Not by trees alone: centering community in urban forestry

Urban forestry and urban greening efforts are blossoming as cities and towns work to enhance their open spaces as green infrastructure that provides multiple benefits. This work has reached new urgency given the need for both high-performance landscapes that can mitigate the effects of climate change and accessible, safe greenspaces that can support community well-being during the COVID-19 pandemic. At the same time, activists, practitioners, scholars, and decision-makers--particularly those within Black, Indigenous, People of Color, and frontline communities who bear the brunt of negative impacts--are calling for the need to attend to environmental justice implications of greening efforts. Following a review of the literature, we draw upon our observations as researchers embedded in the field of urban and community forestry to offer three themes and related guiding questions that can help advance that work: (1) supporting human capacity and care (investments in people and organizations);(2) community organizing beyond the green silo (intersectional and cross-sectoral approaches);and (3) re-envisioning the functions of the urban forest (productive systems and biocultural approaches). Our perspective is inspired by the work of residents, practitioners, and decision-makers who are engaging in reflection and innovation in pursuit of "just cities" that can enhance diversity, equity, and inclusion as critical to and inseparable from sustainability and resilience. We suggest that the field of urban forestry draw upon a community forestry ethos as we center the needs, capacities, and priorities of historically marginalized communities at the heart of the work of creating more just, sustainable cities.

Durvalumab (D) +/- tremelimumab (T) + chemotherapy (CT) in 1L metastatic (m) NSCLC: Overall survival (OS) update from POSEIDON after median follow-up (mFU) of approximately 4 years (y)

