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

2018 ◽  
Vol 21 (13) ◽  
pp. 2497-2506 ◽  
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.

scholarly journals Fruit and Vegetable Prescriptions for Pediatric Patients Living in Flint, Michigan: A Cross-Sectional Study of Food Security and Dietary Patterns at Baseline

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1423 ◽  
Author(s):  
Amy Saxe-Custack ◽  
Jenny LaChance ◽  
Mona Hanna-Attisha ◽  
Tiffany Ceja
Keyword(s):  
Food Security ◽  
Low Income ◽  
Dietary Patterns ◽  
Fruits And Vegetables ◽  
Vegetable Consumption ◽  
Daily Intake ◽  
Fruit And Vegetable ◽  
Dietary Recommendations ◽  
Cross Sectional ◽  
Health Maintenance

Though fruit and vegetable consumption is essential for disease prevention and health maintenance, intake among children fails to meet dietary recommendations. Limited access to and the affordability of fresh produce, particularly among low-income youth, are barriers to adequate intake. To address these challenges, researchers and pediatricians in Flint, Michigan, expanded a successful fruit and vegetable prescription program that provides one $15 prescription for fresh fruits and vegetables to every child at every office visit. Vendors include the downtown farmers’ market and a local mobile market. This study describes baseline characteristics, dietary patterns, food access, and food security among 261 caregiver–child dyads enrolled August 2018–March 2019. The child-reported mean daily intake of vegetables (0.72 cups ± 0.77), dairy products (1.33 cups ± 1.22), and whole grains (0.51 ounces ± 0.49) were well below recommendations. Furthermore, 53% of children and 49% of caregivers who completed the food security module indicated low or very low food security. However, there were no statistically significant differences in the child consumption of fruits and vegetables between households that reported high versus low food security (p > 0.05). Results validate and raise deep concerns about poor dietary patterns and food insecurity issues facing Flint children, many of whom continue to battle with an ongoing drinking water crisis. Additional poverty-mitigating efforts, such as fruit and vegetable prescription programs, are necessary to address these gaps.

scholarly journals Influence of a Pediatric Fruit and Vegetable Prescription Program on Child Dietary Patterns and Food Security

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2619
Author(s):  
Amy Saxe-Custack ◽  
Jenny LaChance ◽  
Jennifer Jess ◽  
Mona Hanna-Attisha
Keyword(s):  
Food Security ◽  
Low Income ◽  
Dietary Patterns ◽  
Fruits And Vegetables ◽  
Household Food Security ◽  
Office Visits ◽  
Fruit And Vegetable ◽  
Pediatric Clinic ◽  
Central Hypothesis ◽  
Fresh Foods

Limited access to fresh foods is a barrier to adequate consumption of fruits and vegetables among youth, particularly in low-income communities. The current study sought to examine preliminary effectiveness of a fruit and vegetable prescription program (FVPP), which provided one USD 15 prescription to pediatric patients during office visits. The central hypothesis was that exposure to this FVPP is associated with improvements in dietary patterns and food security. This non-controlled longitudinal intervention trial included a sample of caregiver–child dyads at one urban pediatric clinic who were exposed to the FVPP for 1 year. Patients received one USD 15 prescription for fresh produce during appointments. A consecutive sample of caregivers whose children were 8–18 years of age were invited to participate in the study. Dyads separately completed surveys that evaluated food security and dietary behaviors prior to receipt of their first prescription and again at 12 months. A total of 122 dyads completed surveys at baseline and 12-month follow-up. Approximately half of youth were female (52%), and most were African American (63%). Mean caregiver-reported household food security improved from baseline to 12 months (p < 0.001), as did mean child-reported food security (p = 0.01). Additionally, child-reported intake of vegetables (p = 0.001), whole grains (p = 0.001), fiber (p = 0.008), and dairy (p < 0.001) improved after 12 months of exposure to the FVPP. This study provides evidence that pediatric FVPPs may positively influence food security and the dietary patterns of children.

