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Farm Fresh Foods for Healthy Kids (F3HK): An innovative community supported agriculture intervention to prevent childhood obesity in low-income families and strengthen local agricultural economies.

ABSTRACT: BACKGROUND:Childhood obesity persists in the United States and is associated with serious health problems. Higher rates of obesity among children from disadvantaged households may be, in part, attributable to disparities in access to healthy foods such as fruits and vegetables. Community supported agriculture can improve access to and consumption of fresh produce, but the upfront payment structure, logistical barriers, and unfamiliarity with produce items may inhibit participation by low-income families. The aim of this project is to assess the impact of subsidized, or "cost-offset," community supported agriculture participation coupled with tailored nutrition education for low-income families with children. METHODS/DESIGN:The Farm Fresh Foods for Healthy Kids community-based, randomized intervention trial will build on formative and longitudinal research to examine the impact of cost-offset community supported agriculture on diet and other health behaviors as well as the economic impacts on local economies. The intervention will involve reduced-price community supported agriculture shares which can be paid for on a weekly basis, nine skill-based and seasonally-tailored healthy eating classes, and the provision of basic kitchen tools. Low income families with at least one child aged 2-12 years will be recruited to join existing community supported agriculture programs in New York, North Carolina, Vermont, and Washington. In each program, families will be randomized 1:1 to intervention or delayed intervention groups. Data will be collected at baseline, and in the fall and spring for 3 years. The primary outcomes are children's intake of fruits and vegetables and foods high in sugar and/or (solid) fat, as well as diet quality; secondary outcomes include physical, behavioral, psychosocial, and environmental variables. Cost-effectiveness and economic impact at the farm and community levels also will be assessed. DISCUSSION:This integrated project will provide important information and contribute to the evidence base regarding the use of local agricultural interventions to improve children's dietary behaviors and weight maintenance. Findings also will inform the development of a toolkit for farmers and education modules related to local food system innovations for undergraduate and graduate students. TRIAL REGISTRATION:ClinicalTrials.gov NCT02770196 . Registered 5 April 2016.

SUBMITTER: Seguin RA

PROVIDER: S-EPMC5385092 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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Farm Fresh Foods for Healthy Kids (F3HK): An innovative community supported agriculture intervention to prevent childhood obesity in low-income families and strengthen local agricultural economies.

Seguin Rebecca A RA Morgan Emily H EH Hanson Karla L KL Ammerman Alice S AS Jilcott Pitts Stephanie B SB Kolodinsky Jane J Sitaker Marilyn M Becot Florence A FA Connor Leah M LM Garner Jennifer A JA McGuirt Jared T JT

BMC public health 20170408 1

<h4>Background</h4>Childhood obesity persists in the United States and is associated with serious health problems. Higher rates of obesity among children from disadvantaged households may be, in part, attributable to disparities in access to healthy foods such as fruits and vegetables. Community supported agriculture can improve access to and consumption of fresh produce, but the upfront payment structure, logistical barriers, and unfamiliarity with produce items may inhibit participation by low ...[more]

PMID: 28390403

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Project description:IntroductionSocioeconomically vulnerable individuals often face poor access to nutritious food and bear a disproportionate burden of diet-related chronic illness. This study tested whether a subsidized community-supported agriculture intervention could improve diet quality.Study designAn RCT was conducted from May 2017 to December 2018 (data analyzed in 2019).Setting/participantsAdults with a BMI >25 kg/m2 seen at a community health center in central Massachusetts, or who lived in the surrounding county, were eligible.InterventionIndividuals were randomized to receive either subsidized community-supported agriculture membership (which provided a weekly farm produce pickup from June to November) or healthy eating information (control group). For equity, the control group received financial incentives similar to the intervention group.Main outcome measuresThe primary outcome was the Healthy Eating Index 2010 total score (range, 0-100; higher indicates better diet quality; minimum clinically meaningful difference, 3). Healthy Eating Index was assessed using 3 24-hour recalls per participant collected each growing season. Intention-to-treat analyses compared Healthy Eating Index scores between the intervention and control group, accounting for repeated measures with generalized estimating equations.ResultsThere were 128 participants enrolled and 122 participants for analysis. The participants' mean age was 50.3 (SD=13.6) years; 82% were women; and 88% were white, non-Hispanic, with a similar distribution of baseline characteristics comparing the intervention and control groups. Baseline Healthy Eating Index total score was 53.9 (SD=15.3) in the control group and 55.1 (SD=15.2) in the intervention group (p=0.68). The intervention increased the mean Healthy Eating Index total score relative to the control group (4.3 points higher, 95% CI=0.5, 8.1, p=0.03). Food insecurity was lower in the intervention group (RR=0.68, 95% CI=0.48, 0.96).ConclusionsA community-supported agriculture intervention resulted in clinically meaningful improvements in diet quality. Subsidized community-supported agriculture may be an important intervention for vulnerable individuals.Trial registrationThis study is registered at www.clinicaltrials.gov NCT03231592.Supplement informationThis article is part of a supplement entitled Identifying and Intervening on Social Needs in Clinical Settings: Evidence and Evidence Gaps, which is sponsored by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, Kaiser Permanente, and the Robert Wood Johnson Foundation.