Background: In the Phase 3 POSEIDON study, 1L T+D+CT demonstrated statistically significant improvements in PFS and OS (OS HR 0.77;95% CI 0.65-0.92;p=0.0030;mFU 34.9 mo in censored pts) vs CT alone in pts with mNSCLC. D+CT showed a statistically significant improvement in PFS and a positive trend for OS improvement vs CT that did not reach significance (OS HR 0.86;95% CI 0.72-1.02;p=0.0758). Here we report an updated exploratory analysis of OS, and histology and mutational status subgroups, after a mFU of ~4 y. Method(s): Pts with EGFR/ALK wild-type mNSCLC were randomised 1:1:1 to 1L D (until progression) +/- limited-course T (up to 5 doses) + platinum-based CT (up to 4 cycles);or CT (up to 6 cycles). Alpha-controlled endpoints were PFS and OS for D+CT vs CT and T+D+CT vs CT. Pt tumours were molecularly characterised via sequencing of tissue and/or ctDNA samples. Result(s): At an updated data cutoff (DCO) of 11 Mar 2022 (mFU 46.5 mo in censored pts), T+D+CT continued to show OS benefit vs CT (HR 0.75;95% CI 0.63-0.88) with an estimated 25.0% of pts alive at 3 y vs 13.6% (Table). D+CT continued to numerically improve OS vs CT (HR 0.84;95% CI 0.71-0.99;3 y OS 20.7%). Consistent with results at the earlier DCO, OS benefit appeared more pronounced with T+D+CT vs CT in pts with non-squamous (than squamous;data will be presented) histology. A trend for OS benefit with T+D+CT vs CT continued to be observed in non-squamous subgroups with mutations (m) in STK11 (Table), KEAP1 or KRAS (data will be presented). No new safety signals were identified based on collection of serious AEs during long-term FU. [Formula presented] Conclusion(s): The results of this exploratory analysis from POSEIDON, after mFU of ~4 y, demonstrate the durable long-term OS benefit of adding a limited course of T to D and 4 cycles of CT. These data support the use of this regimen as a 1L treatment option for pts with mNSCLC, including harder-to-treat mutational subgroups such as STK11m, KEAP1m or KRASm. Clinical trial identification: NCT03164616 (release date: 23 May 2017). Editorial acknowledgement: Medical writing support for the development of this , under the direction of the authors, was provided by James Holland, PhD, of Ashfield MedComms (Macclesfield, UK), an Inizio company, and was funded by AstraZeneca. Legal entity responsible for the study: AstraZeneca PLC. Funding(s): AstraZeneca. Disclosure: B.C. Cho: Financial Interests, Personal, Advisory Board: KANAPH Therapeutic Inc, Brigebio therapeutics, Cyrus therapeutics, Guardant Health, Oscotec Inc;Financial Interests, Personal, Member of the Board of Directors: Interpark Bio Convergence Corp., J INTS BIO;Financial Interests, Personal, Stocks/Shares: TheraCanVac Inc, Gencurix Inc, Bridgebio therapeutics, KANAPH Therapeutic Inc, Cyrus therapeutics, Interpark Bio Convergence Corp, J INTS BIO;Financial Interests, Personal, Royalties: Champions Oncology;Financial Interests, Personal, Research Grant: Novartis, Bayer, AstraZeneca, MOGAM Institute, Dong-A ST, Champions Oncology, Janssen, Yuhan, Ono, Dizal Pharma, MSD, AbbVie, Medpacto, GIInnovation, Eli Lilly, Blueprint medicines, Interpark Bio Convergence Corp;Financial Interests, Personal, Advisory Role, Consulting: Novartis, AstraZeneca, Boehringer Ingelheim, Roche, BMS, Ono, Yuhan, Pfizer, Eli Lilly, Janssen, Takeda, MSD, Janssen, Medpacto, Blueprint medicines;Financial Interests, Personal, Other: DAAN Biotherapeutics. J.A. Alatorre Alexander: Financial Interests, Personal, Speaker's Bureau: BMS, Roche, AstraZeneca, MSD, Boehringer Ingelheim, Takeda, Eli Lilly, Janssen;Financial Interests, Personal, Advisory Board: BMS, Roche, AstraZeneca, MSD, Boehringer Ingelheim, Takeda, Eli Lilly, Janssen. S. Lucien Geater: Financial Interests, Personal, Advisory Board: Pfizer;Financial Interests, Institutional, Principal Investigator: AstraZeneca, Roche, Novartis, Boehringer Ingelheim;Financial Interests, Personal, Advisory Role: Pfizer. K. Sang-We: Non-Financial Interests, Personal, Invited Speaker: Boehringer Ingelheim;Financial I terests, Personal, Research Grant: Yuhan;Non-Financial Interests, Personal, Advisory Role: AstraZeneca, BMS, Boehringer Ingelheim, Norvatis, Lilly, Takeda, Therapex, and Yuhan. M. Hussein: Financial Interests, Personal, Advisory Board: AbbVie, Aptitude Health, AstraZeneca, Biopahrama, BMS, Exelixis, Mirati Therapeutics, Cardinal Health, Coherus Biosciences, Athenex, Karyopharm Therapeutics, IntegraConnect, Oncocyte. C.T. Yang: Financial Interests, Personal, Principal Investigator: AstraZeneca, Boehringer Ingelheim, Lilly, MSD, Merck, Amgen, Johnson & Johnson, AbbVie, Hanso Pharma, Roche, Ono, BMS, Chugai. L.H. Araujo: Financial Interests, Personal, Invited