Impact of a Public-Private Mobile Market to Improve Fruit & Vegetable Access

描述（由申请人提供）：低收入和少数群体在肥胖、癌症、心脏病和其他慢性疾病方面面临着重大的健康差距。不良的饮食习惯，水果和蔬菜摄入量低，饱和脂肪、钠和糖含量高，造成了弱势群体面临的许多健康问题。虽然贫穷、受教育程度低和个人食物偏好都与食品和饮料消费减少有关，但这些个人层面的因素必须放在环境背景下看待。研究一再表明，环境对健康决策和行为起着重要作用。与高收入社区相比，低收入社区和少数族裔社区不太可能拥有销售各种食品和其他健康食品的超市。这是由于一种潜在的误解，即在这些社区中，新的健康食品企业的需求或潜在利润有限。在服务不足的地区开设新食品店的少数情况下，他们得到了大量的客户支持。北卡绿车计划希望证明，在低收入社区销售负担得起的、容易获得的食品和饮料不仅在经济上可行，而且可以影响目标社区个人的行为风险因素。北卡州绿色推车项目将建立在对北卡州当地可持续食品系统日益增长的支持基础上，并利用公私合作伙伴关系，增加服务不足社区获得新鲜食品和饮料的机会。该项目采用每周移动市场模式，将低成本盒装新鲜食品送到方便到达的社区地点（如教堂和日托中心），并提供营养和烹饪教育。与Green Cart团队合作，该项目将1.)采用随机对照设计，测量移动市场在6、12和18个月时对食品和饮料消费的主要结果的影响，以及对食品和饮料的感知途径和购买、准备、服务和食用新鲜食品和饮料的自我效能感；2.)评估公私合作的社区支持、可行性和财务可持续性；3.)探索可能影响该模式未来发展和传播的公私绿色车运营的政策相关障碍和促进因素。这项研究的结果将使我们了解食品环境如何影响饮食选择，并为研究人员、企业、非营利组织和政策制定者提供证据，说明使用类似模型减少食物获取差距和改善饮食的潜在影响和可行性。

DESCRIPTION (provided by applicant): Lower-income and minority groups face significant health disparities with respect to obesity, cancer, heart disease and other chronic conditions. Poor diets, low in fruits and vegetables (F&V) and high in saturated fat, sodium and sugar, contribute to many of the health problems faced by vulnerable groups. While poverty, low- educational attainment and personal food preference are all associated with reduced F&V consumption, these individual-level factors must be viewed in an environmental context. Research has repeatedly demonstrated the important role that environment plays on health decisions and behaviors. Compared with higher-income neighborhoods, lower-income and minority neighborhoods are less likely to have a supermarket that sells a variety of F&V and other healthy foods. This is perpetuated by an underlying misconception that there is limited demand or potential profit for new healthy food ventures in these communities. In the few cases where new food outlets have opened in underserved areas, they have been met with substantial customer support. The NC Green Cart program hopes to demonstrate that selling affordable, accessible F&V in lower-income communities is not only financially viable, but can impact behavioral risk factors of individuals in target communities. The NC Green Cart program will build on burgeoning support for a local sustainable food system in NC and leverage a public-private partnership to increase access to fresh F&V in underserved communities. Using a weekly mobile market model, the program will deliver low-cost boxes of fresh F&V to easily accessible community locations (such as churches and day care centers) and provide nutrition and cooking education. Working together with the Green Cart team, this project will 1.) measure the impact of a mobile market at 6, 12 and 18 months on the primary outcome of F&V consumption as well as perceived access to F&V and self- efficacy to purchase, prepare, serve and eat fresh F&V using a randomized controlled design; 2.) assess community support, feasibility, and financial sustainability of the public-private Green Cart partnership; and 3.) explore policy-related barriers and facilitators to the public-private Green Cart operation that could influence future growth and dissemination of the model. Results of this research will inform our understanding of how the food environment impacts dietary choices and provide evidence for researchers, businesses, non-profits and policy makers on the potential impact and viability of using similar models to reduce food access disparities and improve diet.