A farmers' market at a federally qualified health center improves fruit and vegetable intake among low-income diabetics

Objective: A 22-week federally qualified health center (FQHC)-based farmers' market (FM) and personal financial incentive intervention designed to improve access to and consumption of fruits and vegetables (FVs) among low-income diabetics in rural South Carolina was evaluated. Methods: A mixed methods, one-group, repeated-measures design was used. Data were collected in 2011 before (May/June), during (August), and after (November) the intervention with 41 diabetes patients from the FQHC. FV consumption was assessed using a validated National Cancer Institute FV screener modified to include FV sold at the FM. Sales receipts were recorded for all FM transactions. A mixed-model, repeated measures analysis of variance was used to assess intervention effects on FV consumption. Predictors of changes in FV consumption were examined using logistic regression. Results: A marginally significant (p. =. 0.07) average increase of 1.6 servings of total FV consumption per day occurred. The odds of achieving significant improvements in FV consumption increased for diabetics using financial incentives for payment at the FM (OR: 38.8, 95% CI: 3.4-449.6) and for those frequenting the FM more often (OR: 2.1, 95% CI: 1.1-4.0). Conclusions: Results reveal a dose-response relationship between the intervention and FV improvements and emphasize the importance of addressing economic barriers to food access.