Speaker: MSD, Roche, Pfizer, AstraZeneca, Takeda, Lillly, Janssen, Amgen, Novartis, BMS, Sanofi;Financial Interests, Personal, Advisory Board: Roche, MSD, Takeda, AstraZeneca, Sanofi. H. Saito: Financial Interests, Personal, Speaker's Bureau: AstraZeneca, ONO Pharmaceutical;Financial Interests, Personal, Principal Investigator: AstraZeneca, Chugai Pharmaceutical ONO Pharmaceutical, Bristol Myers Squibb. N. Reinmuth: Financial Interests, Personal, Invited Speaker: Amgen, AstraZeneca, Bristol Myers Squibb, Boehringer Ingelheim, Daiichi Sankyo, Hoffmann-La Roche, Janssen, Lilly, MSD, Merck, Pfizer, and Takeda;Financial Interests, Personal, Speaker's Bureau: Amgen, AstraZeneca, Bristol Myers Squibb, Boehringer-Ingelheim, Daiichi Sankyo, Hoffmann-La Roche, Janssen, Lilly, MSD, Merck, Pfizer, and Takeda;Financial Interests, Personal, Advisory Board: Amgen, AstraZeneca, Bristol Myers Squibb, Hoffmann-La Roche, Janssen, MSD, Merck, Pfizer, and Takeda;Financial Interests, Personal, Other: Symphogen: Data Safety Monitoring Board. Z. Lai, H. Mann, X. Shi: Financial Interests, Personal, Full or part-time Employment: AstraZeneca;Financial Interests, Personal, Stocks/Shares: AstraZeneca. S. Peters: Financial Interests, Institutional, Advisory Board: Vaccibody, Takeda, Seattle Genetics, Sanofi, Roche/Genentech, Regeneron, Phosplatin Therapeutics, PharmaMar, Pfizer, Novartis, Mirati, Merck Serono, MSD, Janssen, Incyte, Illumina, IQVIA, GlaxoSmithKline, Gilhead, Genzyme, Foundation Medicine, F-Star, Eli Lilly, Debiopharm, Daiichi Sankyo, Boehringer Ingelheim, Blueprint Medicines, Biocartis, Bio Invent, BeiGene, Bayer, BMS, AstraZeneca, Arcus, Amgen, AbbVie, iTheos, Novocure;Financial Interests, Institutional, In ited Speaker: Takeda, Sanofi, Roche/Genentech, RTP, Pfizer, PRIME, PER, Novartis, Medscape, MSD, Imedex, Illumina, Fishawack, Eli Lilly, Ecancer, Boehringer Ingelheim, AstraZeneca, BMS, OncologyEducation, RMEI, Mirati;Financial Interests, Personal, Other, Associate Editor Annals of Oncology: Elsevier;Financial Interests, Institutional, Invited Speaker, MERMAID-1: AstraZeneca;Financial Interests, Institutional, Invited Speaker, MERMAID-2, POSEIDON, MYSTIC: AstraZeneca;Financial Interests, Institutional, Invited Speaker, Clinical Trial Steering committee CheckMate 743, CheckMate 73L, CheckMate 331 and 451: BMS;Financial Interests, Institutional, Invited Speaker, RELATIVITY 095: BMS;Financial Interests, Institutional, Invited Speaker, BGB-A317-A1217-301/AdvanTIG-301: BeiGene;Financial Interests, Institutional, Invited Speaker, Clinical Trial Chair ZEAL-1: GSK;Financial Interests, Institutional, Invited Speaker, Clinical Trial steering Committee PEARLS, MK-7684A: MSD;Financial Interests, Institutional, Invited Speaker, Clinical Trial Steering Committee SAPPHIRE: Mirati;Financial Interests, Institutional, Invited Speaker, LAGOON: Pharma Mar;Financial Interests, Institutional, Invited Speaker, phase 1/2 trials: Phosplatin Therapeutics;Financial Interests, Institutional, Invited Speaker, Clinical Trial Chair Skyscraper-01;chair ALEX;steering committee BFAST;steering committee BEAT-Meso;steering committee ImPower-030, IMforte: Roche/Genentech;Financial Interests, Institutional, Invited Speaker, Phase 2 Inupadenant with chemo: iTeos;Non-Financial Interests, Personal, Officer, ESMO President 2020-2022: ESMO;Non-Financial Interests, Personal, Officer, Council Me ber & Scientific Committee Chair: ETOP/IBCSG Partners;Non-Financial Interests, Personal, Officer, Vice-President Lung Group: SAKK;Non-Financial Interests, Personal, Other, Involved in Swiss politics: Swiss Political Activities;Non-Financial Interests, Personal, Officer, President and Council Member: Ballet Bejart Lausanne Foundation;Non-Financial Interests, Personal, Principal Investigator, Involved in academic trials: ETOP / EORTC / SAKK;Non-Financial Interests, Personal, Member: Association of Swiss Physicians FMH (CH), IASLC, ASCO, AACR;Non-Financial Interests, Personal, Leadership Role, ESMO President: ESMO;Non-Financial Interests, Personal, Member, Vice-President Lung Group: SAKK;Non-Financial Interests, Personal, Leadership Role, Vice -President: SAMO;Non-Financial Interests, Personal, Member, Association of Swiss interns and residents: ASMAC/VSAO. E.B. Garon: Financial Interests, Personal, Advisory Board: ABL Bio, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Dracen Pharmaceuticals, Eisai, Eli Lilly, EMD Serono, Gilead, GSK, Merck, Natera, Novartis, Personalis, Regeneron, Sanofi, Shionogi, Xilio Therapeutics;Financial Interests, Personal, Research Grant: ABL Bio, AstraZeneca, Bristol Myers Squibb, Dynavax Technologies, EMD Serono, Genentech, Iovance Biotherapeutics, Eli Lilly, Merck, Mirati