THE VEGGIE VAN STUDY
  • Home
  • Toolkit
    • Sign Up for Toolkit Access
    • Veggie Van Model >
      • Veggie Van Food Access Intervention
      • Veggie Van Educational Intervention
      • Theory and Conceptual Model
    • Program History >
      • Background & Formative Work
      • Pilot Phase
      • Program Expansion Phase
      • Lessons Learned
      • Research Study Phase
    • Running a Mobile Market >
      • Assess Interest
      • Create Partnerships
      • Develop Market Model >
        • Food Sourcing
        • Customers and Pricing
        • Equipment and Vehicles
      • Working with Host Sites >
        • Site Recruitment
        • Community Engagement >
          • Customer Newsletter
      • Launch the Program >
        • Operations and Logistics >
          • Staffing
          • Food Procurement
          • Mobile Market Set-up
        • Educational Materials >
          • Produce Information
          • Nutrition Curriculum >
            • Snacks
            • Healthy Fats, Healthy Heart
            • Making Meals Go Further
            • Eating Local & In Season
            • Choose MyPlate
            • Fruits & Veggies Matter​
            • Choosing Healthy Proteins
            • Food Labels
            • Whole Grains
            • What's for Breakfast?
            • Cut Out The Sugar​
            • Healthy Substitutions
            • Activity Bank
          • Recipes
      • Research Partner Resources >
        • Communication with Research Sites
        • 2020 Partner Training
        • Newsletter Resources
        • Partner Materials
    • Webinar Series
  • Research
    • Previous Research >
      • Program Outcomes
      • Scientific Publications
    • Current Research >
      • The Veggie Van Study
      • Veggie Van Partners
  • About Us
    • Press
    • Contact
    • Join Us
  • MM Summit
    • 2020 Summit Agenda
    • 2020 Summit Organizers
    • 2020 Summit Presentations
    • 2019 Summit >
      • 2019 Mobile Market Summit
      • 2019 Summit Survey
  • COVID-19
  • Opportunities

Scientific Publications

We have published several manuscripts on the impact of Veggie Van on diet, access to healthy food and related outcomes.​

Research Supporting the Need for Mobile Markets


​Low-income individuals’ perceptions about fruit and vegetable access programs: A qualitative study (2015)

​Objective—To examine how fruit and vegetable (F&V) programs address barriers to F&V access and consumption as perceived by low-income individuals.
Design—From 2011–2012 thirteen focus groups were used to better understand low-income individuals’ perceptions about F&V programs.
Setting—Five North Carolina counties at community-serving organizations.
Participants—Low-income participants ages 18 or older were included in the study. A majority were African American females with a high school education or less and received government assistance.
Phenomenon of Interest—Low-income individuals’ perceptions about how F&V access programs can reduce barriers and increase consumption.
Analysis—A socioecological framework guided data analysis, and 2 trained researchers coded transcripts, identified major themes, and summarized findings.
Results—A total of 105 participants discussed that mobile markets could overcome barriers such as availability, convenience, transportation, and quality/variety. Some were worried about safety in higher crime communities. Participants’ opinions about how successful food assistance programs were at overcoming cost barriers were mixed. Participants agreed that community gardens could increase access to affordable, conveniently located produce, but worried about
feasibility/implementation issues.
Implications for Research and Practice—Addressing access barriers through F&V programs could improve consumption. Programs have the potential to be successful if they
address multiple access barriers.
haynes-maslow_et_al._2015.pdf
File Size: 219 kb
File Type: pdf
Download File

The introduction of new food retail opportunities in lowerincome
communities and the impact on fruit and vegetable intake: a systematic review

​A lack of access to fresh fruits and vegetables (F&Vs) is
associated with consumption of fewer F&Vs and higher risk
of obesity, especially for lower-income individuals. It is widely
believed that the addition of new food retail opportunities
could improve F&V consumption and subsequently reduce the
chronic disease burden. Observational studies provide some
support for these hypotheses, but contradictions exist. In this
study we sought to examine if the introduction of a food retailer
affects F&V consumption in lower-income communities. We
used a systematic PRISMA approach to conduct this study.
We searched PubMed, EMBASE, and ProQuest Dissertations
& Theses for academic journal references and gray literature
published before August 2018. Included studies were those
looking at the effect of the introduction of a new food retailer
on F&V consumption. Studies were also categorized based on
which dimensions of food access were targeted by the food
retailer. We identified 15 studies meeting inclusion criteria:
11 studies reported a positive increase in F&V consumption
attributable to the introduction of a new food retailer, of which
6 were statistically significant. The remaining 4 studies, all
of which examined the impact of introducing a new retail
supermarket, showed no change or a decrease in F&V intake.
Results from studies which change the food environment
generally support the idea that increased access to healthy food
improves diet, but more studies are needed in order to assess
the differences between the various types of retailers, and to
identify strategies for improving impact. Understanding which
types of new food retail programs are most likely to impact diet
has implications for policies which incentivize new food retail.
hollis-hansen_et_al._2019.pdf
File Size: 211 kb
File Type: pdf
Download File

