Increasing access to fresh produce by pairing urban farms with corner stores: a case study in a low-income urban setting

AbstractObjectiveOur objective was to pilot collaborations between two urban farms with two corner stores to increase access to fresh produce in low-income neighbourhoods.DesignWe conducted a pre–post evaluation of two farm–store collaborations using quantitative distribution and sales data. Using semi-structured interviews, we qualitatively assessed feasibility of implementation and collaboration acceptability to farmers and storeowners.SettingLow-income urban neighbourhoods in Baltimore, MD, USA in 2012.SubjectsPair #1 included a 0·25 acre (0·1 ha) urban farm with a store serving local residents and was promoted by the neighbourhood association. Pair #2 included a 2 acre (0·8 ha) urban farm with a store serving bus commuters.ResultsProduce was delivered all nine intervention weeks in both pairs. Pair #1 produced a significant increase in the mean number of produce varieties carried in the store by 11·3 (P<0·01) and sold 86 % of all items delivered. Pair #2 resulted in a non-significant increase in the number of produce varieties carried by 2·2 (P=0·44) and sold 63 % of all items delivered.ConclusionsOur case study suggests that pairing urban farms with corner stores for produce distribution may be feasible and could be a new model to increase access to fruits and vegetables among low-income urban neighbourhoods. For future programmes to be successful, strong community backing may be vital to support produce sales.

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Increasing access to fresh produce by partnering urban farms with corner stores: a pilot study in a low‐income urban setting

The FASEB Journal ◽

10.1096/fasebj.27.1_supplement.842.6 ◽

2013 ◽

Vol 27 (S1) ◽

Author(s):

Kimberly Anne Gudzune ◽

Claire Welsh ◽

Elisa Lane ◽

Zach Chissell ◽

Elizabeth Anderson ◽

...

Keyword(s):

Pilot Study ◽

Low Income ◽

Fresh Produce ◽

Urban Setting ◽

Corner Stores

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Assessing the scale and spread of an experiential teaching kitchen in after-school programming among school-age children

Public Health Nutrition ◽

10.1017/s1368980020004206 ◽

2020 ◽

pp. 1-8

Author(s):

William J Heerman ◽

Yasmeen Elsakary ◽

Evan C Sommer ◽

Juan Escarfuller ◽

Shari L Barkin

Keyword(s):

Low Income ◽

Fruits And Vegetables ◽

Community Setting ◽

Urban Setting ◽

School Age Children ◽

After School ◽

Minority Children ◽

Parks And Recreation ◽

Experiential Teaching ◽

School Programming

Abstract Objective: To scale-out an experiential teaching kitchen in Parks and Recreation centres’ after-school programming in a large urban setting among predominantly low-income, minority children. Design: We evaluated the implementation of a skills-based, experiential teaching kitchen to gauge programme success. Effectiveness outcomes included pre–post measures of child-reported cooking self-efficacy, attitudes towards cooking, fruit and vegetable preference, intention to eat fruits and vegetables and willingness to try new fruits and vegetables. Process outcomes included attendance (i.e., intervention dose delivered), cost, fidelity and adaptations to the intervention. Setting: After-school programming in Parks and Recreation Community centres in Nashville, TN. Participants: Predominantly low-income minority children aged 6–14 years. Results: Of the twenty-five city community centres, twenty-one successfully implemented the programme, and nineteen of twenty-five implemented seven or more of the eight planned sessions. Among children with pre–post data (n 369), mean age was 8·8 (sd 1·9) years, and 53·7 % were female. All five effectiveness measures significantly improved (P < 0·001). Attendance at sessions ranged from 36·3 % of children not attending any sessions to 36·6 % of children attending at least four sessions. Across all centres, fidelity was 97·5 %. The average food cost per serving was $1·37. Conclusions: This type of nutritional education and skills building experiential teaching kitchen can be successfully implemented in a community setting with high fidelity, effectiveness and organisational alignment, while also expanding reach to low-income, underserved children.

