Michigan Farmers’ Market Nutrition Program

The target population of Project FRESH is low-income women in underprivileged parts of Michigan. The actual study population specifically consisted of women who participate either in Women, Infants, and Children (WIC) or Commodity Supplemental Food Program (CSFP) programs. The metropolitan-Flint-area is 45% African American, with numerous women living at or below 185% of federal poverty income guidelines.

The essential components of the program include the delivery of education and farmers’ market coupons. The idea of the program is by giving women the proper nutritional education about the importance of consuming fruits and vegetables they will in turn help encourage the purchase of healthy foods. However, because WIC participants are often from low-income areas, they may not have the resources to purchase fresh produce. Project FRESH counters this problem by issuing coupons through WIC agencies that can be used to buy fresh fruits and vegetables at local farmers’ markets. Many farmers’ markets are also now joining and becoming involved in the Project FRESH program.

Project FRESH, under the Michigan Department of Community Health, facilitates the program. The program also works in cooperation with local agencies and the Michigan State University Extension/Expanded Food and Nutrition Education Program and Family Nutrition Program. Project FRESH implements its program by delivering coupons and providing education and services to low-income and nutritionally-at-risk consumers through local farmers’ markets. This is in the efforts of changing the attitudes and consumption behavior of fruit and vegetable intake while also ensuring the availability of such resources. The local agencies of WIC identify eligible participants and proceed to give $20 in coupons, which can be used at any authorized farmers’ market. Participants are also given a brief food and nutrition presentation, 5-A-Day for Better Health materials, and other resources for more nutrition education.

The goal of the program is to increase fruit and vegetable consumption behavior in participants of the Women, Infants, and Children program in Genessee County, Michigan.

Participants of the program increased their fruit and vegetable consumption and the program had a positive effect on participants attitudes toward consuming fruits and vegetables.

A randomized controlled trial was conducted to determine the effects of education, monetary incentives, or both, on fruit and vegetable consumption behavior. The intervention groups were chosen from metropolitan Genessee County in Michigan, which is approximately 45% African American. Subjects were selected from WIC and CSFP populations. Both of these organizations serve women and children at or below 185% of federal poverty income guidelines. Of the 669 recruited women from WIC or CSFP, 564 (84.3%) completed the questionnaire beforehand, and 455 (80.7%, attrition 19.3%) returned to complete it.

Subjects were randomly assigned to receive either education and coupons, education-only, coupons-only, or no intervention. Education involved obtaining information about the storage and nutritional value of fruits and vegetables. Participants in the two groups that received education were more likely to hear the phrase, “5 A Day for Better Health” (p<0.001), which proved to have a direct effect on subjects’ positive attitudes toward fruit and vegetable consumption, which in turn increased their consumption. Coupons had a direct effect on increasing actual consumption, but not on the attitudes. Participants in the two groups who received coupons were more likely to report visiting farmers’ markets during the study (p<0.001). Thus, a combination of education and coupons enhanced the impact of the intervention.