Market Nutrition Program Research Articles

More than Fresh Fruits and Veggies: Farmers’ Markets as a Locus of Social Participation for Older Adults

As awareness of the benefits of social participation for older adults has grown, ideas for how social services agencies can increase older adults’ social participation have proliferated. The goal of this research is to explore how older adults experience the farmers’ market as a hub of social participation. Fifteen older adults in a rural area in the deep South of the U.S. participated in semi-structured interviews. All interviews were transcribed verbatim; transcripts were analyzed using analytic induction techniques. Most participants describe the farmers’ market as an important context for their social participation. They enjoyed the family-like environment, expanded their social network with vendors and volunteers, and received financial support such as the Senior Farmers’ Market Nutrition Program. Some described their experiences of civil engagement and their contribution to the community. Yet some barriers to their participation exist, such as transportation issues. Implications include further exploration into the potential for farmers’ markets as a context for increasing social participation of rural older adults. In particular, future research should explore the perceptions of social service professionals regarding this connection and the potential for social service agencies to harness the reciprocal nature of the relationship between markets and older patrons.

Analysis of the food and medicines provision in the northern regions of the USA and Canada

The article is devoted to the analysis of foreign experience in ensuring the availability of medicines and food products for the population of the northern regions of the United States and Canada. The author considers in detail the work of support mechanisms in hard-to-reach places in Alaska and the Northwest Territories of Canada, where there is no transport communication all year round. The content of the U.S. government programs on drug coverage (Medicare and Medicaid), mechanisms of subsidizing food and essential commodities (Supplemental Nutrition Assistance Program (SNAP), Women/Infants and Children Program (WIC), Commodity Supplemental Food Program (CSFP), Farmers’ Market Nutrition Program (FMNP), Senior Farmers’ Market Nutrition Program (SFMNP)) were analyzed. The delivery of food by the Alaska ByPass mail program, which delivers food and necessary goods to hard-to-reach settlements where there are no roads, was studied. The article also pays attention to the state policy on a healthy lifestyle, which includes proper and balanced nutrition, considers state programs and recommendations on nutrition for Americans (Dietary Guidelines for Americans) and Canadians (Canada’s Food Guide). The results of the work can be used in the development of programs and proposals for improving measures to support and provide Arctic regions of the Russian Federation with food products and medicines.

An Evaluation of the Implementation of the Women, Infants, and Children (WIC) Farmers Market Nutrition Program at Four Chicago WIC Sites

The Farmers Market Nutrition Program (FMNP), a program of the U.S. Department of Agriculture (USDA), provides coupons to individuals/families enrolled in the Special Supplemental Nutrition program for Women, Infants, and Children (WIC) to purchase fresh produce from approved farmers markets. While some studies suggest FMNP may improve nutrition for WIC clients, there is limited research on program implementation in practice. A mixed-methods equitable evaluation framework was utilized to: (1) better understand the FMNP in practice at four WIC clinics on Chicago's west and southwest sides that serve predominately Black and Latinx families; (2) detail facilitators and barriers to participation in the FMNP; and (3) describe the potential impact on nutrition. In this manuscript, we present qualitative findings from Aim 1. We identified six steps for how the FMNP has been implemented in our study setting and opportunities to improve the implementation of the program. Findings suggest that well-defined and consistent guidelines on: (1) how to seek state approval for farmers markets; and (2) coupon distribution and redemption, are necessary to optimize utilization. Future research should explore the impact of newly offered electronic coupons on redemption rates and fresh fruit and vegetable purchasing behaviors.

Perspectives From Urban WIC-Eligible Caregivers to Improve Produce Access.