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Participant Perceptions of Character Concepts in a Physical Activity–Based Positive Youth Development Program

Journal of Sport and Exercise Psychology ◽

10.1123/jsep.2016-0061 ◽

2016 ◽

Vol 38 (5) ◽

pp. 481-492 ◽

Cited By ~ 3

Author(s):

Shaina Riciputi ◽

Meghan H. McDonough ◽

Sarah Ullrich-French

Keyword(s):

Physical Activity ◽

Youth Development ◽

Positive Youth Development ◽

Low Income ◽

Character Development ◽

Development Program ◽

Structured Interviews ◽

Low Income Families ◽

The Impact

Physical activity–based positive youth development (PYD) programs often aim to foster character development. This study examined youth perspectives of character development curricula and the impact these activities have on their lives within and beyond the program. This case study examined youth from low-income families in a physical activity–based summer PYD program that integrated one character concept (respect, caring, responsibility, trust) in each of 4 weeks. Participants (N = 24) included a cross section of age, gender, ethnicity, and past program experience. Semi-structured interviews were analyzed using inductive thematic analysis and constant comparative methods. Thirteen themes were grouped in four categories: building highquality reciprocal relationships; intrapersonal improvement; moral reasoning and understanding; and rejection, resistance, and compliance. The findings provide participant-centered guidance for understanding youth personal and social development through physical activity in ways that are meaningful to participants, which is particularly needed for youth in low-income communities with limited youth programming.

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Caregiver perceptions of a fruit and vegetable prescription programme for low-income paediatric patients

Public Health Nutrition ◽

10.1017/s1368980018000964 ◽

2018 ◽

Vol 21 (13) ◽

pp. 2497-2506 ◽

Cited By ~ 8

Author(s):

Amy Saxe-Custack ◽

Heather Claire Lofton ◽

Mona Hanna-Attisha ◽

Colleen Victor ◽

Gwendolyn Reyes ◽

...

Keyword(s):

Food Security ◽

Low Income ◽

Fruits And Vegetables ◽

Good Health ◽

Social Environments ◽

Fruit And Vegetable ◽

Structured Interviews ◽

Farmers Market ◽

Data Saturation ◽

Perceived Impact

AbstractObjectiveThe physical and social environments that surround children should support good health. However, challenges with food security and access prevent many children from consuming a healthy diet, which is critical to proper growth and development. The present study sought to gain a better understanding of primary care initiatives to address these issues in a low-income setting.DesignFollowing the relocation of a paediatric clinic to a farmers’ market building and the implementation of a fruit and vegetable prescription programme, researchers conducted thirty-two semi-structured interviews with caregivers. Researchers elicited caregivers’ perceptions of clinic co-location with the farmers’ market; experiences with the prescription programme; opinions of the farmers’ market; and perceived impact on child consumption of fresh produce. Interview recordings were transcribed for textual analysis. Using thematic analysis, researchers examined qualitative data to identify patterns across transcripts and formulate emerging themes. Researchers concluded when data saturation was reached.SettingFlint, Michigan, USA.SubjectsThe majority of participants were female (91 %) and African American (53 %).ResultsFour recurrent themes emerged during interviews: (i) convenience of relocation; (ii) attitude towards prescription programme; (iii) challenges with implementation; and (iv) perceived impact of combined interventions. Caregivers indicated that the co-location and prescription programme increased family shopping at the farmers’ market, improved access to high-quality produce and improved food security.ConclusionsA fruit and vegetable prescription programme involving a partnership between a farmers’ market and paediatric clinic was perceived as effective in improving food security, food access and child consumption of fresh fruits and vegetables.

