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

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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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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The Baltimore Urban food Distribution (BUD) App: Study Protocol for A Food Systems Intervention

10.21203/rs.3.rs-271068/v1 ◽

2021 ◽

Author(s):

Joel Gittelsohn ◽

Emma C. Lewis ◽

Nina M. Martin ◽

Siyao Zhu ◽

Lisa Poirier ◽

...

Keyword(s):

Low Income ◽

Distribution System ◽

Food Systems ◽

Food System ◽

The United States ◽

Food Distribution ◽

High Sodium ◽

Extensive Evaluation ◽

Corner Stores ◽

Systems Intervention

Abstract Background: Low-income urban communities in the United States commonly lack ready access to healthy foods. This is due in part to a food distribution system that favors the provision of high-fat, high-sugar, high-sodium processed foods to small retail food stores, and impedes their healthier alternatives, such as fresh produce. Methods: The Baltimore Urban food Distribution (BUD) study is a multi-level, multi-component systems intervention that aims to improve healthy food access in low income neighborhoods of Baltimore, Maryland. The primary intervention is the BUD application (app), which uses the power of collective purchasing and delivery to affordably move foods from local producers and wholesalers to the city’s many corner stores. We will implement the app in a sample of 38 corner stores, randomized to intervention and comparison. Extensive evaluation will be conducted at each level of the intervention to assess effectiveness via process and impact measures on suppliers, corner stores, and consumers. Discussion: BUD represents one of the first attempts to implement an intervention that engages multiple levels of a local food system. The design of the intervention and the evaluation plan of the BUD project are documented here.Trial registration #: #### (register since not yet recruiting)

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Multi-Level, Multi-Perspective Formative Research to Develop a Mobile Application to Improve Healthy Food Access in Low-Income Urban Settings

Current Developments in Nutrition ◽

10.1093/cdn/nzab043_011 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 559-559

Author(s):

Emma Lewis ◽

Lisa Poirier ◽

Kelley Koeppen ◽

Dahiany Zayas-Toro ◽

Antonio Trujillo ◽

...

Keyword(s):

Low Income ◽

Distribution System ◽

Mobile Application ◽

Food System ◽

Formative Research ◽

Food Distribution ◽

Future Research ◽

Corner Stores ◽

Multi Level ◽

Depth Interviews

Abstract Objectives Small urban corner stores typically have low access to healthy foods to stock due to an inadequate food distribution system. Strategies to increase access to healthier foods are needed in low-income urban settings where consumers depend on these stores to meet their main food shopping needs. We conducted multi-level, multi-perspective formative research and user-centered design to inform the development of the Baltimore Urban food Distribution (BUD) mobile application (app), which aims to provide a sustainable, cost-effective, and culturally-acceptable strategy for purchasing and delivering fresh produce to corner stores through local suppliers within the Baltimore City food system. Methods In-depth interviews (N = 36) were conducted across multiple stages of formative research with increasing refinement of the BUD app design. Stakeholders included producers (n = 5), wholesalers (n = 12), representatives of city agencies (n = 4), and corner store owners (n = 15). Future research will include community members. Data were collected regarding participants’ role within the local food system and feedback was elicited during a researcher-led demonstration of a prototype app. Results Stakeholders at multiple levels of the food system found the BUD app to have high feasibility (acceptability, operability, perceived sustainability). In-depth interviews revealed that suppliers (producers, wholesalers) were willing to use the app but had concerns about transportation and storage of produce. Corner store owners desired features such as in-app collaborative purchasing and low-cost delivery. City agency representatives emphasized the need to focus on promotion of local suppliers. Limitations included language barriers and payment security. Strengths included options for networking within the app. Conclusions The BUD app aims to provide a digital solution to address a critical gap in the food distribution system in a low-income urban setting. Multi-level, multi-perspective formative research that is user-centered is a crucial first step to developing a feasible app that appropriately addresses the needs of the community. Future research demonstrating the BUD prototype to stakeholders will enable further development of the app for use in Baltimore and other cities nationwide. Funding Sources NHLBI, NIH, award number R34HL145368.