Research on the Veggie Van Model


Veggie Van Pilot Study: Impact of a Mobile Produce Market for Underserved Communities on Fruit and
Vegetable Access and Intake (2016)

Recruiting Community Partners for Veggie Van: Strategies and Lessons Learned From a Mobile Market Intervention in North Carolina, 2012–2015

We conducted a pilot evaluation of the Veggie Van, a mobile
produce market that brings weekly boxes of reduced-cost
locally grown fruits and vegetables (F&V) to lower-income
communities and offers cooking and nutrition education to
customers. We conducted surveys just prior to starting Veggie
Van at each of 3 sites and again at 2–3 months. F&V intake
was measured with a 2-question item and a 10-item food
frequency questionnaire (FFQ) in a subset of participants. At
baseline, average servings/day of F&V was 4.9 (SD = 2.6, n =
60). At follow-up, individuals who reported shopping at
Veggie Van frequently (n = 32) increased their F&V consumption
by 0.41 servings/day compared with a decrease of −1.19
for those who rarely/never used Veggie Van (n = 27), a total
difference of 1.6 servings/day (P = .01). There were no statistically significant differences in F&V consumption between
groups based on the FFQ measure. Frequent shoppers
reported additional health improvements and increases in
their ability to buy enough F&V. We conclude that offering
weekly boxes of affordable F&V paired with education in
underserved communities may improve F&V consumption
for frequent program users.
leone_haynes-maslow_and_ammerman_2016.pdf
File Size: 1103 kb
File Type: pdf
Download File

Background
Food access interventions are promising strategies for improving
dietary intake, which is associated with better health. However,
studies examining the relationship between food access and intake are limited to observational designs, indicating a need for more rigorous approaches. The Veggie Van (VV) program was a
cluster-randomized intervention designed to address the gap
between food access and intake. In this article, we aim to describe the approaches involved in recruiting community partners to participate in VV.
Community Context
The VV mobile market aimed to improve access to fresh fruits and vegetables by providing subsidized, high-quality, local produce in low-resource communities in North Carolina. This study describes the strategies and considerations involved in recruiting community partners and individual participants for participation in the VV program and evaluation.
Methods
To recruit partners, we used various strategies, including a site
screener to identify potential partners, interest forms to gauge future VV use and prioritize enrollment of a high-need population, marketing materials to promote VV, site liaisons to coordinate community outreach, and a memorandum of understanding between all invested parties.
Outcome
A total of 53 community organizations and 725 participants were
approached for recruitment. Ultimately, 12 sites and 201 participants were enrolled. Enrollment took 38 months, but our approaches helped successfully recruit a low-income, low-access population. The process took longer than anticipated, and funding constraints prevented certain strategies from being implemented.
Interpretation
Recruiting community partners and members for participation in a multi-level, community-based intervention was challenging.
Strategies and lessons learned can inform future studies.

tripicchio_et_al._2017.pdf
File Size: 332 kb
File Type: pdf
Download File

Cluster randomized controlled trial of a
mobile market intervention to increase fruit and vegetable intake among adults in lower-income communities in North
Carolina (2018)

A Cluster-Randomized Trial of a Mobile Produce Market Program in 12 Communities in North Carolina: Program Development, Methods, and
Baseline Characteristics

Background: Poorer diets and subsequent higher rates of chronic disease among lower-income individuals may be
partially attributed to reduced access to fresh fruits and vegetables (F&V) and other healthy foods. Mobile markets
are an increasingly popular method for providing access to F&V in underserved communities, but evaluation efforts
are limited. The purpose of this study was to determine the impact of Veggie Van (VV), a mobile produce market,
on F&V intake in lower-income communities using a group randomized controlled trial.
Methods: VV is a mobile produce market that sells reduced-cost locally grown produce and offers nutrition and
cooking education. We recruited 12 sites in lower-income communities in North Carolina (USA) to host VV,
randomizing them to receive VV immediately (intervention) or after the 6-month study period (delayed intervention
control). Participants at each site completed baseline and follow-up surveys including F&V intake, perceived access
to fresh F&V and self-efficacy for purchasing, preparing and eating F&V. We used multiple linear regression to
calculate adjusted differences in outcomes while controlling for baseline values, education and clustering within
site.
Results: Among 142 participants who completed the follow-up, baseline F&V intake was 3.48 cups/day for control
and 3.33 for intervention. At follow-up, adjusted change in F&V consumption was 0.95 cups/day greater for
intervention participants (p = 0.005), but was attenuated to 0.51 cups per day (p = 0.11) after removing extreme
values. VV customers increased their F&V consumption by 0.41 cups/day (n = 30) compared to a 0.25 cups/day
decrease for 111 non-customers (p = 0.04). Intervention participants did not show significant improvements in
perceived access to fresh F&V, but increased their self-efficacy for working more F&V into snacks (p = 0.02), making
up a vegetable dish with what they had on hand (p = 0.03), and cooking vegetables in a way that is appealing to
their family (p = 0.048).
Conclusions: Mobile markets may help improve F&V intake in lower-income communities.
Background Mobile markets are an increasingly popular method for providing access to fresh fruits and vegetables (F/V) in underserved communities; however, evaluation of
these programs is limited, as are descriptions of their development, study designs, and needs of the populations they serve.
Objective Our aim was to describe the development and theoretical basis for Veggie Van (VV), a mobile produce market intervention, the study design for the VV evaluation,
and baseline characteristics of the study population.
Design The protocol and sample for a cluster-randomized controlled trial with 12 sites are described.
Participants/setting Community partner organizations in the Triangle region of North Carolina that primarily served lower-income families or were located in areas that had
limited access to fresh produce were recruited. Eligible individuals at each site (older than 18 years of age, self-identified as the main shoppers for their household, and expressed interest in using a mobile market) were targeted for enrollment. A total of 201 participants at 12 sites participated in the VV program and evaluation, which was implemented from November 2013 to March 2016.
Main outcome measures Change in F/V intake (cups/day), derived from self-reported responses to the National Cancer Institute F/V screener, was the main outcome measure.
Statistical analyses performed We performed a descriptive analysis of baseline sample characteristics.
Results Mean reported F/V intake was 3.4 cups/day. Participants reported generally having some access to fresh F/V, and 57.7% agreed they could afford enough F/V to feed
their family. The most frequently cited barriers were cost (55.7%) and time to prepare F/V (20.4%). Self-efficacy was lowest for buying more F/V than usual and trying new
vegetables.
Conclusions By addressing cost and convenience and building skills for purchasing and preparing F/V, the VV has the potential to improve F/V consumption in underserved
communities.
leone_et_al._2018_baseline.pdf
File Size: 339 kb
File Type: pdf
Download File

