ABSTRACT
Food insecurity disproportionately burdens low-income households and has deleterious impacts on diet quality and health. Food system interventions are gaining in political salience, including short value chain (SVC) models of healthy food access that aim to minimize physical and social distance between producers and consumers. To evaluate, quantitatively, the influence of SVC interventions on food security, diet, and health outcomes, and characterize qualitatively-reported barriers to and facilitators of SVC participation. systematic review of English-language, peer-reviewed studies focused on low-income, US-based households. The search was executed across 9 databases in June 2021: Agricola, CAB s, CINAHL, Embase, Public Affairs Index, PubMed, Scopus, SocINDEX, and Web of Science. All references were imported into Covidence for deduplication, screening (in duplicate) and full-text review, with Excel used for data extraction. Studies were included for synthesis if they reported: relationships between SVC intervention participation and quantitative measures of food security, fruit and vegetable intake, total diet quality, or health markers (e.g., anthropometrics, clinical biomarkers), or qualitatively-reported barriers to or facilitators of SVC participation (i.e., uptake) for low-income consumers. Risk of bias was assessed using either the NHLBI Quality Assessment Tools or the Standards for Reporting Qualitative Research. A total of 13,458 articles were identified and screened for potential inclusion. Specific SVC interventions varied widely and included farmers market programming, community supported agriculture, produce prescriptions, and mobile markets, among other models. Among quantitative studies, food security and fruit and vegetable intake were frequent outcomes, and ones for which findings were generally promising. Measures of total diet quality and health biomarkers, though, were employed less consistently and study design often precluded causal inference. Factors influencing intervention participation varied by model. SVC healthy food access interventions hold potential to benefit low-income households and communities but more studies are needed to discern their causal influence on key outcomes and to inform optimization of their implementation for uptake and impact. None.