Therapeutics, Neon Therapeutics, Novartis. T.S.K. Mok: Financial Interests, Personal, Invited Speaker: ACEA Pharma, Alpha Biopharma Co., Ltd., Amgen, Amoy Diagnostics Co., Ltd., AstraZeneca (before 1/1/19), BeiGene, BI, BMS, Daiichi Sankyo, Daz Group, Fishawack Facilitate Ltd., InMed Medical Communication, Janssen Pharmaceutica NV, Jiahui Holdings Co. Limi, Novartis, OrigiMed Co. Ltd., P. Permanyer SL, PeerVoice, Physicians' Education Resource, Pfizer, PrIME Oncology, Research to Practice, RochePharmaceuticals/Diagnostics/Foundation One, Sanofi-Aventis, Shanghai BeBirds Translation & Consulting Co., Ltd., T;Financial Interests, Personal, Advisory Board: AbbVie Inc., ACEA Pharma, Amgen, AstraZeneca, Berry Oncology, Blueprint Medicines Corporation, Boehringer Ingelheim Pharmaceuticals Inc., Bristol Myers Squibb Company, C4 Therapeutics, Inc, Covidien LP, CStone Pharmaceuticals, Curio Science, D3 Bio Ltd., Hengrui Therapeutics Inc., HutchMed, Ignyta, Inc., Incyte Corporation, Inivata, IQVIA, Janssen, Lily, Loxo-Oncology Inc., Lunit, Inc., Mer k Serono, Merck Sharp & Dohme, Mirati Therapeutics, Inc., MiRXES Group, Novartis, OrigiMed, Pfizer, Puma Biotechnolo;Financial Interests, Personal, Member of the Board of Directors: AstraZeneca PLC, HutchMed;Financial Interests, Personal, Full or part-time Employment: The Chinese University of Hong Kong (Full-Time);Financial Interests, Personal, Stocks/Shares: Aurora Tele-Oncology Ltd., HutchMed, Act Genomics-Sanomics Group, Loxo-oncology, Virtus Medical Group and Lunit USA, Inc;Non-Financial Interests, Institutional, Research Grant: AstraZeneca, BMS, G1 Therapeutics, MSD, Merck Serono, Novartis, Pfizer, Roche, SFJ, Takeda, XCovery;Financial Interests, Personal, Leadership Role: Lunit USA, Inc., ACT Genomics-Sanomics Group, Aurora;Financial Interests, Personal, Other, Independent contractor: AbbVie Inc., ACEA Pharma, Alpha Biopharma Co., Ltd., Amgen, Amoy Diagnostics Co., Ltd., AstraZeneca (before 1/1/19), BeiGene, Berry Oncology, BI, Blueprint Medicines Corporation, BMS, C4 Therapeutics, Inc, CStone Pharmaceuticals, Curio Science, Daiichi Sa, Loxo-Oncology, Merck Serono, MSD, Mirati Therapeutics Inc., MoreHealth, Novartis, OrigiMed, Pfizer, Puma Biotechnology Inc., Qiming Development (HK) Ltd., Roche Pharmaceuticals, Sanofi-Aventis, SFJ Pharmaceutical Ltd., Takeda Pharmaceuticals HK Ltd., Vert, Guardant Health, Hengrui Therapeutics Inc., HutchMed, Ignyta, Inc., Incyte Corporation, Inivata, IQVIA, Janssen, Lilly, Lunit USA, Inc., Loxo-Oncology, Lucence Health Inc., Medscape LLC/ WebMD, Merck Serono, MSD, Mirati Therapeutics Inc., MiRXES, MoreHea. M.L. Johnson: Financial Interests, Institutional, Research Grant: AbbVie;Acerta;Adaptimmune;Amgen;Apexigen;Arcus B osciences;Array BioPharma;Artios Pharma;AstraZeneca;Atreca, BeiGene;BerGenBio;BioAtla;Boehringer Ingelheim, Calithera Biosciences;Checkpoint Therapeutics;Corvus Pharmaceuticals;Curis;CytomX, Daiichi Sanyo;Dracen Pharmaceuticals;Dynavax, Eli Lilly, Elicio Therapeutics, EMD Serono, Erasca, Exelixis, Fate Therapeutics, Genentech/Roche, Genmab, Genocea Biosciences, GlaxoSmithKline, Gritstone Oncology, Guardant Health, Harpoon, Helsinn Healthcare SA, Hengrui Therapeutics, Hutchison MediPharma, IDEAYA Biosciences, IGM Biosciences, Immunocore, Incyte, Janssen, Jounce Therapeutics, Kadmon Pharmaceuticals, Loxo Oncology, Lycera, Memorial Sloan Kettering, Merck, Merus, Mirati Therapeutics, NeoImmuneTech, Neovia Oncology, Novartis, Numab Therapeutics, Nuvalent, OncoMed Pharmaceuticals, Pfizer, PMV Pharmaceuticals, RasCal Therapeutics, Regeneron Pharmaceuticals, Relay Therapeutics, Revolution Medicines, Ribon Therapeutics, Rubius Therapeutics, Sanofi, Seven and Eight Biopharmaceuticals/Birdie Pharmaceuticals, Shattuck Labs, Silicon Therapeutics, Stem CentRx, Syndax Pharmaceuticals, Takeda Pharmaceuticals, Tarveda, TCR2 Therapeutics, Tempest Therapeutics, Tizona Therapeutics, Tmunity Therapeutics, Turning Point Therapeutics, University of Michigan, Vyriad, WindMIL, Y-mAbs Therapeutics;Financial Interests, Institutional, Advisory Role: AbbVie, Amgen, Astellas, AstraZeneca, Axelia Oncology, Black Diamond, Boehringer Ingelheim, Bristol Myers Squibb, Calithera Biosciences, Checkpoint Therapeutics, CytomX Therapeutics, Daiichi Sankyo, EcoR1, Editas Medicine, Eisai, Eli Lilly, EMD Serono, G1 Therapeutics, Genentech/Roche, Genmab, Genocea Biosciences, GlaxoSmithKline, Gritstone Oncology, IDEAYA Biosciences, iTeos, Janssen, Merck, Mirati Therapeutics, Novartis, Oncorus, Regeneron Pharmaceuticals, Revolution Medicines, Ribon Therapeutics, Sanofi, Turning Point Therapeutics, WindMIL. All other authors have declared no conflicts of interest. Copyright © 2022