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Access to food source and food source use are associated with healthy and unhealthy food-purchasing behaviours among low-income African-American adults in Baltimore City

Public Health Nutrition ◽

10.1017/s1368980011000498 ◽

2011 ◽

Vol 14 (9) ◽

pp. 1632-1639 ◽

Cited By ~ 73

Author(s):

Heather D'Angelo ◽

Sonali Suratkar ◽

Hee-Jung Song ◽

Elizabeth Stauffer ◽

Joel Gittelsohn

Keyword(s):

Low Income ◽

Food Source ◽

Healthy Food ◽

Food Sources ◽

Baltimore City ◽

Food Purchasing ◽

Corner Store ◽

Corner Stores ◽

Source Use ◽

Purchasing Patterns

AbstractObjectiveAlthough previous research has shown limited availability of healthy food in low-income urban neighbourhoods, the association between food source use and food-purchasing patterns has not yet been examined. We explored food-purchasing patterns in the context of food source use and food source access factors in low-income areas of Baltimore City.DesignCross-sectional survey.SettingPredominantly low-income neighbourhoods in East and West Baltimore City.SubjectsA total of 175 low-income African-American adult residents.ResultsSupermarkets and corner stores were the most frequently used food sources. Walking was the main form of transportation used by 57 % of all respondents, 97 % of corner-store shoppers and 49 % of supermarket shoppers. Multiple linear regression models adjusting for demographic factors, type of food source used and transportation type found that corner-store use was associated with obtaining more unhealthy food (P = 0·005), whereas driving to the food source was associated with obtaining more healthy food (P = 0·012).ConclusionsThe large number of corner stores compared with supermarkets in low-income neighbourhoods makes them an easily accessible and frequently used food source for many people. Interventions to increase the availability and promotion of healthy food in highly accessed corner stores in low-income neighbourhoods are needed. Increased access to transportation may also lead to the use of food sources beyond the corner store, and to increased healthy food purchasing.

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Shaping Physical, Economic, and Policy Components of the Food Environment to Create Sustainable Healthy Diets

Food and Nutrition Bulletin ◽

10.1177/0379572120945904 ◽

2020 ◽

Vol 41 (2_suppl) ◽

pp. 74S-86S

Author(s):

Adam Drewnowski ◽

Eva C. Monterrosa ◽

Saskia de Pee ◽

Edward A. Frongillo ◽

Stefanie Vandevijvere

Keyword(s):

Low Income ◽

Food Environment ◽

Food System ◽

Well Being ◽

Food Environments ◽

Healthy Foods ◽

Equitable Access ◽

Nutrition Labels ◽

Healthy Diets ◽

Physical Spaces

Background: Sustainable healthy diets are those dietary patterns that promote all dimensions of individuals’ health and well-being; have low environmental pressure and impact; are accessible, affordable, safe, and equitable; and are culturally acceptable. The food environment, defined as the interface between the wider food system and consumer’s food acquisition and consumption, is critical for ensuring equitable access to foods that are healthy, safe, affordable, and appealing. Discussion: Current food environments are creating inequities, and sustainable healthy foods are generally more accessible for those of higher socioeconomic status. The physical, economic, and policy components of the food environment can all be acted on to promote sustainable healthy diets. Physical spaces can be modified to improve relative availability (ie, proximity) of food outlets that carry nutritious foods in low-income communities; to address economic access certain actions may improve affordability, such as fortification, preventing food loss through supply chain improvements; and commodity specific vouchers for fruits, vegetables, and legumes. Other policy actions that address accessibility to sustainable healthy foods are comprehensive marketing restrictions and easy-to-understand front-of-pack nutrition labels. While shaping food environments will require concerted action from all stakeholders, governments and private sector bear significant responsibility for ensuring equitable access to sustainable healthy diets.