The Farmer's Market Nutrition Program (FMNP) provides fresh, locally grown fruits and vegetables (FV) to eligible participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). However, redemption of FMNP benefits remains low. This qualitative study explores facilitators and barriers to produce access and FMNP redemption for caregivers of WIC-eligible children in Philadelphia during the COVID-19 pandemic. We conducted semistructured phone interviews with caregivers between August and December 2020 to understand experiences with produce access and programming preferences to increase benefit redemption and produce consumption. We used content analysis with constant comparison with code interviews inductively and identified emerging themes through an iterative process. Participants (n = 30) wanted their children to eat more produce but described barriers to produce access, including limited availability, higher cost, and limited time. The Supplemental Nutrition Assistance Program and WIC benefits improved the ability to purchase produce, but difficulties with electronic benefit transfer and pandemic-related office closures limited use of WIC benefits. Similarly, lack of convenient market locations and hours prohibited use of FMNP benefits. Caregivers described that an ideal food program would be delivery based, low cost, offer a variety of FV, and provide recipes and educational activities. WIC-eligible caregivers want their children to eat more produce; however, they face multiple barriers in redeeming their benefits to access fresh produce. Delivery-based, low-cost produce programs may lead to increased produce access as well as benefit use. Future study is needed on feasibility and acceptability of produce delivery options among WIC-eligible families.

Implementing Locally Tailored Strategies to Promote Redemption of Farmers' Market Nutrition Program Vouchers Among WIC Participants in Central Pennsylvania.

The Pennsylvania Farmers' Market Nutrition Program (FMNP) provides vouchers to participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to purchase locally grown fruits, vegetables (F&V), and herbs every year from June to November. Voucher redemption is suboptimal among WIC participants in Lebanon County, a community with high numbers of low-income and Hispanic families. Supported by a Racial and Ethnic Approaches to Community Health (REACH) award, our community-academic coalition partnered with the local WIC provider to implement locally tailored strategies to promote redemption of FMNP vouchers. In 2019, we surveyed FMNP participants (n = 100) to examine opportunities for improved voucher redemption. Increasing sites for voucher use (47%) and a larger variety of F&V (27%) were the most commonly selected improvements participants identified. Participants also supported improvements to increase awareness of available seasonal produce (14%), text/phone reminders to redeem vouchers (13%), and having recipes to cook meals with FMNP-approved F&V (12%). These findings led us to implement a weekly, Farm-to-WIC "grab bag" program in 2020/2021. We partnered with a local farmer to offer a variety of FMNP-approved produce in $3 and $6 grab bags at the local WIC provider. Each grab bag included healthy recipes using the included produce. In 2021, we launched a text/phone reminder intervention to encourage voucher redemption among FMNP participants (n = 57). Our work demonstrates the value of community-academic partnerships to identify and implement feasible strategies that are responsive to local needs as well as supporting existing programs providing greater access to affordable produce.

Identifying Cofactors Contributing to Food Insecurity in Elderly Maine Residents Living at Home

ObjectivesThe purpose of this study was to identify cofactors that contribute to food insecurity in Maine’s older adults living at home, examine how the COVID-19 pandemic affected access to nutritious food, and make recommendations for program expansion and development. MethodsThis study was a cross-sectional survey design of older adults aged 65 years and older participating in the Meals on Wheels program in Maine (n = 58) in early 2021. Research participants were compensated with grocery store gift cards. The DETERMINE Nutrition Checklist total nutrition scores and USDA Six-Item Food Security scores were compared to self-reported access to food to see how accurately older adults view their nutritional status. Chi-squared analysis was used to examine associations among food insecurity and demographic traits. A probability of p ≤ 0.05 was chosen for significance. ResultsRegion of residence and food security score were significantly associated; 55.2% (n = 32) of participants had scores (0–1) indicating they were food secure. One-quarter of participants had low food security, and 11 persons had very low food security. DETERMINE scores were not statistically significant for either age range or region, suggesting that risk of malnutrition functioned independently from region and age range. However, 75.9% (n = 44) of participants received scores indicating that they were at high risk of malnutrition. Only 20 persons regularly used SNAP benefits, and few people took advantage of other food programs such as the Senior Farmers Market Nutrition Program and food pantries. ConclusionsFood security among Maine seniors is not necessarily related to finances, especially during the COVID-19 pandemic. The most common cofactors influencing access to food were physical access and ability, and fear or guilt of asking for help. Future work should seek to survey older adults, especially those in the most rural and impoverished counties, who are not currently using food support services such as Meals on Wheels to better evaluate food insecurity among older Maine residents. Funding SourcesMaine Top Scholar Award and NIFA Hatch funds were used in this study.