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The complexities of selling fruits and vegetables in remote Navajo Nation retail outlets: perspectives from owners and managers of small stores

Public Health Nutrition ◽

10.1017/s1368980019003720 ◽

2020 ◽

Vol 23 (9) ◽

pp. 1638-1646 ◽

Cited By ~ 1

Author(s):

Emily M Piltch ◽

Sonya S Shin ◽

Robert F Houser ◽

Timothy Griffin

Keyword(s):

Native American ◽

Low Income ◽

Fruits And Vegetables ◽

Grocery Stores ◽

Healthy Foods ◽

Sampling Frame ◽

Structured Interviews ◽

Navajo Nation ◽

Product Selection ◽

The Usa

AbstractObjective:Navajo Nation residents experience extreme rates of poverty, food insecurity and diet-related diseases. While many residents travel far to shop at grocery stores, there are small stores closer to home that could provide more healthy options, like fruits and vegetables (F&V). Little is known from the perspective of store owners and managers regarding the barriers and facilitators to offering F&V; the present study contributes to filling that gap.Design:Data were collected through structured interviews from a sampling frame of all store owners or managers in the setting (n 29).Setting:Small stores in Navajo Nation, New Mexico, USA. Navajo Nation is predominantly rural and the largest federally recognized Native American tribe in the USA.Participants:Sixteen managers and six owners at twenty-two stores.Results:When asked about the types of foods that were most commonly purchased at their stores, most participants reported snacks and drinks (82 and 68 %, respectively). Many participants reported they would like to offer more fresh F&V. However, barriers included varying perceived customer demand, limited F&V choices from distributors and (for some managers) limited authority over product selection.Conclusions:Findings contribute to the discussion on engaging store owners and managers in providing quality, healthy foods close to home in low-income, rural regions.

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Local Farmer Perspectives on Improving Produce Distribution Networks in Low-Income Urban Settings

Current Developments in Nutrition ◽

10.1093/cdn/nzab035_057 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 149-149

Author(s):

Kelley Koeppen ◽

Dahiany Zayas-Toro ◽

Nina Martin ◽

Lisa Poirier ◽

Emma Lewis ◽

...

Keyword(s):

Low Income ◽

Fresh Produce ◽

Distribution Networks ◽

Food Distribution ◽

Urban Settings ◽

Market Expansion ◽

Corner Store ◽

Corner Stores ◽

The City ◽

Local Farmers

Abstract Objectives The Baltimore food system includes small hyper-local urban farms within city limits, larger local farms surrounding the city, and ubiquitous corner stores particularly in low-income neighborhoods of the city. In this system, farmers mainly reach consumers through farmer's markets that are only open for a limited number of hours per week, seasonally, and may not be adequate for meeting the needs of low-income households with low access to fresh produce. To address this gap, our team is working to develop a mobile application (app), called the Baltimore Urban food Distribution (BUD) app, that will provide a platform for farmers to sell their produce directly to corner stores for resale. Our present aims were to: (1) understand farmer's current interactions with corner stores; (2) explore perceived challenges that the BUD app may pose to farmers; and (3) pinpoint how the BUD app can sustainably expand farmers’ market base to include corner stores. Methods After designing a BUD app prototype based on formative research, 1-hour in-depth interviews were conducted with hyper-local and local farmers. Farmers were asked about their current distribution practices within Baltimore and perceived challenges in adopting the app. Farmers were then shown the prototype and asked to provide input on user-friendliness, and interest level in future use of the app. Results Local farmers currently have little to no interaction with corner stores. Interviews revealed that local farmers did not want the responsibility of delivering produce to corner stores due to long travel times. Choosing a central location for pickup by corner store owners, such as a farmer's market, could address this. Farmers liked app features such as product info pages and alerts for deals to support market expansion to corner stores. Social networking opportunities within the app can help foster sustainable relationships among local farmers and corner store owners. Conclusions A stronger distribution network is needed to facilitate increased access to fresh produce in low-income urban settings and strengthen connections between local farmers, corner stores, and consumers. Mobile technology offers a promising approach to improve food distribution between local farmers and corner stores and should be further explored. Funding Sources NHLBI, NIH, award number R34HL145368.

