Mobile produce markets (MPM) are a community-based strategy to improve produce access in areas with few fruits and vegetables (FV) retail options. The purpose of this thesis is to assess the functionality of MPM in low-income urban neighborhoods. This thesis includes three studies. Study 1 investigates FV availability in areas around MPM locations (n=13). We found limited fresh FV availability in stores, but high prevalence of 100% juice, and canned FV and beans. Study 2 applied questionnaire data from MPM shoppers (n=143) to assess MPM experiences. Chi Square was used to compare shopping behaviors between older (≥ 60) and younger (18-59.9 years) adults. Separate logistic regression models were used to predict Electronic Benefit Transfer (EBT) use, money spent, shopping frequency, and distance travelled to MPM, with age, race/ethnicity, sex, living alone/with others, and EBT in models. Participants indicated positive experiences with five dimensions of access: availability (variety), accessibility (location), affordability (price), acceptability (freshness), and accommodation (EBT use). Older shoppers were more likely to be long-term shoppers (P=0.002) and use EBT (P=0.012). Living alone predicted EBT use (P=0.03), shopping weekly (P=0.03), and traveling < 1 mile (P=0.02). In Study 3, we interviewed 16 farmers to investigate experiences and perceptions of local markets including MPM. Income and community interaction were prominent themes. Farmers identified community organizations as important liaisons to coordinate MPM distribution and communicate community needs. MPM offer a promising strategy for serving low-income and minority populations—to be organized by communities themselves and to bring needed food directly to neighborhoods.

This thesis focuses on the food environment of Masiphumelele and seeks to understand how mixed-method approaches could be employed to facilitate an advanced understanding of food access in Masiphumelele. Masiphumelele was chosen as the case study for this research project as this work is sponsored by the IDRC-funded Nourishing Spaces project, which works in Masiphumelele. Based on the food-environment framework, this thesis embarked on the valuation of food environment literature to establish the interconnections between the four pillars of food security, food environments, and food systems in the urban context. The findings of this study endorse other work on food environments that issues of access should not only be understood through the physical and socioeconomic lens but also consider related social aspects that shape, enable or constrain food choices and behaviours in urban contexts. The findings of this thesis underscore the need for the reconceptualization of food environments beyond the simplistic physical and economic access framings which dominate earlier food environment work characterized by food deserts. Following the assessment of existing literature on food security, the discourse revealed that adopting the mixed-method approach that integrates participatory and retail mapping is an applicable conceptual framework for exposing socio-spatial dynamics influencing food utilization and food accessibility in the urban context. Building on the growing scholarly and policy interest of mixed methods approaches this thesis endeavours to establish the significance of the mixed-method approach in facilitating an improved understanding of food access in Masiphumelele.

<p>Food insecurity, or limited access to enough foods for an active, healthy life, characterizes the situation of 65% of US food pantry clients. Food insecurity is associated with poor dietary intake of key food groups and nutrients, diet-related chronic disease, poor physical and mental health, and reduced quality of life. Although food pantry clients are prevalently food insecure, there is a sizeable proportion of clients who are classified as food secure (FS), or report having adequate access to healthy foods. Previous studies suggest that food secure pantry clients may use pantry resources differently, and have diets that differ in quality and intake, compared to food insecure clients (including low food secure [LFS] and very low food secure [VLFS] clients). </p><p>Food pantries may be an important venue for interventions to improve food security and dietary outcomes. Since dietary intake and use of food pantries may differ by food security status, the efficacy of such interventions may also differ by food security status. A social ecological modeled (SEM), community-based intervention in the food pantry setting is promising in sustaining local change efforts and may facilitate long-term implementation of strategies to improve diet-related outcomes among food pantry clients. Therefore, the aims of this dissertation were to 1) characterize differences in diet quality and intake between FS, LFS and VLFS pantry clients; 2) explore associations between the nutritional quality of the pantry food environment (foods in stock and foods distributed to clients) and client diet quality by food security status; and 3) evaluate the intermediate effects of a SEM, community-based intervention to improve diet-related outcomes among pantry clients with comparison by food security status.</p><p>Aim 1 was addressed by examining associations between food security and both diet quality and usual intake (in separate mixed multiple linear regression models) in a cross-sectional analysis of adult food pantry clients at baseline. FS status was associated with a higher Healthy Eating Index-2010 (HEI-2010) whole grains score, as well as a higher mean usual intakes of whole grains and iron, compared to LFS status. FS status was also associated with higher mean usual intakes of dark green vegetables and total dairy compared to LFS and VLFS status.