Evaluation of a Peer-to-Peer Approach to Improve the Reach of Farmers’ Markets among Low-income Populations

Farmers’ markets have been implemented to improve access to nutritious foods, yet use is low among people receiving Supplemental Nutrition Assistance Program (SNAP) benefits. This study’s objectives were to assess the feasibility of implementing the FreshLink Ambassador intervention to promote use of farmers’ markets located in high SNAP neighborhoods, describe information dissemination by Ambassadors, and evaluate intervention impact on SNAP use. The theory-based and data-driven intervention trained nine community residents as FreshLink Ambassadors in 2017; eight completed the study. Ambassadors conducted weekly outreach disseminating coupons to promote use of three intervention markets. Four comparison markets were selected to evaluate impact on SNAP use. SNAP sales from 2016 to 2017, standardized per vendor per market day open, were compared using paired and cluster-adjusted t-tests, p < .05. FreshLink Ambassadors conducted 155 outreach events reaching 1,138 people through coupon dissemination. The coupon redemption rate was 13.9%; redemption was significantly higher for people 50+ years of age, without children in the household, not currently receiving SNAP benefits, and living in the zip code with an intervention market. Intervention versus comparison markets had greater improvements in standardized SNAP sales ($0.73 vs. $0.44). These changes were not statistically significant but may be practically significant for farmers’ market operations. Findings provide evidence that implementation of the peer-to-peer outreach approach was feasible and coupon redemption rates exceeded industry standards indicating the “product” promoted by FreshLink Ambassadors was considered advantageous. Future research is warranted to evaluate different strategies intended to promote social access to farmers’ markets within a broader agenda to advance health equity.