite setting. The purpose of this study was to determine the effects of a worksite FVRx program on diet quality, body mass index (BMI), waist circumference, blood lipid concentrations, hemoglobin A1c (HbA1c), and blood pressure. Methods In the first of two planned cohorts, we randomized healthy adults employed at a community hospital in southern Connecticut to receive either the FVRx program for 10 weeks (n = 20) or standard worksite wellness offerings (n = 20). Each week, intervention participants received a 45-minute cooking and nutrition education session held during the workday and a voucher valuing $15–25, depending on household size, that could be redeemed for fruit and vegetable purchases at a local grocery store. Outcome measures were assessed at baseline and at the end of the intervention. Results Compared to the control group, participants in the FVRx group significantly increased their HEI-2010 score for vegetable intake (0.91 ± 1.41 vs. 0.02 ± 1.18, P < 0.05) and reduced their HE-2010 score for empty calories (−4.61 ± 4.82 vs. −0.75 ± 3.20, P < 0.01). There were no between-group differences in other HEI-2010 components, body composition, HbA1c blood lipids, or blood pressure. However, the FVRx group did improve their overall HEI-2010 score from baseline (7.85 ± 10.82, P < 0.05) whereas the control group did not (3.57 ± 9.51, P > 0.05). Conclusions In this interim analysis, we demonstrated potential benefits of a worksite FVRx program on intake of vegetables and empty calories. Changes in anthropometric or biochemical measures were not observed immediately post-intervention, but this may be due to enrollment of a low-risk population or length of time needed to influence those measures. That the intervention nevertheless improved dietary intake suggests that it may be valuable for prevention of diet-related disease in healthy adults. Funding Sources Centers for Disease Control and Prevention, Prevention Research Centers Program grant.

Download Full-text