</p><p>Aim 2 was addressed by evaluating the relationship between the quality of the mix of foods in stock (pantry inventories) and distributed (client food bags) at food pantries with client diet quality, and investigating how these relationships varied by food security status, in a cross-sectional analysis of adult food pantry clients at baseline. Client food bag HEI-2010 scores were positively associated with client diet scores for the total vegetables, total fruit, total protein foods, and sodium components, while pantry inventory HEI-2010 scores were negatively associated with client diet scores for the total score and for the total fruit and fatty acids components. VLFS clients consumed more whole grains from client food bags compared to FS clients, and consumed more greens and beans from pantry inventories compared to LFS clients.</p><p>Aim 3 was addressed by evaluating longitudinal changes in adult food security, diet quality and usual intake over the first two years (baseline to midpoint) of a three-year SEM, community-based food pantry intervention‒ Voices for Food (Clinical Trial Registry: NCT0356609). Adult food security score improved in the intervention group, while HEI-2010 total score and several component scores improved in the comparison group. When comparing the change in main outcomes over time between the intervention and comparison groups, no favorable differences were observed at this intermediate time point.</p><p> </p><p>Food pantries do not comprise a homogeneous population of clients. Pantry clients have different quality diets and rely on pantries to acquire different types of foods depending on their food security status. Food pantries may be an important venue to target interventions that improve diet-related outcomes, with consideration for the complex interplay between food security status, the pantry food environment and availability of resources to prepare healthy foods. Evaluation of the final study time point, as well as further investigation of the dose-dependent effect of each intervention component and other individual community characteristics, may elucidate the relationship between the intervention and client outcomes.</p><p></p>

Uma das conseqüências da transição nutricional é a elevação da prevalência de obesidade na população mundial. Entre os fatores ambientais determinantes da escolha alimentar, destaca-se a influência dos meios de comunicação. O objetivo do estudo foi construir e aplicar um questionário para análise da comunicação de marketing no varejo de alimentos do município de São Paulo. Amostra propositiva de 52 setores censitários do município de São Paulo foi selecionada conforme níveis de IDH e densidade de indicadores ambientais para análise do marketing no varejo de alimentos para consumo imediato e domiciliar. A pesquisa identificou maior número de estabelecimentos de varejo de alimentos para consumo imediato (472) do que para consumo domiciliar (305). O volume de mensagens nos pontos-de-venda foi consideravelmente maior para alimentos industrializados (484) do que alimentos in natura (275). Registrou-se propaganda de alimentos em maior número de varejos de alimento para consumo imediato (47%) do que consumo domiciliar (20%). Identificou-se associação positiva entre renda e IDH em relação ao volume de propagandas de alimentos in natura que abordavam o conteúdo \"saúde\". Houve associação negativa entre renda e volume de propagandas para alimentos industrializados em \"economia\" e \"saúde\". O volume total de propagandas em estabelecimentos de alimentos para consumo domiciliar apresentou correlação negativa com IDH, enquanto no varejo de alimentos para consumo imediato houve correlação negativa com renda. Os resultados do presente trabalho apontam para a necessidade de maior esforço de pesquisa no que tange à propaganda de alimentos nos equipamentos de varejo de alimentos. O fortalecimento de ações de monitoramento de propagandas de alimentos nos equipamentos varejistas possibilitaria maior conformidade das mensagens das propagandas em relação à legislação de alimentos, em benefício da saúde do consumidor. / The nutrition transition presents as consequence an increase in obesity prevalence among worldwide population. Among environmental factors determining food choices of individuals, it is possible to point out the influence of mass media communication. The objective of the study is to structure and apply a questionnaire for the study of marketing communication in food retail at the city of Sao Paulo. 52 census sectors from Sao Paulo city were selected for data collection, according HDI and environmental variables, in order to allow the analysis on marketing communication on retail of food for immediate or household consumption. Results indicate that there are more retail stores of food for immediate consumption (472) than household consumption in Sao Paulo city. Volume of advertisement in food retail stores was considerably higher for processed foods (484) than in natura (275). Food advertisement was registered in higher number of retail stores of food for immediate consumption (47%) than in retail stores of food for household consumption (20%). There was a positive association between income and HDI in relation to the volume of advertisement for in natura foods approaching the \"health\" content. A negative association between income and volume of advertisement for processed foods was identified in relation to \"economy\" and \"health\" contents. The total volume of advertisement in retail stores of food for household consumption presented negative correlation in relation to HDI, while retail of food for immediate consumption had negative correlation in relation to income. Results obtained in the study indicate the need for joint efforts in research towards food advertisement in food retail stores. Strengthening of monitoring action in food advertisement located in retail stores may assure higher accomplishment food regulation patterns in relation to the messages published, benefiting the consumers\' health.

