Fruit and Vegetable Preferences and Practices May Hinder Participation in Community-Supported Agriculture Among Low-Income Rural Families

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

OBJECTIVE

Inadequate 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.

DESIGN

Longitudinal comparison of outcomes at baseline, end of CO-CSA season, and 1 year later.

PARTICIPANTS

Caregivers of children aged 2-12 years from households with low income in rural areas of 4 US states (n = 148).

INTERVENTION

Summer season, half-price CO-CSA share plus tailored nutrition education classes. Comparison to a control group not included in this analysis.

VARIABLES MEASURED

Monthly frequency of preparing 9 FV for children's snacks and 5 vegetables for dinner; use of healthy preparation methods for dinner.

ANALYSIS

Repeated measures ANCOVA including state with Bonferroni correction and 95% confidence.

RESULTS

At 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 IMPLICATIONS

Community-supported agriculture plus education is a promising approach to sustained increases in vegetable preparation for children's snacks and dinner meals.

Importance of Nutrition Security to CVD Prevention Efforts in the USA

PURPOSE OF REVIEW

The importance of addressing nutrition security for the primary and secondary prevention of cardiovascular disease (CVD) in the USA is reviewed by describing the relationships between food security, diet quality, and CVD risk along with the ability of governmental, community, and healthcare policies and interventions to address nutrition security.

RECENT FINDINGS

Existing safety net programs have shown to be effective at improving food security and diet quality and reducing risk for CVD, but continued efforts to increase reach and improve standards are needed. Adoption of policies, healthcare initiatives, and community- and individual-level interventions addressing the nutritional intake of socioeconomically disadvantaged populations may also lessen CVD burden, but scaling interventions remains a key challenge. Research suggests simultaneously addressing food security and diet quality is feasible and could help reduce socioeconomic disparities in CVD morbidity and mortality. Intervening at multiple levels among high-risk groups should be a priority.

Convivial cooking: Impacts of an educational intervention on college students' food agency

Objective: This research examines the effects of educational materials, delivered with "take-home and cook-with-friends" meal kits, on college students' food agency. Participants: In the spring of 2021, 186 students were recruited at a US public university and randomly allocated into either an intervention group that received meal kits and educational materials or a control group that received only meal kits. Methods: Meal kits containing local ingredients were distributed weekly to the participants and surveys were conducted to measure participants' food agency, using the Cooking and Food Provisioning Action Scale (CAFPAS). Hypothesis tests and regression analysis were then conducted to examine the educational intervention's effects on the CAFPAS scores. Results: The educational intervention had a positive and statistically significant effect on students' CAFPAS scores. Conclusions: Educational interventions hold promise in enhancing college students' food agency, at least in the short term.

Eggplant Flour Addition in Cookie: Nutritional Enrichment Alternative for Children

This research aimed to evaluate the effect of adding different levels of eggplant flour in cookie on the physicochemical and nutritional characteristics and to verify the sensory acceptability among children. Four eggplant flour cookie formulations were prepared: EF0 (or standard), EF2.5, EF5.0, and EF7.5 (Eggplant Flour 0, 2.5, 5.0 and 7.5%, respectively). The sensory acceptability, physicochemical and nutritional composition were evaluated. The eggplant flour addition of 7.5% to cookie reduced the acceptability (p > 0.05). The samples EF5.0 and EF7.5 showed higher diameter, expansion and thermal factor, while the EF0 and EF2.5 had higher thickness (p < 0.05). The flour addition significantly increased the hardness, Water activity (Aw), Titratable Acidity (TA) and Soluble Solids (SS) in the cookie, however, L* a* and b*, pH and SS/TA ratio values were reduced (p < 0.05). Increased levels of ash, dietary fibers, ascorbic acid, anthocyanins, total phenolic compounds and antioxidant activity were verified on the cookie after eggplant flour addition. Meanwhile, there was a reduction in energy and carbohydrate values. It is concluded that eggplant flour addition up to 5% in cookie maintains the sensory acceptability similar to the standard product when evaluated by children. In addition, it can be considered a viable alternative to improve most of the physicochemical and nutritional characteristics of the product.

