Cost-offset Community-supported Agriculture Research Articles

Fruit and Vegetable Preparation Changes During and After Cost-Offset Community-Supported Agriculture Plus Nutrition Education

ObjectiveInadequate consumption of fruits and vegetables (FV) can negatively impact health. Cost-offset, or subsidized, community-supported agriculture (CO-CSA) may change FV preparation behaviors among caregivers in low-income households. We assessed changes in FV preparation frequency and methods during and after participation in a CO-CSA plus tailored nutrition education intervention. DesignLongitudinal comparison of outcomes at baseline, end of CO-CSA season, and 1 year later. ParticipantsCaregivers of children aged 2–12 years from households with low income in rural areas of 4 US states (n = 148). InterventionSummer season, half-price CO-CSA share plus tailored nutrition education classes. Comparison to a control group not included in this analysis. Variables MeasuredMonthly frequency of preparing 9 FV for children's snacks and 5 vegetables for dinner; use of healthy preparation methods for dinner. AnalysisRepeated measures ANCOVA including state with Bonferroni correction and 95% confidence. ResultsAt baseline, caregivers prepared fruit for children's snacks and vegetables for dinner almost daily and vegetables for children's snacks every other day. The frequency of total FV preparation and most vegetable varieties increased during the intervention. Increases in total vegetables for snacks, dinner, and leafy greens were maintained 1 year later (n = 107). Conclusions and ImplicationsCommunity-supported agriculture plus education is a promising approach to sustained increases in vegetable preparation for children's snacks and dinner meals.

Participation in Cost-offset Community Supported Agriculture by Low-income Households in the U.S. is Associated with Community Characteristics and Operational Practices.

Subsidized or cost-offset community supported agriculture (CO-CSA) connects farms directly to low-income households and can improve fruit and vegetable intake. This analysis identifies factors associated with participation in CO-CSA. Farm Fresh Foods for Healthy Kids (F3HK) provided a half-price, summer CO-CSA plus healthy eating classes to low-income households with children. Community characteristics (population, socio-demographics, health statistics) and CO-CSA operational practices (share sizes, pick-up sites, payment options, produce selection) are described and associations with participation levels examined. Ten communities in New York (NY), North Carolina (NC), Vermont, and Washington states in USA. Caregiver-child dyads enrolled in spring 2016 or 2017. Residents of micropolitan communities had more education and less poverty than in small towns. The one rural location (NC2) had the fewest college graduates (10%) and most poverty (23%), and poor health statistics. Most F3HK participants were white, except in NC where 45.2% were African American. CO-CSA participation varied significantly across communities from 33% (NC2) to 89% (NY1) of weeks picked-up. Most CO-CSAs offered multiple share sizes (69.2%) and participation was higher than when not offered (76.8% vs. 57.7% of weeks); whereas 53.8% offered a community pick-up location, and participation in these communities was lower than elsewhere (64.7% vs. 78.2% of weeks). CO-CSAs should consider offering choice of share size and innovate to address potential barriers such as rural location and limited education and income among residents. Future research is needed to better understand barriers to participation, particularly among participants utilizing community pick-up locations.

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

AbstractCommunity-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.

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

BackgroundAdults 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.MethodsThe 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.ResultsNo 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.ConclusionsCost-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 registrationClinicalTrials.gov. NCT02770196. Registered 5 April 2016. Retrospectively registered.

Models for cost-offset community supported agriculture (CO-CSA) programs

Cost-offset community supported agriculture (CO-CSA) appears to be a promising way to increase low-income households’ access and intake of fresh produce, while also helping CSA farms expand their farm business. Yet single farms operating CO-CSAs may struggle to balance the demands of farming with CO-CSA program administration, funding, and recruitment. To address these chal­lenges, CO-CSA programs operated by nonprofits have emerged, equipped with dedicated infrastruc­ture, resources, and staffing. This study aims to describe organizational models and best practices of nonprofit CO-CSA programs, using a qualitative approach. We conducted interviews with five well-established nonprofit CO-CSA programs in the U.S. Administration of these five nonprofit CO-CSAs took several forms: (1) providing direct sub­sidies to individual CO-CSA member farms; (2) functioning themselves as an aggregator, packer, and distributor of regional produce; and (3) sourcing from an in-house farm incubator or food hub, then packing and coordinating delivery to pick-up sites. Nonprofit CO-CSA funding strategies included grants from federal and local government sources, private donations, fundrais­ing, and grants. Marketing efforts occurred via social media, community events, and word of mouth. Both fundraising and recruitment were greatly facilitated by relationships with community partners. Having dedicated staff, as well as a com­munity that values local agriculture and social jus­tice, were identified as success factors. This descriptive, qualitative study systematically com­pares the attributes of five nonprofit CO-CSA programs. Future research should focus on identifying the cost-effectiveness of nonprofit CO-CSAs, compare the relative merits of single-farm and nonprofit CO-CSAs, and quantify the eco­nomic benefit of CO-CSA programs for farmers and local communities.

