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Households with limited financial resources often struggle with inadequate access to healthy, affordable food. Community supported agriculture (CSA) has the potential to improve access to fresh fruits and vegetables, yet low-income households seldom participate due to cost and other barriers. Cost-offset (or subsidized) CSA reduces financial barriers, yet engagement varies widely among those who enroll. This scoping review explored factors associated with CSA participation among low-income households in the United States. Eighteen articles met the inclusion criteria, quantitative and qualitative data were extracted, the evidence was synthesized, and themes were developed. The findings suggested that women may be more likely than men to enroll in CSA. A lack of familiarity with CSA may hinder enrollment, whereas more education and self-efficacy for food preparation may facilitate participation. In terms of share contents, high-quality produce, a variety of items, more fruit, a choice of share contents, and a choice of share sizes may facilitate participation. In terms of CSA operations, a low price, good value, acceptance of Supplemental Nutrition Assistance Program (SNAP) benefits, close pick-up locations on existing travel routes, delivery of shares, clear communication, fostering a sense of belonging and trust, and educational support may support participation. Together these findings support 13 recommendations for cost-offset CSA implementation to engage low-income households. [ABSTRACT FROM AUTHOR]

Objective: To examine cross-sectional associations between farmers' market shopping behaviours and objectively measured and self-reported fruit and vegetable (FV) intake among rural North Carolina (NC) and New York City (NYC) shoppers.Design: Cross-sectional intercept surveys were used to assess self-reported FV intake and three measures of farmers' market shopping behaviour: (1) frequency of purchasing FV; (2) variety of FV purchased and (3) dollars spent on FV. Skin carotenoids, a non-invasive biomarker for FV intake, were objectively measured using pressure-mediated reflection spectroscopy. Associations between farmers' market shopping behaviours and FV intake were examined using regression models that controlled for demographic variables (e.g. age, sex, race, smoking status, education, income and state).Setting: Farmers' markets (n 17 markets) in rural NC and NYC.Participants: A convenience sample of 645 farmers' market shoppers.Results: Farmers' market shoppers in NYC purchased a greater variety of FV and had higher skin carotenoid scores compared with shoppers in rural NC. Among all shoppers, there was a positive, statistically significant association between self-reported frequency of shopping at farmers' markets and self-reported as well as objectively assessed FV intake. The variety of FV purchased and farmers' market spending on FV also were positively associated with self-reported FV intake, but not skin carotenoids.Conclusion: Those who shop for FV more frequently at a farmers' markets, purchase a greater variety of FV and spend more money on FV have higher self-reported, and in some cases higher objectively measured FV intake. Further research is needed to understand these associations and test causality. [ABSTRACT FROM AUTHOR]

Objective: To examine participants' experiences with nutrition education classes that were implemented with and designed to complement a cost-offset community-supported agriculture (CSA) programme.Design: Qualitative analysis of data from twenty-eight focus groups with ninety-six participants enrolled in Farm Fresh Foods for Healthy Kids (F3HK). Transcribed data were coded and analysed by a priori and emergent themes.Setting: Rural and micropolitan communities in New York, North Carolina, Vermont and Washington (USA).Participants: Ninety-six F3HK participants.Results: Participants found recipes and class activities helpful and reported improvements in nutrition knowledge, food preservation skills and home cooking behaviours for themselves and their children; they also reported that classes promoted a sense of community. Some educators better incorporated CSA produce into lessons, which participants reported as beneficial. Other obligations and class logistics were barriers to attendance; participants recommended that lessons be offered multiple times weekly at different times of day. Other suggestions included lengthening class duration to encourage social engagement; emphasising recipes to incorporate that week's CSA produce and pantry staples and offering additional strategies to incorporate children in classes.Conclusion: Complementing a cost-offset CSA with nutrition education may enhance programme benefits to low-income families by improving nutrition knowledge and cooking behaviours. However, future interventions will benefit from ongoing coordination between educators and local growing trajectories to maximise timely coverage of unfamiliar produce in lessons; synchronous scheduling of CSA pick-up and classes for participant convenience and creative strategies to engage children and/or provide childcare. [ABSTRACT FROM AUTHOR]