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Strengthening public financial management in the health sector: a qualitative case study from South Africa

BMJ Global Health ◽

10.1136/bmjgh-2021-006911 ◽

2021 ◽

Vol 6 (11) ◽

pp. e006911

Author(s):

Jodi Wishnia ◽

Jane Goudge

Keyword(s):

South Africa ◽

Service Delivery ◽

Low Income ◽

Financial Management ◽

Boundary Crossing ◽

Multidisciplinary Teams ◽

Health Coverage ◽

Structured Interviews ◽

Public Financial Management

IntroductionEffective public financial management (PFM) ensures public health funds are used to deliver services in the best way possible. Given the global call for universal health coverage, and concerns about the management of public funds in many low-income and middle-income countries, PFM has become an important area of research. South Africa has a robust PFM framework, that is generally adhered to, and yet financial outcomes have remained poor. In this paper, we describe how a South African provincial department of health tried to strengthen its PFM processes by deploying finance managers into service delivery units, involving service delivery managers in the monthly finance meeting, using a weekly committee to review expenditure requests and starting a weekly managers’ ‘touch-base’ meeting. We assess whether these strategies strengthened collaboration and trust and how this impacted on PFM.MethodThis research used a case study design with ethnographic methods. Semi-structured interviews (n=30) were conducted with participant observations. Thematic analysis was used to identify emergent themes and collaborative public management theory was then used to frame the findings. The authors used reflexive methods, and member checking was conducted.ResultsThe deployment of staff and touch-base meeting illustrated the potential of multidisciplinary teams when members share power, and the importance of impartial leadership when trying to achieve consensus on how to prioritise resource use. However, the service delivery and finance managers did not manage to collaborate in the monthly finance meeting to develop realistic budgets, or to reprioritise expenditure when required. The resulting mistrust threatened to derail the other strategies, highlighting how critical trust is for collaboration.ConclusionEffective PFM requires authentic collaboration between service delivery and finance managers; formal processes alone will not achieve this. We recommend more opportunities for ‘boundary crossing’, embedding finance managers in service delivery units and impartial effective leadership.

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Disparities in the availability of fruits and vegetables between racially segregated urban neighbourhoods

Public Health Nutrition ◽

10.1017/s1368980007000079 ◽

2007 ◽

Vol 10 (12) ◽

pp. 1481-1489 ◽

Cited By ~ 177

Author(s):

Kimberly Morland ◽

Susan Filomena

Keyword(s):

Predominantly White ◽

Census Tract ◽

Fruits And Vegetables ◽

Fresh Produce ◽

Grocery Stores ◽

Fruit And Vegetable ◽

Predominantly Black ◽

Food Stores ◽

Urban Neighbourhoods ◽

Fresh Vegetables

AbstractObjectivePublic health professionals continue to see the benefits of fruit and vegetable consumption on population health. While studies that evaluate the availability of produce are sparse in the medical literature, disparities in availability may explain the disproportional intake of produce for some people. Therefore, the purpose of this study was to evaluate the availability and variety of produce located in two racially and economically diverse urban neighbourhoods.DesignA cross-sectional study was conducted in which 50% of the supermarkets, small grocery stores, delicatessens, and fruit and vegetable markets located in specific neighbourhoods were randomly sampled and surveyed between September 2004 and July 2005. Food stores were evaluated for the availability of 20 types of fresh fruits and 19 types of fresh vegetables, as well as their varieties and whether they were canned, frozen or previously prepared. 2000 US Census information was used to determine characteristics of the geo-coded census tracts where the food stores were located.SettingBrooklyn, New York.ResultsA supermarket was located in approximately every third census tract in predominantly white areas (prevalence = 0.33) and every fourth census tract in racially mixed areas (prevalence = 0.27). There were no supermarkets located in the predominantly black areas. With the exception of bananas, potatoes, okra and yucca, a lower proportion of predominantly black area stores carried fresh produce, while supermarkets carried the largest variety of produce types. Canned and frozen fruits and vegetables were found in the majority of stores, whereas prepared and organic produce was limited to predominantly white area stores.ConclusionsThese data demonstrate that the availability and variety of fresh produce is associated with neighbourhood racial composition and may be a factor contributing to differences in intake among residents.

