Abstract
BackgroundChildhood obesity persists in the United States and is associated with serious health problems. Higher rates of obesity among children from disadvantaged households may be, in part, attributable to disparities in access to healthy foods such as fruits and vegetables. Community supported agriculture can improve access to and consumption of fresh produce, but the upfront payment structure, logistical barriers, and unfamiliarity with produce items may inhibit participation by low-income families. The aim of this project is to assess the impact of subsidized, or “cost-offset,” community supported agriculture participation coupled with tailored nutrition education for low-income families with children.Methods/designThe Farm Fresh Foods for Healthy Kids community-based, randomized intervention trial will build on formative and longitudinal research to examine the impact of cost-offset community supported agriculture on diet and other health behaviors as well as the economic impacts on local economies. The intervention will involve reduced-price community supported agriculture shares which can be paid for on a weekly basis, nine skill-based and seasonally-tailored healthy eating classes, and the provision of basic kitchen tools. Low income families with at least one child aged 2–12 years will be recruited to join existing community supported agriculture programs in New York, North Carolina, Vermont, and Washington. In each program, families will be randomized 1:1 to intervention or delayed intervention groups. Data will be collected at baseline, and in the fall and spring for 3 years. The primary outcomes are children’s intake of fruits and vegetables and foods high in sugar and/or (solid) fat, as well as diet quality; secondary outcomes include physical, behavioral, psychosocial, and environmental variables. Cost-effectiveness and economic impact at the farm and community levels also will be assessed.DiscussionThis integrated project will provide important information and contribute to the evidence base regarding the use of local agricultural interventions to improve children’s dietary behaviors and weight maintenance. Findings also will inform the development of a toolkit for farmers and education modules related to local food system innovations for undergraduate and graduate students.Trial registrationClinicalTrials.gov NCT02770196. Registered 5 April 2016.
Highlights
Childhood obesity persists in the United States and is associated with serious health problems
Findings will inform the development of a toolkit for farmers and education modules related to local food system innovations for undergraduate and graduate students
There is a need for well-designed studies that evaluate the impact of agricultural programs, including community-supported agriculture (CSA), on diet and nutrition-related outcomes, especially for populations at elevated risk for malnutrition and nutrition-related diseases [37, 67, 68], and on farmers’ profitability. The aim of this project is to assess the impact of cost-offset community supported agriculture (CO-CSA) participation coupled with tailored nutrition education for low-income families with children in four geographically diverse states: New York (NY), North Carolina (NC), Vermont (VT), and Washington (WA)
Summary
Childhood obesity persists in the United States and is associated with serious health problems. Higher rates of obesity among children from disadvantaged households may be, in part, attributable to disparities in access to healthy foods such as fruits and vegetables. Community supported agriculture can improve access to and consumption of fresh produce, but the upfront payment structure, logistical barriers, and unfamiliarity with produce items may inhibit participation by low-income families The aim of this project is to assess the impact of subsidized, or “costoffset,” community supported agriculture participation coupled with tailored nutrition education for low-income families with children. Home availability is associated with children’s fruit and vegetable intake [20], and lower consumption by individuals in poor households [15, 21, 22] may be due, in part, to limited access to a variety of fresh, affordable foods [23]. Even when local food stores stock fresh produce, factors such as limited quantities, high prices, inferior quality, poor store cleanliness, and suboptimal item placement may be barriers to the purchase fruits and vegetables [24, 25]
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