Background: The Georgia Senior Farmers’ Market Nutrition Program (GSFMNP) is intended to increase consumption of fruits and vegetables among Georgia’s low-income, older adults. The program provides $20 in vouchers with which participants may purchase Georgia-grown fruits and vegetables at approved farmers’ markets. Similar programs operate in other states, and studies suggest that these programs are successful in increasing fruit and vegetable intake among participants. However, because Georgia’s program operates somewhat differently, offering only a single market event at most locations, it may have different results. The purpose of this study was to determine whether or not produce purchased at GSFMNP events in 2008 contributed to an increase in the fruit and vegetable intakes of the participants and to identify factors that may have influenced those intakes. The study focused on purchase, consumption, preservation, waste, and sharing of fresh fruits and vegetables. Methods: For this qualitative study, a sample of 198 GSFMNP participants was surveyed from ten metro Atlanta senior centers where markets were held in August and September of 2008. Descriptive statistics were produced to summarize purchase behaviors, food utilization behaviors, and attitudes. Analyses of relationships between variables were performed using Pearson chi-square tests. Results: Twenty-seven percent of subjects reported consuming more fruits and vegetables than usual in the week following the farmers’ market event. There was a significant association between a larger than usual purchase amount and increased intake. There was also a significant association between increased intake and sharing purchased items. No significant associations with increased intake were found for variety of items purchased, preserving food, or discarding food. Those who purchased more fresh produce than usual appeared to be more likely to share their food with others but were not more likely to discard food. Ninety-seven percent of subjects said they would participate in the program again. Conclusion: Results of this study suggest that the majority of GSFMNP participants did not increase their intakes of fruits and vegetables. Sharing, preserving, and discarding food did not appear to be responsible for this outcome. More research is needed to discover what strategies could increase fruit and vegetable intakes among participants of the GSFMNP.

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<p>This thesis described socioeconomic inequalities in fruit and vegetable consumption in Stockholm County.<strong> </strong>A comparative descriptive analysis was carried out with the use of secondary data from the 2006 Stockholm County Public Health Survey. The data was analyzed through cross tabulations that were conducted in SPSS.<strong> </strong>The findings showed that people with high socioeconomic position consumed fruit and vegetables more frequently than those of low socioeconomic position. Differences in fruit and vegetable consumption were found for the three measures of socioeconomic position; education, occupation and income. These differences were pronounced to a larger extent across different education levels compared to levels of occupation and income. Further research is needed to investigate which factors may explain the observed differences.</p>

This thesis described socioeconomic inequalities in fruit and vegetable consumption in Stockholm County. A comparative descriptive analysis was carried out with the use of secondary data from the 2006 Stockholm County Public Health Survey. The data was analyzed through cross tabulations that were conducted in SPSS. The findings showed that people with high socioeconomic position consumed fruit and vegetables more frequently than those of low socioeconomic position. Differences in fruit and vegetable consumption were found for the three measures of socioeconomic position; education, occupation and income. These differences were pronounced to a larger extent across different education levels compared to levels of occupation and income. Further research is needed to investigate which factors may explain the observed differences.

