Factors Associated With Uptake of an Open Access Health Center–Based Mobile Produce Market: A Case for Expanded Eligibility

Abstract

BackgroundHealth care–based food assistance programs show promise but are underutilized. Strict eligibility requirements and program scheduling may dampen reach and outcomes. ObjectiveTo explore factors associated with uptake of a health center–based mobile produce market with no eligibility requirements and few barriers to entry. DesignA cross-sectional analysis of medical record, sociodemographic, environmental, and market attendance data was used. Participants/SettingThe study sample consisted of 3071 adults (18+ years) who were patients of an urban health center in eastern Massachusetts and registered for the mobile market during the study period of August 2016 to February 2020. Main Outcome MeasuresThe main outcome measure was monthly market attendance over the study period. Statistical AnalysesT-tests and χ2 tests were used to compare market users and never-users. Multiple logistic regression was used to analyze variables associated with market attendance each month. ResultsIn multiple variable analyses, Supplemental Nutrition Assistance Program (SNAP) enrollment was associated with slightly less frequent monthly market use (odds ratio [OR], 0.989; 95% CI, 0.984–0.994). Day-of, on-site market registration was associated with more frequent monthly use than self-registration on nonmarket days (OR, 1.08; 95% CI, 1.07–1.08). Having a psychiatric or substance use disorder diagnosis was associated with slightly less frequent market attendance (OR, 0.99; 95% CI, 0.98–0.99; and OR, 0.96; 95% CI, 0.95–0.97, respectively) compared with registrants without these diagnoses. ConclusionsIndividual, community-level, and organizational factors are associated with uptake of a free mobile produce market and should be considered when designing programs.