Uma das conseqüências da transição nutricional é a elevação da prevalência de obesidade na população mundial. Entre os fatores ambientais determinantes da escolha alimentar, destaca-se a influência dos meios de comunicação. O objetivo do estudo foi construir e aplicar um questionário para análise da comunicação de marketing no varejo de alimentos do município de São Paulo. Amostra propositiva de 52 setores censitários do município de São Paulo foi selecionada conforme níveis de IDH e densidade de indicadores ambientais para análise do marketing no varejo de alimentos para consumo imediato e domiciliar. A pesquisa identificou maior número de estabelecimentos de varejo de alimentos para consumo imediato (472) do que para consumo domiciliar (305). O volume de mensagens nos pontos-de-venda foi consideravelmente maior para alimentos industrializados (484) do que alimentos in natura (275). Registrou-se propaganda de alimentos em maior número de varejos de alimento para consumo imediato (47%) do que consumo domiciliar (20%). Identificou-se associação positiva entre renda e IDH em relação ao volume de propagandas de alimentos in natura que abordavam o conteúdo \"saúde\". Houve associação negativa entre renda e volume de propagandas para alimentos industrializados em \"economia\" e \"saúde\". O volume total de propagandas em estabelecimentos de alimentos para consumo domiciliar apresentou correlação negativa com IDH, enquanto no varejo de alimentos para consumo imediato houve correlação negativa com renda. Os resultados do presente trabalho apontam para a necessidade de maior esforço de pesquisa no que tange à propaganda de alimentos nos equipamentos de varejo de alimentos. O fortalecimento de ações de monitoramento de propagandas de alimentos nos equipamentos varejistas possibilitaria maior conformidade das mensagens das propagandas em relação à legislação de alimentos, em benefício da saúde do consumidor. / The nutrition transition presents as consequence an increase in obesity prevalence among worldwide population. Among environmental factors determining food choices of individuals, it is possible to point out the influence of mass media communication. The objective of the study is to structure and apply a questionnaire for the study of marketing communication in food retail at the city of Sao Paulo. 52 census sectors from Sao Paulo city were selected for data collection, according HDI and environmental variables, in order to allow the analysis on marketing communication on retail of food for immediate or household consumption. Results indicate that there are more retail stores of food for immediate consumption (472) than household consumption in Sao Paulo city. Volume of advertisement in food retail stores was considerably higher for processed foods (484) than in natura (275). Food advertisement was registered in higher number of retail stores of food for immediate consumption (47%) than in retail stores of food for household consumption (20%). There was a positive association between income and HDI in relation to the volume of advertisement for in natura foods approaching the \"health\" content. A negative association between income and volume of advertisement for processed foods was identified in relation to \"economy\" and \"health\" contents. The total volume of advertisement in retail stores of food for household consumption presented negative correlation in relation to HDI, while retail of food for immediate consumption had negative correlation in relation to income. Results obtained in the study indicate the need for joint efforts in research towards food advertisement in food retail stores. Strengthening of monitoring action in food advertisement located in retail stores may assure higher accomplishment food regulation patterns in relation to the messages published, benefiting the consumers\' health.