This thesis aimed to investigate the potential to increase young children s vegetable consumption by using caregivers as facilitators. This was achieved in two parts. Part I set out to investigate whether parent led interventions using three known successful methods of offering can be effective for increasing children s acceptance of a disliked vegetable. Three studies were conducted for Part I. The first tested the efficacy of these interventions, the second investigated the role of individual factors in intervention success, and the third examined the longitudinal efficacy of such interventions over two, six and 12 months. The findings suggested that parent led home-based interventions may be successful for increasing children s acceptance of disliked vegetables in the short-term, and that such interventions may be more successful for children who are more sociable and less fussy eaters. While these interventions may not be successful for sustained long-term changes, there was a lack of statistical power for these analyses and further studies with larger samples are required. Part II of the thesis sought to investigate the wider variety of methods which caregivers use to offer vegetables to their children, as well as the possible barriers to offering. These studies worked towards informing the design of future interventions as well as providing information for caregivers on achieving a healthful diet in their children. This was achieved via two studies which used qualitative and quantitative methods. One study used focus groups to gather a comprehensive report of caregivers methods of offering, as well as caregivers perceived influences on how and whether they offer their child vegetables. Methods of offering vegetables formed three main categories: active/behavioural methods, passive methods, and food manipulations. The influences on offering which caregivers perceived formed four categories: information, cost, caregiver factors, and child factors. These methods and influences were then assessed in a large scale cross-sectional study. This study examined which methods caregivers perceive as successful for encouraging consumption of vegetables, as well as assessing predictors of offering vegetables and children s vegetable consumption. Caregiver factors predicted reoffering of rejected vegetables while a combination of caregiver and child factors predicted children s consumption of vegetables. A number of discrepancies were found between methods caregivers perceived as successful and those which were associated with greater consumption of vegetables. As food fussiness was identified as a significant factor in children s consumption of vegetables, a final study investigated whether children categorised as fussy or not fussy with vegetables differed on a number of caregiver and child factors. Differences were found between these groups on both caregiver and child factors. Using a mixed methodology, the research in this thesis investigates possibilities for increasing vegetable consumption in early childhood and highlights the central role or caregivers in this process. Together, these findings suggest utility of whole family interventions aimed at increasing vegetable consumption, as well as providing caregivers with information on how best to offer vegetables to children of this age.

Objective: To examine the influence of farmers' market pricing and accessibility on willingness to shop at farmers' markets, among low-income women. Design: Qualitative interviews using scenarios with quantitative assessment of willingness to shop at farmers' markets given certain pricing and accessibility scenarios. Setting: Eastern North Carolina. Participants: A total of 37 low-income women of childbearing age (18-44 years) receiving family planning services at the health department. Phenomenon of Interest: Willingness to shop at a farmers' market. Analysis: Fisher's exact test was used to examine associations between willingness to shop at farmers' markets by urban/rural residence, race, and employment status. Direct quotations relevant to participants' use of farmers' markets were extracted based on a positive deviance framework. Results: Participants were increasingly willing to shop at the farmers' market when price savings increased and when the market was incrementally closer to their residence. Willingness was highest when there was at least a 20% price savings. Participants seemed to be influenced more by a visual representation of a greater quantity of produce received with the price savings rather than a quantitative representation of the money saved by the reduced price. Conclusions and Implications: Future farmers' market interventions should take into account these consumer level preferences.

Master of Science / Department of Horticulture, Forestry, and Recreation Resources / Candice A. Shoemaker / Professionals in health promotion are starting to look at gardening as a strategy for health behavior change. This popular leisure time activity provides access to physical activity and fresh fruits and vegetables for consumption, two behaviors consistently recommended for optimum physical health. Coupled with a lifestyle low in sedentary behavior these behaviors can offset the health risks of the prevailing trends of overweight and obesity. Spending time outdoors is associated with higher levels of physical activity, while screen based behaviors are associated with unhealthy eating. No studies to date have looked at the health behaviors of gardeners, or the effects it may have on their family’s health behaviors. The purpose of this report is to examine, through descriptive research, the health behaviors of gardening and non-gardening parents and their fourth or fifth grade child. Surveys were administered to a convenience sample of 366 fourth and fifth grade students and their guardians within a school district in Riley County, Kansas. The survey assessed the physical health behaviors mentioned above; comparisons were made according to parental classification of gardener (n=189) or non-gardener (n=177). Significant association was found with gardening classification and adult self-reports of the number of days and amount of time respondents participated in moderate to vigorous physical activity. The median days per week parents reported participation in moderate to vigorous physical activity was 3 for non-gardeners, and 4 for gardeners and was influenced by gender. Eighty-seven percent of gardeners compared to 59.3% of non-gardeners reported meeting the current physical activity recommendation of 150 minutes per week of moderate intensity activity.

