title: Impact of a focused nutrition educational intervention coupled with improved access to fresh produce on purchasing behavior and consumption of fruits and vegetables in overweight patients with diabetes mellitus.
abstract: The purpose of this study was to test the impact of distributing coupons redeemable at farmers markets plus an educational intervention on fruit and vegetable (F&V) purchase and consumption in overweight patients with type 2 diabetes (T2DM).
  
  
  
  Seventy-eight participants with T2DM being followed at Jacobi Medical Center, a large public hospital in the Bronx, New York, were randomized to receive the standard of care or a 1-hour session focused on benefits of F&V consumption and $6 in coupons. Questionnaires assessed demographics, F&V intake, and farmers market purchasing at baseline and 12 weeks. Clinical parameters were obtained through chart review at baseline and at 12 weeks.
  
  
  
  Participants were predominantly Latino, females, and low income. At 12 weeks, there was a statistically significant increase in the number of participants in the intervention arm who reported purchasing from a farmers market. In addition, there was a minimal increase in fresh fruit intake in the intervention arm at 12 weeks.
  
  
  
  Focused education combined with a small economic incentive resulted in an increase in purchasing behavior and fresh fruit intake per day. A more intense behavioral intervention combined with increased access may result in a significant impact on obesity and diabetes, particularly among low-income and racially diverse communities.
authors.affiliation: Albert Einstein College of Medicine, Bronx, New York (Dr Weinstein, Dr Davis, Dr Rucker, Mr Fried),|Jacobi Medical Center, Bronx, New York (Dr Weinstein, Dr Rucker, Dr Galindo)
authors.forename: Eleanor
authors.initials: E
authors.lastname: Weinstein
authors.affiliation: Jacobi Medical Center, Bronx, New York (Dr Weinstein, Dr Rucker, Dr Galindo)
authors.forename: Rodolfo J
authors.initials: RJ
authors.lastname: Galindo
authors.affiliation: Albert Einstein College of Medicine, Bronx, New York (Dr Weinstein, Dr Davis, Dr Rucker, Mr Fried),
authors.forename: Martin
authors.initials: M
authors.lastname: Fried
authors.affiliation: Albert Einstein College of Medicine, Bronx, New York (Dr Weinstein, Dr Davis, Dr Rucker, Mr Fried),|Jacobi Medical Center, Bronx, New York (Dr Weinstein, Dr Rucker, Dr Galindo)
authors.forename: Lisa
authors.initials: L
authors.lastname: Rucker
authors.affiliation: North Central Bronx Hospital, Bronx, New York (Dr Davis)
authors.forename: Nichola J
authors.initials: NJ
authors.lastname: Davis
mesh_terms: D000328:Adult; D002755:Choice Behavior; D003132:Commerce; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000208:ethnology / Q000523:psychology; D005247:Feeding Behavior; D005260:Female; D005638:Fruit / Q000600:supply & distribution*; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009518:New York / Q000453:epidemiology / Q000208:ethnology; D044623:Nutrition Therapy; D009752:Nutritional Status; D015397:Program Evaluation; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014675:Vegetables / Q000600:supply & distribution*