Lower-income and minority groups face significant health disparities with respect to obesity, cancer, heart
disease and other diet-related 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
socioeconomic status and other individual level factors (i.e., food preferences, time and skills to prepare
healthy food, etc.) can lead to reduced F&V consumption, these must be viewed in an environmental context.
Compared with higher-income neighborhoods, lower-income and minority neighborhoods are less likely to
have stores that sell a variety of F&V and other healthy foods. And when stores are available, produce may
not be affordable, high quality or culturally appropriate. Farmers' markets and mobile produce markets (MM)
have become increasingly popular strategies to alleviate food access concerns in underserved communities.
However, it is unclear if these programs have the necessary components to have an appreciable impact on
diet. Our research team recently completed one of the first randomized controlled trials of a MM program called
the Veggie Van. Veggie Van was run in partnership with our team and a small non-profit organization in North
Carolina; it delivered boxes of fresh, locally grown produce and food-focused education to communities with
significant barriers to F&V consumption including availability, affordability, quality and knowledge. In this small
cluster-randomized trial in 12 communities (N=201), we saw impressive changes in F&V intake with
intervention participants eating almost 1 more cups per day of F&Vs than the control group. Intervention
participants also reported increases in perceived access to healthy foods and Veggie Van customers attributed
many dietary changes to the MM program. While these results are very promising, we believe it is important to
test the effectiveness of the Veggie Van program when implemented by different organizations in multiple
communities. If shown to be effective, we can create a research-tested intervention toolkit which can be
disseminated to communities across the country. For this research, we will use a request for proposals
process to identify 8 organizations nationwide that are well-qualified to implement the Veggie Van model.
Organizations will identify appropriate sites for MM deliveries (32 total) and we will randomize them to either an
implementation or planning condition. With the help of our team's technical assistance and provided funding,
partner organizations will engage community members in the process and initiate a MM program. We will use
a Type 1 Hybrid Effectiveness-Implementation
to measure effectiveness (diet, BMI, dermal carotenoids) and
implementation (customer reach and sales, process measures, qualitative interviews with MM staff). We will
also examine sustainability of MM financial models and determine implementation standards (i.e., dose needed
to maintain impact) for inclusion in our MM toolkit for future dissemination.