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Huang Y, Wang Y, Pan Y. Investigating consumers' experiences with community supported agriculture: Convergent parallel design methods. PLoS One 2024; 19:e0303184. [PMID: 38739608 PMCID: PMC11090362 DOI: 10.1371/journal.pone.0303184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/19/2024] [Indexed: 05/16/2024] Open
Abstract
Community-supported agriculture (CSA) represents a collaborative model where local farms and community members form partnerships to facilitate the direct delivery of fresh produce from farms to consumers. This study primarily investigates the experiences of current CSA members, focusing on the key factors influencing their retention intentions. Employing a convergent parallel mixed methods approach, this study gathers and analyzes both quantitative data (such as factors affecting members' retention intentions) and qualitative data (derived from interviews reflecting members' perceptions of their CSA experiences). The integration of these datasets provides a comprehensive understanding of the factors that shape CSA membership dynamics. The research findings underscore that Convenience, Product Quality, and Positive Interactions are pivotal factors that contribute to members' Intentions to continue their CSA memberships. These insights are crucial for enhancing the services provided to CSA members and hold significant implications for the broader scope of CSA membership research. This study not only fills a critical gap in understanding the Chinese CSA context but also contributes to the global discourse on sustainable agriculture practices and community engagement.
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Affiliation(s)
- Yuanyuan Huang
- Department of Smart Experience Design, Kookmin University, Seoul, Korea
| | - Yuhan Wang
- Department of Smart Experience Design, Kookmin University, Seoul, Korea
| | - Younghwan Pan
- Department of Smart Experience Design, Kookmin University, Seoul, Korea
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Vasold KL, Mantinan K, Hofer R, Waddle M, Slechta A. Evaluation of a Distribution Model to Increase Access to Affordable Fruits and Vegetables. Prev Chronic Dis 2024; 21:E01. [PMID: 38176697 PMCID: PMC10805273 DOI: 10.5888/pcd21.230206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Abstract
Introduction Identifying effective, sustainable strategies to increase fruit and vegetable consumption is critical to addressing chronic disease risk. Models that provide incentives for produce purchases through reduced-cost or no-cost produce shares are promising. The purpose of our study was to examine the impact on fruit and vegetable intake of Good Food for All, a community-based program to distribute no-cost produce boxes to participants with low incomes. We also assessed program satisfaction and future interest in purchasing an affordable produce box. Methods The Good Food for All program was implemented in 22 US cities. Surveys were administered at baseline and postintervention. An online research panel was used as a comparison group and weighted to be demographically comparable to the intervention group. Descriptive statistics and adjusted difference-in-difference (ADID) models were used to examine differences in outcomes between groups. Results Respondents (intervention n = 632; comparison n = 1,153) were primarily White, non-Hispanic, and female. Intervention participants had a greater increase in total fruit consumption frequency (ADID: 0.43 times/d; 95% CI, 0.21-0.64; P < .001), total vegetable consumption frequency (ADID: 0.52 times/d; 95% CI, 0.12-0.91; P = .01), and total fruit and vegetable consumption frequency (ADID: 1.03 times/d; 95% CI, 0.49-1.56; P < .001) than comparison respondents. Most intervention participants reported boxes contained the right amount of food (71.9%) and high-quality produce (68.4%) and were willing to purchase a future produce box (85.0%). Conclusion Findings indicate that a produce box distribution model increased fruit and vegetable consumption, had high satisfaction among participants, and generated interest in purchasing affordable produce boxes. Future studies should explore feasibility of offering low-cost produce boxes at grocery stores and determine appropriate pricing models to enhance access and sustainability.
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Affiliation(s)
- Kerri L Vasold
- Altarum Institute, 3520 Green Ct #300, Ann Arbor, MI 48105
| | | | | | - Michael Waddle
- Partnership for a Healthier America, Washington, District of Columbia
| | - Amy Slechta
- Partnership for a Healthier America, Washington, District of Columbia
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Wang Q, Baranow N, Kolodinsky J, Trubek A, Wang W. Convivial cooking: Impacts of an educational intervention on college students' food agency. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-9. [PMID: 36170543 DOI: 10.1080/07448481.2022.2122721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 08/08/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
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.