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Improving Food System Connectivity: Using Mobile Technology to Leverage Community Partnerships and Strengthen Local Food Systems

Current Developments in Nutrition ◽

10.1093/cdn/nzab043_021 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 569-569

Author(s):

Dahiany Zayas Toro ◽

Kelley Koeppen ◽

Emma Lewis ◽

Lisa Poirier ◽

Nina Martin ◽

...

Keyword(s):

Low Income ◽

Food Environment ◽

Food System ◽

Local Food ◽

Fresh Produce ◽

Community Partnerships ◽

Food Distribution ◽

Food Sources ◽

Corner Store ◽

Corner Stores

Abstract Objectives In low-income areas of Baltimore, corner stores are common food sources yet often lack fresh produce. Corner stores are uniquely positioned in the urban food system and offer an opportunity to intervene on the supply chain. However, there is a critical gap in our understanding of the local food distribution network and the best strategies for provisioning corner stores with produce. We sought to inform the development of the Baltimore Urban food Distribution (BUD) mobile application (app), which moves fresh produce from local suppliers to corner stores. We sought to: (1) identify existing networks of local food distribution; (2) explore barriers to increasing fresh produce access within the local food system; and (3) evaluate the potential for sustainability of the BUD app. Methods Secondary data analysis of in-depth interviews (n = 17) conducted in 2016 among local food environment experts, corner store owners, distributors, and wholesalers was completed with the purpose of understanding existing networks of local food distribution, and barriers to increasing food access among stakeholders in the Baltimore food environment. Primary data collection was conducted in 2020–2021 with local stakeholders (n = 10) to confirm and expand upon these findings. Results Existing community distributor partnerships with corner stores and producers contribute to local food networks. Community food distributors with an established connection to wholesalers and urban farmers offer more direct access to fresh produce, but delivery is costly for corner stores. The BUD app could facilitate the arrangement of collective delivery services between distributors, urban farmers and corner stores. Potential barriers include a lack of demand for produce from consumers and a need for community engagement to be incorporated into the app. Conclusions Our findings suggest that enhancing community partnerships is a viable method for distributing fresh foods to local corner stores in Baltimore. Further research is needed to identify ways to increase consumer demand for these foods at the corner store level, and to strengthen the local food distribution system in Baltimore. Funding Sources NHLBI, NIH, award number R34HL145368.

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Youth Willingness to Purchase Whole Grain Snack Packs from New York City Corner Stores Participating in a Healthy Retail Program

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16183233 ◽

2019 ◽

Vol 16 (18) ◽

pp. 3233

Author(s):

Tashara M. Leak ◽

Felicia Setiono ◽

Navika Gangrade ◽

Erika Mudrak

Keyword(s):

New York ◽

New York City ◽

Low Income ◽

York City ◽

Fruits And Vegetables ◽

Whole Grain ◽

Corner Stores ◽

Willingness To Purchase ◽

The City ◽

Healthy Retail

Corners stores in low-income communities are a promising setting to intervene in youth whole grain intake. One strategy that may encourage whole grain intake is if corner stores were to pair and sell whole grain snacks in combination with either a liked fruit or vegetable and an optional condiment (i.e., a whole grain snack pack). This study examined youth in terms of their (1) liking of fruits, vegetables, and whole grain snacks; (2) perceptions about which fruits and vegetables pair best with whole grain snacks; and (3) willingness to pay for a whole grain snack pack. One-time intercept surveys were conducted with 10–18-year-olds (n = 402) who visited a New York City (NYC) corner store (n = 34) participating in the City Harvest Healthy Retail Program. On average, youth were willing to spend $2.38 (SD $4.32) on a whole grain snack pack. Higher overall liking scores for vegetables and whole grain snacks were associated with willingness to spend 24.4% (95% confidence interval (CI): 11.5–38.7%) and 21.6% (95%CI: 5.2–40.6%) more on whole grain snack packs, respectively. In conclusion, youth are receptive to purchasing whole grain snack packs from NYC corner stores participating in a healthy retail program.

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