PCR109 Improving ACEI/ARB Adherence Among Nonadherent Patients Using Motivational Interviewing Intervention

Objectives: Angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs) are recommended for patients with comorbid diabetes mellitus and hypertension due to their favorable impact on microvascular and macrovascular events, cardiovascular outcomes, and mortality. Poor adherence to ACEI/ARB is a major public health concern. Motivational interviewing (MI) intervention is an effective patient-centered approach to improve adherence. The objective of this study was to evaluate the effectiveness of a telephonic MI intervention conducted by pharmacy students, tailored by the past ACEI/ARB adherence trajectories among nonadherent patients with comorbid diabetes mellitus and hypertension. Methods: Patients continuously enrolled in a Medicare Advantage Plan from July 2017-July 2021 with an ACEI/ARB prescription between July 2017-December 2017 were identified. Group-based trajectory modeling (GBTM) was used to identify 4 distinct patterns of ACEI/ARB adherence: adherent, gaps in adherence, gradual decline, and rapid decline in adherence. Patients from the 3 nonadherent trajectories were randomized either into MI intervention or control group. The intervention group received an initial call followed by 5 follow-up calls. The primary outcome was adherence measured as proportion of days covered (PDC) ≥ 0.80 for 1-year post-MI implementation. Multivariable logistic regression model evaluated the effect of the intervention on ACEI/ARB adherence. Results: This study included 240 patients who received intervention and 480 randomly selected controls. Patients who had received ≥ 4 calls were more likely to be adherent than those who received ≤ 3 follow-up calls (OR=2.01;P=0.01) despite the gaps in follow-up calls due to the COVID-19 outbreak. Other significant predictors of adherence were baseline adherence trajectories, number of other medications on the index date, prevalent users, regimen complexity, and CMS risk score. Conclusions: At 1 year, patients who received ≥ 4 calls had significantly better adherence than controls. MI intervention by pharmacy students has been demonstrated to improve adherence on a long-term basis.