O37 Fruit and Vegetable Preparation Changes During and After Cost-Offset Community Supported Agriculture and Nutrition Education

<h3>Background</h3> Most adults and children in the US do not consume recommended levels of fruit and vegetables (FV). Providing subsidized or cost-offset community supported agriculture (CO-CSA) alongside nutrition education is 1 approach to increase FV intake among rural, low-income families. <h3>Objective</h3> This analysis assessed change in the frequency and method of FV preparation during and after a CO-CSA plus nutrition education intervention. <h3>Study Design, Setting, Participants</h3> Participants were caregivers in low-income households (<185% FPL) living in rural areas of 4 U.S. states (n = 148). Half-price weekly summer CSA shares of farm produce and 9 seasonal nutrition education lessons were provided. Attendance was recorded at lessons and other data were collected via online surveys at baseline, 1 season later, and 1 year later. <h3>Measurable Outcome/Analysis</h3> Outcomes included monthly frequency of preparing 9 different, seasonal FV for children's snacks and 6 different vegetables for dinner with preparation methods for each. Repeated measures ANOVA and pairwise comparisons with Bonferroni correction tested change in FV preparation frequency over time at 95% confidence. Moderation analysis assessed whether changes in FV preparation frequency varied by lesson attendance. <h3>Results</h3> At baseline, caregivers prepared fruit for snacks and vegetables for dinner almost every day, and vegetables for snacks every other day. Preparation frequency for total snack fruit, celery, cucumber, peppers, other vegetables, total snack vegetables, lettuce, cabbage, greens, squash, and total dinner vegetables all increased during the intervention; and, increases in vegetables for both snacks (celery, cucumber, and total) and dinner (greens and total) were maintained one-year later. At baseline, the majority of participants (>70%) reported using healthy methods to prepare vegetables, and no changes were observed over time. Observed increases in FV preparation frequency were not moderated by lesson attendance. <h3>Conclusion</h3> CO-CSA plus education was associated with increases in FV preparation frequency, increases in vegetable preparation were maintained 1 year later, but improvements were not associated with attending nutrition education.

Helping Farmers with Continuation Planning for Cost-Offset Community Supported Agriculture to Low-Income Families

To improve low-income families’ access to fresh local produce, some farmers offer subsidized or “cost-offset” community supported agriculture (CO-CSA) shares. We evaluated a structured planning and implementation process conducted during the final intervention year of the Farm Fresh Foods for Healthy Kids (F3HK) study, which aimed to help participating farmers (N=12) to sustain a CO-CSA program after study funding ended. The process included training webinars, planning tools to develop CO-CSA continuation funding and recruitment strategies, regional coach­ing teams to provide technical assistance, and peri­odic group conference calls to facilitate shared learning among F3HK farmers. Our evaluation explored the content of farmers’ CO-CSA contin­u­ation plans, their experiences during implementa­tion, their opinions about the planning process, and their future plans regarding their CO-CSA. We found that F3HK farmers used diverse methods to plan, recruit, and raise funds, with each farm adapt­ing strategies to fit their local conditions and farm business. Many farmers found success with word-of-mouth advertising and CSA member donations. Yet lack of farm resources—time, money, and ex­pertise—was a continual barrier to moving for­ward. As with full price CSAs, reciprocity was a key factor: farmers needed to consider the needs and preferences of low-income consumers, and CO-CSA members needed to understand their financial responsibility to the farmer. In general, F3HK farmers appreciated the continuation planning pro­cess, but expressed a desire for more technical assistance with grant writing. Farmers were com­mitted to the success of the CO-CSA continuation planning process, and most intended to continue the CO-CSA the following year.

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

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.

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

To examine participants' experiences with nutrition education classes that were implemented with and designed to complement a cost-offset community-supported agriculture (CSA) programme. 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. Rural and micropolitan communities in New York, North Carolina, Vermont and Washington (USA). Ninety-six F3HK participants. 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. 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.

