Farmers’ markets are community health promotion interventions that increase access to fresh fruits and vegetables. As farmers’ markets continue to develop, it is important to strategically locate them in settings that are accessible to populations disparately affected by health disparities. One potential setting is a community health center. The goal of this analysis is to extend existing research on community readiness to identify indicators of preparedness among community health centers for establishing onsite farmers’ markets. The sampling frame for the readiness assessment included all community health centers in South Carolina (N = 20) representing 163 practice sites. Data collection included two brief online surveys, in-depth key informant interviews, and secondary analysis of contextual data. Five themes related to readiness for establishing a farmers market at a community health center were identified: capacity, social capital, awareness of health problems and solutions, logistical factors, and sustainability. Findings from this study provide guidance to researchers and community health center staff as they explore the development of environmental interventions focused on reducing diet-related health conditions by improving access to healthy foods.
Farmers’ markets have the potential to improve the health of
underserved communities, shape people’s perceptions, values, and
behaviors about healthy eating, and serve as a social space for both community
members and vendors. This study explored the influence of health care provider
communication and role modeling for diabetic patients within the context of a
farmers’ market located at a federally qualified health center (FQHC).
Although provider communication about diet decreased over time, communication
strategies included: providing patients with “prescriptions” and
vouchers for market purchases; educating patients about diet; and modeling
healthy purchases. Data from patient interviews and provider surveys revealed
that patients enjoyed social aspects of the market including interactions with
their health care provider, and providers distributed prescriptions and vouchers
to patients, shopped at the market, and believed the market had potential to
improve the health of FHQC staff and patients. Provider modeling of healthy
behaviors may influence patients’ food-related perceptions and dietary
behaviors.
Federally qualified health centers (FQHCs) offer primary and preventive healthcare, including cancer screening, for the nation’s most vulnerable population. The purpose of this study was to explore the relationship between access to FQHCs and cancer mortality-to-incidence ratios (MIRs). One-way analysis of variance was conducted to compare the mean MIRs for breast, cervical, prostate, and colorectal cancers for each U.S. county for 2006–2010 by access to FQHCs (direct access, in-county FQHC; indirect access, adjacent-county FQHC; no access, no FQHC either in the county or in adjacent counties). ArcMap 10.1 software was used to map cancer MIRs and FQHC access levels. The mean MIRs for breast, cervical, and prostate cancer differed significantly across FQHC access levels (p < 0.05). In urban and healthcare professional shortage areas, mean MIRs decreased as FQHC access increased. A trend of lower breast and prostate cancer MIRs in direct access to FQHCs was found for all racial groups, but this trend was significant for whites only. States with a large proportion of rural and medically underserved areas had high mean MIRs, with correspondingly more direct FQHC access. Expanding FQHCs to more underserved areas and concentrations of disparity populations may have an important role in reducing cancer morbidity and mortality, as well as racial-ethnic disparities, in the United States.
Background
Federally qualified health centers (FQHCs) provide a health care safety net for
underserved populations and contribute unique expertise to research that could further
enhance quality of patient care. The purpose of this research was to assess interest in,
readiness to, and capacity for conducting research in FQHCs in South Carolina (SC).
Methods
A web-based survey was administered to 20 FQHCs across SC. Fourteen
representatives of FQHCs completed the 39-item survey that assessed research experience
and interest, partnerships and funding, barriers and benefits to research participation,
training and technical assistance needs, and research capacity.
Results
FQHCs are interested in conducting research. FQHCs reported that health center
leadership, organizational benefit, active engagement of staff, and clear roles for
partners were important factors for successful partnerships. Inequity of budget and
resources were the greatest challenges encountered. Improved patient outcomes,
additional resources for the center, reduction in disparities, and academic partnerships
were considered benefits for participation. FQHCs were interested in training and
technical assistance opportunities for research funding and best practices for the use
of research to inform programs and services.
Conclusions
FQHCs are willing to collaborate on research. For successful research
partnerships, collaborators should understand FQHCs’ challenges and barriers to
participation.
The South Carolina Cancer Prevention and Control Research Network, in partnership with the South Carolina Primary Health Care Association, and Federally Qualified Health Centers (FQHCs), aims to promote evidence-based cancer interventions in community-based primary care settings. Partnership activities include (1) examining FQHCs’ readiness and capacity for conducting research, (2) developing a cancer-focused data sharing network, and (3) integrating a farmers’ market within an FQHC. These activities identify unique opportunities for public health and primary care collaborations.
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