Environment and economics as barriers to fruit and vegetable consumption in the Bronx

Introduction: Bronx Health REACH, a Coalition of more than 70 community-based organizations, has been working to increase fruit and vegetable consumption among school-age children in the South Bronx, a low income neighborhood with limited healthy food options. Method: As a preliminary step to develop a healthy eating social marketing campaign, the coalition used participatory methods to conduct formative research with 4th and 5th graders (n=13), their parents (n=13) and school staff (n=4) at an afterschool program. Using photovoice, focus groups, and interviews, data were collected on food purchasing and dietary behavior and the factors that influence them. Results: Children and adults described and illustrated environmental and economic conditions that served as impediments to the purchase and consumption of fresh produce. Students photographed rotting fruit and dead rodents to illustrate conditions in some local stores. Economic constraints were described by several participant families: because of limited income, parents reported preferences for canned or frozen food over pricey and perishable produce. Many parents cited time constraints, fatigue resulting from busy work schedules, and single parent households as reasons for their reliance on packaged and fast food. Unhealthy food preferences, particularly among the children, compounded environmental and economic barriers. Discussion: The project was unique in assessing food purchasing and dietary behavior from multiple perspectives using a variety of research methods. Engaging in formative research has built capacity within our Coalition to design a social marketing campaign that is sensitive to the attitudes, expectations and experiences of the South Bronx's children, families and teachers.