Factors Associated With Uptake of an Open Access Health Center-Based Mobile Produce Market: A Case for Expanded Eligibility

J Acad Nutr Diet. 2024 Oct;124(10):1328-1335. doi: 10.1016/j.jand.2024.04.008. Epub 2024 Apr 12.

Abstract

Background: Health care-based food assistance programs show promise but are underutilized. Strict eligibility requirements and program scheduling may dampen reach and outcomes.

Objective: To explore factors associated with uptake of a health center-based mobile produce market with no eligibility requirements and few barriers to entry.

Design: A cross-sectional analysis of medical record, sociodemographic, environmental, and market attendance data was used.

Participants/setting: The study sample consisted of 3071 adults (18+ years) who were patients of an urban health center in eastern Massachusetts and registered for the mobile market during the study period of August 2016 to February 2020.

Main outcome measures: The main outcome measure was monthly market attendance over the study period.

Statistical analyses: T-tests and χ2 tests were used to compare market users and never-users. Multiple logistic regression was used to analyze variables associated with market attendance each month.

Results: In multiple variable analyses, Supplemental Nutrition Assistance Program enrollment was associated with slightly less frequent monthly market use (odds ratio [OR], 0.989; 95% CI, 0.984-0.994). Day-of, on-site market registration was associated with more frequent monthly use than self-registration on nonmarket days (OR, 1.08; 95% CI, 1.07-1.08). Having a psychiatric or substance use disorder diagnosis was associated with slightly less frequent market attendance (OR, 0.99; 95% CI, 0.98-0.99; and OR, 0.96; 95% CI, 0.95-0.97, respectively) compared with registrants without these diagnoses.

Conclusions: Individual, community-level, and organizational factors are associated with uptake of a free mobile produce market and should be considered when designing programs.

Keywords: Federally qualified health center; Food assistance; Food security; Mobile market; Produce.

MeSH terms

  • Adult
  • Commerce / statistics & numerical data
  • Cross-Sectional Studies
  • Eligibility Determination
  • Female
  • Food Assistance* / statistics & numerical data
  • Humans
  • Male
  • Massachusetts
  • Middle Aged
  • Mobile Health Units / statistics & numerical data
  • Young Adult