Impact of a Veggie Van Program to Increase Access to Fresh Fruits and Vegetables in Lower-Income and Underserved Communities

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The Veggie Van program is funded by the Robert Woods Johnson Foundation, and is envisioned to increase access to fresh fruits and vegetables in lower-income and underserved communities.

PURPOSE

Children from lower-income and minority groups face significant health disparities with respect to obesity, diabetes and future chronic conditions.  Poor diets, low in fruits and vegetables (F&V) and high in saturated fat, sodium and sugar, contribute to many of the health problems faced by vulnerable children.  While young children’s food choice are limited by parent’s food preference, shopping behaviors and socioeconomic status, research has repeatedly demonstrated the important role that the macro-environment plays in determining diet. However, most research examining the effects of food environment on child diet is mostly limited to cross-sectional, observational studies.  Randomized controlled trials (RCTs) are needed to better understand the relationship between food access and child diet.  This proposed RCT will add to the literature describing how the food environment affects children’s dietary behaviors and weight.

PROJECT DESCRIPTION

We plan to evaluate a separately funded intervention delivered by our community partners.  The intervention consists of a mobile market (aka The Veggie Van) that sells weekly boxes of reduced cost fresh North Carolina grown F&V and provides nutrition education, taste testing and cooking demos. We will evaluate the Veggie Van (VV) using a cluster-randomized RCT design with 12 sites (6 intervention, 6 control).  Community sites (e.g., child care centers, lower-income housing, churches) are located in lower-income or low food access areas. We will collect data from approximately 15 parents with a child age 3-10 at each site.
Aim 1: Determine the impact of the VV program using an intent-to-treat analysis and by measuring at baseline & 6 months:

a) Parent-report of child’s intake of fruits, vegetables, added sugars, refined carbohydrates and saturated fat at home via 24-hour dietary recalls
b) Body Mass Index (BMI) via parent-reported height and weight

Hypothesis: The VV program will improve children’s F&V intake and attitudes and consequently reduce their intake of “obesogenic” food relative and prevent increases in BMI at 6 months relative to control.

Aim 2: Understand the mechanisms by which the VV program affects child diet using:
a) Veggie Van purchasing data and grocery store receipts for child’s household
b) Parents’ self-reported behaviors and efficacy for preparing and serving fresh F&V
c) Parent report of child attitudes toward consuming fresh F&V

Hypothesis: Households participating in the VV program will purchase more F&V and fewer foods high in sugar, refined carbohydrates and saturated fat and household purchasing behaviors, child attitudes toward F&V and parent self-efficacy for preparing and serving F&V will mediate the intervention effect.
Communication and Dissemination:  Study findings will be shared with community partners so they can enhance the VV and deliver an improved program to the control group after the study period has ended.  If proven effective, partners will spread the VV to additional sites across the state.

FUNDING

  • Funding Source: Robert Woods Johnson Foundation
  • Dates of funding: January 1, 2013 to June 30, 2014