Increasing access to fresh produce by partnering urban farms with corner stores: a pilot 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.

Download Full-text

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.

Download Full-text

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.

Download Full-text

Choice architecture to promote fruit and vegetable purchases by families participating in the Special Supplemental Program for Women, Infants, and Children (WIC): randomized corner store pilot study

Public Health Nutrition ◽

10.1017/s1368980016003074 ◽

2016 ◽

Vol 20 (7) ◽

pp. 1297-1305 ◽

Cited By ~ 30

Author(s):

Anne N Thorndike ◽

Oliver-John M Bright ◽

Melissa A Dimond ◽

Ronald Fishman ◽

Douglas E Levy

Keyword(s):

Pilot Study ◽

Low Income ◽

Statistical Significance ◽

Infants And Children ◽

Choice Architecture ◽

Intervention Period ◽

Supplemental Program ◽

Corner Stores ◽

Low Income Families ◽

New Policies

AbstractObjectiveTo conduct a pilot study to determine if improving the visibility and quality of fresh produce (choice architecture) in corner stores would increase fruit/vegetable purchases by families participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).DesignSix stores were randomly assigned to choice architecture intervention or control. Store-level WIC sales data were provided by the state. Primary outcomes were WIC fruit/vegetable voucher and non-fruit/vegetable voucher sales, comparing trends from baseline (December 2012–October 2013) with the five-month intervention period (December 2013–April 2014). Secondary outcomes were differences in customer self-reported fruit/vegetable purchases between baseline and end of the intervention.SettingChelsea, MA, USA, a low-income urban community.SubjectsAdult customers (n575) completing store exit interviews.ResultsDuring baseline, WIC fruit/vegetable and non-fruit/vegetable sales decreased in both intervention and control stores by $US 16/month. During the intervention period, WIC fruit/vegetable sales increased in intervention stores by $US 40/month but decreased in control stores by $US 23/month (difference in trends: $US 63/month; 95 % CI 4, 121 $US/month;P=0·036); WIC non-fruit/vegetable sales were not different (P=0·45). Comparing baseline and intervention-period exit interview responses by customers participating in WIC (n134), intervention store customers reported increased fruit/vegetable purchases compared with control store customers (18v. −2 %), but this did not achieve statistical significance (P=0·11).ConclusionsPlacement of fruits/vegetables near the front of corner stores increased purchase of produce by customers using WIC. New policies that incentivize stores to stock and prominently display good-quality produce could promote healthier food choices of low-income families.

Download Full-text

Social Networks and Chronic Illness Management among Low-Income Tenants in Publicly Subsidized Housing: Findings from a Pilot Study

Social Work in Public Health ◽

10.1080/19371918.2021.1900012 ◽

2021 ◽

pp. 1-14

Author(s):

Hyunsung Oh ◽

Mee Young Um ◽

Renee Garbe

Keyword(s):

Social Networks ◽

Chronic Illness ◽

Pilot Study ◽

Low Income ◽

Subsidized Housing ◽

Illness Management ◽

Chronic Illness Management

Download Full-text

The long term effect of pulmonary tuberculosis on income and employment in a low income, urban setting

Thorax ◽

10.1136/thoraxjnl-2020-215338 ◽

2020 ◽

pp. thoraxjnl-2020-215338

Author(s):

Jamilah Meghji ◽

Stefanie Gregorius ◽

Jason Madan ◽

Fatima Chitimbe ◽

Rachael Thomson ◽

...

Keyword(s):

Low Income ◽

Disease Onset ◽

Treatment Completion ◽

Well Being ◽

Urban Setting ◽

Financial Strain ◽

First Episode ◽

Health Seeking ◽

Tb Treatment

BackgroundMitigating the socioeconomic impact of tuberculosis (TB) is key to the WHO End TB Strategy. However, little known about socioeconomic well-being beyond TB-treatment completion. In this mixed-methods study, we describe socioeconomic outcomes after TB-disease in urban Blantyre, Malawi, and explore pathways and barriers to financial recovery.MethodsAdults ≥15 years successfully completing treatment for a first episode of pulmonary TB under the National TB Control Programme were prospectively followed up for 12 months. Socioeconomic, income, occupation, health seeking and cost data were collected. Determinants and impacts of ongoing financial hardship were explored through illness narrative interviews with purposively selected participants.Results405 participants were recruited from February 2016 to April 2017. Median age was 35 years (IQR: 28–41), 67.9% (275/405) were male, and 60.6% (244/405) were HIV-positive. Employment and incomes were lowest at TB-treatment completion, with limited recovery in the following year: fewer people were in paid work (63.0% (232/368) vs 72.4% (293/405), p=0.006), median incomes were lower (US$44.13 (IQR: US$0–US$106.15) vs US$72.20 (IQR: US$26.71–US$173.29), p<0.001), and more patients were living in poverty (earning <US$1.90/day: 57.7% (211/366) vs 41.6% (166/399), p<0.001) 1 year after TB-treatment completion compared with before TB-disease onset. Half of the participants (50.5%, 184/368) reported ongoing dissaving (use of savings, selling assets, borrowing money) and 9.5% (35/368) reported school interruptions in the year after TB-treatment completion. Twenty-one participants completed in-depth interviews. Reported barriers to economic recovery included financial insecurity, challenges rebuilding business relationships, residual physical morbidity and stigma.ConclusionsTB-affected households remain economically vulnerable even after TB-treatment completion, with limited recovery in income and employment, persistent financial strain requiring dissaving, and ongoing school interruptions. Measures of the economic impact of TB disease should include the post-TB period. Interventions to protect the long-term health and livelihoods of TB survivors must be explored.