An Investigation of Social Ecological Barriers to and Facilitators of WIC Farmers Market Nutrition Program Voucher Redemption.

In the United States, many communities lack sufficient access to fresh produce. To improve access to fresh fruits and vegetables, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides eligible participants vouchers through the Farmers Market Nutrition Program (FMNP) that can be redeemed directly from farmers at markets or farm stands. However, FMNP voucher redemption rates in New Jersey remain lower than those in neighboring states. This article used the social ecological model to examine differences between FMNP participants who redeem vouchers (Redeemers) and those who do not (non-Redeemers) in the areas of: produce procurement practices and consumption frequency, and barriers to and facilitators of FMNP voucher redemption. This cross-sectional study included WIC FMNP participants (N = 329) in northern New Jersey, USA. Analyses were conducted using descriptive statistics, independent sample t-tests, and one-way ANOVA. Compared to Redeemers, non-Redeemers consumed fewer average daily vegetable servings, were more likely to shop at small grocery/corner stores, and encountered significant barriers to FMNP redemption, e.g., difficulty finding time to redeem vouchers.

Older Adults and the Food Security Infrastructure.

This project explores the correlates of state variation in food security using data from the 2008 to 2018 Current Population Survey's Food Security Supplements. The focus is on the relationship between state-level availability and accessibility of congregate and home-delivered meal programs, the Supplemental Nutrition Assistance Program (SNAP), the Senior Farmer's Market Nutrition Program (SFMNP) and the Commodity Supplemental Food Program (CSFP) on food security among lower-income households headed by older adults (ages 60 and up). Results show evidence that a senior-specific state level food security infrastructure plays a role in the food security status of households headed by older adults.

Farmers’ Market Nutrition Program Educational Events Are Broadly Accepted and May Increase Knowledge, Self-Efficacy and Behavioral Intentions

The Farmers’ Market Nutrition Program (FMNP) in the U.S. provides coupons for the purchase of fruit and vegetables (FV) to pregnant women and children enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), and to income-eligible adults 60+ years of age. The New York State FMNP Education Event Guide was developed to support cooperative extension educators in providing information, food tastings, and cooking demonstrations at farmers’ markets (FM) to encourage consumption of FV. This paper describes implementation at seven FM in New York City, and shopping and eating behaviors in a cross-sectional survey of FM shoppers (n = 377). Three of nine lessons were implemented more than once, typically with food sampling (78.9%). FM shoppers were primarily women (81.5%), racially diverse (30.5% Black, 23.1% White), frequent shoppers (2.4 times/month), and had high FV consumption (2.24 cups fruit; 2.44 cups vegetables daily). Most FM shoppers participated in the FM education event (84%), and participants and non-participants had equivalent shopping and eating behaviors. More than 70% of FM education participants believed that the event positively impacted their knowledge, self-efficacy, and behavioral intentions. FMNP education events at FM were broadly accepted by FM shoppers of all characteristics, and may improve knowledge, self-efficacy, and behavioral intention.

Pilot Study of a Farm-to-Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Intervention Promoting Vegetable Consumption

