Boston&Farmers’&Market&Incentive& Programs ......2!!!!! & & Acknowledgements& & & SpecialThanksTo:!! Cammy!Watts!and!the!staff!of!The!Food!Project!! Mass!Farmers!Markets!! TheCongressionalHungerCenter!

Boston Farmers’ Market Incentive Programs: Increasing Access to Fresh

and Local Produce

February 2010

Aisha Amuda Bill Emerson National Hunger Fellow

Congressional Hunger Center

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Acknowledgements

Special Thanks To:

Cammy Watts and the staff of The Food Project

Mass Farmers Markets

The Congressional Hunger Center

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Table of Contents

Introduction …………………………………………………………………………………………………………. Page 4 Methods ……………………………………………………………………………………………………………….. Page 6 Results …………………………………………………………………………………………………………………. Page 9 Impacts of Incentive Programs ……………………………………………………………………………. Page 23 Recommendations ………………………………………………………………………………………...……. Page 32 Sources Consulted ………………………………………………………………………………………………. Page 35 Appendix ……………………………………………………………………………………………………………. Page 37

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Introduction While there are a large number of farmers’ markets in the Greater Boston area,

some of these markets struggle to reach members of low-‐income neighborhoods of the city

on a consistent basis. This report will evaluate the success of various farmers’ market

incentive programs and what effect they have had on the Boston residents’ capacity to shop

for local produce at area farmers’ markets and their likelihood to continue to frequent

markets for fresh produce.

Many low-‐income neighborhoods in Boston rely on convenience or corner stores to

obtain their food. In the United States, 11.5 million people who are low-‐income and live in

low-‐income areas are more than one mile way from a supermarket. This reality forces

many individuals in low-‐income areas, who don’t have access to vehicles, to spend

increased travel time to reach supermarkets or grocery stores. Not only is distance and

transportation a major factor in accessing food in low-‐income area for low-‐income people,

but time is also an issue in how and where people shop for their food. Farmers’ markets

can greatly increase or enhance food access, particularly to fresh produce, for residents of

their surrounding communities. While farmers’ market have been increasing in popularity

rapidly throughout the Commonwealth of Massachusetts and many other areas of the

United States, there are still communities who are unaware of the benefits to shopping at

markets or are reluctant to shop regularly at farmers’ markets because of cost, convenience

or other factors (United States Department of Agriculture, 2009).

Produce at farmers’ market is often perceived as prohibitively expensive for those

with limited resources, so federal policy has been instrumental in increasing access to

farmers’ markets in low-‐income communities. The Supplemental Nutrition Assistance

Program (SNAP) is federal nutrition assistance program that provides electronic benefits to

households that meet eligibility requirements around income. SNAP recipients can now

use an Electronic Benefit Transfer (EBT) card to authorize transactions for purchase of

food at SNAP retailers. Farmers’ markets can get licensed by the Food and Nutrition

Services Department of the USDA to process SNAP payments. In Massachusetts, another

federal food assistance program that provides more access to farmers’ markets in low-‐

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income communities is the Women, Infants and Children (WIC) Program. The WIC

Program grants funds to states for food, health care, breastfeeding and non-‐breastfeeding

postpartum women and to children up to age five who are at nutritional risk. The Special

Supplemental Nutrition Program of WIC administers the WIC Farmers’ market Nutrition

Program (FMNP) that provides fresh and local fruits and vegetables to WIC participants. In

Massachusetts, these benefits are distributed with farmers’ market coupons worth $2.50

each. A third federal program that helps to increase access to farmers’ markets is the

Senior Farmers’ Market Nutrition Program (SFMNP) like WIC grants funds to states, United

States territories and federally-‐recognized Indian tribal governments to provide low-‐

income seniors with coupons for fruits, vegetables, honey and fresh-‐cub herbs at farmers’

markets (USDA, 2010).

State policy has also contributed to providing more access for low-‐income people to

farmer’s markets. In March 2010, the Patrick-‐Murray Administration authorized a grant to

purchase EBT terminals allowing customers to use SNAP benefits at farmers’ markets.