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Affiliation(s)
- Qingbin Wang
- Department of Community Development and Applied Economics, University of Vermont, Burlington, Vermont, USA
| | - Natasha Baranow
- Center for Rural Studies, University of Vermont, Burlington, Vermont, USA
| | - Jane Kolodinsky
- Department of Community Development and Applied Economics, University of Vermont, Burlington, Vermont, USA
| | - Amy Trubek
- Department of Nutrition and Food Sciences, University of Vermont, Burlington, Vermont, USA
| | - Weiwei Wang
- Center for Rural Studies, University of Vermont, Burlington, Vermont, USA
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Hanson KL, Xu L, Marshall GA, Sitaker M, Jilcott Pitts SB, Kolodinsky J, Bennett A, Carriker S, Smith D, Ammerman AS, Seguin-Fowler RA. Participation in Cost-offset Community Supported Agriculture by Low-income Households in the U.S. is Associated with Community Characteristics and Operational Practices. Public Health Nutr 2022; 25:1-25. [PMID: 35416140 PMCID: PMC9991818 DOI: 10.1017/s1368980022000908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 01/31/2022] [Accepted: 04/04/2022] [Indexed: 11/06/2022]
Abstract
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.
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Affiliation(s)
- Karla L Hanson
- Department of Public and Ecosystem Health, Shurman Hall, Cornell University, Ithaca, NY14853, USA
| | - Lynn Xu
- Department of Public and Ecosystem Health, Shurman Hall, Cornell University, Ithaca, NY14853, USA
| | - Grace A Marshall
- Department of Public and Ecosystem Health, Shurman Hall, Cornell University, Ithaca, NY14853, USA
| | | | | | - Jane Kolodinsky
- Center for Rural Studies, University of Vermont, Burlington, VT, USA
| | - April Bennett
- Cornell Cooperative Extension of Jefferson County, Watertown, NY, USA
| | - Salem Carriker
- University of South Carolina, School of Medicine, Columbia, SC, USA
| | - Diane Smith
- Washington State University, Extension of Skagit County, Burlington, WA, USA
| | - Alice S Ammerman
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Seguin-Fowler RA, Hanson KL, Jilcott Pitts SB, Kolodinsky J, Sitaker M, Ammerman AS, Marshall GA, Belarmino EH, Garner JA, Wang W. 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. Int J Behav Nutr Phys Act 2021; 18:112. [PMID: 34461931 PMCID: PMC8406558 DOI: 10.1186/s12966-021-01168-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 07/05/2021] [Indexed: 12/03/2022] Open
Abstract
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.
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Affiliation(s)
- Rebecca A Seguin-Fowler
- Texas A&M AgriLife Research, 600 John Kimbrough Boulevard, Suite 512, College Station, TX, 77843, USA.
| | - Karla L Hanson
- Department of Population Medicine and Diagnostic Sciences, Master of Public Health Program, Cornell University, S2064 Schurman Hall, Ithaca, NY, 14853, USA
| | - Stephanie B Jilcott Pitts
- Department of Public Health, East Carolina University, 600 Moye Blvd, Lakeside Annex Modular 7, Greenville, NC, 27834, USA
| | - Jane Kolodinsky
- Department of Community Development and Applied Economics, University of Vermont, 202 Morrill Hall, Burlington, VT, 05405, USA
| | - Marilyn Sitaker
- Ecological Agriculture and Food Systems, The Evergreen State College, 2700 Evergreen Parkway NW, Olympia, WA, 98505, USA
| | - Alice S Ammerman
- Department of Nutrition, Gillings School of Global Public Health, Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin Luther King Boulevard, CB#7426, Chapel Hill, NC, 27599, USA
| | - Grace A Marshall
- Master of Public Health Program, Cornell University, S2074 Schurman Hall, Ithaca, NY, 14853, USA
| | - Emily H Belarmino
- Department of Nutrition and Food Sciences, University of Vermont, 225 B Marsh Life Science, Burlington, VT, 05405, USA
| | - Jennifer A Garner
- School of Health and Rehabilitation Sciences, College of Medicine, John Glenn College of Public Affairs, The Ohio State University, 210N Page Hall, Columbus, OH, 43210, USA
| | - Weiwei Wang
- Center for Rural Studies, University of Vermont, 206 Morrill Hall, 146 University Place, Burlington, VT, 05405, USA
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Garner JA, Jilcott Pitts SB, Hanson KL, Ammerman AS, Kolodinsky J, Sitaker MH, Seguin-Fowler RA. Making community-supported agriculture accessible to low-income families: findings from the Farm Fresh Foods for Healthy Kids process evaluation. Transl Behav Med 2021; 11:754-763. [PMID: 32930794 DOI: 10.1093/tbm/ibaa080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
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.