<p>Övervikt och fetma är ett av de mest omfattande folkhälsoproblemen i Sverige och det är en stor andel barn och unga som lever med detta problem. Då goda matvanor grundläggs i tidig ålder utgör skolmåltiden en betydelsefull roll för att upprätta hälsosamma matvanor. Faktorer i den fysiska matmiljön, såsom möblering, städning, dekorering, inredning, belysning samt ljudnivå påverkar elevernas upplevelse av måltidssituationen. Den psykiska miljön som innefattar både psykologiska och sociala faktorer, det vill säga servering av skolmaten, arbetskläder, matglädje, elevernas matintag samt möjligheterna för skolmåltidspersonalen att gå någon fortbildning är även av betydelse för måltidssituationen. Dessa faktorer har studerats i detta examensarbete som utförts på uppdrag av Region Halland och som syftade till att studera skolmåltidspersonalens upplevelser av att påverka måltidssituationen i skolan. En kvalitativ forskningsansats har tillämpats då avsikten var att studera skolmåltidspersonalens upplevelser och livsvärld. Intervjuer har genomförts på skolmåltidspersonal som varit köksansvariga i ett mottagningskök i Varbergs kommun. Resultatet tyder på att skolmåltidspersonalen kan påverka matmiljön gällande användandet av det som redan finns till förfogande. Brist på pengar uppges utgöra ett hinder för att kunna påverka måltidssituationen. Skolmåltidspersonalen kan inte påverka huvudkomponenten men däremot de tillbehör och komponenter som serveras därtill. Kunskaperna anses vara goda för att kunna påverka måltidssituationen, dock finns det önskemål om fortbildning på vissa områden.</p> / <p>Overweight and obesity are among the largest public health issues in Sweden with a high proportion of children and young people living under these conditions. Healthy eating habits are established early in life and the daily school meal plays an important role in the work for creating and sustaining those habits. Factors in the physical environment, such as furnishing, cleaning, decorating, lighting and sound, all affect the students’ experience of their food situation in school. Also the mental environment, including both psychological and social factors like the serving of the school meal, food happiness, the students’ food intake, working clothes for the school restaurant staff and the possibility for further education, are relevant to the meal situation and environment. These factors were studied in this thesis which was carried out on behalf of the Region Halland and which aimed to study the school restaurant staff´s experiences to influence the food situation in school. A qualitative research approach has been applied as the intention was to study the school food staff´s own thoughts and experiences. Interviews were conducted with persons responsible for reception kitchens in Varberg municipality. The results show that school food staff can to some degree influence the school meal environment with means already available to them, although lack of money is considered a barrier to further improve the food situation. The school food staff cannot themselves affect the main component, but the accessories and other components. Knowledge among the staff is considered good enough to influencing the meal situation. However, there are requests for more in-service training and further education in certain areas.</p>

Övervikt och fetma är ett av de mest omfattande folkhälsoproblemen i Sverige och det är en stor andel barn och unga som lever med detta problem. Då goda matvanor grundläggs i tidig ålder utgör skolmåltiden en betydelsefull roll för att upprätta hälsosamma matvanor. Faktorer i den fysiska matmiljön, såsom möblering, städning, dekorering, inredning, belysning samt ljudnivå påverkar elevernas upplevelse av måltidssituationen. Den psykiska miljön som innefattar både psykologiska och sociala faktorer, det vill säga servering av skolmaten, arbetskläder, matglädje, elevernas matintag samt möjligheterna för skolmåltidspersonalen att gå någon fortbildning är även av betydelse för måltidssituationen. Dessa faktorer har studerats i detta examensarbete som utförts på uppdrag av Region Halland och som syftade till att studera skolmåltidspersonalens upplevelser av att påverka måltidssituationen i skolan. En kvalitativ forskningsansats har tillämpats då avsikten var att studera skolmåltidspersonalens upplevelser och livsvärld. Intervjuer har genomförts på skolmåltidspersonal som varit köksansvariga i ett mottagningskök i Varbergs kommun. Resultatet tyder på att skolmåltidspersonalen kan påverka matmiljön gällande användandet av det som redan finns till förfogande. Brist på pengar uppges utgöra ett hinder för att kunna påverka måltidssituationen. Skolmåltidspersonalen kan inte påverka huvudkomponenten men däremot de tillbehör och komponenter som serveras därtill. Kunskaperna anses vara goda för att kunna påverka måltidssituationen, dock finns det önskemål om fortbildning på vissa områden. / Overweight and obesity are among the largest public health issues in Sweden with a high proportion of children and young people living under these conditions. Healthy eating habits are established early in life and the daily school meal plays an important role in the work for creating and sustaining those habits. Factors in the physical environment, such as furnishing, cleaning, decorating, lighting and sound, all affect the students’ experience of their food situation in school. Also the mental environment, including both psychological and social factors like the serving of the school meal, food happiness, the students’ food intake, working clothes for the school restaurant staff and the possibility for further education, are relevant to the meal situation and environment. These factors were studied in this thesis which was carried out on behalf of the Region Halland and which aimed to study the school restaurant staff´s experiences to influence the food situation in school. A qualitative research approach has been applied as the intention was to study the school food staff´s own thoughts and experiences. Interviews were conducted with persons responsible for reception kitchens in Varberg municipality. The results show that school food staff can to some degree influence the school meal environment with means already available to them, although lack of money is considered a barrier to further improve the food situation. The school food staff cannot themselves affect the main component, but the accessories and other components. Knowledge among the staff is considered good enough to influencing the meal situation. However, there are requests for more in-service training and further education in certain areas.