More locally, The Food Project and the City of Boston have implemented the Boston Bounty

Bucks Program. The program provides a dollar-‐for-‐dollar match for EBT purchases up to

$10 at participating farmers’ markets (Commonweath of Massachusetts, 2010).

In addition to federally or state funded farmers’ market initiatives, farmers’ markets

and community organizations in Boston have created farmers’ market coupon incentive

initiative programs to increase the number of low-‐income customers at farmers’ markets in

the city and to expose them to a new source of fresh produce in their communities.

Ultimately, these programs are designed to assist participants in changing their shopping

and eating behaviors to include more fresh fruits and vegetables and in doing so contribute

increased health outcomes. Farmers’ market are an integral way to contribute to food

security and increase access to fresh and local food for low-‐income residents in Boston.

This report will contribute constructive suggestions for how to further expand or improve

these incentive initiatives.

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Methods To evaluate the success of the four various farmers’ market coupon programs, the

Hunger Fellow collected and analyzed pre and post program survey data from program

participants, interviewed individual participants and program coordinators, and analyzed

coupon redemption data from farmers’ markets in Boston as well as aggregate redemption

data for farmers’ markets across the Commonwealth of Massachusetts.

Massachusetts General Hospital Farmers’ Market Coupons

The Massachusetts General Hospital (MGH) farmers’ market coupons were

distributed to two groups: attendees at 7News Partners Healthcare Health & Fitness Expo

in Boston, and families and parents of youth who work at The Food Project (TFP). The

Food Project facilitated the distribution of the MGH coupons to both target groups, so TFP

staff were interviewed about the distribution methods and the level of education provided

with the coupons. The coupons that were distributed to families of TFP youth had been

marked with a red stripe before being given out to distinguish them from the coupons

distributed at the Expo. Massachusetts General Hospital staff distributed remaining

coupons at their post events. The MGH farmers’ market coupon redemption data were

collected from Mass Farmers Markets.

Farmers’ Market Promotion at Boston Farmers’ Markets

Nine farmers’ markets received subgrants from The Food Project to do market

promotion targeted at low-‐income customers and SNAP participants with the goal of

increasing the number of low-‐income customers at the markets. Each market prepared a

report that summarized the outcomes of their outreach. The managers of the nine markets

were also interviewed in person or by phone to obtain more information on:

• the goal of the coupon distribution program,

• the mechanism through which coupons were distributed,

• what education was provided to consumers or participants,

• how many coupons were printed,

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• how many coupons were redeemed,

• what outreach and education methods resulted in the highest redemption rates, and

• whether managers and directors perceived success for their programs.

The Food Project’s Fruit & Vegetable Coupon Program

Seven organizations participated in The Food Project’s Fruit & Vegetable Coupon

Program. The managers of each of these programs were interviewed in person or by phone

to learn:

• the specific details of the program,

• what outreach and education methods resulted in the highest redemption rates

• the opinions and perceptions on the success of the program, and

• recommendations for improvements in program designs.

Pre and post program shopping habits of these program participants was collected

through surveys administered by the program managers and analyzed by The Food

Project. Individual interviews were conducted with participants of the seven programs as

well. The redemption data for these coupons was collected from Mass Farmers Markets.

The coupons were labeled with a serial number, so that coupon redemption could be

tracked by program.

Fruit & Veggie Prescription Program

Ceiling and Visibility Unlimited Foundation (CAVU), an organization that supports

the efforts of community programs that work to improve the healthcare for underserved

children, and Wholesome Wave, a Foundation whose mission is to increase access to fresh

and affordable locally grown food for all, piloted the Fruit & Veggie Prescriptions Program

for Massachusetts. Dr. Shikha Anand, the director of the Healthy Weight Initiative at CAVU,

led the administration of the program in various Healthy Weight Clinics across

Massachusetts. Dr. Anand was interviewed to learn:

• where the coupons were distributed,

• what education was received with the coupons,

• how many coupons were distributed to each family, and

• recommendations for the Veggie Prescriptions program.