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Around the Corner to Better Health: A Milwaukee Corner Store Initiative

American Journal of Health Promotion ◽

10.1177/0890117117736970 ◽

2017 ◽

Vol 32 (6) ◽

pp. 1353-1356 ◽

Cited By ~ 5

Author(s):

Staci Young ◽

Melissa DeNomie ◽

JoAnne Sabir ◽

Eric Gass ◽

Jessie Tobin

Keyword(s):

Fresh Produce ◽

Evaluation Research ◽

Community Outreach ◽

Pilot Project ◽

Food Justice ◽

Food Storage ◽

Business Practices ◽

Community Members ◽

Corner Store ◽

Corner Stores

Purpose: To discuss successes and challenges of a collaborative pilot project to increase healthy food availability in corner stores in Milwaukee, Wisconsin. The Lindsay Heights Healthy Corner Store Initiative aimed to help corner stores sell high-quality produce by increasing supply of healthy foods and funding minor store upgrades to facilitate change. Design: Evaluation research. Setting: Milwaukee, Wisconsin. Participants: Corner stores; youth and adult community members. Intervention: (1) Supporting businesses in purchasing equipment to stock fresh produce, (2) connecting stores with produce sources, and (3) community outreach and marketing. Measures: Partnership capacity, youth engagement in food justice, and community members’ usage of corner stores. Analysis: Qualitative analysis; descriptive statistics. Results: Storeowners reported more sold produce items per week and increased noticeable fresh produce upon entrance into the store. There was increased or improved store redesign, fresh produce signage, in-store cooking demonstrations, and small business development resources. Conclusion: Youth learned about new vegetables, increased kitchen skills and proper food storage, and the effects of obesity on overall health. Similar interventions must address infrastructure costs, cooperation with property owners, and local policies and regulations affecting business practices.

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Household food sources and diarrhoea incidence in poor urban communities, Accra Ghana

PLoS ONE ◽

10.1371/journal.pone.0245466 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245466

Author(s):

Reuben Tete Larbi ◽

D. Yaw Atiglo ◽

Maame B. Peterson ◽

Adriana A. E. Biney ◽

Naa Dodua Dodoo ◽

...

Keyword(s):

Urban Communities ◽

Low Income ◽

Food Environment ◽

Diarrhoeal Disease ◽

Global South ◽

Food Sources ◽

Systematic Sampling ◽

Structured Interviews ◽

Multi Stage ◽

Diarrhoeal Diseases

Diarrhoeal diseases remain a significant cause of morbidity and mortality, particularly in poor urban communities in the Global South. Studies on food access and safety have however not considered the sources of discrete food categories and their propensity to harbour and transmit diarrhoeal disease pathogens in poor urban settings. We sought to contribute to knowledge on urban food environment and enteric infections by interrogating the sources and categories of common foods and their tendency to transmit diarrhoea in low-income communities in Accra. We modelled the likelihood of diarrhoea transmission through specific food categories sourced from home or out of home after controlling for alternate transmission pathways and barriers. We used structured interviews where households that participated in the study were selected through a multi-stage systematic sampling approach. We utilized data on 506 households from 3 low-income settlements in Accra. These settlements have socio-economic characteristics mimicking typical low-income communities in the Global South. The results showed that the incidence of diarrhoea in a household is explained by type and source of food, source of drinking water, wealth and the presence of children below five years in the household. Rice-based staples which were consumed by 94.5% of respondents in the week preceding the survey had a higher likelihood of transmitting diarrhoeal diseases when consumed out of home than when eaten at home. Sources of hand-served dumpling-type foods categorized as “staple balls” had a nuanced relationship with incidence of diarrhoea. These findings reinforce the need for due diligence in addressing peculiar needs of people in vulnerable conditions of food environment in poor urban settlements in order to reap a co-benefit of reduced incidence of diarrhoea while striving to achieve the global development goal on ending hunger.