Balancing Social Values with Economic Realities: Farmer Experience with a Cost-offset CSA

Some farmers are offering subsidized or “cost-offset” community supported agriculture (CO-CSA) shares as a strategy to counter market saturation and improve low-income families’ access to fresh local foods. However, little is known about farmers’ experiences with this model, particularly in regard to the balance between additional resources required for adoption and subsequent contributions to farm revenue. As part of the Farm Fresh Foods for Healthy Kids Study of the impact of a CO-CSA on dietary behaviors in low-income families, we conducted qualitative interviews with 12 farmers across four states after the first and the third years of CO-CSA implementation. We explored these data to understand what accommodations farmers provided to low-income families, the benefits and challenges of implementing the CO-CSA model, and farmers’ perceptions of its impact on cash flow and profitability. We found that farmers selected pick-up locations that met CO-CSA members’ needs, were responsive to members’ food preferences in selecting CSA contents, and allowed for late payments and pickups, though sometimes this placed an additional burden on farmers’ time and resources. Additionally, weekly payment transactions led to increased recordkeeping. Despite its challenges, most farmers said CO-CSA adoption was a worthwhile addition to their business model. Expanding food access through this mechanism may become more sustainable with the additional support of innovative policies like eased land-use restrictions, operational models, and community strategies to fund and operate CO-CSA programs. This is an area ripe for future research, as there is little documentation on both single farm and multifarm CO-CSA operations.

P78 Low-Income Adults Enrolled in a Cost-Offset, Community-Supported Agriculture Intervention are not Nationally Representative

<h3>Background</h3> Cost-offset, Community-supported Agriculture (CO-CSA) is a model in which low-income households receive subsidized shares of a local farm's harvest. The goal is to address diet and health disparities among a population with historically poor access to and consumption of healthy foods. The appeal of such an intervention, and thus its reach, is limited to a self-selected sub-sample of the low-income population that may be non-representative. <h3>Objective</h3> To compare characteristics of CO-CSA enrolled adults from low-income households with those of a nationally-representative sample of low-income adults. We hypothesized that CO-CSA enrollees would be less demographically diverse, have greater nutrition-related knowledge, and report better health than the national sample. <h3>Study Design, Setting, Participants</h3> CO-CSA enrollee data were drawn from the baseline survey of a multi-state randomized controlled trial testing the CO-CSA model in conjunction with nutrition education among low-income households with children in Vermont, New York, North Carolina, and Washington (n=305). Those data were compared to a nationally-representative sample of low-income adults from households with children evaluated via the National Health and Nutrition Examination Survey (2007-2010). <h3>Measurable Outcome/Analysis</h3> Descriptive statistics for demographic, food security, nutrition knowledge, and self-reported health status data were generated using SPSS for both samples. <h3>Results</h3> Compared to the national sample, a greater proportion of CO-CSA enrollees were female (97% vs 57%), white (76% vs 45%), highly educated (49% vs 7% college graduates), and food insecure (57% vs 49%); a smaller proportion were Hispanic (6% vs 34%). A greater proportion of CO-CSA enrollees knew the daily recommendation for fruits and vegetables (3-5 cups; 61% vs 16%) and reported being in good or excellent health (34% vs 25%). <h3>Conclusions</h3> Differences between the CO-CSA and NHANES samples may be related to the CO-CSA study sampling frame (English-speaking households in certain regions of the U.S.). Results support continued exploration into whether CO-CSA and other local food system interventions have the potential to reach beyond female, white, educated, and nutritionally-knowledgeable segments of the target population.

P147 Cost-offset Community-Supported Agriculture plus Nutrition Education Improves Household Food Security and Nutrition Attitudes and Self-efficacy: A Randomized Controlled Trial

