MIXED METHOD EVALUATIONS OF COMMUNITY-BASED FRUIT AND VEGETABLE PROMOTION PROGRAMS FOR LOW-INCOME HOUSEHOLDS
Garner, Jennifer Ann
The objective of this dissertation was to examine the implementation and effectiveness of a farmers market incentive program (FMIP), Double Up Food Bucks (DUFB), and a cost-offset community supported agriculture (CO-CSA) program, Farm Fresh Foods for Healthy Kids (F3HK) – both of which are designed to improve food security and fruit and vegetable (FV) intake among low-income consumers. This is a timely effort given disparities in obesity and chronic disease risk between individuals of lower- and higher-socioeconomic status and ongoing conversations regarding the 2018 Farm Bill and Supplemental Nutrition Assistance Program (SNAP) reform. Chapter 1 reviews the persistence of food insecurity in the U.S. and explains the relationship of this issue with our food system before introducing FMIPs and CO-CSAs as possible solutions needing robust evaluation. Chapter 2 introduces this work’s specific aims and theoretical framework. The aims were three-fold: to conduct a mixed methods process evaluation of F3HK from the perspective of multiple stakeholders (Chapter 3); to calculate the effectiveness and cost-effectiveness of using F3HK to shift users’ FV-related knowledge, attitudes, beliefs, behaviors, self-efficacy, food security status, and home food environment (Chapter 4); and to calculate the effectiveness and cost-effectiveness of using DUFB to improve food security status and FV intake among SNAP users (Chapter 5). Results have implications for the implementation of community-based food system-focused nutrition interventions and for the design of federal food assistance and agricultural policy.
Food security; Nutrition; Economics; Sociology; community supported agriculture; cost effectiveness; farmers market; fruit and vegetable; process evaluation
Sobal, Jeffery; Brannon, Patsy Marie; Kenkel, Donald S.
Ph. D., Nutrition
Doctor of Philosophy
dissertation or thesis