Operational challenges that may affect implementation of evidence-based mobile market interventions

Abstract

Introduction Mobile produce markets are becoming an increasingly prevalent, accepted, and effective strategy for improving fruit and vegetable (F&V) access and consumption across underserved and lower-income communities. However, there is limited published research on mobile market operations. The goal of this research is to identify the challenges mobile markets face and ways to potentially mitigate those challenges. We will also discuss implications of our findings for future implementation of evidence-based food access interventions. Methods We conducted 21 semi-structured key informant (KI) interviews to assess common practices of mobile market organizations that had been operating for 2 + years. We asked KIs about their organizational structure, operations, procurement and logistics, evaluation efforts, marketing and community engagement, success and challenges. A primary qualitative analysis involved deductive coding using qualitative software. A secondary qualitative analysis identified subthemes related to common challenges and remedial practices. A deductive coding process was applied to match identified challenges to the appropriate Consolidated Framework for Implementation Research (CFIR). Results The leading challenges cited by KIs correspond to the CFIR domains of inner setting (e.g., funding and resources), outer setting (e.g., navigating regulations), and process (e.g., engaging community partnership). Practices that may mitigate challenges include maximizing ancillary services, adopting innovative volunteer and staffing structures, and formalizing agreements with community partners. Conclusion Common and persistent challenges ought to be addressed to ensure and enhance the positive public health impacts of mobile produce markets. Contextual factors, particularly organizational factors, that impact implementation should also be considered when implementing an evidence-based intervention at a mobile market. Further research is needed to determine which innovative solutions are the most effective in mitigating challenges, improving implementation, and enhancing sustainability of mobile markets.

Using implementation mapping to refine strategies to improve implementation of an evidence-based mobile market intervention: a study protocol

“…As such, we recognize that even well designed and executed strategies that target the individual implementer may still be limited by these organizational, community, and policy-level constraints. Many of these challenges further validate our past formative work identifying common operational challenges among mobile market organizations ( 14 ) and justify the need for further exploration of the interplay between individual and environmental factors. Technical assistance is an effective strategy aimed at building organizational capacity to support implementation ( 27 , 28 ) and could be viewed as a way of helping organizations overcome barriers at multiple levels including the environment.…”

“…Relevant CFIR constructs were selected from the 39 measures in the 5 domains of CFIR (characteristics of intervention, outer setting, inner setting, characteristics of individuals, and process). Identification of the most salient constructs for inclusion in the interview guide was guided by our past research with 21 key informants representing established mobile market organizations across the US; findings from that formative work highlighted persistent operational challenges faced by organizations across the US that may undermine implementation of an evidence-based intervention (e.g., the Veggie Van model) ( 14 ). The final interview guides focused on the following CFIR constructs: relative advantage, adaptability, complexity, design quality and packaging, cost, external policy and incentives, customer needs and resources, cosmopolitanism, peer pressure, structural characteristics, implementation climate, readiness for implementation, knowledge and beliefs about the intervention, self-efficacy, planning, engaging, and executing.…”

Impacts of the COVID-19 Pandemic on Mobile Produce Market Operations: Adaptations, Barriers, and Future Directions for Increasing Food Access

“…Mobile market season lengths vary across the nation due to a combination of factors, including growing seasons, weather, organizational missions (e.g., only selling locally produced fruits and vegetables in a region with a short growing season), market infrastructure and set-up, community demand, finances, and other support [ 31 , 34 ]. Similar to season length, number of sites visited by a mobile market during the season is indicative of its community impact and reach.…”

“…Although mobile markets can fall under the umbrella of HROs, including food banks, food pantries, and anti-hunger advocacy organizations [ 53 ], they often exist between a food retailer and a true HRO, which could influence funding considerations when compared to a more familiar food access program like a food bank or food pantry. Having a for-profit component, where produce is sold at a reduced cost and incentive programs like SNAP are accepted as payment, can help support the sustainability of mobile markets [ 34 ]; however, access to funding for HROs during a disaster response like a pandemic can be stymied by this food distribution model.…”

“…Mobile produce markets are one such solution that has been growing in popularity [ 31 , 32 , 33 ], especially within the context of the COVID-19 pandemic. Mobile produce markets, also referred to as mobile markets, are small fruit and vegetable markets that travel to communities with reduced access to traditional food retail [ 31 , 32 , 34 ]. Mobile markets work to increase affordability of healthy foods through nutrition incentive programs and strategic pricing, and typically provide customers with nutrition education [ 31 ].…”