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The redemption data of these veggie prescription coupons was gathered MA Farmers

Market.

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Results Program Descriptions

The program descriptions portion of this section will summarize the four farmers’

market coupon incentive initiative programs and the mechanism through which the

coupons were distributed. The programs, which all had different levels of outreach and

included varied forms of education, are:

• Distribution of farmers’ market coupons to anonymous attendees at a Boston health

expo and families of youth who work at The Food Project

• Targeted market promotion with farmers’ market coupons by nine farmers’ markets to

attract more low-‐income customers to those specific markets in Boston

• Education on food assistance programs, nutrition and wellness at health centers and

head start programs with farmers’ market coupons incentives

• Recommendations to families through three health centers for Veggie Prescriptions

farmers’ market coupons.


Massachusetts General Hospital worked with The Food Project and MA Farmers

Markets to distribute $30,000 worth of farmers’ market coupons that could be redeemed

for fruits and vegetables at any farmers’ market in MA. These coupons were valued at

$2.50 each allowing the printing of 12,000 market vouchers. Approximately $25,000 in

coupons was distributed at the 7News Partners Healthcare Health & Fitness Expo. The

Health & Fitness Expo took place on June 12 and 13, 2011 at the Hynes Convention in

Boston, Massachusetts. Partners Healthcare, one of the sponsors of the Expo, is a health

system with various hospitals, health care professionals and community health centers

whose mission is to improve the overall health of communities through education and

research.

At the Health & Fitness Expo, members of staff from The Food Project and Mass

Farmers Markets distributed farmers’ market coupons at an informational booth where

attendees of the Expo could learn about their local farmers’ markets. The Health & Fitness

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Expo was a free event and this outreach did not specifically target low-‐income people. The

Food Project invited the Expo attendees to participate in an interactive display were they

had to demonstrate where they might use the coupons to buy fresh and local food. They

were able to access the Mass Farmers market website to look up the location of markets

and print out a map to take with them. On the first day of the Expo, attendees who

participated in the interactive display received two coupons ($5.00) and on the second day,

The Food Project staff gave four coupons ($10.00) to participants. Massachusetts General

Hospital also provided funding for printed materials with information about The Food

Project, the Mass Farmers Markets and Boston Bounty Bucks.

Approximately $2500 worth of the same coupons funded by Massachusetts General

Hospital was distributed to the families of youth who worked with The Food Project’s

Summer Youth Program and Alumni Internship Program. Each family of a youth in these

two programs received six or seven coupons. They were distributed at two family events,

through mailed letters to families, and directly to members of the Alumni Internship

Programs. TFP families that received coupons were from a wide range of backgrounds and

economic levels. The remainder of the market vouchers was distributed by Massachusetts

General Hospital through other channels.


The Food Project offered several subgrants from USDA’s Farmers’ Market

Promotion Program (FMPP) at a number of Boston area farmers’ markets. Nine markets

that received grant money used portions of the funds to produce farmers’ market coupons

to encourage members of surrounding communities to shop for fresh, local produce at

these markets. An overview of these market promotion programs is illustrated in Table 1.

Allston Farmers’ Market

The Allston Farmers’ Market wanted to introduce more low-‐income consumers to

local farms and vendors at their market, so they distributed $900 in $5 coupons through

various means to targeted community groups at Charlesview Apartments, Veronica Smith

Senior Center, the Honon-‐Allston Library’s EcoKids Club, the Gardner Pilot Academy

Summer-‐School Program, the Allston-‐Brighton WIC Office, and the Harvard Allston Field

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and Fairway. Tenants of Charlesview Apartments received their coupons through a direct

mailing promoting the Harvard Allston Market in June 2010 and August 2010. The

Veronica Smith Senior Center distributed coupons to their patrons who were not eligible

for the Seniors Farmers’ Market Nutrition Program in July and August 2010. Staff from the

Harvard Allston Farmers’ Market led a lesson for children of the Honan-‐Allston Library

EcoKids and the Gardner Pilot Academy’s summer school 1st grade class. The participants

in each of these programs learned about making salsa with farmers’ market ingredients

and planting seeds. In addition to this lesson, the children at Gardner Pilot Academy

participated in a scavenger hunt at the market where they were given coupons to purchase

produce. In August, market staff gave coupons to the Allston-‐Brighton WIC office for them

to distribute to their clients. The final distribution of coupons was to patrons of the

Harvard Allston Field and Fairway, a free, public recreation center.

