A pilot study of an online produce market combined with a fruit and vegetable prescription program for rural families

Abstract

Despite being surrounded by farms, rural families are often at risk for diet-related diseases because of food disparities. Barriers such as distance and transportation to a full service grocery store, lack of cooking knowledge and skills, and the cost of fresh produce, force families to shop at convenience stores that carry predominantly unhealthy, processed foods. We combined a Fruit and Vegetable Prescription Program (F&VRx) with family cooking/nutrition classes and a pilot online produce shopping to promote lifestyle dietary changes in rural families. In 2 rural upstate New York communities school health staff referred low income families with one or more children at risk for chronic disease related to obesity for this pilot program. Each family was given a weekly online produce credit for 5 months, September/October 2017 through January/February 2018. Two monthly nutrition/cooking lessons were provided for the entire family. Evaluation was done using pre and post program surveys and Photovoice. Families took photos in response to the question "How has the F&VRx program affected my family?". Redemption of online produce credit was 94% and class attendance was 80%. Fruit and vegetable consumption rose for children. Confidence, culinary skills, and food literacy increased slightly. Three months after program completion, 60% of the families continued weekly online produce shopping without the F&VRx. Healthy behaviors for shopping, preparing, and consuming fruits and vegetables can be increased using a F&VRx, online produce ordering, and family cooking classes.

Keywords: Food access; Online produce market; Photovoice; Produce consumption; Produce prescription; Rural family.

Fig. 1

Parents showed a slight increase in confidence about their cooking skills and attitudes towards trying new foods.

Fig. 2

Parents reported consuming more FV, approaching the recommended 5 or more servings per day.

Fig. 3

Parents reported an increase in FV servings per child per day.

Fig. 4

Six families indicated financial constraints at the start of the program, compared to three at program completion.

Fig. 5

“That would be my 12 year old, son at home, who has a bad habit of cutting himself with knives. … And he has gotten better at class, using them right, helping cook dinner that night.”

Fig. 6

the children are more apt to eat vegetables now….. and fruits; they’re seeing different ways that you can prepare them that are healthy. And so they are more into trying different things, as opposed to not liking something. They are more willing to try it.“

Fig. 7

plus we’re preparing more (meals) together versus just grabbing something quick”.

Fig. 8

we started doing this (F&VRx) and then I’ve got all this fruit and I’m like, ‘Where am I gonna put it?’ So I cleaned out the bowl and it sits on the counter and now the kids just walk by and grab a fruit and keep walking …. instead of looking for cookies or chips…!”