Determine how Farmers Market (FM) shopping is associated with fruit and vegetable (FV) intake and food literacy scores, and to understand knowledge, barriers, and rationale for FM usage among Supplemental Nutrition Assistance Program (SNAP) participants in Oklahoma.
Design
Cross-sectional study, online and in-person surveys.
Setting
SNAP-accepting FMs in Oklahoma.
Sample
SNAP participants in Oklahoma aged 18-64 years of age.
Measures
Surveys captured self-reported FV intake (cups/day), food literacy scores reflecting knowledge, skills, and confidence related to food, and perceived barriers and facilitators to FM shopping. Sociodemographic information was collected to characterize the sample.
Analysis
Descriptive summaries presented with counts and frequencies. FV intake and food literacy scores summarized by means and standard deviations. FM awareness scores summarized with medians and IQR.
Results
FM shoppers had a significantly higher intake of FV (19.1 ± 4.2 vs 16.6 ± 4.2; P = 0.0006) and higher food literacy scores (27.7 ± 4.9 vs 25.0 ± 5.5; P = 0.0025) than non-shoppers. FM awareness did not differ between shoppers and non-shoppers. Most prevalent barrier to FM shopping was “I don’t know where any markets are” (31.6%) most prevalent facilitator was “fresher produce” (43.3%).
Conclusion
FM shopping was associated with increased FV intake. Differences in food literacy suggest improving literacy may increase FM shopping among SNAP participants. Study provides new understanding to tailor and positively impact future interventions.
AuneDGiovannucciEBoffettaP, et al.Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol. 2017;46(3):1029-1056. doi:10.1093/ije/dyw319
Lee-KwanSHMooreLVBlanckHMHarrisDMGaluskaD. Disparities in state-specific adult fruit and vegetable consumption—United states. MMWR Morbidity and mortality weekly report. 2017;66(45):1241-1247.
HansonKLConnorLM. Food insecurity and dietary quality in US adults and children: a systematic review. Am J Clin Nutr. 2014;100(2):684-692. doi:10.3945/ajcn.114.084525
6.
GaraskySMbwanaKRomualdoATenaglioARoyMFoods typically purchased by supplemental nutrition assistance program (SNAP) households (Nutrition Assistance ProgramReport No. GS-10-F-0240U). U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support2016. https://fns-prod.azureedge.us/sites/default/files/ops/SNAPFoodsTypicallyPurchased.pdf
7.
BegleyAButcherLMBobongieVDhaliwalSS. Identifying participants who would benefit the Most from an adult food-literacy program. Int J Environ Res Publ Health. 2019;16(7):16071272. doi:10.3390/ijerph16071272
8.
BegleyAPaynterEButcherLMDhaliwalSS. Effectiveness of an adult food literacy program. Nutrients. 2019;11(4):797.
9.
StroudBSastreL. Impact and acceptability of the fresh start produce Rx program on food literacy, nutrition and health. J Nutr Educ Behav. 2023;55(7):79. doi:10.1016/j.jneb.2023.05.172
10.
BlumenthalSJHoffnagleEELeungCW, et al.Strategies to improve the dietary quality of supplemental Nutrition Assistance Program (SNAP) beneficiaries: an assessment of stakeholder opinions. Public Health Nutr. 2014;17(12):2824-2833. doi:10.1017/s1368980013002942
MabliJOhlsJDragosetLCastnerLSantosB. Measuring the effect of Supplemental Nutrition Assistance Program (SNAP) participation on food security (Nutrition Assistance ProgramReport No. GS-10F-0050L). U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support. 2013. https://fns-prod.azureedge.us/sites/default/files/Measuring2013.pdf
14.
Jilcott PittsSBWuQDemarestCL, et al.Farmers' market shopping and dietary behaviours among supplemental nutrition assistance program participants. Public Health Nutr. 2015;18(13):2407-2414. doi:10.1017/s1368980015001111
15.
WalkinshawLPQuinnELRochaAJohnsonDB. An evaluation of Washington state SNAP-Ed farmers' market initiatives and SNAP participant behaviors. J Nutr Educ Behav. 2018;50(6):536-546. doi:10.1016/j.jneb.2018.01.003
16.