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

OBJECTIVE

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.

DESIGN

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.

SETTING

Ten communities in New York (NY), North Carolina (NC), Vermont, and Washington states in USA.

PARTICIPANTS

Caregiver-child dyads enrolled in spring 2016 or 2017.

RESULTS

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).

CONCLUSION

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.

How to Measure Organic Fruit Consumer Behavior: A Systematic Review

This review article seeks to systematically identify appropriate ways to measure the consumption behavior of organic fruits. The systematic review of the literature was performed according to the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the eligibility criteria were declared through the PICOS (population, interventions, comparators, outcomes, and study) tool based on 277 article records scientiometrically identified in both the Journal Citation Report databases from Web of Science. The literature review stages determined a reduced set of articles that presented valid and reliable measurement scales that covered determinant constructs in organic fruit consumer behavior (OFCB). The measurement scale with the best results reported within the screened articles covered the constructs related to health, fear, environment, effort, and economy, allowing it to serve as a reference instrument in further studies on food consumer behavior.

Growing Opportunities for Equitable, Interdisciplinary Undergraduate Food Systems Education: A Review of Food Systems Education at Land-Grant Institutions and Development of Open-Access Materials

Post-secondary coursework related to agriculture and the food supply has been at the core of the United States' land-grant system for more than 150 years. However, as the complexity of food systems has grown, so too have critiques that the education provided in these programs is too narrow to adequately prepare graduates to address pressing food systems issues. In response, some higher education institutions have developed degrees in food systems. To support development of this burgeoning field, we created, tested, and refined four evidence-informed, interdisciplinary, equity-oriented, open-access teaching modules. These modules are based on our experience conducting a multi-site, multi-year transdisciplinary investigation of subsidized, or “cost-offset”, community supported agriculture and a survey asking instructors at land-grant institutions (n = 66) about topic offerings and current unmet needs for instructional materials. Our collaboration illuminated the potential and challenges of food systems research; underscored the value of transdisciplinary research teams; and identified several equity-oriented topics related to the design, implementation, and evaluation of local food initiatives suitable for advancing sustainable foods systems education. Instructors reported that the most helpful teaching aids would be case studies, lesson plans with active learning components, and reference lists with relevant peer-reviewed publications. The final modules seek to shed light on the complexity of food systems projects and build knowledge, vocabularies, and skills across disciplines engaged with food systems. Per instructor-defined needs, each module features a case study, active-learning activities, and references. We anticipate that the adaptable modules will be suitable for a wide range of students and courses.

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

Background

Adults 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.

Methods

The 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.

Results

No 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.

Conclusions

Cost-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 registration

ClinicalTrials.gov. NCT02770196. Registered 5 April 2016. Retrospectively registered.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-021-01168-x.

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

OBJECTIVE

To examine participants' experiences with nutrition education classes that were implemented with and designed to complement a cost-offset community-supported agriculture (CSA) programme.

DESIGN

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.

SETTING

Rural and micropolitan communities in New York, North Carolina, Vermont and Washington (USA).

PARTICIPANTS

Ninety-six F3HK participants.

RESULTS

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.

CONCLUSION

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.

Evaluation of Farm Fresh Food Boxes: A Hybrid Alternative Food Network Market Innovation

Using a mixed-methods design, we evaluated Farm Fresh Food Box (F3B) a market innovation designed to expand producer markets, stabilize rural retail businesses, and improve rural food access. In the F3B model, pre-ordered Community Supported Agriculture (CSA)-style produce boxes are sold through rural retail outlets. F3B was implemented from 2016 to 2018 as part of a United States Department of Agriculture (USDA)-funded multi-state extension and research collaboration project in 3 geographically diverse and rural areas: Vermont, Washington, and California. The F3B evaluation aimed to (1) assess market potential; (2) determine logistics for successful implementation; (3) describe the benefits and drawbacks for farmers and retailers; and (4) measure consumers’ attitudes and purchase behavior. A national market survey indicated consumers would be likely to purchase F3B if it was perceived to offer good value on fresh local produce, without need for a subscription. The model put a few additional labor burdens on farmers and retailers, but required time for relationship-building and more record-keeping time for farmers. Those who purchased a F3B were generally satisfied with the quality, quantity and variety of produce each week and a high proportion considered F3B to be a good value for the money. As a new business innovation, F3B showed only modest profit, but retailers and farmers felt it was worthwhile to expand their customer base, promote their brand and develop their partnership. F3B began a means to address flattened growth in direct to consumer produce sales, food deserts and dwindling retail options for fresh foods in rural areas. We discuss F3B as a potential solution to food system weaknesses exposed by the COIVD-19 pandemic because it offers touch-free, high-quality local produce ready for curbside pickup at a convenient location.

