Evaluating the Implementation of a Farmers' Market Targeting WIC FMNP Participants.

The present study planned and implemented a new farmers' market (FM) at a WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) clinic in North Carolina, of which WIC FM Nutrition Program (FMNP) participants were the main priority population. The purpose of this FM was to provide convenience and improve access to locally grown fresh fruits and vegetables in the community and to increase the FMNP coupon redemption rate. The main objective of this study was to describe the overall process and key strategies involved in implementing a FM at a WIC clinic. A community-based participatory research design using different formative methods documented the process and key inputs in FM implementation. Local farmers, program administrators, and community advocates were involved in documenting the implementation process. Multiple formative methods included direct observation and semistructured interviews with staff and farmers (n = 13). A community partnership was key in implementing the FM. The market operated weekly over the course of 24 weeks, involved 12 WIC-approved farmers, and featured over 50 types of fresh fruits and vegetables. The FMNP coupon redemption rate at the county level increased from 51.3% to 62.9%. The results demonstrate that a FM can be successfully located near a WIC clinic with positive effects of increasing availability to fresh fruits and vegetables for a low-income population and revenue for local farmers.

Environmental, Nutrition and Health Issues in a US Refugee Resettlement Community.

INTRODUCTION In 2012, North Carolina ranked in the top ten states in refugee resettlement, with central Guilford County one of the most diverse in the southeast. OBJECTIVE Examine the local resettlement environmental, nutrition and health barriers and needs of refugees in Guilford County, as perceived by individuals providing services to them. METHODS Participants (n = 40) included: medical and social service providers, educators, faith-based volunteers, resettlement agency caseworkers and liaisons to a variety of refugee communities. Guided semistructured interviews were audio-recorded and transcribed verbatim. Themes were identified using deductive content analysis and categorized by frequency of reporting by participants. RESULTS Perceptions were consistent across participants regarding a diverse local refugee population. Resettlement housing was observed to be in poor condition, located in areas of poverty with transportation barriers. However, refugees rarely relocated, due to strong community relationships and support. Perceived dietary risks included: difficulties budgeting and maintaining food assistance, hoarding food, high consumption of sodas and sweets, misperceptions regarding US products (e.g., perceived need for infant formula), and limited health knowledge. Respondents observed that most refugees preferred "fresh" foods, and had strong agricultural skills but lacked green space. Major barriers to health care reported were: poverty, short duration of initial Medicaid coverage, and language (both lack of interpretation services and translated materials). Providers consistently observed type 2 diabetes, weight gain and dental problems across refugee groups. CONCLUSIONS Direct service providers' experiences and observations working with a diverse resettlement population provide unique insight into consistent barriers to achieving good health that confront refugees. While refugees face many barriers, groups often have impressive strengths, such as agricultural skills, on which to focus. KEYWORDS Refugees, emigration, immigration, minority health, health care disparities, diet, environment, USA.

Are nutrition knowledge, attitudes, and beliefs associated with obesity among low-income Hispanic and African American women caretakers?

The purposes of this descriptive study were to (1) describe nutrition knowledge, attitudes, beliefs (KAB), and self-efficacy among low-income African American and Hispanic women; (2) identify the associations these variables have on diet quality and weight status; (3) identify barriers to healthy eating. Data from three separate studies were combined and analyzed. The total sample included African Americans (N = 92) and Hispanics (N = 272). Descriptive statistics and bivariate analyses were used to identify associations between KAB and body mass index (BMI) and diet quality. The majority of African Americans had good knowledge in nutrition while Hispanics had fair knowledge. Attitudes toward eating a healthy diet were significantly associated with high fiber intake among African Americans and low fat consumption among Hispanics. A computed KAB score showed no significant relation to individuals' weight status or diet quality. However, attitudes and beliefs about healthy foods strongly correlated with participants' weight or diet consumption among Hispanics. The most common barrier to consuming a healthy diet reported by both groups was the cost of healthy foods. It is therefore recommended to address these variables when addressing obesity and poor dietary intake among low-income minority groups.

What changes when we move? A transnational exploration of dietary acculturation.

This study aimed to explore Mexican dietary acculturation patterns among immigrants using a unique transnational photographic assessment. Participants (N = 10) were Latino mother and child pairs living in Mexico (1 pair) and in the United States (4 pairs). Data were collected in 2 phases: 1) participant observation and photography in Mexico, and 2) in-depth interviewing using photographic guides in North Carolina. Environment, daily activity patterns, shopping, and dietary patterns in Mexico were all documented. Acculturation resulted in poor dietary intake due to decreased availability, food displacement, and cost. Decreases in physical activity due to environmental and social barriers were also reported.

Cultural adaptation resources for nutrition and health in new immigrants in Central North Carolina.

This paper presents results of a study that was conducted for the purposes of describing available human services resources relating to nutrition, physical health, and behavioral health for new and recent immigrants (predominantly Mexican immigrants, but groups from Southeast Asia and continental Africa as well) in Guilford County, NC. Sixty-five service providers were determined to represent cultural adaptation resources providing either direct and/or ancillary assistance to limited English proficient immigrants. Seventeen direct assistance providers specialized in food and nutrition programs, but only 2 had targeted programs for addressing food scarcity, insecurity, and nutritional deficiencies in immigrant households. Four of 15 direct physical health services providers had clinical care or specialty programs for immigrants. Finally, 5 of 16 direct behavioral health care providers offered mental health treatment and counseling services adapted specifically for targeted immigrant groups. These findings highlight the limited development of the existing human services network to increase its capacity to provide nutrition and health related services to a growing community of diverse immigrant groups. These descriptive results underscore a need for additional local level or community based resources to be directed towards increasing the community's ability to provide essential human services to population groups not yet language proficient and acculturated to "American community standards."