During college, students establish nutritional habits that may last a lifetime. Fruit and vegetable consumption often decreases during the first few years of college and the vast majority of college-­‐aged students are not meeting current recommendations. Social norms theory has been shown to be an effective method for influencing behaviors in this population. This study was designed to test whether or not providing students with normative and manipulated social norms feedback could influence fruit and vegetable intakes among college-­‐aged students as evidenced by changes in skin carotenoid levels and food frequency questionnaire reports. Participants (n=244) were randomly assigned to a control group or given either normative feedback or manipulated social norms feedback regarding their skin carotenoid levels in comparison to their peers, with carotenoid levels being an objective measurement of fruit and vegetable intake. Those receiving manipulated feedback were given an artificially low carotenoid score implying that peer consumption was greater than their own. Results indicated no significant within-­‐participant changes in fruit and vegetable intakes reported in the FFQ (P=.635). While there was no change in the control groups skin carotenoid levels (P=.996), there was a borderline significant increase among those receiving normative feedback (P=.066) and a significant increase among those receiving manipulated social norms feedback (P<.001). Repeated measures of analysis showed that within-­‐participant increases in carotenoid scores were dependent on group assignment (P=.033) with an effect size of η2p=.026 which according to Cohen’s guideline is a small effect size. The distribution of carotenoid scores and FFQ results were approximately normal. Comparisons between FFQ results and skin carotenoid levels found Pearson correlation coefficients of .301 (P<.001) and other positive correlations were found between skin carotenoid levels and both exercise and BMI (.111, P=.049; -­‐.253, P<.001). The results of this study suggest that manipulated social norms feedback can increase skin carotenoid levels. The observed increases may indicate higher carotenoid containing fruit and vegetable consumption. These findings imply that social norms feedback may potentially be used as a strategy to promote and influence greater fruit and vegetable consumption among college students.

Mean daily vegetable consumption is below the recommended 7-10 servings in the diet of adult Canadians. This thesis aimed to investigate the moderating role of perceived barriers on the relationship between motivation and (greater) vegetable consumption. 606 people from the Ontario Food panel participated in the online study. The results identified a positive moderating effect of perceived barriers on the relationship between autonomous motivation and vegetable consumption (p < .05) and negative approaching significance moderating effect of perceived barriers on controlled motivation and vegetable intake (p = 0.056). Also four motivational profiles of consumers were identified and described in terms of vegetable consumption, food related behaviors, stages of change and socio-demographic characteristics. These results extend the Self-Determination Theory with perceived barriers component and can inform intervention program development for social marketers and policy makers.

University students have low levels of fruit and vegetable consumption (FVC). There is a paucity of research about changing FVC in this population, including the specific use of environmental cues to influence behaviour change. The purpose of this research was to investigate the effect of a cue (a modified plate design and/or plate size) on FVC while exploring explicit cognitions and attitudes in first year undergraduates. Methods: This study utilized an experimental pre-post randomized control group design across six weeks, with two recruitment waves. First year full-time University students living off campus and consuming less than six servings of fruits and vegetables were eligible. Participants (n=39) were randomly assigned to intervention with an 8-inch dinner plate displaying recommended portion sizes, with an 8-inch dinner plate with no design, or a control group. All participants completed a food frequency questionnaire (FFQ), 24-hour food recall (24Hr), demographics, anthropometry and intentions toward FVC, with intervention groups receiving a lesson on Canada’s Food Guide in addition to their plate. Results: Eight out of twelve outcome measures had meaningful time by group effect sizes (ɳ2>0.06). For fruit frequency (per day), the effect was statistically significant (p=0.03). Adherence to plate use varied (design plate: 0.69±2.38 to 4.23±5.55 times per week; plain plate 3.39±7.31 to 12.80±7.89 times per week) but was low in the designed plate condition (average 4 use: 2.46±3.88 times per week). Baseline intention, affective and instrumental attitudes, perceived behavioural control, subjective norms and automaticity did not predict FVC. Conclusion: An environmental cue in the form of a modified dinner plate may significantly influence fruit and vegetable consumption in young adults. Change occurred despite low plate use, which appears to indicate that the role of the plate was more explicit; participants may have become more consciously aware of portion size because of the plate cue. It also appeared, based on effect sizes, that affective attitudes, subjective norms and automaticity may have been influenced. This pilot study established the effect sizes needed to power a larger randomized controlled trial and fully test the impact of the environmental cue. / Graduate / 0573 / 0570 / 0680 / hmrose@uvic.ca