Farmers’ Market Total Amount of Money Distributed through Coupons

Target Population Served

Education Received with Coupon

Allston $900 Seniors; children

Boston Bounty Bucks; cooking and planting demonstrations;

market tours Boston Medical

Center $1,800 Low-‐income

consumers Nutrition talks and advisement

Bowdoin-‐Geneva $1,000 Low-‐income consumers

Workshops on the health benefits of fresh, local food; information on Boston Bounty

Bucks Community Servings

$1,230 Low-‐income consumers

Sessions on how to create healthy meals; cooking courses

Dorchester House $1,700 Low-‐income consumers

Information on SNAP/EBT use at farmers’ markets

East Boston Neighborhood Health Center

$1,250 Seniors Presentations on nutrition and SNAP/EBT use at farmers’

markets Grove Hall $1,000 Low-‐income

consumers Information on the effects of

increased produce consumption Mattapan $1,200 Low-‐income

consumers Market tours; cooking

demonstrations South Boston $600 Low-‐income

consumers Information on the market, SNAP

and Boston Bounty Bucks Table 1. Descriptions of nine farmers’ markets promotion programs.

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Boston Medical Center Farmers’ Market

The Boston Medical Center Market wanted to increase awareness of the Boston

Bounty Bucks program and increase the number farmers’ market customers who are low-‐

income or who participate in federal food assistance programs. Nutrition and Fitness for

Life, a program of the Boston Medical Center that works on overweight and obesity

prevention and the administrator of the BMC farmers’ market, printed 360 coupons, each

at $5 value, to distribute to clients of the South End WIC Program, the Cathedral Housing

Development, and Health Leads (formerly Project Health) an organization sponsored by

the Boston Medical Center to provide mentors for inner-‐city children and families. The

Development Manager and Health Advocate at the Cathedral Housing distributed farmers’

market coupons to residents through various nutrition education programs including a

health fair at the site. Staff at the South End WIC Program and Health Leads distributed

coupons to clients during their appointments at each of these sites. The specific

mechanism through which they were given out was unknown by the Boston Medical Center

Farmers’ market staff.

Bowdoin-Geneva Farmers’ Market

In order to increase the number of customers at the Bowdoin-‐Geneva Market, the

market manager did outreach at several organizations in or near the Bowdoin-‐Geneva

neighborhood that serve low-‐income populations and SNAP participants. The market

manager held workshops at Geneva Avenue Head Start, Geneva Avenue Elderly Housing,

Pasciucco House, which is a development of the Boston Housing Authority, and College

Bound Dorchester. The workshops provided information about the health benefits of fresh,

local produce and where to find it in the neighborhood at an affordable cost while also

providing information about Boston Bounty Bucks and how to use EBT at Bowdoin-‐Geneva

Farmers’ Market. These workshop participants were all given $5 coupons for use at the

market. Additionally, the market manager asked health care providers at Bowdoin Street

Health Center to promote the market to their clients and to distribute the $5 coupons to

them with a recommendation to eat more fruits and vegetables.

Community Servings Farmers’ Market

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The Community Servings Farmers’ Market worked to increase the number of

market customers on each market day, increase EBT sales, and to increase SNAP

participant visits. From July to October, Community Servings offered a series of seminars

called “Kitchen Talk,” to educate consumers on how to create healthy, inexpensive meals.