BackgroundVegetable intake is below recommended levels among adults served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). ObjectiveThe aim of this study was to determine whether a novel, theory-driven, farm-to-WIC intervention to promote vegetable intake showed promise of being successful and is therefore appropriate for efficacy testing. DesignFrom June 2019 to January 2020, the intervention was piloted in three WIC agency sites (one randomized to the intervention study group and two to the control group) selected based on similarity in size and the demographics of participants served. Participants/settingRecruited between June 3, 2019 and August 1, 2019, participants were 297 primarily Hispanic adults served by a large WIC agency located in a densely populated urban area in New Jersey (160 were enrolled at the intervention site and 137 at control sites). InterventionThe intervention combined behaviorally focused instruction and handouts with the introduction of a WIC-based farmers’ market, field trips to an area farmers’ market, telephone coaching and support before and after trips, and recipe demonstrations and tastings. Main outcome measuresThe primary outcomes were vegetable intake (measured objectively using dermal carotenoids as a biomarker of intake and via self-report) and the redemption of vouchers provided through the WIC Farmers’ Market Nutrition Program (FMNP) for fruit and vegetable purchases at farmers’ markets (objectively assessed using data provided by WIC). Statistical analyses performedBetween-group differences in vegetable intake were examined at mid- and post-intervention (3 and 6 months post-baseline, respectively) with linear mixed-effects models adjusted for baseline vegetable intake and covariates. Logistic regression analysis was used to relate FMNP voucher redemption to study group and covariates. ResultsAt mid-intervention, objectively measured vegetable intake was higher among participants in the control group as compared with the intervention group; self-reported intake did not differ by group. Post-intervention, objectively measured and self-reported vegetable intake were higher among participants in the intervention group as compared with the control group. Receipt of the intervention was associated with a greater likelihood of FMNP voucher redemption. Voucher redemption rates were 87% in the intervention group and 28% in the control group (odds ratio = 17.39, 95% confidence interval [8.64, 35.02]). ConclusionsMeaningful associations found between the intervention, vegetable intake, and FMNP voucher redemption suggest that the program is appropriate for efficacy testing.

Serving Homebound Seniors: In-Home Senior Farmers’ Market Nutrition Program Enrollment and Fresh Fruit and Vegetable Home Delivery for Homebound Seniors in Central New Jersey

Low-income, homebound seniors may encounter affordability and accessibility-related barriers to consuming enough fresh fruits and vegetables (FV). This paper describes a two-stage pilot intervention to improve fresh FV affordability and access for home-delivered meal (HDM) program clients in Central New Jersey. The first stage of the intervention offered in-home Senior Farmers’ Market Nutrition Program (SFMNP) enrollment assistance to low-income HDM program clients, with 13 clients successfully enrolling in SFMNP. The second stage of the intervention offered fresh FV home deliveries to all 64 HDM program clients at no cost to clients. We sourced fresh FV from a farmers’ market run in partnership with a Cooperative Extension program affiliated with a large public research university. We carried out a post-intervention evaluation by conducting semi-structured interviews with 17 clients. Interviews addressed themes of farmers’ market access, SFMNP awareness, perceived changes to FV intake, and home delivery satisfaction. Evaluation results suggest that this short-term pilot intervention was well-received and effective in reducing barriers to FV access and affordability for a vulnerable senior population.

The relationship between food deserts, farmers' markets, Nutrition Benefits, and health in Delaware census tracts; 2017.

Food desert residents struggle to maintain a well-balanced, nutritious diet, increasing their risk of obesity and diabetes. Farmers’ markets are a community-level intervention, bringing healthy food to food deserts. This study explores the relationship between food deserts, farmers’ market location, the prevalence of obesity and diabetes, and the availability of Nutrition Benefit Programs (NBPs) in Delaware. Data are from the 2017 USDA Food Access Research Atlas and the Farmers’ Market Directory. Descriptive statistics and spatial visualization were used to explore census tract-level relationships. Twenty percent of Delaware census tracts are food deserts. Of these, 7.2% have a farmers’ market within their boundary, compared to 5.7% of non-food desert tracts. Of these markets, 3.2% accept Farmers’ Market Nutrition Program coupons, 9.6% accept WIC Fruit and Vegetable Checks, and 21.6% accept Supplemental Nutrition Assistance Program. Sussex County has the highest obesity and diabetes rates, and the least number of markets that accept NBPs. Fresh food remains inaccessible to low-income residents, which is associated with diet-related chronic diseases. To reduce food insecurity, farmers’ markets could expand acceptance of NBPs. Additional farmers’ markets could be established in food deserts to increase the availability of healthy food, reducing the risk of developing obesity and diabetes.