Jefferson-MooreKYRobbinsRDJohnsonDBradfordJ. Consumer preferences for local food products in North Carolina. J Food Distrib Res. 2014;45(856-2016-58140):41-46.
17.
RitterGWalkinshawLPQuinnELIckesSJohnsonDB. An assessment of perceived barriers to farmers' market access. J Nutr Educ Behav. 2019;51(1):48-56. doi:10.1016/j.jneb.2018.07.020
18.
SchmitTMSeversonRMSawauraE. Accessing the barriers to increasing customer participation and farm sales at farmers markets; implications for marketing strategy (Cornell University, Dyson School of Applied Economics and Management, Economic Bulletin No. EB 2019-05). 2019. https://dyson.cornell.edu/wp-content/uploads/sites/5/2019/08/Cornell-Dyson-eb1905.pdf
19.
KarpynAPonJGrajedaSB, et al.Understanding impacts of SNAP fruit and vegetable incentive program at farmers' markets: findings from a 13 state RCT. Int J Environ Res Publ Health. 2022;19(12):7443. doi:10.3390/ijerph19127443
20.
Savoie RoskosMRWengreenHGastJLeBlancHDurwardC. Understanding the experiences of low-income individuals receiving farmers' market incentives in the United States: a qualitative study. Health Promot Pract. 2017;18(6):869-878. doi:10.1177/1524839917715438
21.
BradfordVAQuinnELWalkinshawLP, et al.Fruit and vegetable access programs and consumption in low-income communities. J Hunger Environ Nutr. 2019;14(6):780-795. doi:10.1080/19320248.2018.1498819
22.
JohnRScottMOwenJ. SNAP Beneficiaries and Oklahoma SNAP Farmers’ Markets. Oklahoma University Health Sciences Center, 2011.
BegleyAPaynterEButcherLMDhaliwalSS. Examining the association between food literacy and food insecurity. Nutrients. 2019;11(2):11020445. doi:10.3390/nu11020445
25.
WetherillMSGrayKA. Farmers' markets and the local food environment: identifying perceived accessibility barriers for SNAP consumers receiving temporary assistance for needy families (TANF) in an urban Oklahoma community. J Nutr Educ Behav. 2015;47(2):127-133.e1. doi:10.1016/j.jneb.2014.12.008
26.
FreedmanDAChoiSKHurleyTAnaduEHébertJR. A farmers' market at a federally qualified health center improves fruit and vegetable intake among low-income diabetics. Prev Med. 2013;56(5):288-292. doi:10.1016/j.ypmed.2013.01.018
27.
Di NoiaJMonicaDSikorskiiACullenKW. Outcomes of a randomized controlled trial of nutrition education to promote farmers' market fruit and vegetable purchases and consumption among women enrolled in the special supplemental nutrition program for women, infants, and children (WIC). BMC Nutr. 2017;3:48. doi:10.1186/s40795-017-0172-0
28.
VidgenHAGallegosD. Defining food literacy and its components. Appetite. 2014;76:50-59. doi:10.1016/j.appet.2014.01.010
29.
PerkinsSDaleyAYerxaKTherrienM. The effectiveness of the expanded food and nutrition Education Program (EFNEP) on diet quality as measured by the healthy eating index. Am J Lifestyle Med. 2019;14(3):316-325. doi:10.1177/1559827619872733
30.
SprakeEFRussellJMCecilJE, et al.Dietary patterns of university students in the UK: a cross-sectional study. Nutr J. 2018;17(1):90. doi:10.1186/s12937-018-0398-y
31.
LavelleFSpenceMHollywoodL, et al.Learning cooking skills at different ages: a cross-sectional study. Int J Behav Nutr Phys Activ. 2016;13(1):119. doi:10.1186/s12966-016-0446-y
32.
McLaughlinCTarasukVKreigerN. An examination of at-home food preparation activity among low-income, food-insecure women. J Am Diet Assoc. 2003;103(11):1506-1512. doi:10.1016/j.jada.2003.08.022
33.