As an incentive for participation in the program, $10 in coupons, each worth $5, was

distributed to the first 10 attendees at each “Kitchen Talk” seminar. Community Servings

Farmers’ Market also gave coupon allocations of $20 to ten people in a six-‐week cooking

course facilitated by Community Servings and Cooking Matters, formerly Operation

Frontline, an organization that uses cooking courses to inform families and children about

the role of food in health. Community Servings also allocated coupons to low-‐income

housing residents and seniors programs. Community Servings staff did not do this

outreach, so they are unsure of the results of these efforts.

Dorchester House Farmers’ Market

Dorchester House Farmers’ Market distributed $5 coupons for their market to first

time shoppers at the market. With the coupon, the first time shoppers also received

information about SNAP and EBT usage at farmers’ markets. The customers could only

redeem the coupons with the market manager during their first visit.

East Boston Neighborhood Health Center Farmers’ Market

East Boston Neighborhood Health Center Farmers’ Market sought to increase

awareness of and access to the market in the elder community. The market staff gave a

series of presentations at elder homes and community centers to raise awareness of the

farmers’ market and the importance of buying local and fresh foods. The East Boston

Neighborhood Health Center market partnered with the Elder Service Plan, a department

of the health center, to determine the best sites for the presentations. The farmers’ market

staff visited one site each week and provided information about SNAP, the benefits of fruits

and vegetables and the importance of staying hydrated. The Health Center also provided a

van that picked seniors up from these sites and drove them to and from the market every

week. First-‐time shoppers and customers who brought friends to the market were given

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$10 worth of coupons to spend at the market. Returning senior customers also received $5

coupons.

Grove Hall Farmers’ Market

The Grove Hall Farmers’ Market, which was new this past season, wanted to build

community awareness of the market as well as of the importance of fruit and vegetable

consumption. The market manager attended block association meetings to talk about the

market and distributed $5 coupons to spend at the Grove Hall market to meeting attendees.

Those attendees were asked for their contact information so they could be mailed future

information about the market.

Mattapan Farmers’ Market

The Mattapan Farmers’ Market hoped to build the customer base for the market by

distributing $5 coupons to seniors at Foley Senior Residences and Mattapan Center for Life.

They provided market tours for patrons of these two sites and performed a cooking

demonstration at the Mattapan Center for Life.

South Boston Farmers’ Market

In order to attract new customers to the South Boston market, the market manager

attended Boston Housing Authority Task Force meetings at O’Conley, Mary Ellen McCormic

and West Broadway, where she educated people about SNAP, Boston Bounty Bucks and the

South Boston Farmers’ Market, provided them with a $5 coupon to redeem at the market.

The market manager also asked meeting attendees to bring friends to the market, and she

gave those additional customers coupons.


The following health centers, programs and community organizations received

grants from The Food Project for farmers’ market coupons worth $2.50 that could be

redeemed for fresh produce at any Massachusetts farmers’ market. Each director asked

recipients of these coupons to complete a pre-‐survey about their shopping and

consumption habits for fruits and vegetables and a post-‐survey about how new access to

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farmers’ markets may have changed these habits. These programs are summarized in Table

2.

Program Sponsoring Agency

Total Amount of Money

Distributed

Amounts Given to

Individuals

Target Population Served

Education Received with

Coupon

Upham’s Corner Health Center

-‐-‐-‐

$1,200 $5 -‐ $12.50 Overweight clients

Nutrition recommendations

Roxbury Weigh-‐In

Roxbury Community Alliance for Health

$450 $5 -‐ $10 African-‐American overweight women

Nutrition and fitness

Health Kids, Healthy Futures

Boston Red Sox and

Northeastern University

$1,200 $5 -‐ $10 Families and child

caregivers

Obesity prevention, nutrition and physical activity

South End Health Center

-‐-‐-‐

$900 $15 -‐ $20 Clients with asthma or who are obese


Let’s Get Moving

East Boston Neighborhood Health Center

$600 $10 Children and families

Childhood obesity awareness,

nutrition, fitness Dorchester House

-‐-‐-‐

$400 $10 Pregnant teenagers

Healthy meal preparation

Boston Public Health

Commission

-‐-‐-‐

$250 $10 Community members


Table 2. Descriptions of programs in The Food Project’s Fruit & Vegetable Coupon Program.

