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A farmers' market at a federally qualified health center improves fruit and vegetable intake among low-income diabetics
Open accessAbstract
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 (-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]
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Metadata
- 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.
- Venue
- Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2013-05
- Volume
- 56
- Issue
- 5
- Pages
- 288-292
- ISSN
- 0091-7435 (ISSN-L)
- 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
- 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 › Medicine › Public Health, Environmental and Occupational Health › 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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