TessaroIRyeSParkerL, et al.Cookin' up health: developing a nutrition intervention for a rural Appalachian population. Health Promot Pract. 2006;7(2):252-257. doi:10.1177/1524839905278887
34.
OvercashFMVickersZRitterAE, et al.An in-home intervention of parent-implemented strategies to increase child vegetable intake: results from a non-randomized cluster-allocated community trial. BMC Public Health. 2019;19(1):881. doi:10.1186/s12889-019-7079-4
35.
KirkpatrickSI. Understanding and addressing barriers to healthy eating among low-income Americans. J Acad Nutr Diet. 2012;112(5):617-620. doi:10.1016/j.jand.2012.02.009
36.
MancinoLNewmanC. Who has time to cook? How family resources influence food preparation (Economic Research Report No. 40). U.S. Department of Agriculture, Economic Research Service. https://ageconsearch.umn.edu/record/55961/files/err40.pdf (2007).
37.
JabsJDevineCM. Time scarcity and food choices: an overview. Appetite. 2006;47(2):196-204. doi:10.1016/j.appet.2006.02.014
38.
GraceCGraceTBeckerNLydenJ. Barriers to using urban Farmers' Markets: an Investigation of Food Stamp Clients' perceptions. J Hunger Environ Nutr. 2007;2(1):55-75. doi:10.1080/19320240802080916
39.
DurwardCMSavoie-RoskosMAtoloyeA, et al.Double up food bucks participation is associated with increased fruit and vegetable consumption and food security among low-income adults. J Nutr Educ Behav. 2019;51(3):342-347. doi:10.1016/j.jneb.2018.08.011
40.
FerdinandRTorresRScottJSaeedIScribnerR. Incentivizing fruit and vegetable purchasers at fresh markets in lower 9th ward, New Orleans. Ethn Dis. 2017;27(Suppl 1):287-294. doi:10.18865/ed.27.S1.287
41.
YoungCRAquilanteJLSolomonS, et al.Improving fruit and vegetable consumption among low-income customers at farmers markets: Philly food bucks, Philadelphia, Pennsylvania, 2011. Prev Chronic Dis. 2013;10:E166. doi:10.5888/pcd10.120356
42.
PellegrinoSBostAMcGonigleM, et al.Fruit and vegetable intake among participants in a District of Columbia farmers' market incentive programme. Public Health Nutr. 2018;21(3):601-606. doi:10.1017/s1368980017003020
43.
Savoie-RoskosMDurwardCJeweksMLeBlancH. Reducing food insecurity and improving fruit and vegetable intake among farmers' market incentive program participants. J Nutr Educ Behav. 2016;48(1):70-76.e1. doi:10.1016/j.jneb.2015.10.003
44.
HamiltonDLWalkinshawLPQuinnELJohnsonDB. Increasing farmers market access among low-income shoppers in Washington state: understanding the role of peer-to-peer programs. J Hunger Environ Nutr. 2020;15(1):80-92. doi:10.1080/19320248.2018.1544527
45.
ElkaramanyMA. Ahead of the curve: how Oregon succeeded in enrolling all eligible households in the Supplemental Nutrition Assistance Program (SNAP). J Hunger Environ Nutr. 2024;19(1):50-66. doi:10.1080/19320248.2023.2211973
46.
MillerTMAbdel-MaksoudMFCraneLAMarcusACByersTE. Effects of social approval bias on self-reported fruit and vegetable consumption: a randomized controlled trial. Nutr J. 2008;7(1):18. doi:10.1186/1475-2891-7-18
47.
KarakusMMilfortRMacAllumKHaoH. Nutrition assistance in farmers markets: understanding the shopping patterns of SNAP participants (Nutrition Assistance Program Report No. AG-3198-B-10-0029, Task AG-3198-K-11-0059). U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support2014. https://fns-prod.azureedge.us/sites/default/files/FarmersMarkets-Shopping-Patterns.pdf
48.
YlitaloKRDuringCThomasKEzellKLillardPScottJ. The veggie Van: customer characteristics, fruit and vegetable consumption, and barriers to healthy eating among shoppers at a mobile farmers market in the United States. Appetite. 2019;133:279-285. doi:10.1016/j.appet.2018.11.025
