Consumption of fresh fruits and vegetables is a feature of diets consistently associated with a lower risk of cancer. It is also a feature of diets that is consistently missing from low-income populations.
William Paterson University sociology professor Jennifer Di Noia is hoping to change that for some at-risk people living in New Jersey, and the National Cancer Institute – via the National Institutes of Health (NIH) – is lending its support.
Through a prestigious $310,000 grant from NIH, Di Noia will be testing an education and intervention initiative geared to low-income pregnant and postpartum women served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Applications submitted to the NIH are assigned to a review group for evaluation of scientific and technical merit. Only those applications ranked in the top seven percent are eligible for funding; Di Noia’s proposal was ranked in the top two percent
Her funded proposal, a feasibility study, combines behaviorally-focused nutrition education with the establishment of a WIC-based farmers’ market. Staffed with trained nutrition educators in place of farmers, the market was in operation from mid-June to early August. That period coincides with the period during which WIC issued annual vouchers to its participants for use at farmers’ markets.
The Farmers’ Markets Nutrition Program (FMNP) was established by Congress in 1992 to improve WIC participants’ access to fresh, locally grown fruits and vegetables, and to expand awareness, use of, and sales at farmers’ markets. In 2017, 1.7 million WIC families received FMNP benefits nationwide, but only 55 percent of FMNP vouchers were redeemed that year.
Why? According to Di Noia, barriers limiting access to area markets, e.g., lacking transportation or having inconsistent access to transportation and distance to markets, is one part of the problem. Limited farmers’ market-related knowledge and skills is another, for example, not knowing what local foods are and correspondingly, how to select, store, and prepare them.
Therefore, Di Noia created educational lessons and materials with extensive input from an advisory board of WIC agency representatives and focus groups of WIC participants, in which she aimed to target unhealthy behaviors and their influence, as well as promote fruit and vegetable intake and FMNP voucher redemption.
WIC participants who visited the on-site market received both group and individual instruction. To create additional opportunities for experiential and hands-on learning, Di Noia has arranged monthly trips to the Paterson Farmers’ Market this fall. Door-to-door bus transportation will be provided at no cost. During the bus trips and at the market, nutrition educators will provide instruction on such topics as how to navigate the market and communicate with farmers, as well as offer informational and emotional support for healthy eating. The nutritionists also will conduct fruit and vegetable recipe demonstrations and tastings to increase awareness of and preferences for unfamiliar foods.
To determine whether her intervention created a positive outcome, its effects on participants’ fruit and vegetable intake, as well as their FMNP voucher redemption, will be examined. If found effective, follow-up funding will be sought to fully develop and test the intervention.
“Ethnic and racial minorities are disproportionately affected by cancer and other diet-related diseases,” Di Noia says. “I’m hoping we can say, ‘Here’s a program that is one option for long-term health gains.’”
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