Background Subsidized or ‘cost-offset’ Community-Supported Agriculture (CO-CSA) has the potential to improve food security in low-income households. Furthermore, CO-CSA coupled with tailored nutrition education may affect nutrition knowledge, attitudes, and self-efficacy. To date, many studies of CO-CSA had small samples and no comparison group; few studies incorporated formal nutrition education into CO-CSA. Objective To understand the effect of CO-CSA plus education on nutrition knowledge, attitudes, self-efficacy, and food security among low-income families; whether any observed effects are durable beyond the CO-CSA season; and whether intervention dose mediated net effect. Study Design, Setting, Participants Farm Fresh Foods for Healthy Kids (F3HK), a randomized controlled trial in New York, North Carolina, Vermont, and Washington (2016-2018) that assigned caregiver-child dyads (n = 305) from low-income households into intervention or control. The F3HK intervention included a cost-offset (50% subsidy) CSA, weekly payments (including SNAP-EBT), kitchen equipment, and 9 CSA-tailored education classes. Measureable Outcome/Analysis Household food security was measured using the 6-item Short Form of the US Department of Agriculture Food Security Survey Module (FSSM). Caregiver knowledge was assessed by asking recommended cups of fruit and vegetables (FV) per day and FV as a fraction of a dinner plate. The 4-item Negative Cooking Attitude Scale measured caregiver's attitudes towards cooking. The 4-item Self-Efficacy for Eating/Cooking Fruits and Vegetables Scale measured FV self-efficacy. Results Significant net effects were observed for outcomes related to household food security as well as caregiver nutrition attitudes and self-efficacy. Improvements in caregiver attitudes and self-efficacy remained 6 months post-intervention. Weeks of CSA pick-up mediated changes household food security. Conclusions CO-CSA plus nutrition education for low-income caregivers and their children improved household food security and caregiver attitudes and self-efficacy. Attitude and self-efficacy but not food security effects were maintained post-intervention, indicating both the promise and limitations of seasonal food access interventions. Funding USDA.

P104 Theory-Informed Predictors of Fruit and Vegetable Intake Among Cost-Offset Community Supported Agriculture Enrollees

<h3>Background</h3> In cost-offset, community-supported agriculture (CO-CSA), low-income households receive subsidized shares of locally-grown produce with the aim of improving their access to and consumption of fruits and vegetables (FV). Social Cognitive Theory (SCT) is a commonly leveraged behavior change theory and informed the design of a CO-CSA plus nutrition education intervention trial for low-income households. <h3>Objective</h3> To examine the cross-sectional relationships between SCT-related variables and FV intake among CO-CSA enrollees at baseline. We hypothesized that nutrition-related attitudes, beliefs, and self-efficacy as well as perceived FV availability and accessibility would be significant predictors of FV intake. <h3>Study Design, Setting, Participants</h3> In Spring 2016 and 2017, adult enrollees (n = 305) completed a baseline questionnaire containing study-specific and validated questions to measure nutrition-related psychosocial (knowledge, attitudes, and beliefs), environmental (FV availability and accessibility), and behavioral factors (self-efficacy) in relation to self-reported and proxy measures of FV intake (National Cancer Institute's All-Day FV Screener and resonance Raman spectroscopy to assess dermal carotenoid status). <h3>Measurable Outcome/Analysis</h3> Descriptive statistics and multiple regression models were completed in SPSS. Models controlled for demographic characteristics. Self-efficacy to prepare and eat FV (β = 0.27, <i>P</i> ≤ .001) and in-home FV availability (β = 0.13, <i>P</i> = .04) were significant predictors of self-reported daily FV intake (R2 = 0.121, <i>P</i> ≤ .001). In-home FV availability (β = 0.20, <i>P</i> ≤ .001), accurate knowledge of FV recommendations (β = 0.15, <i>P</i> = .008), and perceived geographic access to FV (β = 0.11, <i>P</i> = .046) were significant predictors of carotenoid status (R2 = 0.227, <i>P</i> ≤ .001). <h3>Conclusions</h3> Among a set of SCT-related variables, knowledge of FV recommendations, geographic access to FV, in-home availability of FV, and self-efficacy to prepare and eat FV were significant predictors of FV intake. However, these only explained 22-23% of outcome variability among a sample of CO-CSA adult enrollees. SCT alone may not be the most appropriate theory through which to understand potential levers of FV intake among adults participating in CO-CSA programs.

A Mixed-methods Examination of the Geospatial and Sociodemographic Context of a Direct-to-Consumer Food System Innovation

Spatial context may be important to direct to con­sumer (DTC) programs aimed at improving fresh fruit and vegetable access for low-income individu­als. The purpose of this study was to examine the sociodemographic and geospatial context (distance to pickup sites, number and density of proximal food retail outlets, etc.) surrounding community supported agriculture (CSA) pickup locations in relation to low-income customer residential loca­tions, and to synthesize this information with inter­view-derived perspectives on the challenges and opportunities of the pickup location from DTC producers and customers. This in-depth study examined cost-offset community supported agri­culture (CO-CSA) operations across four U.S. states (New York, North Carolina, Vermont, and Washington) and varying pickup sites (n=23), with pickup operational decisions determined by farm­ers (n=12). Physical addresses of farms, CO-CSA customers, and pickup sites were collected and geocoded. Geographic information systems (GIS) was used to examine road network distances for pickup locations across the study sites. Demo­graphic information at the census block level (e.g., percent racial minority, percent poverty level) was obtained for all study sites. Descriptive statistics were generated for geospatial variables. In-depth interviews with farmers and focus groups with CO-CSA customers were conducted to understand experiences with the CO-CSA in terms of physical access of pickup sites. We found that pickup sites were an average of 6.2 miles (10 kilometers) from customers’ homes, and on average, further than the supermarket (2.9 miles or 4.7 km). Farmers reported their efforts to select convenient pickup locations for low-income customers, though CO-CSA customers expressed mixed levels of accessi­bility. Spatial inaccessibility and differences in soci­odemographic data for customer versus pickup may explain perceived inaccessibility for some cus­tomers. These findings may help inform future approaches to plan and evaluate DTC operations targeting low-income individuals by consider­ing geospatial context and stakeholder experiences. See the press release for this article.

