Monetary matched incentives to encourage the purchase of fresh fruits and vegetables at farmers markets in underserved communities.
BACKGROUND
Farmers market programs may increase access to more healthful foods and reduce the high prevalence of obesity in low-income communities. The objective of this study was to examine outcomes of the Fresh Fund farmers market program serving low-income neighborhoods in San Diego, California.


METHODS
Through its Farmers Market Fresh Fund Incentive Program, the County of San Diego Health and Human Services Agency offered monetary incentives to government nutrition assistance recipients to purchase fresh produce at 5 farmers markets. Participants enrolled at participating markets from June 1, 2010, through December 31, 2011; they completed baseline and follow-up surveys of daily consumption and weekly spending on fruits and vegetables. We examined enrollment, participation, participant health perceptions, and vendor revenue.


RESULTS
During the study period, 7,298 eligible participants enrolled in Fresh Fund; most (82%) had previously never been to a farmers market. Among 252 participants with matched surveys at baseline and 12-month follow-up, the proportion who reported their diet to be "healthy" or "very healthy" increased from 4% to 63% (P < .001); nearly all (93%) stated that Fresh Fund was "important" or "very important" in their decision to shop at the farmers market. Vendors reported that 48% of all market revenue they received was received through the Fresh Fund program. At 2 markets, revenue from June 1, 2011, through January 31, 2012, increased by 74% and 68% compared with revenue from June 1, 2010, through January 31, 2011.


CONCLUSIONS
Participants in the Fresh Fund program self-reported increases in daily consumption and weekly spending on fruits and vegetables, and vendors at participating farmers markets also increased their revenue.
Graduate School of Public Health, and Executive Director, Institute for Public Health, San Diego State University, 6505 Alvarado Rd, Ste 116, San Diego, CA 92120. E-mail: slindsay@mail.sdsu.edu.
Suzanne
S
Lindsay
Jennifer
J
Lambert
Tanya
T
Penn
Susan
S
Hedges
Kristine
K
Ortwine
Anchi
A
Mei
Tracy
T
Delaney
Wilma J
WJ
Wooten
D000328:Adult; D000368:Aged; D000383:Agriculture / Q000191:economics*; D002140:California; D003132:Commerce / Q000191:economics / Q000379:methods*; D004779:Environment Design; D005260:Female; D005523:Food Supply / Q000191:economics / Q000379:methods*; D005638:Fruit; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011204:Poverty Areas; D011632:Public Assistance; D012111:Residence Characteristics; D012923:Social Class; D014675:Vegetables; D035862:Vulnerable Populations; D055815:Young Adult