243686 Evaluation of a farmers' market incentive program: The New York City Health Bucks initiative

Wednesday, November 2, 2011: 1:06 PM

Lauren Olsho, PhD , Domestic Health Division, Abt Associates Inc., Cambridge, MA
Deborah Klein Walker, EdD , Domestic Health Division, Abt Associates Inc., Cambridge, MA
Yvonne Abel, MS , Domestic Health Division, Abt Associates Inc., Cambridge, MA
Cheryl Austin, MPH, RD, LDN , Domestic Health Division, Abt Associates Inc., Cambridge, MA
Cristina A. Booker, MPH , Domestic Health Division, Abt Associates Inc., Cambridge, MA
Jacey Greece, DSc, MPH , Domestic Health Division, Abt Associates Inc., Cambridge, MA
Erin Lee, MPH , Domestic Health Division, Abt Associates Inc., Cambridge, MA
Jessica Levin , Public Health and Epidemiology, Abt Associates Inc., Cambridge, MA
Leah Staub-DeLong , Domestic Health Division, Abt Associates Inc., Cambridge, MA
Jan Jernigan, PhD , Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, GA
Gayle Payne, PhD , Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, GA
Sonia Ann Kim, PhD , Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, GA
Holly Wethington, PhD, MS , Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, GA
Raegan Tuff, MPH , Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, GA
Sabrina S. Baronberg, MPH , Bureau of Chronic Disease, Physical Activity and Nutrition Program, New York City Department of Health and Mental Hygiene, New York, NY
Alyson Abrami, RD, MPH , Bureau of Chronic Disease, Physical Activity and Nutrition Program, New York City Department of Health and Mental Hygiene, New York, NY
Kasey Holloway, MPH , Bureau of Chronic Disease, Physical Activity and Nutrition Program, New York City Department of Health and Mental Hygiene, New York, NY
INTRODUCTION: Limited access to healthful foods may contribute to higher obesity rates in underserved urban areas. To increase access to and purchase of fruits and vegetables in three underserved New York City neighborhoods, Health Bucks distributes coupons for fresh fruits and vegetables at farmers' markets. SNAP participants receive one $2 coupon for every $5 in benefits spent at participating markets. Additionally, community organizations distribute coupons to clients. We conducted a mixed-methods process and outcome evaluation of Health Bucks. METHODS: Primary data collection activities included on-site environmental assessments and surveys of farmers' market managers, vendors, and shoppers; a web survey of community organizations; a representative telephone survey of Health Bucks neighborhood residents; key informant interviews; shopper focus groups; and vendor telephone discussions. We additionally analyzed impacts using longitudinal data from the 2002-2009 Community Health Survey. RESULTS: Health Bucks intends to influence individual-level outcomes by increasing purchases of healthful foods, and community-level outcomes by improving access and community partnerships. Program awareness is high in targeted neighborhoods, and it is popular among farmers' market staff and shoppers. Farmer/vendors report the program increases likelihood of selling at a particular farmers' market, and consumers report it increases frequency and amount of farmers' market purchases. However, while self-reported fruit and vegetable consumption rose throughout New York after Health Bucks was introduced, we did not detect a greater increase in Health Bucks neighborhoods. DISCUSSION: Health Bucks encourages farmers' market access and purchases as one component of a broader strategy to improve the New York City food environment.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
1. Describe findings from evaluation of the New York City Health Bucks initiative. 2. Describe qualitative and quantitative methods used in conducting process and outcome evaluations.

Keywords: Food and Nutrition, Community-Based Public Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I designed and implemented the evaluation as Project Director. Currently I serve as Project Director on a CDC-funded mixed-methods evaluation of the New York City Health Bucks program, a farmersí market financial incentive program for Food Stamp/SNAP participants and other low-income residents of three underserved New York City neighborhoods. Additionally, I am the Deputy Director of Analysis for the Congressionally-mandated USDA evaluation of the Fresh Fruit and Vegetable Program (FFVP), an initiative which provides free fresh fruits and vegetables to students in participating schools during the school day, outside of normal school breakfast and lunch meals, and for the Healthy Incentives Pilot (HIP), a USDA pilot demonstration providing incentives to SNAP participants to encourage purchase and consumption of fruits and vegetables. I also work extensively with large national datasets including the Health and Retirement Study (HRS), the National Health and Nutrition Examination Surveys (NHANES), and the National Health Interview Survey (NHIS), with a particular focus on nutrition and chronic medical conditions.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.