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

Public Health Nutrition ◽

10.1017/s1368980015000051 ◽

2015 ◽

Vol 18 (15) ◽

pp. 2770-2774 ◽

Cited By ~ 10

Author(s):

Kimberly A Gudzune ◽

Claire Welsh ◽

Elisa Lane ◽

Zach Chissell ◽

Elizabeth Anderson Steeves ◽

...

Keyword(s):

Low Income ◽

Fruits And Vegetables ◽

Fresh Produce ◽

Urban Setting ◽

Structured Interviews ◽

Post Evaluation ◽

Urban Neighbourhoods ◽

Urban Farm ◽

Corner Stores

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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Local food communities: exploring health-related adaptivity and self-management practices

British Food Journal ◽

10.1108/bfj-12-2020-1176 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Ilona Liliána Birtalan ◽

Ágnes Neulinger ◽

György Bárdos ◽

Adrien Rigó ◽

József Rácz ◽

...

Keyword(s):

Food Consumption ◽

Food Environment ◽

Management Practices ◽

Food System ◽

Local Food ◽

Self Management ◽

Community Supported Agriculture ◽

Research Approach ◽

Content Type ◽

Health Related

PurposeWhile many characteristics of food consumption have been examined, little attention has been given to the health potential of consuming from local food communities. Local food communities, including community supported agriculture (CSA) are food initiatives, which try to respond to the healthy food, environmental or socioeconomic challenges of the food system. As a step toward understanding local food communities, this study sets out to examine the health-related adaptivity and self-management practices of CSA participation.Design/methodology/approachThe qualitative research approach, which included semi-structured interviews (n = 35), was designed to discover the potential for being healthy: the ability to adapt and to self-manage among CSA participants. The data were analyzed using thematic analysis.FindingsThe results suggest that local food communities can influence health-related adaptivity and self-management in the following themes: awareness of product origins; enhanced food-management capability; expanding applicability and usability of the food environment; and strengthening one's food-related self-image.Practical implicationsIncreasing the presence of local food communities might be part of developing strategies to evaluate the health effects of the local food environment and to encourage consumers to take responsibility for their own health.Originality/valueThis study extends the food consumption literature to include new knowledge about how local food communities facilitate individual efforts to enhance their own potential for health as well as improving understanding of the mechanisms that underpin a healthy diet.

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The role of a food policy coalition in influencing a local food environment: an Australian case study

Public Health Nutrition ◽

10.1017/s1368980016003001 ◽

2016 ◽

Vol 20 (5) ◽

pp. 917-926 ◽

Cited By ~ 5

Author(s):

Julia McCartan ◽

Claire Palermo

Keyword(s):

Food Environment ◽

Food System ◽

Food Policy ◽

Action Theory ◽

Local Food ◽

Eastern Coast ◽

Study Approach ◽

Comparison Approach ◽

Australian Case

AbstractObjectiveTo explore how an Australian rural food policy coalition acts to influence a local food environment, focusing specifically on its composition, functions and processes as well as its food-related strategies and policy outputs.DesignA qualitative case study approach was undertaken. Three sources were used to triangulate data: eleven semi-structured in-depth interviews with coalition members, analysis of thirty-seven documents relating to the coalition and observation at one coalition meeting. Data were analysed using a thematic and constant comparison approach. Community Coalition Action Theory provided a theoretical framework from which to interpret findings.SettingTwo rural local government areas on the south-eastern coast of Victoria, Australia.SubjectsEleven members of the food policy coalition.ResultsFive themes emerged from the data analysis. The themes described the coalition’s leadership processes, membership structure, function to pool resources for food system advocacy, focus on collaborative cross-jurisdictional strategies and ability to influence policy change.ConclusionsThis Australian case study demonstrates that with strong leadership, a small-sized core membership and focus on collaborative strategies, food policy coalitions may be a mechanism to positively influence local food environments.

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