(in English): The diploma thesis deals with the issue of local foods and analyses factors influencing the purchasing behavior of Czech consumers. The theoretical part focuses on the problems related to the definition of local food, relying on the three domains of proximity taxonomy as proposed by Eriksen (2013). It further examines the reasons of increased interest in local production, which include anti-globalization trends, environmental issues and other value changes in society. Significant foreign and Czech research of local production and Czech consumer behavior is presented. At the end of the theoretical part, selected theories suitable for explaining the purchasing behavior of local foods as well giving insight into the theoretical foundation and research of this thesis are described. This is primarily the Alphabet Theory (Zepeda & Deal, 2009), which is based on earlier theories of Value-Belief-Norm Theory (Stern et al., 1999) and Attitude-Behavior-Context Theory (Guagnano et al., 1995). The empirical part builds on the theoretical basis and provides an analysis of the Czech consumer based on qualitative semi-structured interviews as well as a quantitative survey representative of Czech population aged 18 to 65 years in terms of selected sociodemographic characteristics. They give insight...

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Objectifs : Les inégalités sociales de l’alimentation sont vécues différemment parmi les populations vulnérables. Cette étude examine la relation entre le statut d’immigration, l’insécurité alimentaire (IA) et la fréquence de consommation de fruits et légumes (F/L) et de boissons sucrées (BS) dans les ménages à faible revenu pendant la pandémie de COVID-19. Méthodes : Étude transversale auprès de 467 adultes (231 immigrants, 236 personnes nées au Canada) dans quatre quartiers défavorisés de Montréal (Québec). La fréquence de consommation de F/L et de BS a été modélisée selon l’IA et l’environnement alimentaire (densité des commerces d’alimentation, perceptions d’accès physique aux aliments sains et utilisation des ressources alimentaires communautaires) pour l’échantillon total et selon le statut d’immigration. Résultats : Les immigrants consommaient plus fréquemment des F/L (3,19 ± 1,64/jour) et moins de BS (0,22 ± 0,39/jour) que ceux nés au Canada (respectivement 2,80 ± 1,78 et 0,43 ± 0,88/jour). L’IA grave était fortement associée à une fréquence de consommation moindre de F/L. L’utilisation de kiosques de F/L chez les Canadiens natifs et des perceptions positives d’accès aux aliments dans les commerces chez les immigrants étaient associées à une fréquence de consommation plus élevée de FL. L’IA modérée était associée à un rapport de cotes plus élevé de consommer plus fréquemment des BS chez les natifs du Canada tandis qu’on observe l’inverse chez les immigrants en IA grave. Conclusion : Les inégalités sociales liées à l’alimentation sont vécues différemment chez les populations à faible revenu selon leur statut d’immigration / Objectives: Social inequalities in diet exist among vulnerable populations. This study assessed relationships between immigrant status, food insecurity (FI), frequency of fruit, and vegetable (F/V), and sugary drinks intake among urban low-income households during COVID-19 pandemic. Method: Cross-sectional analysis among 467 adults in 2021 (231 immigrants and 236 Canadianborn individuals) in 4 disadvantaged neighborhoods in Montreal (Quebec). Frequency of F/V and sugary drinks intakes were modeled using multivariate linear regression and logistic regression respectively, including variables of food security status, the density of food stores, perceptions of physical access to healthy foods, and usage of community food resources using multivariate linear regression and logistic regression respectively, for the entire sample then stratified by immigrant status. Results: Immigrants consumed F/V (3.19 ± 1.64/day) more frequently and sugary drinks (0.22 ± 0.39/day) less regularly than Canadian-born individuals (respectively 2.80 ± 1.78 and 0.43 ± 0,88/day). Severe FI was strongly associated with lower frequency of F/V intake. When stratifying by immigrant status, using F/V kiosks was associated with higher frequency of F/V consumption among Canadian-born individuals (β=0.49 times/day, CI= [0.04, 0.94]), and positive perceptions of food access were associated with higher frequency of F/V intake among immigrants. For sugary drinks, moderate FI was associated with higher odds of consuming more frequently sugary drinks among Canadian-born individuals (OR= 4.52; CI= [1.42, 14.35]) and with lower odds among immigrants with severe FI (OR=0.19, CI= [0.05, 0.76]). Conclusion: Social inequalities associated with diet are experienced differently among lowincome populations according to their immigrant status.