A Mixed-Methods Examination of the Impact of the Partnerships to Improve Community Health Produce Prescription Initiative in Northeastern North Carolina.

OBJECTIVE: To conduct a mixed-methods examination of the impact of the Partnerships to Improve Community Health produce prescription initiative in northeastern North Carolina. DESIGN: Quantitative surveys were conducted among participants before and after the distribution of produce prescription vouchers. Univariate statistics were used to describe the participant population, and paired t tests were used to examine change in fruit and vegetable intake. Qualitative, in-depth telephone interviews were conducted among participants, health educators, and food retailers and coded for themes. SETTING: Eight health promotion programs, 2 food pantries, and 11 food retailers. PARTICIPANTS: In each health promotion program or food pantry, between 6 and 97 participants were enrolled. INTERVENTION: Produce prescription vouchers were distributed to participants and redeemed at local food retailers. MAIN OUTCOME MEASURE S: An increase in local fruit and vegetable purchasing and consumption. RESULTS: Of the produce prescription participants who completed the baseline survey (n = 93), 86% were female, 64% were African American, and 68% were food insecure. The voucher redemption rate was 18%. The majority of participants indicated that they visit farmers' markets more now than before the produce prescription initiative, that shopping at the farmers' market made it easy to include more fresh produce in their family's diet, and that they tried a new farmers' market because of the produce prescription initiative. All health educators and food retailers who participated felt that the initiative benefited their program or operation and were willing to partner with the program again. CONCLUSIONS: While redemption rates were lower than anticipated, the produce prescription initiative had positive impacts on participants' local fruit and vegetable purchasing and consumption. Because of COVID-19, the initiative was not implemented until late in the North Carolina produce season. Moving forward, the program will start earlier and work with local food retailers to connect with their communities to increase redemption rates.

A meta-analysis of studies examining associations between resonance Raman spectroscopy-assessed skin carotenoids and plasma carotenoids among adults and children.

CONTEXT: No meta-analyses appeared to have been conducted to examine overall correlations between resonance Raman spectroscopy (RRS)-assessed skin carotenoids and plasma/serum carotenoids. OBJECTIVE: To review the available literature and quantify the association between RRS-assessed skin carotenoids and plasma/serum carotenoids via a meta-analysis of observational studies. DATA SOURCES: To identify relevant publications, we searched the PubMed, Embase, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, ProQuest, and Scopus databases in April 2020 for items combining 3 concepts: Raman spectroscopy, skin, and plasma or serum. DATA EXTRACTION: Criteria for inclusion were publication in a peer-reviewed journal between 1990 and 2020, available in English language, and results reported as a baseline Pearson correlation coefficient. In teams of 2, the researchers independently reviewed titles and abstracts of 2212 nonduplicate papers with initial screening yielding 62 papers for full-text review, of which 15 were deemed eligible for inclusion. DATA ANALYSIS: A random-effects model in R (version 4.0.0) "meta" package was used to analyze the correlation between RRS-assessed skin and plasma/serum carotenoids. A subgroup analysis was conducted for studies involving adults and children, respectively. CONCLUSIONS: The 15 studies included 1155 individuals: 963 adults and 192 children. One study included children and adults. The random-effects model yielded an overall correlation of 0.68 (95%CI, 0.61-0.74; I2 = 74%; P < 0.01). The results were similar when grouped by adults and children. Among 963 adults, the correlation in the random-effects model was 0.69 (95%CI, 0.61-0.75; I2 = 78%; P < 0.01). Among 192 children, the correlation in the random-effects model was 0.66 (95%CI, 0.52- 0.77; I2 = 55%; P = 0.06). Overall, there was a positive, statistically significant correlation between RRS-assessed skin carotenoids and plasma/serum carotenoids in a pooled meta-analysis of 15 studies. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (record number 178835).

Perceived barriers and facilitators to participating in the North Carolina Healthy Food Small Retailer Program: a mixed-methods examination considering investment effectiveness.

OBJECTIVE: The North Carolina Legislature appropriated funds in 2016-2019 for the Healthy Food Small Retailer Program (HFSRP), providing small retailers located in food deserts with equipment to stock nutrient-dense foods and beverages. The study aimed to: (1) examine factors facilitating and constraining implementation of, and participation in, the HFSRP from the perspective of storeowners and (2) measure and evaluate the impact and effectiveness of investment in the HFSRP. DESIGN: The current analysis uses both qualitative and quantitative assessments of storeowner perceptions and store outcomes, as well as two innovative measures of policy investment effectiveness. Qualitative semi-structured interviews and descriptive quantitative approaches, including monthly financial reports and activity forms, and end-of-programme evaluations were collected from participating HFSRP storeowners. SETTING: Eight corner stores in North Carolina that participated in the two cohorts (2016-2018; 2017-2019) of the HFSRP. PARTICIPANTS: Owners of corner stores participating in the HFSRP. RESULTS: All storeowners reported that the HFSRP benefitted their stores. In addition, the HFSRP had a positive impact on sales across each category of healthy food products. Storeowners reported that benefits would be enhanced with adjustments to programme administration and support. Specific suggestions included additional information regarding which healthy foods and beverages to stock; inventory management; handling of perishable produce; product display; modified reporting requirements and a more efficient process of delivering and maintaining equipment. CONCLUSIONS: All storeowners reported several benefits of the HFSRP and would recommend that other storeowners participate. The barriers and challenges they reported inform potential approaches to ensuring success and sustainability of the HFSRP and similar initiatives underway in other jurisdictions.