Consumer Attitudes and Preference Exploration towards Fresh-Cut Salads Using Best-Worst Scaling and Latent Class Analysis

This research explored the preferences and buying habits of a sample of 620 consumers of fresh-cut, ready-to-eat salads. A best–worst scaling approach was used to measure the level of preference stated by individuals regarding 12 attributes for quality (intrinsic, extrinsic and credence) of fresh-cut salads. The experiment was carried out through direct interviews at several large-scale retail outlets in the Turin metropolitan area (north-west of Italy). Out of the total number of questioned consumers, 35% said they did not consume fresh-cut salads. On the contrary, the rest of the involved sample expressed the highest degree of preference towards the freshness/appearance attribute, followed by the expiration date and the brand. On the contrary, attributes such as price, organic certification and food safety did not emerge as discriminating factors in consumer choices. Additionally, five clusters of consumers were identified, whose preferences are related both to purchasing styles and socio-demographic variables. In conclusion, this research has highlighted the positive attitude of consumers towards quality products backed by a brand, providing ideas for companies to improve within this sector and implement strategies to answer the needs of a new segment of consumers, by determining market opportunities that aim to strengthen local brands.

A Supplemental Produce and eLearning Nutrition Education Program for Georgians Who Use Safety-Net Clinics for Their Health Care

OBJECTIVE

To explore the experiences of safety-net clinic patients who engaged in a 12-week supplemental produce and eLearning nutrition education program.

METHODS

This mixed-method study employed a nonrandomized comparison study design. Participants (intervention [n = 20] and comparison control [n = 6]) had diet-related chronic diseases. Data collection included pre- and post-intervention, focus group interviews, 24-hour diet recalls, and clinical and anthropometric outcome assessments. Interviews were recorded, transcribed, and coded using the constant comparison method. Nonparametric data analyses were conducted for quantitative data.

RESULTS

Three primary themes emerged: (1) program benefits, (2) challenges to achieving health benefits and optimal engagement of the program, and (3) recommendations for program improvement. Quantitative data analysis did not show significant differences in pre- and post-clinical and anthropometric measures between the intervention and comparison groups.

CONCLUSIONS AND IMPLICATIONS

Findings suggest a unique Supplemental Nutrition Assistance Program Education dissemination model that may decrease barriers to healthful eating and increase engagement in eLearning nutrition education.

Community Supported Agriculture Farmers’ Perceptions of Management Benefits and Drawbacks

Community Supported Agriculture (CSA) is a direct partnership between producer(s) and a group of consumers/members to share the risks and responsibilities of farming activities. CSA aims at producing and providing environmentally, socially, economically, and nutritionally sustainable food. Past research has focused on CSA members’ motivations. This research aims to gain a better understanding of CSA farmers’ perceived benefits and drawbacks in managing a CSA farm, and whether CSA management perception varies in different countries. The research collected data from 35 farmers that were based in the United States (US) and Hungary (HU). Data elaboration includes a one-way Anova test, Chi-square test, principal component analysis, and multiple multivariate linear regressions. The results support that US and HU farmers have similar positive perceptions of CSA farming management, especially in food quality, nutritional value products, environmental, and community benefits. The main differences concentrate on economic, financial, and management perceptions. CSA success as an alternative agro-food production and distribution system relies on the capability to involve CSA members. Therefore, CSA farmers’ management skills may evolve to ensure the performance of communication and community engaging practices. The main CSA concern is ensuring a fair income and living wage for the farmers and labor force. There is a need for better balancing non-monetary and monetary benefits for the farmers.

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.