Evaluation of a Distribution Model to Increase Access to Affordable Fruits and Vegetables.

Introduction: Identifying effective, sustainable strategies to increase fruit and vegetable consumption is critical to addressing chronic disease risk. Models that provide incentives for produce purchases through reduced-cost or no-cost produce shares are promising. The purpose of our study was to examine the impact on fruit and vegetable intake of Good Food for All, a community-based program to distribute no-cost produce boxes to participants with low incomes. We also assessed program satisfaction and future interest in purchasing an affordable produce box. Methods: The Good Food for All program was implemented in 22 US cities. Surveys were administered at baseline and postintervention. An online research panel was used as a comparison group and weighted to be demographically comparable to the intervention group. Descriptive statistics and adjusted difference-in-difference (ADID) models were used to examine differences in outcomes between groups. Results: Respondents (intervention n = 632; comparison n = 1,153) were primarily White, non-Hispanic, and female. Intervention participants had a greater increase in total fruit consumption frequency (ADID: 0.43 times/d; 95% CI, 0.21-0.64; P < .001), total vegetable consumption frequency (ADID: 0.52 times/d; 95% CI, 0.12-0.91; P = .01), and total fruit and vegetable consumption frequency (ADID: 1.03 times/d; 95% CI, 0.49-1.56; P < .001) than comparison respondents. Most intervention participants reported boxes contained the right amount of food (71.9%) and high-quality produce (68.4%) and were willing to purchase a future produce box (85.0%). Conclusion: Findings indicate that a produce box distribution model increased fruit and vegetable consumption, had high satisfaction among participants, and generated interest in purchasing affordable produce boxes. Future studies should explore feasibility of offering low-cost produce boxes at grocery stores and determine appropriate pricing models to enhance access and sustainability.

Concerns in measurement of healthy eating and physical activity standards implementation.

As part of its 2011 commitment to the Partnership for Healthier America, the YMCA of the USA (Y-USA) pledged that by 2015, 85 percent of its local Y associations with early childhood or afterschool programs would have at least one program site that met 100 percent of the Y-USA's healthy eating and physical activity (HEPA) standards. To inform the measurement and monitoring of HEPA standards, the Y-USA designed a thirty-three-item online survey to assess which HEPA standards were being met in afterschool program sites each year in order to track progress over time. Verification activities including direct observation, key informant interviews, and document review generated overall compliance ratings for each standard. Compliance ratings were then compared to the self-reported survey results to determine the validity of the survey for assessing each HEPA standard. The survey had variable accuracy when compared to the validation methods. This chapter aims to inform the measurement and monitoring of HEPA standards implementation in larger afterschool networks by reporting on learnings from the Y-USA's early efforts in its network.

Travel to, and use of, twenty-one Michigan trails.

OBJECTIVE AND METHODS: This study examined trail use among 857 trail users on 21 trails in Michigan from 2008 to 2011 using a valid and reliable intercept survey. RESULTS: Most of the 857 participants traveled to the trail from their home (92.6%), lived within 15 min of the trails (74.8%), and used active transport to travel to the trails 69.7%. The odds of active transport to the trails were greater among those who had not graduated high school (OR=3.49; 95% CI=1.02, 11.99) and high school graduates (OR=7.432; 95% CI=2.02, 27.30) compared to college graduates. Whites and adults also had greater odds of active transport than non-Whites (OR=3.160, 95% CI: 1.65, 6.05), and older adults (OR=1.75; 95% CI: 1.20, 2.54). The majority of respondents (89.7%) reported using trails for recreational purposes. A significantly greater proportion of females (73.3%) compared to males (64.7%) reported using the trail with others. CONCLUSIONS: The findings from this study might enable health and parks and recreation professionals to better promote physical activity on trails.

Demographic characteristics and physical activity behaviors in sixteen Michigan parks.

The Building Healthy Communities (BHC) initiative addresses inadequate physical activity in Michigan using a population-based approach to prevent chronic disease. Eighteen local health departments through 2010 received $1,505,179 to plan and implement community-based interventions to increase physical activity among low-income and minority populations. This paper examines park user demographics, compares park user demographics to the demographic characteristics and examines physical activity behaviors of park users in these parks. BHC Park usage was examined from 2008 to 2010 using the System for Observing Play and Recreation in Communities (SOPARC). One sample binomial tests were used to examine if the proportion of male and female park users was different than the proportion of males and females in Michigan and to examine if the proportion of white and other park users was different than the proportion of whites and others in Michigan. A chi-square goodness-of-fit test was used to examine whether the observed proportions for age groups observed using the park differed from the actual proportions for age groups in Michigan. The majority of BHC park users were white. More children were observed than other age groups. Park users were most often observed engaging in walking or vigorous activity rather than sedentary activities. When comparing the proportion of whites (54.7%) and others (42.8%) observed using the parks to the proportion of whites (79%) and others (21%) residing in Michigan, there was a significant difference (P < 0.001) with a greater proportion of whites and smaller proportion of persons of other ethnicities expected to be observed using the parks. This chi square goodness of fit test showed a significant difference in the observed and expected number of persons observed using the trail in each age group (χ(2) = 4,897.707, df = 3, P < 0.001) with a greater number of children (n = 1,939) and teens (n = 1,116) observed than the number of children (n = 828) and teens (n = 305) expected based on 2010 Michigan census data. A greater proportion of non-whites (compared to whites) were observed using the park than would be expected. In Michigan, 60% of blacks, 37% of Hispanics, and 53% of other minority groups do not meet national physical activity recommendations. Perhaps developing additional parks in Michigan can increase physical activity behaviors among minorities.