Translating Research-Funded Mobile Produce Market Trials Into Sustained Public Health Programs

2021 ◽  
pp. 003335492110124
Author(s):  
E. Whitney Evans ◽  
Reece Lyerly ◽  
Kim M. Gans ◽  
Nicole Alexander Scott ◽  
Eliza Dexter Cohen ◽  
...  
Keyword(s):  
Public Health ◽  
Rhode Island ◽  
Low Income ◽  
Controlled Trial ◽  
Public Health Practice ◽  
Fruit And Vegetables ◽  
Assistance Program ◽  
Community Partners ◽  
Nutrition Assistance ◽  
Mobile Market

Food on the Move is an ongoing mobile produce market program in Rhode Island whose operations evolved from previous mobile market programs evaluated by 2 research studies: (1) one on Fresh to You, a prospective cohort study evaluating markets at community sites serving low-income families; and (2) one on Live Well, Viva Bien, a cluster randomized controlled trial evaluating markets and complementary nutrition interventions at public housing sites. The 2 studies spanned more than a decade and demonstrated the effect of mobile produce markets on access to, affordability of, and consumption of fruit and vegetables in low-income communities in Rhode Island. When grant funding ended in 2016, academic and community partners continued the mobile market program as Food on the Move. The Rhode Island Public Health Institute adopted the program model and developed a business plan to maximize market efficiency. To address price as a barrier to buying fruit and vegetables, the Institute implemented an innovative incentive program for purchases made with Supplemental Nutrition Assistance Program (SNAP) benefits, funded by a federal Food Insecurity Nutrition Incentive grant program. In 2018, Food on the Move sold more than $160 000 in produce at 335 markets, more than $50 000 of which came from these SNAP incentive programs. For sustained change in communities, researchers and community partners need examples of how to translate findings from research trials into public health practice. Food on the Move serves as a case study for the successful transition of community-focused research into a sustainable and scalable evidence-based program.

Effectiveness of mobile produce markets in increasing access and affordability of fruits and vegetables among low-income seniors

2020 ◽  
Vol 23 (17) ◽  
pp. 3226-3235
Author(s):  
Reece Lyerly ◽  
Pasquale Rummo ◽  
Sarah Amin ◽  
Whitney Evans ◽  
Eliza Dexter Cohen ◽  
...  
Keyword(s):  
Rhode Island ◽  
Low Income ◽  
Fruits And Vegetables ◽  
Economic Status ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Assistance Program ◽  
Logistic Regression Models ◽  
Populations At Risk ◽  
Nutrition Assistance

AbstractObjective:Mobile produce markets (MPM) offering Supplemental Nutrition Assistance Program (SNAP) incentive programmes have the potential to provide accessible and affordable fruits and vegetables (FV) to populations at risk of food insecurity. The objective of this study is to characterise the customer base of an MPM and describe their participation at twelve market sites serving low-income seniors.Design:In 2018, customers from an MPM in Rhode Island (RI) participated in a cross-sectional survey (n 330; 68 % response rate), which measured dietary patterns, food security and food shopping behaviours. We compared the shopping habits and market experiences of customers who currently received SNAP benefits with those who did not currently receive SNAP benefits.Setting:An MPM in RI which offers a 50 % discount for FV purchased with SNAP benefits.Participants:This study describes current market customers at twelve market sites serving low-income seniors.Results:Market customers were mostly low-income, female, over the age of 50 years and Hispanic/Latino. Most customers received SNAP benefits, and almost half were food insecure. In addition, three quarters of SNAP customers reported their SNAP benefits last longer since shopping at the markets. Mixed logistic regression models indicated that SNAP customers were more likely to report buying and eating more FV than non-SNAP customers.Conclusions:MPM are critical resources of affordable produce and have been successful in improving access to FV among individuals of low socio-economic status in RI. This case study can inform policy and programme recommendations for MPM and SNAP incentive programmes.