Flint Kids Cook: Influence of a Farmers' Market Cooking and Nutrition Program on Pediatric Quality of Life

Flint Kids Cook: Influence of a Farmers' Market Cooking and Nutrition Program on Pediatric Quality of Life

Feasibility of a farm-to-WIC intervention.

To examine whether an intervention consisting of a WIC-based farmers' market, nutrition education, recipe demonstrations and tastings, and handouts could be implemented as intended and the acceptability of the programme to recipients. The availability, variety and prices of fruits and vegetables (F&V) and the Farmers' Market Nutrition Program voucher redemption rate at the site with market (relative to the rate among fourteen other WIC agency sites) also were examined. Site-level data were used to evaluate programme implementation. Acceptability was assessed with participant data. A large, New Jersey-based, urban WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) agency. Fifty-four women who purchased F&V at the market. Gaps in stakeholder communication and coordination, F&V selling out by midday and staffing levels affected implementation fidelity. On average, 12 (sd 3) F&V were available daily at the market (twenty-five unique F&V in total). For thirteen of nineteen items, prices were lower at the WIC-based market than area farmers' markets. The voucher redemption rate at the site with the market (46 %) was higher than the rate among the fourteen other sites (39 %; P < 0·01). The mean rating of satisfaction with the programme was 6·9 (sd 0·6) on a 7-point scale. All participants reported intending to purchase F&V again at the market, owing to the convenient location, quality of the F&V and helpfulness of the staff. Improving F&V availability and variety were recommended. The intervention is feasible with improved stakeholder communication and coordination, F&V availability and variety, and staffing.

Food Safety Knowledge and Eating Behaviors in Low Income Adults Participating in SNAP-Ed Nutrition Education in DC Farmers Markets (P04-084-19)

ObjectivesFarmers Markets are a valuable source of affordable quality foods for Supplemental Nutrition Assistance Program (SNAP) recipients. However, according to a study in the American Journal of Agricultural Economics, farmers markets increase the number of foodborne illnesses. Low-income individuals are at the highest risk of foodborne illnesses and is thought to be related to poor food safety knowledge and limited food preparation skills. Reduced produce consumption has also been indicated in low-income populations. Produce is a major source of foodborne illnesses. Therefore, in addition to increasing access to produce, efforts must be made to ensure that consumers practice proper food safety. The purposes of this study were to 1) assess the food safety knowledge of farmers-market consumers in low-income neighborhoods, 2) their likelihood to use food assistance benefits, 3) consume produce and 4) cook a recipe provided by a SNAP-Ed program. MethodsIn 2018, the University of the District of Columbia (UDC) SNAP-Ed nutrition educators delivered nutrition and food safety education in 17 DC Farmers Markets located in low-income communities. 822 subjects completed a 3 question post-assessment on eating behaviors and of those, 669 participated in an additional 2 question survey on food safety. ResultsThe results show that after the education, 99.0% plan on eating more produce; 95.6% of participants plan to cook the provided recipe; and 92.7% will use SNAP, WIC, Produce Plus or Farmers’ Market Nutrition Program benefits at the Farmers’ Market that day. Additionally, 92.8% think that contamination of food by germs is a serious food safety problem, and 94.3% wash or rinse fresh produce purchased at the Farmers’ Market prior to consumption. ConclusionsMajority of low-income farmers market participants had general food safety knowledge and planned on consuming more produce, use food assistance benefits and try a new recipe. Further research is necessary to assess food safety knowledge of other domains and identify the impact of SNAP-Ed food safety education on behavior change. Funding SourcesThis project was funded through money appropriated by Congress through the Nutrition Education and Obesity Prevention Grant Program in the Healthy, Hunger-Free Kids Act of 2010 to states for evidence-based nutrition education and obesity prevention interventions and projects. Supporting Tables, Images and/or Graphs▪▪▪

Increasing WIC Farmers’ Market Nutrition Program Redemption Rates: Results and Policy Recommendations