Project description:AimConservation conflict takes place where food production imposes a cost on wildlife conservation and vice versa. Where does conservation impose the maximum cost on production, by opposing the intensification and expansion of farmland? Where does conservation confer the maximum benefit on wildlife, by buffering and connecting protected areas with a habitable and permeable matrix of crop and non-crop habitat? Our aim was to map the costs and benefits of conservation versus production and thus to propose a conceptual framework for systematic conservation planning in agricultural landscapes.LocationWorld-wide.MethodsTo quantify these costs and benefits, we used a geographic information system to sample the cropland of the world and map the proportion of non-crop habitat surrounding the cropland, the number of threatened vertebrates with potential to live in or move through the matrix and the yield gap of the cropland. We defined the potential for different types of conservation conflict in terms of interactions between habitat and yield (potential for expansion, intensification, both or neither). We used spatial scan statistics to find 'hotspots' of conservation conflict.ResultsAll of the 'hottest' hotspots of conservation conflict were in sub-Saharan Africa, which could have impacts on sustainable intensification in this region.Main conclusionsSystematic conservation planning could and should be used to identify hotspots of conservation conflict in agricultural landscapes, at multiple scales. The debate between 'land sharing' (extensive agriculture that is wildlife friendly) and 'land sparing' (intensive agriculture that is less wildlife friendly but also less extensive) could be resolved if sharing and sparing were used as different types of tool for resolving different types of conservation conflict (buffering and connecting protected areas by maintaining matrix quality, in different types of matrix). Therefore, both sharing and sparing should be prioritized in hotspots of conflict, in the context of countryside biogeography.

Project description:The data was collected in the Karagwe and Kyerwa districts of the Kagera region in north-west Tanzania. It encompasses 150 smallholder farming households, which were interviewed on the composition of their household, agricultural production and use of organic farm waste. The data covers the two previous rainy seasons and the associated vegetation periods between September 2016 and August 2017. The knowledge of experts from the following institutions was included in the discussion on the selection criteria: two local non-profit organisations, i.e., WOMEDA and the MAVUNO Project; the International Institute of Tropical Agriculture (IITA); and the National Land Use Planning Commission (NLUPC). Households were selected for inclusion if all of the following applied to them: 1) less than 10 acres of land (4.7 ha) registered in the village offices, 2) no agricultural training, and 3) decline in the fertility of their land since they started farming (self-reported). We selected 150 smallholder households out of a pool of 5,000 households known to WOMEDA in six divisions of the Kyerwa and Karagwe districts. The questionnaire contained 54 questions. The original language of the survey was Kiswahili. All interviews were audio recorded. The answers were digitalised and translated into English. The data set contains the raw data with 130 quantitative and qualitative variables. For quantitative variables, the only analysis that was made was the conversion of units, e.g., land area was converted from acres to hectares, harvest from buckets to kilograms and then to tons, and heads of livestock to Tropical Livestock Units (TLU). Qualitative variables were summarised into categories. All data has been anonymised. The data set includes geographical variables, household information, agricultural information, gender-specific responsibilities, economic data, farm waste management, and water, energy and food availability (Water-Energy-Food (WEF) Nexus). Variables are written in italics. The following geographical variables are part of the data set: district, division, ward, village, hamlet, longitude, latitude, and altitude. Household information includes start of farming, household size, gender and age of household members. Agricultural information includes land size, size of homegarden, crops, livestock and livestock keeping, trees, and access to forest. Gender-specific responsibilities includes producing and exchanging seeds, weed control, terracing, distributing organic material to the fields, care of annual and perennial crops, harvesting of crops, decisions about the harvest and animal products, selling and buying products, working on their own farm and off-farm, cooking, storing food, collecting and caring for drinking water, washing, and toilet cleaning. Economic data includes distance to the market, journey time to market, transport methods, labourers employed by the household, working off-farm, and assets such as type of house. Variables relevant to the WEF Nexus are drinking water source and treatment, meals per day, months without food, cooking fuel, and type of toilet. Variables on farm waste management are the use of crop residues, food and kitchen waste, livestock manure, cooking ash, animal bones, and human urine and faeces. The data can be potentially reused and further developed for the purpose of agricultural production analysis, socio-economic analysis, comparison to other regions, conceptualisation of waste and nutrient management, establishment of land use concepts, and further analysis on food security and healthy diets.

Dataset Information

Farm Fresh Foods for Healthy Kids (F3HK): An innovative community supported agriculture intervention to prevent childhood obesity in low-income families and strengthen local agricultural economies.

Publications

Farm Fresh Foods for Healthy Kids (F3HK): An innovative community supported agriculture intervention to prevent childhood obesity in low-income families and strengthen local agricultural economies.

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