leone_et_al._2018.pdf
File Size: 733 kb
File Type: pdf
Download File

Other Food Access Research from Our Team


A Qualitative Study of Perceived Barriers to Fruit and Vegetable Consumption Among Low-Income Populations, North Carolina, 2011

Introduction
Obesity is the leading preventable cause of illness and a major contributor to chronic disease. Eating fresh fruits and
vegetables can help manage and prevent weight gain and reduce the risk of chronic diseases. Low-income communities
often lack stores that sell fresh fruit and vegetables and have instead stores that sell foods low in nutritional value. The
objective of this study was to understand perceived community-level barriers to fruit and vegetable consumption
among low-income people.
Methods
We conducted 8 focus groups involving 68 low-income participants in 2 North Carolina counties, from May 2011
through August 2011. The socioecological model of health guided data analysis, and 2 trained researchers coded
transcripts and summarized findings. Four focus groups were conducted in each county; 1 was all male, 5 all female,
and 2 mixed sexes. Most participants were black (68%), most were women (69.1%), and most had a high school
education or less (61.8%). Almost half received support from either the Supplemental Nutrition Assistance Program or
another government assistance program.
Results
We identified 6 major community-level barriers to access to fruits and vegetables: cost, transportation, quality, variety,
changing food environment, and changing societal norms on food.
Conclusion
Policymakers should consider supporting programs that decrease the cost and increase the supply of high-quality
fruits and vegetables in low-income communities.
haynes-maslow_et_al._2013.pdf
File Size: 250 kb
File Type: pdf
Download File

Contact Website Support
This site is managed by the University at Buffalo's Community Health Intervention Lab
  • Home
  • Toolkit
    • Sign Up for Toolkit Access
    • Veggie Van Model >
      • Veggie Van Food Access Intervention
      • Veggie Van Educational Intervention
      • Theory and Conceptual Model
    • Program History >
      • Background & Formative Work
      • Pilot Phase
      • Program Expansion Phase
      • Lessons Learned
      • Research Study Phase
    • Running a Mobile Market >
      • Assess Interest
      • Create Partnerships
      • Develop Market Model >
        • Food Sourcing
        • Customers and Pricing
        • Equipment and Vehicles
      • Working with Host Sites >
        • Site Recruitment
        • Community Engagement >
          • Customer Newsletter
      • Launch the Program >
        • Operations and Logistics >
          • Staffing
          • Food Procurement
          • Mobile Market Set-up
        • Educational Materials >
          • Produce Information
          • Nutrition Curriculum >
            • Snacks
            • Healthy Fats, Healthy Heart
            • Making Meals Go Further
            • Eating Local & In Season
            • Choose MyPlate
            • Fruits & Veggies Matter​
            • Choosing Healthy Proteins
            • Food Labels
            • Whole Grains
            • What's for Breakfast?
            • Cut Out The Sugar​
            • Healthy Substitutions
            • Activity Bank
          • Recipes
      • Research Partner Resources >
        • Communication with Research Sites
        • 2020 Partner Training
        • Newsletter Resources
        • Partner Materials
    • Webinar Series
  • Research
    • Previous Research >
      • Program Outcomes
      • Scientific Publications
    • Current Research >
      • The Veggie Van Study
      • Veggie Van Partners
  • About Us
    • Press
    • Contact
    • Join Us
  • MM Summit
    • 2020 Summit Agenda
    • 2020 Summit Organizers
    • 2020 Summit Presentations
    • 2019 Summit >
      • 2019 Mobile Market Summit
      • 2019 Summit Survey
  • COVID-19
  • Opportunities