Whole grains, non-starchy vegetables, fruit, and beans are a consistent feature of diets associated with a lower risk of cancer and other diet-related diseases. For cancer risk reduction, the American Cancer Society recommendation is to consume at least 2.5 cups of a variety of fruits and vegetables (FV) daily. Other than dietary choices, weight control and physical activity levels are important modifiable determinants of cancer risk. The proposed research will finalize a novel, theory-driven intervention developed in preliminary work to promote access to fresh, unprepared, locally grown FV and build knowledge and skills to increase purchases and consumption of these foods among low-income adults served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). In New Jersey (the location of the study), WIC provides participants up to $30 in seasonal Farmers? Market Nutrition Program (FMNP) vouchers and monthly cash value vouchers or CVV (valued at $11 for adults and $8 for children) redeemable at farmers? markets. The intervention will be finalized based on lessons learned in preliminary work. The program combines behaviorally-focused nutrition education with the establishment of a WIC-based farmers? market (to be implemented in 2019 during the FMNP voucher issuance period [June 19 to August 19]). Content to address other modifiable determinants of cancer risk will be added. To create additional opportunities for experiential and hands-on learning, monthly trips to an area farmers? market also are planned (between September 1, 2019 [after the WIC-based market is discontinued] and November 30, 2019 [the end of the local growing season]). The research will employ an experimental design to initially test the intervention in a sample of 244 adults served by two urban, WIC agency sites located in Paterson, New Jersey. Intervention effects on objective biomarkers of FV intake, FMNP voucher redemption, and the redemption of CVV at farmers? markets will be examined 3 and 6 months after intervention. Mediation of intervention effects by targeted secondary outcomes, participant satisfaction with the program, and the cost-effectiveness of the intervention also will be examined. Findings will lay a solid foundation for an R01 grant application to rigorously evaluate the fully developed intervention.

Public Health Relevance

Farm-to-institution programs are recommended to facilitate access to fresh, locally grown fruits and vegetables (FV) and to build knowledge and skills to increase FV purchases and consumption. Designed for low-income adults served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), this project will evaluate the preliminary efficacy, cost-effectiveness, and acceptability of a novel, theory-driven, farm-to-WIC intervention. If found effective, the intervention will significantly impact diet-, physical activity-, and weight-related behaviors of participating adults and support larger-scale testing of the intervention.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Exploratory/Developmental Grants (R21)
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Special Emphasis Panel (ZRG1)
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Agurs-Collins, Tanya
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William Paterson University
Social Sciences
Schools of Arts and Sciences
United States
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