Increasing Community Access to Fresh Fruits and Vegetables: A Case Study of the Farm Fresh Market Pilot Program in Cobb County, Georgia, 2014

Abstract

BackgroundEcological models of health suggest that to effectively prevent chronic disease, community food environments must support healthy eating behaviors. However, disparities in access to healthy foods persist in the United States.Community ContextThe Farm Fresh Market (FFM) was a fruit and vegetable market that sold low-cost fresh produce in Cobb County, Georgia in 2014.MethodsThis case study describes the development of the FFM through a community engagement process and presents evaluation results from the project’s pilot implementation. Community engagement strategies included forming a community advisory board, conducting a needs assessment, and contracting with a community-based organization to implement the FFM. OutcomeIn the pilot year, the FFM served an average of 28.7 customers and generated an average of $140.20 in produce sales per market day. Most returning customers lived in the local community and reported a range of socioeconomic backgrounds. Most returning customers strongly agreed that the FFM made it easier (69.0%) and less expensive (79.0%) for them to buy fresh fruits and vegetables, reported that they ate more vegetables (65.0%) and fruit (55.0%) as a result of the FFM, and reported that they were very satisfied with the FFM overall (92.0%).InterpretationResults from this community case study underscore the importance of engaging communities in the development of community food environment interventions. Results also suggest that the FFM initiative was a feasible and acceptable way to respond to the community-identified public health priority of increasing access to healthy foods.

A systematic review of components of community-based organisation engagement

“…High variability was found during critical appraisal of case studies, with scores ranging from 1 to 10 (Akintobi et al., ; Caldwell et al., ; Chaskin, Goerge, Skyles, & Guiltinan, ; Darling et al., ; LoConte, Weeth‐Feinstein, Conlon, & Scott, ; McFarlane, Kahili, & Johnson, ; Napoles et al., ; Panapasa et al., ; Singer et al., ). Five studies met all the criteria (Chaskin et al., ; Darling et al., ; Gainforth, Latimer‐Cheung, Moore, Athanasopoulos, & Martin Ginis, ; Jewett‐Tennant et al., ; Woodruff et al., ). Points were deducted from case studies that did not describe the methods, analysis and results for the project itself (Caldwell et al., ; Panapasa et al., ; Singer et al., ; Tisnado et al., ).…”

“…Required resources will be linked to the aims of the project and existing conditions for a research project (Akintobi et al., ). CBOs can assist by identifying resources in target communities that will inform the research project (Akintobi et al., ; Woodruff et al., ). Outlining and identifying needed resources allows CBOs and other involved parties to understand what they contribute, how it will be contributed and its efficient use (Bloom et al., ).…”

“…The remaining studies included quantitative design (Bloom et al, 2009;Chandra et al, 2013;Geist, 2010;Glik et al, 2014;Goytia et al, 2013;Patterson et al, 2011); qualitative design (Boutain & McNees, 2013;Burkhalter et al, 2013;Collignon, Men, & Tan, 2001;Honeycutt et al, 2015;Johnson et al, 2006;Radermacher, Karunarathna, Grace, & Feldman, 2011;Taras et al, 2015); systematic review (Frew et al, 2014); and mixed-method design (Houston et al, 2002;Kakietek et al, 2013;Kelaher et al, 2014 High variability was found during critical appraisal of case studies, with scores ranging from 1 to 10 (Akintobi et al, 2012;Caldwell et al, 2015;Chaskin, Goerge, Skyles, & Guiltinan, 2006;Darling et al, 2015;LoConte, Weeth-Feinstein, Conlon, & Scott, 2013;McFarlane, Kahili, & Johnson, 2014;Napoles et al, 2014;Panapasa et al, 2012;Singer et al, 2015). Five studies met all the criteria (Chaskin et al, 2006;Darling et al, 2015;Gainforth, Latimer-Cheung, Moore, Athanasopoulos, & Martin Ginis, 2015;Jewett-Tennant et al, 2016;Woodruff et al, 2016). Points were deducted from case studies that did not describe the methods, analysis and results for the project itself (Caldwell et al, 2015;Panapasa et al, 2012;Singer et al, 2015;Tisnado et al, 2010).…”

Urban Farmers Markets as a Strategy to Increase Access to and Consumption of Fresh Vegetables among SNAP and Non-SNAP Participants: Results from an Evaluation

“…For example, an evaluation of two farmers markets in Los Angeles reported that 97-98% of customers agreed or strongly agreed that they eat more fruits and fresh vegetables because of the market (Ruelas, Iverson, Kiekel, & Peters, 2012). Additionally, an evaluation of a fruit and vegetable stand in Cobb County, Georgia, found that 65% of participants reported eating more vegetables, and 55% reported eating more fruit since they began shopping at the produce stand (Woodruff et al, 2016). These results suggest that farmers markets may have a positive impact on the dietary behavior of customers.…”

“…This evaluation did not use a pre-test, but instead relied on retrospective questions asking customers to reflect on how their community food environments and their own dietary intake have changed since beginning to shop at a TLW farmers market. Although similar measures have been used in prior studies (Woodruff et al, 2016), they may have been susceptible to several forms of bias, including social desirability bias, especially given that approximately 19% of survey respondents reported that they had volunteered for, been employed by, or served on the board of TLW within the previous six months. Although a pre/post design using valid and reliable measures to assess change in key outcomes of interest would have been a stronger evaluation design, this retrospective measurement approach was most feasible given the limited resources available for this evaluation and the need to keep the survey brief.…”