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Affiliation(s)
- Jennifer A Garner
- School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA.,John Glenn College of Public Affairs, The Ohio State University, Columbus, OH, USA
| | - Stephanie B Jilcott Pitts
- Brody School of Medicine, Department of Public Health, East Carolina University, Greenville, NC, USA
| | - Karla L Hanson
- Master of Public Health Program, Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, USA
| | - Alice S Ammerman
- Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jane Kolodinsky
- Department of Community Development and Applied Economics, University of Vermont, Burlington, VT, USA
| | - Marilyn H Sitaker
- Ecological Agriculture and Food Systems, The Evergreen State College, Olympia, WA, USA
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Martin A, Coplen A, Lubowicki L, Izumi B. A Photovoice Inquiry Into the Impacts of a Subsidized CSA Program on Participants' Health. HEALTH EDUCATION & BEHAVIOR 2021; 49:10901981211002453. [PMID: 33899549 DOI: 10.1177/10901981211002453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although consumption of fruits and vegetables is associated with reduced risk of disease, many Americans do not eat the recommended quantity or variety. This is especially true for low-income populations, who may face significant barriers to accessing fresh produce, including cost. Community-supported agriculture (CSA) Partnerships for Health is a subsidized community-supported agriculture program designed to reduce barriers to accessing fresh produce in a low-income population. This Photovoice study gave participants (n = 28) an opportunity to take photos representing how the program affects their lives. The aim was to understand the program's impact from the perspective of CSA members. Participants had 2 to 4 weeks to take photographs, and then selected a few to discuss during a subsequent focus group. Through this discussion, we learned that participants see the program as (a) supporting positive changes to their physical and social health and (b) facilitating learning about new foods, cooking, and agriculture. The study suggests that a reduced-cost CSA membership that incorporates cooking education supports participants' ability to try new foods, build skills, and improve health outcomes.
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Affiliation(s)
- Allea Martin
- Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA
| | - Amy Coplen
- Portland State University, Portland, OR, USA
| | | | - Betty Izumi
- Oregon Health & Science University-Portland State University, Portland, OR, USA
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Cabili C, Briefel R, Forrestal S, Gabor V, Chojnacki G. A Cluster Randomized Controlled Trial of a Home-Delivered Food Box on Children's Diet Quality in the Chickasaw Nation Packed Promise Project. J Acad Nutr Diet 2021; 121:S59-S69. [PMID: 33342526 DOI: 10.1016/j.jand.2020.08.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 08/02/2020] [Accepted: 08/12/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Poor diet quality among children can lead to poor health, development, and academic achievement. Child nutrition assistance programs aim to improve diet quality among children. OBJECTIVE This study tested the impact of the Packed Promise intervention on diet quality among low-income children in Chickasaw Nation territory. DESIGN This study was a cluster randomized controlled trial of 40 school districts and 4,750 eligible, consented households within treatment and control districts. PARTICIPANTS/SETTING Household data were collected at baseline (n = 2,859) and follow-up (n = 2,852) in 12 rural Oklahoma counties. INTERVENTION Packed Promise treatment households chose from 5 types of home-delivered food boxes that contained nutritious foods ($38 food value) and a $15 check for purchasing fruits and vegetables. MAIN OUTCOME MEASURES Key outcomes included children's daily consumed amounts of fruits and vegetables, whole grains, and added sugars collected by a dietary screener questionnaire. Other outcomes included food shopping frequency, type of grocery store used, distance traveled from home to grocery stores, and the number of weekly family dinners. All outcomes in this article are secondary to the study's primary outcome-food insecurity among children. STATISTICAL ANALYSES PERFORMED Differences between the treatment and control groups were estimated by a regression model controlling for baseline characteristics and population-based average portion sizes. RESULTS Children's mean daily consumption of fruits and vegetables combined was about 2.35-cup equivalents in the treatment group and 2.25-cup equivalents in the control group (P < 0.001). Mean consumption of whole grains was 0.73-ounce equivalents in the treatment group compared with 0.67-ounce equivalents in the control group (P < 0.001). Other outcomes were not statistically significant. CONCLUSION Packed Promise led to significant but small improvements in children's daily consumption of fruits and vegetables and whole grains. Several factors, including household participation levels in Packed Promise, may have moderated the size of impacts. FUNDING/SUPPORT This article is published as part of a supplement supported by the US Department of Agriculture, Food and Nutrition Service.
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