A Pilot Fruit and Vegetable Prescription (FVRx) Program Improves Local Fruit and Vegetable Consumption, Nutrition Knowledge, and Food Purchasing Practices

2021 ◽  
pp. 152483992110181
Author(s):  
Nicholas Slagel ◽  
Taylor Newman ◽  
Laurel Sanville ◽  
Jennifer Jo Thompson ◽  
Jackie Dallas ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Low Income ◽  
Fruits And Vegetables ◽  
Vegetable Consumption ◽  
Safety Net ◽  
Nutrition Knowledge ◽  
Fruit And Vegetable Consumption ◽  
Fruit And Vegetable ◽  
Farmers Market ◽  
Food Purchasing

Fruit and Vegetable Prescription (FVRx) programs rely on diverse community and clinic partnerships to improve food security and fruit and vegetable consumption among medically underserved patient populations. Despite the growth in these programs, little is known about the feasibility or effectiveness of the unique partnerships developed to implement FVRx programs conducted in both community and free safety-net clinic settings. A 6-month nonrandomized controlled trial of an FVRx program was pilot tested with 54 Supplemental Nutrition Assistance Program (SNAP)–eligible adults with diet-related chronic conditions. The intervention combined monthly produce prescriptions for local produce at a farmers market, SNAP-Ed direct nutrition education, and health screenings for low-income adults. Process and outcome evaluations were conducted with respective samples using administrative program data (recruitment, retention, and prescription redemption) and self-administered pre- and postintervention surveys with validated measures on dietary intake, nutrition knowledge and behavior, and food purchasing practices. Descriptive statistical analyses were conducted. The FVRx program retained 77.3% of participants who spent nearly 90% of their prescription dollars. After the intervention, the FVRx group reported significantly increased total intake of fruits and vegetables, knowledge of fresh fruit and vegetable preparation, purchase of fresh fruits and vegetables from a farmers market, and significantly altered food purchasing practices compared with the control group. Community-based nutrition education organizations enhance the feasibility and effectiveness of community and clinic-based FVRx programs for improving low-income adults’ ability to enhance food and nutrition-related behaviors.

scholarly journals “My coupons are like gold”: experiences and perceived outcomes of low-income adults participating in the British Columbia Farmers’ Market Nutrition Coupon Program

2021 ◽  
pp. 1-30
Author(s):  
Stéphanie Caron-Roy ◽  
Sayeeda Amber Sayed ◽  
Katrina Milaney ◽  
Bonnie Lashewicz ◽  
Sharlette Dunn ◽  
...  
Keyword(s):  
British Columbia ◽  
Rural Communities ◽  
Low Income ◽  
Well Being ◽  
Qualitative Description ◽  
Farmers Markets ◽  
Social Connections ◽  
Structured Interviews ◽  
Program Outcomes ◽  
Farmers Market

ABSTRACT Objective: The British Columbia Farmers’ Market Nutrition Coupon Program (FMNCP) provides low-income households with coupons valued at $21/week for 16 weeks to purchase healthy foods in farmers’ markets. Our objective was to explore FMNCP participants’ experiences of accessing nutritious foods, and perceived program outcomes. Design: This study used qualitative description methodology. Semi-structured interviews were conducted with FMNCP participants during the 2019 farmers’ market season. Directed content analysis was used to analyse the data whereby the five domains of Freedman et al’s framework of nutritious food access provided the basis for an initial coding scheme. Data that did not fit within the framework’s domains were coded inductively. Setting: One urban and two rural communities in British Columbia, Canada. Participants: 28 adults who were participating in the FMNCP. Results: Three themes emerged: Autonomy and Dignity; Social Connections and Community Building; and Environmental and Programmatic Constraints. Firstly, the program promoted a sense of autonomy and dignity through financial support, increased access to high-quality produce, food-related education and skill development, and mitigating stigma and shame. Secondly, shopping in farmers’ markets increased social connections and fostered a sense of community. Finally, participants experienced limited food variety in rural farmers’ markets, lack of transportation, and challenges with redeeming coupons. Conclusions: Participation in the FMNCP facilitated access to nutritious foods and enhanced participants’ diet quality, well-being and health. Strategies such as increasing the amount and duration of subsidies, and expanding programs may help improve participants’ experiences and outcomes of farmers’ market food subsidy programs.

scholarly journals Healthy eating: a matter of prioritisation by households or policymakers?