NP3 Farm Fresh Foods for Healthy Kids: Innovative Cost-Offset Community-Supported Agriculture Intervention to Prevent Childhood Obesity and Strengthen Local Agricultural Economies

Objective To better understand the potential of cost-offset community supported agriculture (CO-CSA) to improve dietary quality in low-income families by conducting research, extension, and education activities. Description The Farm Fresh Foods for Healthy Kids (F3HK) intervention included a cost-offset (50% subsidy) summer CSA share, weekly payments (including SNAP-EBT), two to four pieces of kitchen equipment, and nine CSA-tailored education classes. F3HK participants were recruited from 12 rural and micropolitan communities in four states in spring 2016 and 2017, and individually randomized to intervention (n = 148) or control (n = 157). All had income Evaluation CO-CSA pickup sites averaged six miles (m) from participants’ homes, which was closer than the farm (18m) but further than the supermarket (3m). F3HK farms reported efforts to reach low-income customers and strategized to modify the F3HK model to suit the local context; however, CO-CSA participants expressed mixed levels of accessibility. Relative to controls, F3HK intervention caregivers had improvement in some measures of attitudes, self-efficacy, skills, and dietary quality after one-season of participation, but not other measures. Lessons from the implementation and evaluation of F3HK informed the development of four undergraduate course modules: development of an intervention in a setting where “local food” is a foreign concept; assessment of dietary quality; economic impact analysis; and how to adapt CSA to open new markets for farmers. Conclusion CO-CSA plus education and kitchen tools is a promising mechanism to improve attitudes, self-efficacy, and skills among caregivers, with mixed results concerning dietary quality among caregivers and children. Longer-term outcome data will be examined for behavioral maintenance. An Extension toolkit for CO-CSA implementation is under development. Education modules are being piloted, and will be evaluated and refined before dissemination in 2020-21.

Knowledge, Attitudes, Beliefs and Behaviors regarding Fruits and Vegetables among Cost-offset Community-Supported Agriculture (CSA) Applicants, Purchasers, and a Comparison Sample.

Community-supported agriculture (CSA) participation has been associated with high fruit and vegetable (FV) consumption, which may be due to better access to FV for CSA purchasers, or to positive knowledge, attitudes, and beliefs (KAB) regarding healthy eating among CSA applicants. The objective of this study was to examine KAB and consumption, in association with application to a cost-offset CSA (CO-CSA) program, and with CO-CSA purchase among applicants. We conducted a cross-sectional survey of CO-CSA applicants and a comparison sample in August 2017. All respondents were English-reading adults with a child 2–12 years old and household income of ≤185% of the federal poverty level. Among CO-CSA applicants, some were CO-CSA purchasers (n = 46) and some were not (n = 18). An online comparison sample met equivalent eligibility criteria, but had not participated in CSA for three years (n = 105). We compared CO-CSA applicants to the comparison sample, and compared purchasers and non-purchaser sub-groups, using Mann-Whitney U tests and chi-square analysis. CO-CSA applicants reported better knowledge, self-efficacy, home habits, and diet than the comparison sample. Among applicants, CO-CSA purchasers and non-purchasers had equivalent KAB, but children in purchaser households had higher FV consumption than in non-purchaser households (4.14 vs. 1.83 cups, p = 0.001). Future research should explore associations between CO-CSA participation and diet using experimental methods.

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

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.

Knowledge, attitudes, beliefs and behaviors regarding fruits and vegetables among cost-offset community-supported agriculture (csa) applicants, purchasers, and a comparison sample

Knowledge, attitudes, beliefs and behaviors regarding fruits and vegetables among cost-offset community-supported agriculture (csa) applicants, purchasers, and a comparison sample

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

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