WIC Farmers' Market Nutrition Program (FMNP) aims to increase consumption of fresh produce among Special Supplemental Nutrition Program for Women, Infants and Children (WIC) participants while supporting local farmers. Area stakeholders are addressing the existing barriers to FMNP use that keep participation low. Increase FMNP check redemption by participants in a Pittsburgh WIC office. Quasiexperimental design including cooking demonstrations, tours of FMs, and community garden visits. Program participation and check redemption rates were tracked. The redemption rate of FMNP checks among research participants and nonparticipants was 46.5% and 39.0% (P &lt; .001), respectively. Lessons learned point to needed changes on the local, state, and federal levels. Barriers to the use of WIC FMNP checks were consistent with the literature. Allowing mobile markets to accept FMNP checks may address barriers to FM shopping while supporting the local farmer. Our stakeholder group continues to recommend multilevel policy changes to improve the redemption rate.

Social Ecological Factors in WIC Farmers Market Nutrition Program Usage

Upon completion, participants will be able to identify social ecological factors that influence WIC FMNP voucher redemption.

Implementation of a WIC clinic farmers’ market improves accessibility and consumption of fresh fruits and vegetables among WIC farmers’ market nutrition program participants

ABSTRACTFew data are available concerning the socio-demographic characteristics and fruit and vegetable (F&V) purchasing behaviors of visitors attending the farmers’ markets sponsored by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Farmers’ Market Food and Nutrition Program (FMNP). The objectives of this cross-sectional study were to compare socio-demographics, food purchasing behaviors, and motivators for visiting a new WIC-based farmers’ market among convenience samples of WIC FMNP participants (n = 124, 30%) and non-participants (n = 291, 70%) using a customer survey (n = 415). Frequency counts and percentages were obtained while independent t-tests and Chi-square were carried out to compare WIC FMNP participants to non-WIC participants (p ≤ 0.05). The age range of most (62%) of the visitors was 25–54 and the majority were female (91%). The primary motivators for market attendance included variety of F&V (76%), quality of F&V (55%), and to purchase food grown locally (59%). The majority of the total sample agreed (88%) that shopping at the WIC-based farmers’ market increased their F&V consumption. WIC FMNP participants were further motivated by low prices (44%) and the ability to easily spend FMNP coupons (75%). Additionally, the study finds that location and convenience play a critical role in increasing FMNP coupon redemption rates.

P111 - Examining WIC Farmers Market Nutrition Program Voucher Redemption in New Jersey

P111 - Examining WIC Farmers Market Nutrition Program Voucher Redemption in New Jersey

Multifaceted Intervention Increases WIC Farmers Market Nutrition Program Check Redemption and Suggests Policy Changes

Increase WIC Farmers Market Nutrition Program (FMNP) check redemption rate. Target audience was WIC participants in a low income 47.6% white, 46.9% African American neighborhood adjacent to the city of Pittsburgh. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) FMNP aims to increase consumption of fresh fruits and vegetables for WIC families while supporting local farmers who sell at area farmers markets (FM). Yet, FMNP check utilization in PA is just over 50% and is lower in the targeted neighborhood. Barriers as well as aids to FMNP utilization and produce consumption are well documented and informed the intervention, CRUNCH!: Eat Fresh, Eat Healthy, Move More. A review of FMNP procedures in several states is informing policy recommendations for PA. Using a quasi-experimental research design, the June through early November intervention included cooking demonstrations in the WIC clinic; informal tours of FMs; and community garden visits. State data provided check redemption rates. Baseline and follow-up questionnaires explored barriers to FMNP check redemption, aids to fruit and vegetable consumption and pre- and post-intervention consumption data. Participation in the intervention activities were tracked. The intervention significantly (p < .001) increased the FMNP check redemption rate by program participants (46%) compared to non-participants (39%). Participation in the intervention activities was lower than expected. Barriers were consistent with the literature and there was no change in fruit or vegetable consumption. Program findings led to discussion of local issues and state policies regarding interpretation of federal FMNP regulations. A local stakeholder group is currently exploring policy recommendations.