Role of Supplemental Nutrition Assistance Program in Improving Diet Quality: Implications for Nurses

2020 ◽  
Vol 21 (2) ◽  
pp. 62-70
Author(s):  
Victoria M. Pak ◽  
Erin Ferranti ◽  
Ingrid Duva ◽  
Melissa Owen ◽  
Sandra B. Dunbar
Keyword(s):  
Public Health ◽  
Diet Quality ◽  
Low Income ◽  
Supplemental Nutrition Assistance Program ◽  
Health Concern ◽  
Supplemental Nutrition ◽  
Assistance Program ◽  
Health Goals ◽  
National Public Health ◽  
Nutrition Assistance

The Supplemental Nutrition Assistance Program (SNAP) provides access to healthy food for low-income individuals and households. Food security, however, does not necessarily achieve higher diet quality for beneficiaries. Diet quality is an important consideration for the development and management of chronic illness, a significant public health concern. In this study, we review incentives and disincentives implemented to improve the diet quality, the evidence on SNAP including benefits, challenges, and the politics of funding. New interventions and policies will be needed in order to improve the overall diet quality of SNAP households. SNAP should align with nutritional science to meet national public health goals. Nurses are trusted advocates for patients and the public and are uniquely positioned to aid in this effort. Informed by evidence, nurses willing to leverage their influence, can lead this needed change.

scholarly journals Strengthening the Public Health Impacts of the Supplemental Nutrition Assistance Program Through Policy

2020 ◽  
Vol 41 (1) ◽  
pp. 453-480
Author(s):  
Sara N. Bleich ◽  
Alyssa J. Moran ◽  
Kelsey A. Vercammen ◽  
Johannah M. Frelier ◽  
Caroline G. Dunn ◽  
...  
Keyword(s):  
Public Health ◽  
Low Income ◽  
Safety Net ◽  
Supplemental Nutrition Assistance Program ◽  
Health Impacts ◽  
Supplemental Nutrition ◽  
Assistance Program ◽  
The Public ◽  
The Us ◽  
Nutrition Assistance

The US Department of Agriculture (USDA) Supplemental Nutrition Assistance Program (SNAP) is the cornerstone of the US nutrition safety net. Each month, SNAP provides assistance to 40 million low-income Americans—nearly half of them children. A number of changes could strengthen the public health impacts of SNAP. This review first presents a framework describing the mechanisms through which SNAP policy can influence public health, particularly by affecting the food security, the diet quality, and, subsequently, the health of SNAP participants. We then discusspolicy opportunities with the greatest potential to strengthen the public health impacts of SNAP, organized into three areas: ( a) food production and distribution, ( b) benefit allocation, and ( c) eligibility and enrollment. For each section, we describe current policy and limitations of the status quo, suggest evidence-based opportunities for policy change to improve public health, and identify important areas for future research.

scholarly journals Child Compared with Parent Perceptions of Child-Level Food Security

2019 ◽  
Vol 3 (10) ◽  
Author(s):  
Matthew J Landry ◽  
Alexandra E van den Berg ◽  
Fiona M Asigbee ◽  
Sarvenaz Vandyousefi ◽  
Reem Ghaddar ◽  
...  
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
Low Income ◽  
Controlled Trial ◽  
Parent Perceptions ◽  
Household Food Security ◽  
Security Assessment ◽  
Cross Sectional ◽  
Assistance Program ◽  
Nutrition Assistance

