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

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.

scholarly journals Perceptions of nutrition education classes offered in conjunction with a community-supported agriculture intervention among low-income families

2020 ◽  
pp. 1-9
Author(s):  
Isabel Lu ◽  
Karla L Hanson ◽  
Stephanie B Jilcott Pitts ◽  
Jane Kolodinsky ◽  
Alice S Ammerman ◽  
...  
Keyword(s):  
New York ◽  
Nutrition Education ◽  
Low Income ◽  
Social Engagement ◽  
A Priori ◽  
Nutrition Knowledge ◽  
Food Preservation ◽  
Community Supported Agriculture ◽  
Cost Offset ◽  
Low Income Families

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.

scholarly journals Offsetting the cost of community-supported agriculture (CSA) for low-income families: perceptions and experiences of CSA farmers and members

2021 ◽  
pp. 1-11
Author(s):  
Stephanie B. Jilcott Pitts ◽  
Leah Connor Volpe ◽  
Marilyn Sitaker ◽  
Emily H. Belarmino ◽  
Amari Sealey ◽  
...  
Keyword(s):  
Low Income ◽  
Community Supported Agriculture ◽  
Future Research ◽  
Major Theme ◽  
Healthy Foods ◽  
Community Members ◽  
Cost Offset ◽  
Low Income Families ◽  
The Cost ◽  
Improve Access

Abstract Community-supported agriculture (CSA) is an alternative food marketing model in which community members subscribe to receive regular shares of a farm's harvest. Although CSA has the potential to improve access to fresh produce, certain features of CSA membership may prohibit low-income families from participating. A ‘cost-offset’ CSA (CO-CSA) model provides low-income families with purchasing support with the goal of making CSA more affordable. As a first step toward understanding the potential of CO-CSA to improve access to healthy foods among low-income households, we interviewed 24 CSA farmers and 20 full-pay CSA members about their experiences and perceptions of the cost-offset model and specific mechanisms for offsetting the cost of CSA. Audio recordings were transcribed verbatim and coded using a thematic approach. Ensuring that healthy food was accessible to everyone, regardless of income level, was a major theme expressed by both farmers and members. In general, CSA farmers and CSA members favored member donations over other mechanisms for funding the CO-CSA. The potential time burden that could affect CSA farmers when administering a cost-offset was a commonly-mentioned barrier. Future research should investigate various CO-CSA operational models in order to determine which models are most economically viable and sustainable.

scholarly journals Spatial Considerations for Implementing Two Direct-to-Consumer Food Models in Two States

2019 ◽  
Vol 11 (7) ◽  
pp. 2081 ◽  
Author(s):  
Marilyn Sitaker ◽  
Jared McGuirt ◽  
Weiwei Wang ◽  
Jane Kolodinsky ◽  
Rebecca Seguin
Keyword(s):  
Low Income ◽  
Public Transportation ◽  
Farmers Markets ◽  
Community Supported Agriculture ◽  
Farmers Market ◽  
Customer Base ◽  
Direct To Consumer ◽  
Cost Offset ◽  
Block Level ◽  
Low Income Families

To open new markets, some farmers have adapted direct-to-consumer (DTC) models, such as Community Supported Agriculture (CSA), to reach new settings or audiences. We compared sociodemographic and geospatial contexts to farmers’ experience with one of two DTC innovations: a cost-offset CSA for low-income families and food boxes distributed through rural convenience stores. We geocoded addresses of thirteen farms and DTC pickup sites in two U.S. states (Vermont and Washington) and calculated road network distances from pickup to supermarket, farmers’ market, and farm. We compiled Census block-level demographic and transportation data, and compared it to postseason interviews to explore the effect of suitability of the pickup location; proximity to food retail; and potential farmer burden. Most pickup areas were heavily car-dependent, with low walkability and few public transportation options. Conventional sources of fresh produce were within six miles of most pickups, but farmers markets were further away. Despite modest profitability, both models were deemed worth pursuing, as they expanded farmers’ customer base. Farmers implementing the store-distributed food box were sensitive to market trends and customer needs in choosing pickup location. Farmers seemed more concerned with marketing in convenience store settings, and finding efficient ways to conduct recordkeeping than with delivery distances.

