Impacts of a farmers' market incentive programme on fruit and vegetable access, purchase and consumption.
OBJECTIVE
The present study examines the impact of Health Bucks, a farmers' market incentive programme, on awareness of and access to farmers' markets, and fruit and vegetable purchase and consumption in low-income New York City neighbourhoods.


METHODS
The evaluation used two primary data collection methods: (i) an on-site point-of-purchase survey of farmers' market shoppers; and (ii) a random-digit-dial telephone survey of residents in neighbourhoods where the programme operates. Additionally, we conducted a quasi-experimental analysis examining differential time trends in consumption before and after programme introduction using secondary Community Health Survey (CHS) data.


METHODS
New York City farmers' markets and communities.


METHODS
Farmers' market shoppers (n 2287) completing point-of-purchase surveys in a representative sample of New York City farmers' markets in 2010; residents (n 1025) completing random-digit-dial telephone survey interviews in 2010; and respondents (n 35 606) completing CHS interviews in 2002, 2004, 2008 and 2009.


RESULTS
Greater Health Bucks exposure was associated with: (i) greater awareness of farmers' markets; (ii) increased frequency and amount of farmers' market purchases; and (iii) greater likelihood of a self-reported year-over-year increase in fruit and vegetable consumption. However, our CHS analysis did not detect impacts on consumption.


CONCLUSIONS
While our study provides promising evidence that use of farmers' market incentives is associated with increased awareness and use of farmers' markets, additional research is needed to better understand impacts on fruit and vegetable consumption.
1US Health Division,Abt Associates Inc.,55 Wheeler Street,Cambridge,MA 02138,USA.
Lauren Ew
http://orcid.org/0000-0003-4503-9745
LE
Olsho
2Division of Nutrition,Physical Activity and Obesity,Centers for Disease Control and Prevention,Atlanta,GA,USA.
Gayle Holmes
GH
Payne
1US Health Division,Abt Associates Inc.,55 Wheeler Street,Cambridge,MA 02138,USA.
Deborah Klein
DK
Walker
3Physical Activity and Nutrition Program,NYC Department of Health and Mental Hygiene,New York,NY,USA.
Sabrina
S
Baronberg
2Division of Nutrition,Physical Activity and Obesity,Centers for Disease Control and Prevention,Atlanta,GA,USA.
Jan
J
Jernigan
3Physical Activity and Nutrition Program,NYC Department of Health and Mental Hygiene,New York,NY,USA.
Alyson
A
Abrami
D000383:Agriculture; D001364:Awareness; D002755:Choice Behavior; D004032:Diet; D000067565:Farmers; D005247:Feeding Behavior; D005260:Female; D005518:Food Preferences; D005523:Food Supply; D005638:Fruit; D015438:Health Behavior; D006293:Health Promotion; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009519:New York City; D011203:Poverty; D015397:Program Evaluation; D058012:Small Business; D014675:Vegetables
Access; Farmers’ markets; Fruits and vegetables; Nutrition incentives