ABSTRACT Background There is a need to directly and accurately conceptualize and measure food insecurity in children as part of surveillance and public health efforts. Objective The aim of this study was to compare parent and child perceptions of child-level food security status via questionnaires within a large, ethnically diverse population. Methods Cross-sectional baseline data from a cluster-randomized controlled trial involving primarily low-income, Hispanic third- to fifth-grade students and their parents were used for analysis. The sample consisted of 2408 dyadic (parent and child) pairs. Parents completed the 8-item child-referenced Household Food Security Survey Module and their responses were compared with an adaption of the 5-item Child Food Security Assessment completed by their child. Levels of association between child and parent perceptions within dyads were calculated using Goodman and Kruskal's γ statistic. A mixed-effects binomial logistic regression model was used to model discordance as a function of child, parent, and household sociodemographic characteristics. Results The child sample was 53% girls, mean age of 9 y, and 63% were Hispanic. The parent sample was 86% women and 65% Hispanic. Child and parent perceptions of child-level food security agreed only 21.7% of the time. There was a weak positive association between child and parent perceptions of child-level food security (γ = 0.162, P < 0.001). Children perceived themselves as less food secure than their parents’ perception 70.1% of the time. Household receipt of Supplemental Nutrition Assistance Program benefits was associated with greater odds of discordant food security perceptions, whereas female children, older children, and parents not working were characteristics associated with lower odds of discordant perceptions. Conclusions Results, in combination with the existing literature, suggest that parent perceptions of child-level food insecurity may underestimate child-level food insecurity experiences. Inaccurate estimations or underestimations of the true prevalence of child-level food insecurity could be detrimental to maternal and child health efforts. This trial was registered at clinicaltrials.gov as NCT02668744.

scholarly journals SNAP Participants and High Levels of Food Insecurity in the Early Stages of the COVID-19 Pandemic

2021 ◽  
pp. 003335492110071
Author(s):  
Sameer M. Siddiqi ◽  
Jonathan Cantor ◽  
Madhumita Ghosh Dastidar ◽  
Robin Beckman ◽  
Andrea S. Richardson ◽  
...  
Keyword(s):  
Public Health ◽  
Food Insecurity ◽  
Low Income ◽  
Food Deserts ◽  
Supplemental Nutrition Assistance Program ◽  
Food Bank ◽  
Predominantly Black ◽  
Assistance Program ◽  
Nutrition Assistance ◽  
Adjusted Logistic Regression

Objectives The coronavirus disease 2019 (COVID-19) pandemic has disproportionately strained households experiencing poverty, particularly Black and Latino households. Food insecurity, which entails having limited or uncertain access to a sufficient quantity of nutritious food, is a key pandemic-related consequence. We examined how people enrolled in the Supplemental Nutrition Assistance Program (SNAP) have been affected by the pandemic, particularly Black participants and participants residing in food deserts. Methods Using survey data from a longitudinal cohort study of predominantly Black low-income adults aged ≥18 residing in urban food deserts in Pittsburgh, Pennsylvania, we examined changes in food insecurity and SNAP participation before COVID-19 (2018) and early in the COVID-19 pandemic (March–May 2020). We modeled changes in food insecurity from 2018 to 2020 via covariate-adjusted logistic regression. Results Food insecurity increased significantly among participants enrolled in SNAP and surveyed in both 2018 and 2020 (from 25.9% in 2018 to 46.9% in 2020; P < .001). Compared with cohort participants not enrolled in SNAP at both points, cohort participants enrolled in SNAP in 2018 and 2020 had the highest rates of using a food bank in 2020 (44.4%) and being newly food insecure in 2020 (28.9%) (ie, they were food insecure in 2020 but not in 2018). Conclusions Food insecurity during the COVID-19 pandemic increased among low-income Black households enrolled in SNAP and residing in a food desert. Public health recovery efforts might focus on modifying SNAP to improve the food security of people experiencing poverty.

scholarly journals The Provision of Assistance Does Not Substantially Impact the Accuracy of 24-Hour Dietary Recalls Completed Using the Automated Self-Administered 24-H Dietary Assessment Tool among Women with Low Incomes

2019 ◽  
Vol 149 (1) ◽  
pp. 114-122 ◽  
Author(s):  
Sharon I Kirkpatrick ◽  
Patricia M Guenther ◽  
Deirdre Douglass ◽  
Thea Zimmerman ◽  
Lisa L Kahle ◽  
...  
Keyword(s):  
Low Income ◽  
Assessment Tool ◽  
Dietary Assessment ◽  
Food Group ◽  
Supplemental Nutrition Assistance Program ◽  
Assistance Program ◽  
Plate Waste ◽  
Low Incomes ◽  
Portion Sizes ◽  
Nutrition Assistance