Upham’s Corner Health Center

Healthcare providers at the Upham’s Corner Health Center of Boston distributed

farmers’ market coupons to clients as incentives to make healthy food choices. A

nutritionist at the Upham’s Health Corner Health Center who counsels on childhood

obesity, weight-‐related complications and healthy eating for pregnant women, provided $5

coupons to clients or their families after his or her first initial visit. Through this process,

one hundred coupons were distributed to patients and their families.

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A diabetes and asthma nurse, who counsels, educates and does case management

for patients, distributed coupons through a program called Diabetic Diet. The sixty-‐eight

patients in the program were charged with lowering their carbohydrate intake through

higher consumption of vegetables. Eighteen participants of this program were given

coupons based on the size of their families. The coupons distributed to these families

ranged from $5 to $12.50 in value.

Roxbury Weigh-In

Roxbury Weigh-‐In was a 12-‐week program of the Roxbury Community Alliance for

Health for thirty women who sought to reduce their weights, lower their blood pressure,

learn nutrition information and participate in regular physical activity. To introduce the

participants to local farmers’ markets, the Roxbury Weigh-‐In coordinator organized four

cooking demonstrations with food purchased from farmers’ markets. The Roxbury Weigh-‐

In coordinator distributed $450 worth of coupons among 27 of the 30 participants in $5 or

$10 quantities.

Let’s Get Moving

Let’s Get Moving is a project of the East Boston Neighborhood Health Center with

the goal of preventing childhood obesity by encouraging lifestyle change and helping to

provide the opportunity to make these changes. The program provides options for physical

activity, nutrition education and medical monitoring for children through soccer programs,

field trips, walking groups, yoga and parent education in the form of cooking classes in

collaboration with Cooking Matters and Project Bread. Over 20 participating families

received $10 worth of coupons to redeem at farmers’ markets.


Healthy Kids, Healthy Futures is program sponsored by Northeastern University

and The Boston Red Sox in collaboration with the Boston Center for Youth and Families

that provides opportunities for enrolled children and families to maintain good health with

a specific focus on obesity prevention. The program works to enhance the capacity of early

childcare providers to increase physical activity and encourage healthy food decisions.

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Last summer, the program offered healthy eating tours of Boston farmers’ markets for

caregivers and provided opportunities for community physical activities through open

gyms for children ages 3-‐8 on Saturday mornings. Healthy Kids, Healthy Futures

distributed $5 worth of coupons to:

• approximately 40 ABCD Head Start caregivers who participated in a 6-‐week walking

challenge,

• about 30 food service staff who participated in a 4-‐session strategy training for

providing healthy foods and activity for their own families, and

• each caregiver who participated in a healthy eating tour of a Boston farmers’ market.

The coupons in $10 amounts were also distributed to the first 20 families who visited

the fresh produce display during three farmers’ fresh market weeks in June, July and

August at the open gyms for families. These families were introduced to and given

recipes to prepare produce that had been purchased at Boston farmers’ markets.


The South End Health Center is a community primary care health center in Boston.

A nutritionist at the South End Health Center who counsels patients with health conditions

such as diabetes, high blood pressure and high cholesterol, as well as patients, who have

anemia, are in need of prenatal care, or who are overweight, used the farmers’ market

coupons as incentives to eat more fresh fruits and vegetables. She gave patients advice on

the importance of fruit and vegetable consumption, gave food demonstrations and tours of

markets, encouraged participation in health fairs and held support groups for diabetes. She

distributed $900 of these coupons over five weeks beginning in July 2010 to approximately

50 different individuals and families. Individuals received $15, and families received $20.

Dorchester House Multi-Service Center

The Dorchester House Multi-‐Service Center is a community organization that offers

health care and other services in the Dorchester area. A nutritionist specializing in pre-‐

natal care used the coupons as an incentive for her patients to seek out healthy food

options. She instituted a Teen Nutrition Program where pre-‐natal teens gained important

information about the WIC program, the importance of a healthy diet and other nutrition

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information. Farmers’ market coupons were distributed to pre-‐natal teens in $10

quantities as well as teenage mothers who were not members of the Teen Nutrition

Program.