The Multifaceted Impact of COVID-19 on Social Media Users' Wellbeing and Relationship With Urban Nature

As the coronavirus disease 2019 (COVID-19) pandemic has unfolded, the media is increasingly recognizing the value of urban nature, with greenspace use increasing. In cities, where people often lack access to private greenspaces, parks and other urban greenspaces offer opportunities for exercise and physically distanced socializing. Previous research has demonstrated the benefits of urban greenspaces to both physical and mental health, during times of relative stability. Here, we seek to examine how people's responses to greenspace are affected by a global pandemic, which uniquely affects both physical movements and mental wellbeing in the population at large. We compare tweets focused on nature- and greenspace-related keywords and hashtags from March to July 2019 with tweets from the same period in 2020 for metropolitan regions in the United States. We also examine the influence of stay-at-home restrictions in 2020. These posts reinforce findings from conventional survey approaches showing that people's relationship to greenspace is multifaceted. Furthermore, the results of our pre–post analysis of people's outdoor use suggest that the pandemic has had a differential impact on these multifaceted dimensions of people's engagement with nature. By applying a multidimensional construct of wellbeing, we identify Positive emotion, Positive relationships, and Meaning as subfactors of wellbeing that potentially can be increased by urban nature. These findings are important in demonstrating that greenspace in cities played a critical role in individuals' resilience and wellbeing during the early months of the pandemic and highlighting the need for maintaining and expanding access to urban greenspaces in the future, for the benefit of all city residents. Copyright © 2022 Johnson and Sachdeva.

Building Adaptive Capacity Through Civic Environmental Stewardship: Responding to COVID-19 Alongside Compounding and Concurrent Crises

A growing body of community resilience literature emphasizes the importance of social resources in preparing for and responding to disturbances. In particular, scholars have noted that community based organizations and strong social networks positively contribute to adaptive capacity, or the ability to adjust and respond to change while enhancing the conditions necessary to withstand future events. While it is well established that strong civic engagement and social networks contribute to enhanced adaptive capacity in times of change, there is more to learn about how adaptive capacity at the civic group and network level is impacted temporally by multiple and compounding crises. Research has shown that the ability for communities to adapt and respond to crisis is closely tied to longer term recovery. In the midst of the COVID-19 pandemic, which has overlapped and intersected with multiple additional climate crises as well as a reigniting of the ongoing American reckoning with racial injustice, the ability for communities to adapt and respond to compounding crises seems more crucial than ever. This paper uses qualitative data from semi-structured interviews with 34 civic environmental stewardship groups in New York City to explore their role in building adaptive capacity. In order to better understand how past crises have impacted stewardship groups' response to COVID-19, we focus on how groups have demonstrated flexibility and learning at an organizational scale. We look at two other crises, both acute (Superstorm Sandy, which hit the East Coast in 2012) and chronic (systemic racism) to identify instances of learning that lead to organizational transformation. We further aim to understand how group professionalization, measured by budget and staff size, and network connectivity impact their actions. By comparing the groups' experiences and responses to each event, we uncover strategies learned from past events (e.g., sharing contact lists, holding internal dialogues, leveraging new funding sources) that enable stewardship groups to respond to disaster in a way that builds their organizational adaptive capacity as well as contributes to the long-term resilience of their communities.

SNAP participants' purchasing patterns at a food co-op during the COVID-19 pandemic: A preliminary analysis

The COVID-19 pandemic has affected the food system, increasing barriers to food access and exacerbating food insecurity across the U.S. The Virginia state government initiated a stay-at- home order to help reduce the spread of COVID-19. Prior to the pandemic, the Virginia Fresh Match (VFM) Nutrition Incentive Network partnered with food retail outlets to provide Supplemental Nutrition Assistance Program (SNAP) participants point-of-purchase incentives (e.g., Double Up Food Bucks, SNAP Match), which function as matching discounts on fresh fruits and vegetables (F/V). These can enable participants to increase their purchasing power and potentially reduce food insecurity. In response to COVID-19, VFM removed the limit on incentive discounts (previously $101) to further incentivize the purchase of fresh F/V by SNAP participants. This study sought to characterize the purchasing patterns of SNAP participants at a food co-operative (co-op) partnered with VFM before and during the Virginia stay-at-home order. A total of 654 transactions at the co-op were included. Independent t-tests were utilized to determine differences before and during the order. The results indicated a significant increase in the mean incentive discount received during the order (pre-shutdown=$3.95, inter-shutdown=$5.01, p=0.035);however, simultaneously there was a decrease in the mean number of fresh F/V purchased (pre-shutdown=3.08, inter-shutdown=2.39, p=0.015). Although F/V purchases decreased, the presence of unlimited point-of-purchase incentives at the food co-op may have helped prevent a greater decline in fresh F/V purchases and helped increase access to fresh F/V in this population during the onset of the COVID-19 pandemic.