2021 ◽  
pp. 1-3
Author(s):  
Joreintje Dingena Mackenbach
Keyword(s):  
Decision Making ◽  
Healthy Eating ◽  
Low Income ◽  
Fruits And Vegetables ◽  
Food System ◽  
Vegetable Consumption ◽  
Fruit And Vegetable Consumption ◽  
Healthy Foods ◽  
Fruit And Vegetable ◽  
Decision Making Processes

Abstract I reflect upon the potential reasons why American low-income households do not spend an optimal proportion of their food budgets on fruits and vegetables, even though this would allow them to meet the recommended levels of fruit and vegetable consumption. Other priorities than health, automatic decision-making processes and access to healthy foods play a role, but solutions for the persistent socio-economic inequalities in diet should be sought in the wider food system which promotes cheap, mass-produced foods. I argue that, ultimately, healthy eating is not a matter of prioritisation by individual households but by policymakers.

The Role of Women in Improving Access to Food at the Household Level in Mandeni Local Municipality, KwaZulu-Natal, South Africa

2021 ◽  
Vol 10 (2) ◽  
pp. 135-155
Author(s):  
Nondumiso Thabisile Mpanza ◽  
Mfaniseni Wiseman Mbatha
Keyword(s):  
Food Security ◽  
Low Income ◽  
Home Gardens ◽  
Household Food Security ◽  
Exploratory Research ◽  
Structured Interviews ◽  
Household Level ◽  
Role Of Women ◽  
Access To Food

This paper censoriously assesses the role of women in improving access to food at the household level. The role of women is essential in the production of food as caretakers of household food security. However, their role is not well recognised, more especially in policymaking and resource allocation. This study was conducted through a qualitative approach with an exploratory research design. The participants were sampled with convenience sampling and interviewed with semi-structured interviews. Content analysis was employed as a tool for data analysis. The study adopted feminisation of poverty as a primary theory of this paper. Certain aspects of the study reveal that women have been struggling to access food from the diversity of retail vents that are obtainable in town because of low income and limitations of transport service. This is a constraint to women who depend on the off-farm sources of income because their household’s livelihood depends on purchasing food from retail vents. Those who rely on home gardens were experiencing low productivity and the unsustainability of their gardens. This has been caused by water scarcity and climate change. Therefore, women must be provided with training that seeks to develop their skills on how to make effective use of home gardens so that food security can be ensured.

scholarly journals Mother-Related Determinants of Children At-Home Fruit and Vegetable Dietary Patterns in a Polish National Sample

2019 ◽  
Vol 11 (12) ◽  
pp. 3398 ◽  
Author(s):  
Barbara Groele ◽  
Dominika Głąbska ◽  
Krystyna Gutkowska ◽  
Dominika Guzek
Keyword(s):  
Marital Status ◽  
Low Income ◽  
Dietary Patterns ◽  
Fruits And Vegetables ◽  
Vegetable Intake ◽  
National Sample ◽  
Fruit And Vegetable Intake ◽  
Fruit And Vegetable ◽  
Level Of Education ◽  
At Home

Fruit and vegetable intake is indicated among the features of sustainable diets, while children’s intake is strongly associated with the intake of their parents, as well as the availability of food products and their accessibility at home. The aim of the study was to analyze the mother-related determinants of children at-home fruit and vegetable dietary patterns in a Polish national sample of children aged 3–10 years. The random quota sampling (with quotas for age, education, and place of residence) was conducted to recruit the national representative sample of Polish mothers of children aged 3–10 years (n = 1200) who were interviewed using a Computer-Assisted Telephone Interviewing (CATI) method. They were asked about their children’s at-home fruit and vegetable dietary patterns, which were later compared in sub-groups that were stratified for age, educational background, marital status, place of residence, occupational status, and total net income in households. The indicated features, but not marital status, were indicated as determinants of children at-home fruit and vegetable dietary patterns. Children of younger mothers more often than others consumed fruits, whereas those of older mothers consumed vegetables. Children of mothers who had a lower level of education more commonly than others consumed fruits alone as a dish, and they had a higher preference for them, while those of mothers who had a higher level of education had a higher consumption of vegetables than others, although they had a medium preference for them. Children of mothers from villages had a lower consumption of vegetables and fruits than others, although they had a higher preference for fruits. Children of mothers with no professional job had a lower consumption of vegetables than others and more often consumed them processed, although they had a higher preference for fruits and vegetables. Children of mothers with low income had a lower consumption of vegetables than others and more often consumed fruits in a dish with other products, although they had a higher preference for fruits and vegetables. To summarize, an indication of a high preference for fruits and vegetables by mothers is not accompanied by the higher consumption and recommended dietary patterns for fruit and vegetable intake by their children. In particular, the sub-samples of mothers who had a low level of education, were from villages, did not have a professional job, and had low income may either overestimate the fruit and vegetable preference of their children or do not offer them sufficient amount of fruits and vegetables, although they indicate a higher preference. In order to encourage more sustainable diet following, in terms of the fruit and vegetable intake, it is essential to introduce actions toward the properly planned nutritional education for the indicated target groups.