ABSTRACT Background Evidence is lacking informing the use of the Automated Self-Administered 24-h Dietary Assessment Tool (ASA24) with populations characterized by low income. Objective This study was conducted among women with low incomes to evaluate the accuracy of ASA24 recalls completed independently and with assistance. Methods Three hundred and two women, aged ≥18 y and with incomes below the Supplemental Nutrition Assistance Program thresholds, served themselves from a buffet; amounts taken as well as plate waste were unobtrusively weighed to enable calculation of true intake for 3 meals. The following day, women completed ASA24-2016 independently (n = 148) or with assistance from a trained paraprofessional in a small group (n = 154). Regression modeling examined differences by condition in agreement between true and reported foods; energy, nutrient, and food group intakes; and portion sizes. Results Participants who completed ASA24 independently and those who received assistance reported matches for 71.9% and 73.5% (P = 0.56) of items truly consumed, respectively. Exclusions (consumed but not reported) were highest for lunch (at which participants consumed approximately 2 times the number of distinct foods and beverages compared with breakfast and dinner). Commonly excluded foods were additions to main dishes (e.g., tomatoes in salad). On average, excluded foods contributed 43.6 g (46.2 kcal) and 40.1 g (43.2 kcal) among those in the independent and assisted conditions, respectively. Gaps between true and reported intake were different between conditions for folate and iron. Within conditions, significant gaps were observed for protein, vitamin D, and meat (both conditions); vitamin A, iron, and magnesium (independent); and folate, calcium, and vegetables (assisted). For foods and beverages for which matches were reported, no difference in the gap between true and reported portion sizes was observed by condition (P = 0.22). Conclusions ASA24 performed relatively well among women with low incomes; however, accuracy was somewhat lower than previously observed among adults with a range of incomes. The provision of assistance did not significantly impact accuracy.

scholarly journals Three-year trends in dietary behaviours among mothers, teenagers and children from SNAP-Ed (Supplemental Nutrition Assistance Program–Education) eligible households across California

2019 ◽  
Vol 23 (1) ◽  
pp. 3-12 ◽  
Author(s):  
Fred Molitor ◽  
Celeste Doerr ◽  
John Pugliese ◽  
Lauren Whetstone
Keyword(s):  
Diet Quality ◽  
Low Income ◽  
Vegetable Intake ◽  
Age Groups ◽  
Healthy Eating Index ◽  
Poverty Level ◽  
Cross Sectional ◽  
Assistance Program ◽  
Dietary Behaviours ◽  
Nutrition Assistance

AbstractObjective:To examine trends from 2015 to 2017 in dietary behaviours and diet quality among low-income mothers, teenagers and children.Design:Cross-sectional telephone surveys using a validated 24 h dietary assessment.Setting:Randomly sampled households with incomes ≤185 % of the US federal poverty level across California.Participants:Survey participants were 13 247 mothers (≥18 years), 3293 teenagers (12–17 years) and 6043 children (5–11 years). Respondents were mostly Latino.Results:Over the 3-year study period, consumption of fruits and vegetables with and without 100 % fruit juice increased (P ≤ 0·05) by at least 0·3 cups/d for mothers, teenagers and children. Intake of water also increased (P ≤ 0·001) by more than 1 cup/d for mothers and children and 2 cups/d for teenagers. Sugar-sweetened beverage (SSB) consumption was unchanged over the 3 years. Overall diet quality, as assessed by the Healthy Eating Index-2015, improved (P ≤ 0·01) for mothers, teenagers and children. Covariates for the fifteen regression models (three age groups by five outcome variables) included race/ethnicity, age, education for mothers, and gender for teenagers and children.Conclusions:The observed increases in fruit and vegetable intake and improvements in overall diet quality during the 3-year period suggest that low-income Californians may have lowered their risk of preventable diseases. However, more intense or strategic SSB-reduction interventions are required. Regional- or state-level, population-based surveillance of dietary behaviours is useful for public health nutrition policy and programme decision making, and can be used to assess potential trends in future negative health outcomes and related costs associated with poor dietary behaviours within at-risk populations.

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