The Veggie Van: Customer characteristics, fruit and vegetable consumption, and barriers to healthy eating among shoppers at a mobile farmers market in the United States.

OBJECTIVE: Mobile farmers markets may improve local food environments by increasing access to healthy food, yet research is limited. The purpose of this study was to describe customer characteristics and barriers to healthy eating among customers at a mobile farmers market called the Veggie Van. DESIGN: In 2016, a customer intercept design was used to survey English-speaking Veggie Van customers (n = 192; 70.5% survey response rate) aged ≥18 years on sociodemographic and health characteristics, normal daily consumption of fruit and vegetables (F/V) using the Health Information National Trends Survey screener, food acquisition and purchasing habits, and potential barriers to healthy eating. We compared customers to service area neighborhood residents. Within customers, we compared first-time and repeat customers, and those with low and high F/V consumption. RESULTS: Veggie Van customers were more likely to identify as non-Hispanic white and have a bachelor's degree than neighborhood residents. Participants were mostly female (76.0%) and non-Hispanic white (53.7%). Approximately half (45.0%) were first-time customers and many (41.7%) did not meet F/V consumption recommendations. In the total sample, cost was the most frequently reported barrier to healthy eating. Among repeat customers, those with low F/V consumption were more likely to report cost as a barrier than those with high F/V consumption (p = 0.02). Only 8.9% reported no transportation to buy healthy food. CONCLUSIONS: Veggie Van customers may not represent neighborhood residents. Although few participants met F/V recommendations, most had transportation to buy healthy food. Mobile markets have lower overhead costs and greater flexibility than traditional stores and can address geo-spatial barriers to food access, but should ensure that they are serving target customers.

Simple screening tools to identify limited health literacy in a low-income patient population.

Adults with limited health literacy have difficulty managing chronic conditions, higher hospitalization rates, and more healthcare expenditures. Simple screening tools have been developed, but limited work has evaluated instruments among low-income populations. This study assessed health literacy among primary care patients of a federally qualified health center, and compared a single screening question about perceived difficulty completing medical forms.A cross-sectional survey was administered to English-speaking patients ≥40 years. Both the Newest Vital Sign (NVS), a 6-item questionnaire, and a single-item screening question about perceived difficulty with completing medical forms, assessed health literacy. Logistic regression was used to identify predictors of inadequate health literacy and receiver operator curves compared the NVS and single-item question.Participants (n = 406) were, on average, aged 58.5 years (±11.3), 72.2% female, and identified as Hispanic/Latino (19.2%), non-Hispanic white (31.0%), non-Hispanic black (40.9%), or other (8.9%). Of the 406 participants, 335 (82.5%) completed the NVS. Patients who declined NVS were more likely to be older (P < .001) and male (P = .01). Only 13.7% had adequate health literacy. Older adults, Hispanic and non-Hispanic black patients, patients with missed office visits, and those reporting less confidence completing medical forms were significantly more likely to have inadequate health literacy. Perceived confidence completing medical forms demonstrated low sensitivity but high specificity at multiple thresholds.This is the first investigation to compare the NVS and confidence completing medical forms question. Many patients declined health literacy assessments, but health literacy screening may identify patients who need additional health education and resources.