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NP3 Farm Fresh Foods for Healthy Kids: Innovative Cost-Offset Community-Supported Agriculture Intervention to Prevent Childhood Obesity and Strengthen Local Agricultural Economies

      Objective

      To better understand the potential of cost-offset community supported agriculture (CO-CSA) to improve dietary quality in low-income families by conducting research, extension, and education activities.

      Description

      The Farm Fresh Foods for Healthy Kids (F3HK) intervention included a cost-offset (50% subsidy) summer CSA share, weekly payments (including SNAP-EBT), two to four pieces of kitchen equipment, and nine CSA-tailored education classes. F3HK participants were recruited from 12 rural and micropolitan communities in four states in spring 2016 and 2017, and individually randomized to intervention (n = 148) or control (n = 157). All had income < 185% poverty and at least one child (2-12y) in the household. Using an intent-to-treat framework, multivariate multi-level regression models were used to examine change in outcomes over time for intervention relative to control. Geospatial data, participant focus groups, and farmer interviews were used to describe CO-CSA accessibility.

      Evaluation

      CO-CSA pickup sites averaged six miles (m) from participants’ homes, which was closer than the farm (18m) but further than the supermarket (3m). F3HK farms reported efforts to reach low-income customers and strategized to modify the F3HK model to suit the local context; however, CO-CSA participants expressed mixed levels of accessibility. Relative to controls, F3HK intervention caregivers had improvement in some measures of attitudes, self-efficacy, skills, and dietary quality after one-season of participation, but not other measures. Lessons from the implementation and evaluation of F3HK informed the development of four undergraduate course modules: development of an intervention in a setting where “local food” is a foreign concept; assessment of dietary quality; economic impact analysis; and how to adapt CSA to open new markets for farmers.

      Conclusion

      CO-CSA plus education and kitchen tools is a promising mechanism to improve attitudes, self-efficacy, and skills among caregivers, with mixed results concerning dietary quality among caregivers and children. Longer-term outcome data will be examined for behavioral maintenance. An Extension toolkit for CO-CSA implementation is under development. Education modules are being piloted, and will be evaluated and refined before dissemination in 2020-21.
      Funding: 2015-68001-23230.

      Appendix. Supplementary data