scholarly journals 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

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.

scholarly journals The perceived influence of cost-offset community-supported agriculture on food access among low-income families

2018 ◽  
Vol 21 (15) ◽  
pp. 2866-2874 ◽  
Author(s):  
Michelle J White ◽  
Stephanie B Jilcott Pitts ◽  
Jared T McGuirt ◽  
Karla L Hanson ◽  
Emily H Morgan ◽  
...  
Keyword(s):  
New York ◽  
Low Income ◽  
Food Access ◽  
Fruits And Vegetables ◽  
Community Supported Agriculture ◽  
Future Research ◽  
Diet Change ◽  
Cost Offset ◽  
Low Income Families ◽  
Meal Planning

AbstractObjectiveTo examine perspectives on food access among low-income families participating in a cost-offset community-supported agriculture (CO-CSA) programme.DesignFarm Fresh Foods for Healthy Kids (F3HK) is a multicentre randomized intervention trial assessing the effect of CO-CSA on dietary intake and quality among children from low-income families. Focus groups were conducted at the end of the first CO-CSA season. Participants were interviewed about programme experiences, framed by five dimensions of food access: availability, accessibility, affordability, acceptability and accommodation. Transcribed data were coded on these dimensions plus emergent themes.SettingNine communities in the US states of New York, North Carolina, Washington and Vermont.SubjectsFifty-three F3HK adults with children.ResultsCSA models were structured by partner farms. Produce quantity was abundant; however, availability was enhanced for participants who were able to select their own produce items. Flexible CSA pick-up times and locations made produce pick-up more accessible. Despite being affordable to most, payment timing was a barrier for some. Unfamiliar foods and quick spoilage hindered acceptability through challenging meal planning, despite accommodations that included preparation advice.ConclusionsAlthough CO-CSA may facilitate increased access to fruits and vegetables for low-income families, perceptions of positive diet change may be limited by the ability to incorporate share pick-up into regular travel patterns and meal planning. Food waste concerns may be particularly acute for families with constrained resources. Future research should examine whether CO-CSA with flexible logistics and produce self-selection are sustainable for low-income families and CSA farms.

scholarly journals Mobile Phone Apps for Low-Income Participants in a Public Health Nutrition Program for Women, Infants, and Children (WIC): Review and Analysis of Features (Preprint)

2018 ◽  
Author(s):  
Summer J Weber ◽  
Daniela Dawson ◽  
Haley Greene ◽  
Pamela C Hull
Keyword(s):  
Mobile Phone ◽  
Nutrition Education ◽  
Low Income ◽  
The United States ◽  
Infants And Children ◽  
Nutrition Program ◽  
User Reviews ◽  
User Input ◽  
Low Income Families ◽  
Electronic Benefits Transfer

BACKGROUND Since 1972, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has been proven to improve the health of participating low-income women and children in the United States. Despite positive nutritional outcomes associated with WIC, the program needs updated tools to help future generations. Improving technology in federal nutrition programs is crucial for keeping nutrition resources accessible and easy for low-income families to use. OBJECTIVE This review aimed to analyze the main features of publicly available mobile phone apps for WIC participants. METHODS Keyword searches were performed in the app stores for the 2 most commonly used mobile phone operating systems between December 2017 and June 2018. Apps were included if they were relevant to WIC and excluded if the target users were not WIC participants. App features were reviewed and classified according to type and function. User reviews from the app stores were examined, including ratings and categorization of user review comments. RESULTS A total of 17 apps met selection criteria. Most apps (n=12) contained features that required verified access available only to WIC participants. Apps features were classified into categories: (1) shopping management (eg, finding and redeeming food benefits), (2) clinic appointment management (eg, appointment reminders and scheduling), (3) informational resources (eg, recipes, general food list, tips about how to use WIC, links to other resources), (4) WIC-required nutrition education modules, and (5) other user input. Positive user reviews indicated that apps with shopping management features were very useful. CONCLUSIONS WIC apps are becoming increasingly prevalent, especially in states that have implemented electronic benefits transfer for WIC. This review offers new contributions to the literature and practice, as practitioners, software developers, and health researchers seek to improve and expand technology in the program.

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