A farmers' market at a federally qualified health center improves fruit and vegetable intake among low-income diabetics

Freedman, Darcy A.; Choi, Seul Ki; Hurley, Thomas; Anadu, Edith; Hébert, James R.

doi:10.1016/j.ypmed.2013.01.018

Cited by 144Food Security and Health in Diverse PopulationsNutrition, Health and Food BehaviorOrganic Food and Agriculture

A farmers' market at a federally qualified health center improves fruit and vegetable intake among low-income diabetics

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Freedman, Darcy A., Choi, Seul Ki, Hurley, Thomas, Anadu, Edith, Hébert, James R.·2013·Preventive Medicine

DOI 10.1016/j.ypmed.2013.01.018PMC PMC3633661

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Abstract

Objective A 22-week federally qualified health center (FQHC)-based farmers' market (FM) and personal financial incentive intervention designed to improve access to and consumption of fruits and vegetables (FVs) among low-income diabetics in rural South Carolina was evaluated. Methods A mixed methods, one-group, repeated-measures design was used. Data were collected in 2011 before (May/June), during (August), and after (November) the intervention with 41 diabetes patients from the FQHC. FV consumption was assessed using a validated National Cancer Institute FV screener modified to include FV sold at the FM. Sales receipts were recorded for all FM transactions. A mixed-model, repeated measures analysis of variance was used to assess intervention effects on FV consumption. Predictors of changes in FV consumption were examined using logistic regression. Results A marginally significant (p=0.07) average increase of 1.6 servings of total FV consumption per day occurred. The odds of achieving significant improvements in FV consumption increased for diabetics using financial incentives for payment at the FM (OR: 38.8, 95% CI: 3.4-449.6) and for those frequenting the FM more often (OR: 2.1, 95% CI: 1.1-4.0). Conclusions Results reveal a dose-response relationship between the intervention and FV improvements and emphasize the importance of addressing economic barriers to food access.

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Studies describing interventions providing food or vouchers reported mixed results for the actual change in fruit/vegetable intake, averaging to no impact when pooled (SMD = -0.03, 95% CI, -0.66 to 0.61).
“Studies describing interventions providing food or vouchers reported mixed results for the actual change in fruit/vegetable intake, averaging to no impact when pooled (-0.03, 95% CI, -0.66 to 0.61).”
From Interventions Addressing Food Insecurity in Health Care Settings: A Systematic Review (2019) · cites this paper as [33]
The Methods and Results describe a voucher-supported farmers’ market intervention that measured fruit and vegetable intake, so this paper fits the category of studies named in the claim. But it reports a marginally significant increase of 1.6 servings per day in one diabetic cohort, not mixed results across studies or the pooled estimate of −0.03 (95% CI −0.66 to 0.61). (LLM, conf=0.88)
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Authors: Freedman, D. A., Choi, S. K., Hurley, T., Anadu, E., & Hébert, J. R.
Affiliations: University of South Carolina (US)
Corresponding author: Freedman, Darcy A.
ORCID: Freedman, Darcy A.
Choi, Seul Ki
Hurley, Thomas
Hébert, James R.
Venue: Preventive Medicine
Publisher: Elsevier BV
Published: 2013-05
Volume: 56
Issue: 5
Pages: 288-292
ISSN: 0091-7435 (ISSN-L)
DOI: 10.1016/j.ypmed.2013.01.018
PMC: PMC3633661
OpenAlex: W2087761903
Cited by: 144
References: 32
Citations by year: 2026: 6 · 2025: 6 · 2024: 10 · 2023: 11 · 2022: 13 · 2021: 10 · 2020: 9 · 2019: 12 · 2018: 10 · 2017: 18 · 2016: 13 · 2015: 10 · 2014: 11 · 2013: 5
FWCI: 23.55
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Preventive Medicine (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: Centers for Disease Control and Prevention (3U48DP001936-01W1)
National Cancer Institute (K05 CA136975)
Topics: Health Sciences › Health Professions › General Health Professions › Food Security and Health in Diverse Populations
Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Life Sciences › Agricultural and Biological Sciences › Plant Science › Organic Food and Agriculture
Keywords: farmers' markets, fruit and vegetable intake, diabetes mellitus, low-income populations, financial incentives, food access, federally qualified health centers, rural health, dose-response relationship, South Carolina
MeSH terms: Adult, Aged, Aged, 80 and over, Community Health Centers, Diabetes Mellitus, Female, Fruit, Humans, Male, Middle Aged, Poverty, Rural Population, Socioeconomic Factors, South Carolina, Vegetables

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A farmers' market at a federally qualified health center improves fruit and vegetable intake among low-income diabetics

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