title: A farmers' market at a federally qualified health center improves fruit and vegetable intake among low-income diabetics.
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.
authors: University of South Carolina, College of Social Work, Columbia, SC 29208, USA. darcy.freedman@sc.edu
authors: Darcy A
authors: DA
authors: Freedman
authors: Seul Ki
authors: SK
authors: Choi
authors: Thomas
authors: T
authors: Hurley
authors: Edith
authors: E
authors: Anadu
authors: James R
authors: JR
authors: Hébert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003151:Community Health Centers / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D005638:Fruit / Q000191:economics / Q000600:supply & distribution*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty; D012424:Rural Population; D012959:Socioeconomic Factors; D013022:South Carolina; D014675:Vegetables / Q000191:economics / Q000600:supply & distribution*
references: JAMA. 2010 Jan 20;303(3):235-41
references: 20071471
references: Am J Prev Med. 2006 Jan;30(1):38-44
references: 16414422
references: Diabetes Care. 2004 Feb;27(2):362-6
references: 14747214
references: N Engl J Med. 2001 Sep 13;345(11):790-7
references: 11556298
references: J Am Diet Assoc. 2010 Mar;110(3):399-408
references: 20184990
references: Prev Med. 2002 Jul;35(1):25-41
references: 12079438
references: Health Place. 2012 Sep;18(5):1137-43
references: 22608130
references: Am J Prev Med. 2012 Jun;42(6):563-70
references: 22608371
references: MMWR Morb Mortal Wkly Rep. 2010 Sep 10;59(35):1125-30
references: 20829745
references: J Am Diet Assoc. 2002 Dec;102(12):1764-72
references: 12487538
references: Diabetes Care. 2005 Nov;28(11):2780-6
references: 16249558
references: Am J Public Health. 2011 Dec;101(12):2226-32
references: 22021298
references: J Nutr. 2008 Jan;138(1):218S-225S
references: 18156428
references: Health Promot Pract. 2012 Mar;13(2):190-7
references: 21441205
references: MMWR Morb Mortal Wkly Rep. 2009 Jul 17;58(27):740-4
references: 19609247
references: J Nutr. 2008 Jan;138(1):200S-204S
references: 18156425
references: J Am Diet Assoc. 2011 Oct;111(10):1549-55
references: 21963022
references: J Am Diet Assoc. 2009 Jan;109(1):45-51
references: 19103322
references: BMJ. 2007 Feb 10;334(7588):299
references: 17237299
references: J Am Diet Assoc. 2001 Feb;101(2):195-202
references: 11271692
references: Am J Public Health. 2008 Jan;98(1):98-105
references: 18048803
references: Am J Clin Nutr. 1987 Jan;45(1):107-14
references: 3799494
references: Prev Med. 2012 Jul;55(1):23-7
references: 22564893