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| Name | Class |
|---|---|
| East Carolina University | OTHER |
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Increasing access to healthy foods is crucial to combating chronic disease in rural communities. The Ripe for Revival mobile market, a non-profit eastern NC-based mobile market, seeks to improve healthy food access among those at greatest risk of food insecurity and poor health. By implementing vouchers at the mobile market, this study will help make healthy food affordable and accessible. This project is poised to improve diet and health among rural residents in eight counties and promote sustainable local food systems in North Carolina.
Increasing fruit and vegetable (FV) intake and reducing saturated fat, salt, and added sugar are central lifestyle recommendations in the Dietary Guidelines for Americans to prevent chronic disease. Yet, while diet is modifiable, rural families face structural and systemic inequities that make accessing affordable, healthy food more difficult.
Recognizing these disparities and adverse impacts, there is a clear need to create opportunities for improved nutrition through comprehensive solutions that account for rurality, affordability, and accessibility. One potential strategy to improve rural food access is mobile markets. Ripe for Revival is a 501(c)3 based in Rocky Mount, North Carolina, with a mission to increase access to fresh foods in lower-resourced communities with a mobile market model. Ripe for Revival owns and operates a produce farm, purchases excess food from eastern NC farmers, and then sells fresh foods to patrons at roughly 20% discounted prices through its mobile market. The mobile market (a retrofitted school bus) offers fresh produce, eggs, meat, and milk weekly in eastern and central NC counties. This project continues NC State Extension's partnership with Ripe for Revival to implement vouchers to help increase mobile market affordability and assess program impacts among rural NC families. The specific aims of this proposed study include:
Aim 1. Determine the nutrition-related impacts of mobile market vouchers among Ripe for Revival patrons in eight rural eastern NC counties (Bertie, Halifax, Hertford, Jones, Lenoir, Northampton, Warren, and Washington).
Aim 2. Examine voucher redemption rates, volume, and dollars of local produce purchased, and suggestions for mobile market improvements among Ripe for Revival mobile market customers.
This proposed project will promote health and advance equity among underserved rural families. The project addresses barriers to equitable food access, promotes a balanced diet to prevent chronic disease, and fosters sustainable local agriculture through a mobile market model.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Voucher Recipients | Experimental | Voucher participants will be referred by Extension professionals who serve lower-resourced individuals during routine programs. Participants who consent to the study will receive a $20 voucher each month for 3 months to redeem at the mobile market in their county. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mobile Market Voucher Outcomes Study | Behavioral | Voucher participants will be referred by Extension professionals who serve lower-resourced individuals during routine programs (i.e., NC Extension programs such as Expanded Food and Nutrition Education Program (EFNEP). After receiving the referrals from Extension professionals, a member of the research team will contact the referred participant to provide a $20 monthly voucher each month for three months for use at the mobile market. Trained researchers will collect data at baseline (when a voucher is issued), at ~4 weeks (2nd voucher), 8 weeks (3rd voucher), and 12-16 weeks (post-program) at the NC Cooperative Extension office. FV intake will be measured by skin carotenoid scan. Researchers will obtain height (baseline), weight, and blood pressure at each data collection time point. Survey measures will include the secondary outcomes using adapted versions of validated instruments, with questions on demographics and food and nutrition security status. |
| Measure | Description | Time Frame |
|---|---|---|
| Skin Carotenoids | Fruit and vegetable intake measured by skin carotenoids (derived from a validated reflection spectroscopy device, Veggie Meter® | Enrollment/baseline (week 0), 4 weeks, 8 weeks and at 12-16 weeks |
| Fruit and vegetable intake | Measured by DSQ FV Module - GusNIP NTAE Survey | Enrollment/baseline (week 0), 4 weeks, 8 weeks and at 12-16 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Weight/Body Mass Index | Weight/Body Mass Index. Weight measured by electronic scale with standiometer SECA 874 as the average of two measures. Height (baseline only). | Enrollment/baseline (week 0), 4 weeks, 8 weeks and at 12-16 weeks |
| Blood Pressure |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Basheerah Enahora, PhD, RDN, LDN | Contact | 9195159125 | benahor@ncsu.edu |
| Name | Affiliation | Role |
|---|---|---|
| Basheerah Enahora, PhD, RDN, LDN | NC State University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| NC State University | Recruiting | Raleigh | North Carolina | 27607 | United States |
Researchers will not make individual participant data available. Researchers will share aggregated participant results
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Quasi-experimental design
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Blood pressure measured by noninvasive automated monitor (Omron HEM-907XL, Vernon Hills, IL) with a first measure after seated for 5 minutes and 2 repeat measures at 1-minute intervals.
| Enrollment/baseline (week 0), 4 weeks, 8 weeks and at 12-16 weeks |
| Food Security Status | Food security status measured by USDA household 6-item screener | Enrollment/baseline (week 0), 4 weeks, 8 weeks and at 12-16 weeks |
| Nutrition Security Status | Measured by the Center for Nutrition & Health Impact 4-item Nutrition Security Screener | Enrollment/baseline (week 0), 4 weeks, 8 weeks and at 12-16 weeks |
| Food Utilization | Measured by the Center for Nutrition & Health Policy Impact 4-item screener | Enrollment/baseline (week 0), 4 weeks, 8 weeks and at 12-16 weeks |
| Voucher Redemption Rate | Tracked in Excel in dollars redeemed per voucher and the number of vouchers redeemed | Monthly through study completion for up to 2 years |
| Local produce distributed | Measured by mobile market POS system in pounds and dollars of produce distributed at each market | Monthly through study completion for up to 2 years |
| Mobile Produce Market Satisfaction | Measured by self-reported survey | Enrollment/baseline (week 0), 4 weeks, 8 weeks and at 12-16 weeks |