title: Farmers' market use is associated with fruit and vegetable consumption in diverse southern rural communities.
abstract: BACKGROUND
  While farmers' markets are a potential strategy to increase access to fruits and vegetables in rural areas, more information is needed regarding use of farmers' markets among rural residents. Thus, this study's purpose was to examine (1) socio-demographic characteristics of participants; (2) barriers and facilitators to farmers' market shopping in southern rural communities; and (3) associations between farmers' market use with fruit and vegetable consumption and body mass index (BMI).
  
  
  METHODS
  Cross-sectional surveys were conducted with a purposive sample of farmers' market customers and a representative sample of primary household food shoppers in eastern North Carolina (NC) and the Appalachian region of Kentucky (KY). Customers were interviewed using an intercept survey instrument at farmers' markets. Representative samples of primary food shoppers were identified via random digit dial (RDD) cellular phone and landline methods in counties that had at least one farmers' market. All questionnaires assessed socio-demographic characteristics, food shopping patterns, barriers to and facilitators of farmers' market shopping, fruit and vegetable consumption and self-reported height and weight. The main outcome measures were fruit and vegetable consumption and BMI. Descriptive statistics were used to examine socio-demographic characteristics, food shopping patterns, and barriers and facilitators to farmers' market shopping. Linear regression analyses were used to examine associations between farmers' market use with fruit and vegetable consumption and BMI, controlling for age, race, education, and gender.
  
  
  RESULTS
  Among farmers' market customers, 44% and 55% (NC and KY customers, respectively) reported shopping at a farmers' market at least weekly, compared to 16% and 18% of NC and KY RDD respondents. Frequently reported barriers to farmers' market shopping were market days and hours, "only come when I need something", extreme weather, and market location. Among the KY farmers' market customers and NC and KY RDD respondents, fruit and vegetable consumption was positively associated with use of farmers' markets. There were no associations between use of farmers' markets and BMI.
  
  
  CONCLUSIONS
  Fruit and vegetable consumption was associated with farmers' market shopping. Thus, farmers' markets may be a viable method to increase population-level produce consumption.
authors.affiliation: Department of Public Health, Brody School of Medicine, East Carolina University, 600 Moye Blvd,, Mailstop 660, Lakeside Annex Modular Unit 8, Room 126, Greenville, NC 27834, USA. jilcotts@ecu.edu.
authors.forename: Stephanie B
authors.initials: SB
authors.lastname: Jilcott Pitts
authors.forename: Alison
authors.initials: A
authors.lastname: Gustafson
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wu
authors.forename: Mariel
authors.initials: M
authors.lastname: Leah Mayo
authors.forename: Rachel K
authors.initials: RK
authors.lastname: Ward
authors.forename: Jared T
authors.initials: JT
authors.lastname: McGuirt
authors.forename: Ann P
authors.initials: AP
authors.lastname: Rafferty
authors.forename: Mandee F
authors.initials: MF
authors.lastname: Lancaster
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Evenson
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Keyserling
authors.forename: Alice S
authors.initials: AS
authors.lastname: Ammerman
mesh_terms: D000383:Agriculture; D015992:Body Mass Index; D003132:Commerce; D003430:Cross-Sectional Studies; D004032:Diet; D005523:Food Supply / Q000706:statistics & numerical data*; D005638:Fruit; D006801:Humans; D007629:Kentucky; D009657:North Carolina; D012424:Rural Population; D014675:Vegetables