To improve low-income families’ access to fresh local produce, some farmers offer subsidized or “cost-offset” community supported agriculture (CO-CSA) shares. We evaluated a structured planning and implementation process conducted during the final intervention year of the Farm Fresh Foods for Healthy Kids (F3HK) study, which aimed to help participating farmers (N=12) to sustain a CO-CSA program after study funding ended. The process included training webinars, planning tools to develop CO-CSA continuation funding and recruitment strategies, regional coaching teams to provide technical assistance, and periodic group conference calls to facilitate shared learning among F3HK farmers. Our evaluation explored the content of farmers’ CO-CSA continuation plans, their experiences during implementation, their opinions about the planning process, and their future plans regarding their CO-CSA. We found that F3HK farmers used diverse methods to plan, recruit, and raise funds, with each farm adapting strategies to fit their local conditions and farm business. Many farmers found success with wordof-mouth advertising and CSA member donations. Yet lack of farm resources—time, money, and expertise—was a continual barrier to moving forward. As with full price CSAs, reciprocity was a key factor: farmers needed to consider the needs and preferences of low-income consumers, and COCSA members needed to understand their financial responsibility to the farmer. In general, F3HK farmers appreciated the continuation planning process, but expressed a desire for more technical assistance with grant writing. Farmers were committed to the success of the CO-CSA continuation planning process, and most intended to continue the CO-CSA the following year. [ABSTRACT FROM AUTHOR]

The Farmers' Market Nutrition Program (FMNP) in the U.S. provides coupons for the purchase of fruit and vegetables (FV) to pregnant women and children enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), and to income-eligible adults 60+ years of age. The New York State FMNP Education Event Guide was developed to support cooperative extension educators in providing information, food tastings, and cooking demonstrations at farmers' markets (FM) to encourage consumption of FV. This paper describes implementation at seven FM in New York City, and shopping and eating behaviors in a cross-sectional survey of FM shoppers (n = 377). Three of nine lessons were implemented more than once, typically with food sampling (78.9%). FM shoppers were primarily women (81.5%), racially diverse (30.5% Black, 23.1% White), frequent shoppers (2.4 times/month), and had high FV consumption (2.24 cups fruit; 2.44 cups vegetables daily). Most FM shoppers participated in the FM education event (84%), and participants and non-participants had equivalent shopping and eating behaviors. More than 70% of FM education participants believed that the event positively impacted their knowledge, self-efficacy, and behavioral intentions. FMNP education events at FM were broadly accepted by FM shoppers of all characteristics, and may improve knowledge, self-efficacy, and behavioral intention. [ABSTRACT FROM AUTHOR]

Objective: The COVID-19 pandemic led to greater food insecurity across the world, and government and charitable organisations did not always respond quickly enough or adequately to meet food needs. Mutual aid (MA) - neighbours helping neighbours to meet survival needs - mobilised residents to share food, often through outdoor food cabinets and refrigerators. This study aims to understand how MA food sharing was implemented, including food availability, acceptability, accessibility and impact on food access., Design: This case study describes one MA food sharing system by triangulating data from flyers, notes from nineteen volunteer meetings, six cabinet host interviews, data extracted from 1387 social media posts and 356 photographs, and 111 resident surveys., Setting: Tompkins County, NY, USA (total population about 100 000)., Results: We estimated high availability of food: approximately 250 000 food servings were shared monthly, mostly carbohydrates. Most residents obtaining food found it acceptable, including satisfaction with food safety and cleanliness, food quantity, and ease of travel to the cabinets but were less satisfied with food variety. MA food sharing was accessible to food-insecure, unemployed and disabled residents, but not other priority populations. About two-thirds of residents reported improved food access. Volunteers exhibited tenacity and ingenuity in meeting operational challenges which included trash and vandalism, winter weather and unusable food contributions while foregrounding residents' safety and privacy as shared values and navigating conflicting views about fairness., Conclusions: In times of crisis, MA can improve food access through free food sharing cabinets, but barriers include unacceptable food contributions and outdoor conditions.