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Cluster randomized controlled trial of a mobile market intervention to increase fruit and vegetable intake among adults in lower-income communities in North Carolina

Leone, LA
; 
Tripicchio, GL
; 
Haynes-Maslow, L
; 
McGuirt, J
; 
Grady Smith, JS
; 
Armstrong-Brown, J
; 
Gizlice, Z
; 
Ammerman, A
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Journal Article
Date
2018-01-05
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Cluster-randomized trial
 Food environment
 Fruits and vegetables
 Lower-income
 Mobile market
 Adult
 Consumer Behavior
 Cooking
 Diet
 Feeding Behavior
 Female
 Fruit
 Health Behavior
 Health Promotion
 Humans
 Male
 Marketing
 Middle Aged
 North Carolina
 Nutritional Status
 Poverty
 Program Evaluation
 Retrospective Studies
 Self Efficacy
 Surveys and Questionnaires
 Vegetables
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http://hdl.handle.net/20.500.12613/4805
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10.1186/s12966-017-0637-1
Abstract
BACKGROUND: Poorer diets and subsequent higher rates of chronic disease among lower-income individuals may be partially attributed to reduced access to fresh fruits and vegetables (F&V) and other healthy foods. Mobile markets are an increasingly popular method for providing access to F&V in underserved communities, but evaluation efforts are limited. The purpose of this study was to determine the impact of Veggie Van (VV), a mobile produce market, on F&V intake in lower-income communities using a group randomized controlled trial. METHODS: VV is a mobile produce market that sells reduced-cost locally grown produce and offers nutrition and cooking education. We recruited 12 sites in lower-income communities in North Carolina (USA) to host VV, randomizing them to receive VV immediately (intervention) or after the 6-month study period (delayed intervention control). Participants at each site completed baseline and follow-up surveys including F&V intake, perceived access to fresh F&V and self-efficacy for purchasing, preparing and eating F&V. We used multiple linear regression to calculate adjusted differences in outcomes while controlling for baseline values, education and clustering within site. RESULTS: Among 142 participants who completed the follow-up, baseline F&V intake was 3.48 cups/day for control and 3.33 for intervention. At follow-up, adjusted change in F&V consumption was 0.95 cups/day greater for intervention participants (p = 0.005), but was attenuated to 0.51 cups per day (p = 0.11) after removing extreme values. VV customers increased their F&V consumption by 0.41 cups/day (n = 30) compared to a 0.25 cups/day decrease for 111 non-customers (p = 0.04). Intervention participants did not show significant improvements in perceived access to fresh F&V, but increased their self-efficacy for working more F&V into snacks (p = 0.02), making up a vegetable dish with what they had on hand (p = 0.03), and cooking vegetables in a way that is appealing to their family (p = 0.048). CONCLUSIONS: Mobile markets may help improve F&V intake in lower-income communities. TRIAL REGISTRATION: Clinicaltrials.gov ID# NCT03026608 retrospectively registered January 2, 2017.
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Springer Science and Business Media LLC
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The international journal of behavioral nutrition and physical activity
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