Download Full-text

The Clean pilot study: evaluation of an environmental hygiene intervention bundle in three Tanzanian hospitals

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-020-00866-8 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Giorgia Gon ◽

Abdunoor M. Kabanywanyi ◽

Petri Blinkhoff ◽

Simon Cousens ◽

Stephanie J. Dancer ◽

...

Keyword(s):

Pilot Study ◽

Study Design ◽

Low Income ◽

High Volume ◽

Surface Cleaning ◽

Low Income Countries ◽

Training Period ◽

Future Research ◽

Environmental Hygiene ◽

The Impact

Abstract Background Healthcare associated infections (HAI) are estimated to affect up to 15% of hospital inpatients in low-income countries (LICs). A critical but often neglected aspect of HAI prevention is basic environmental hygiene, particularly surface cleaning and linen management. TEACH CLEAN is an educational intervention aimed at improving environmental hygiene. We evaluated the effectiveness of this intervention in a pilot study in three high-volume maternity and newborn units in Dar es Salaam, Tanzania. Methods This study design prospectively evaluated the intervention as a whole, and offered a before-and-after comparison of the impact of the main training. We measured changes in microbiological cleanliness [Aerobic Colony Counts (ACC) and presence of Staphylococcus aureus] using dipslides, and physical cleaning action using gel dots. These were analysed with descriptive statistics and logistic regression models. We used qualitative (focus group discussions, in-depth interviews, and semi-structured observation) and quantitative (observation checklist) tools to measure why and how the intervention worked. We describe these findings across the themes of adaptation, fidelity, dose, reach and context. Results Microbiological cleanliness improved during the study period (ACC pre-training: 19%; post-training: 41%). The odds of cleanliness increased on average by 1.33 weekly during the pre-training period (CI = 1.11–1.60), and by 1.08 (CI = 1.03–1.13) during the post-training period. Cleaning action improved only in the pre-training period. Detection of S. aureus on hospital surfaces did not change substantially. The intervention was well received and considered feasible in this context. The major pitfalls in the implementation were the limited number of training sessions at the hospital level and the lack of supportive supervision. A systems barrier to implementation was lack of regular cleaning supplies. Conclusions The evaluation suggests that improvements in microbiological cleanliness are possible using this intervention and can be sustained. Improved microbiological cleanliness is a key step on the pathway to infection prevention in hospitals. Future research should assess whether this bundle is cost-effective in reducing bacterial and viral transmission and infection using a rigorous study design.

Download Full-text

When Vacant Lots Become Urban Gardens: Characterizing the Perceived and Actual Food Safety Concerns of Urban Agriculture in Ohio

Journal of Food Protection ◽

10.4315/0362-028x.jfp-15-181 ◽

2015 ◽

Vol 78 (11) ◽

pp. 2070-2080 ◽

Cited By ~ 14

Author(s):

MICHELLE L. KAISER ◽

MICHELE L. WILLIAMS ◽

NICHOLAS BASTA ◽

MICHELLE HAND ◽

SARAH HUBER

Keyword(s):

Food Safety ◽

Soil Quality ◽

Urban Agriculture ◽

Low Income ◽

Urban Soils ◽

Fresh Produce ◽

Urban Gardens ◽

Soil Contaminants ◽

Improve Access

This study was intended to characterize the perceived risks of urban agriculture by residents of four low-income neighborhoods in which the potential exists for further urban agriculture development and to provide data to support whether any chemical hazards and foodborne pathogens as potential food safety hazards were present. Sixty-seven residents participated in focus groups related to environmental health, food security, and urban gardening. In addition, soils from six locations were tested. Residents expressed interest in the development of urban gardens to improve access to healthy, fresh produce, but they had concerns about soil quality. Soils were contaminated with lead (Pb), zinc, cadmium (Cd), and copper, but not arsenic or chromium. Results from our study suggest paint was the main source of soil contamination. Detectable polyaromatic hydrocarbon (PAH) levels in urban soils were well below levels of concern. These urban soils will require further management to reduce Pb and possibly Cd bioavailability to decrease the potential for uptake into food crops. Although the number of locations in this study is limited, results suggest lower levels of soil contaminants at well-established gardens. Soil tillage associated with long-term gardening could have diluted the soil metal contaminants by mixing the contaminants with clean soil. Also, lower PAH levels in long-term gardening could be due to enhanced microbial activity and PAH degradation, dilution, or both due to mixing, similar to metals. No foodborne pathogen targets were detected by PCR from any of the soils. Residents expressed the need for clearness regarding soil quality and gardening practices in their neighborhoods to consume food grown in these urban areas. Results from this study suggest long-term gardening has the potential to reduce soil contaminants and their potential threat to food quality and human health and to improve access to fresh produce in low-income urban communities.

Download Full-text