scholarly journals Child Consumption of Whole Fruit and Fruit Juice Following Six Months of Exposure to a Pediatric Fruit and Vegetable Prescription Program

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 25 ◽  
Author(s):  
Amy Saxe-Custack ◽  
Jenny LaChance ◽  
Mona Hanna-Attisha
Keyword(s):  
Low Income ◽  
Fruit Juice ◽  
Sugar Content ◽  
Daily Intake ◽  
Office Visit ◽  
Fruit And Vegetable ◽  
Daily Consumption ◽  
Minority Children ◽  
Farmers Market ◽  
Low Income Children

Public health recommendations suggest limiting child consumption of fruit juice in favor of whole fruit due to juice’s high sugar content, lack of fruit fiber, and potential for excess intake. However, replacing juice with whole fruit may be particularly challenging for low-income and minority children, who report the highest intake of 100% juice. To address access and affordability challenges among low-income children, researchers partnered with pediatricians in an urban food desert community, to introduce a fruit and vegetable prescription program (FVPP) that provided a $15 prescription for fresh produce to every child during each office visit. Participating vendors included a farmers’ market and local mobile market. This study assessed changes in daily consumption of total fruit and whole fruit among 108 pediatric patients following six months of exposure to the FVPP. Child-reported mean daily intake of whole fruit increased significantly from the baseline to the 6-month follow-up (p = 0.03): 44% of children reported an increased intake of at least ¼ cup per day, and 30% reported an increased intake of at least ½ cup per day. Changes in total fruit intake (including fruit juice) were not significant. Results suggest a pediatric FVPP may have meaningful impacts on children’s dietary behaviors, particularly with regard to the intake of whole fruits.

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

2020 ◽  
Vol 23 (9) ◽  
pp. 1638-1646 ◽  
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.

Women, Infants and Children (WIC) Program redemptions at California farmers’ markets: making the program work for farmers and participants

2017 ◽  
Vol 33 (4) ◽  
pp. 334-346 ◽  
Author(s):  
Tina L. Saitone ◽  
Patrick W. McLaughlin
Keyword(s):  
Fruits And Vegetables ◽  
Infants And Children ◽  
Farmers Markets ◽  
Fruit And Vegetable ◽  
Wic Program ◽  
Client Participation ◽  
Farmers Market ◽  
Barriers To Use ◽  
Locally Grown

AbstractMany states including California allow fruit and vegetable checks (FVCs) issued by the Women, Infants and Children (WIC) Program to be redeemed at farmers’ markets. Despite the potential of the FVC program to increase the revenue of participating farmers and to provide fresh, locally grown fruits and vegetables to WIC participants, analysis of data for California shows that redemptions of FVCs at farmers’ markets have to date been miniscule. We study the barriers to use of FVCs at farmers’ markets and consider strategies for expanding both farmer and WIC client participation in the farmers’ market program. Our methodology involved design, implementation and analysis of surveys of both farmers’ market managers and farmer vendors who participate in the program and analysis of the behavior of WIC participants through California WIC program redemption data. One major factor limiting redemptions in California is that relatively few farmers’ markets currently accept FVCs and both market managers and farmers report that the authorization process is onerous. WIC participants who shopped at authorized markets more fully utilized the fixed-dollar value of their voucher, compared with participants who shopped at other authorized WIC vendors. Nevertheless, participants who visited a farmers’ market are unlikely to return. The study concludes with suggested pathways to increase WIC participant utilization of farmers’ markets.

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