Boston Public Health Commission

The Boston Public Health Commission distributed coupons as prizes for participants

of the Soda Free Summer campaign, senior participants in the Senior Walk and family day

care providers in the city of Boston.


The Fruit & Veggie Prescription Program was piloted through three community

health centers in Massachusetts: Greater Lawrence Family Health Center, Holyoke Health

Center and Codman Square Health Center which are participants CAVU’s Healthy Weigh

Initiative. The goal of the Fruit & Veggie Prescription program is to increase fruit and

vegetable consumption for families. The program was piloted with 50 families or

approximately 200 participants who were given $112 worth of coupons, each worth $2.50,

per family per month. These coupons can be redeemed at any farmers’ market in the

Commonwealth of Massachusetts. Each of these families had one or more obese child. At

each clinic visit, a nutritionist gave the child a comprehensive diet plan and families had the

option of attending cooking classes and farmers’ market tours.

Summary of Redemption Data This portion of the report details the redemption data for the four farmers’ market

coupon programs.


A total of 12,000 of MGH farmers’ market coupons were printed at a value of

$30,000. Of these printed coupons, 5,486 coupons, or $13,715 worth, were redeemed at

farmers’ markets in Massachusetts. This data is summarized in Table 3

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Value of total

coupons printed

Number of total coupons printed

Value of total

coupons redeemed

Number of total

coupons redeemed

Value of coupons redeemed by families of TFP youth

Number of coupons redeemed by families of TFP youth

Total number of markets at which coupons were

redeemed $30,000 12,000 $13,715 5,486 $730 292 107 Table 3. Redemption data for Massachusetts General Hospital farmers’ market coupons.

Approximately 46% of the MGH coupons were redeemed. TFP families and parents

redeemed 29% of approximately 1,000 coupons distributed to them. Ultimately, these

farmers’ market coupons were redeemed at 107 markets throughout Massachusetts.


In their proposals requesting funding for market promotion, the market managers

indicated how much money they wished to allocate for printing and distributing farmers’

market coupons. Table 4 summarizes the redemption data for the nine Boston farmers’

markets.

Farmers’ market

Value of coupons

distributed

Amount redeemed at market

Number of coupons redeemed

at market

Percentage of Coupons Redeemed

Allston $900 $355 71 39.4% Boston Medical Center

$1,800 $1,660 332 92.2%

Bowdoin-‐Geneva

$1,000 $400 80 40.0%

Community Servings

$1,230 $1,000 200 81.3%

Dorchester House

$1,700 $1,700 340 100%

East Boston $1,250 $1,225 245 98% Grove Hall $1,000 $655 131 65.5% Mattapan $1,200 * * *

South Boston $600 $440 88 73.3% Table 4. Redemption data for nine farmers’ markets coupon programs. * Indicates that redemption for these coupons is unavailable.

Community Servings, Dorchester House, East Boston Neighborhood Health Center

and South Boston Farmers’ Markets ultimately printed and redeemed more coupons than

originally expected. Customers of the Allston, Boston Medical Center, Bowdoin-‐Geneva,

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Grove Hall and Mattapan Farmers’ Markets redeemed fewer coupons than were printed for

each of these markets.


There was a total of $5000 worth of coupons allotted to the program participants in

TFP’s Fruit & Vegetable Coupon Program. The amount of coupons printed and total

redemption data for all the programs is shown in Table 5.

Total value of coupons printed

Total number of coupons printed

Total value of coupons redeemed

Total number of coupons redeemed

$5,000 2,000 $3025 1,210

Table 5. Total redemption data for The Food Project’s Fruit & Vegetable Coupon Program.

Below Table 6 summarizes what amount of coupons each program distributed and how

many were redeemed.

Program Value of coupons

distributed

Number of coupons

distributed

Value of coupons redeemed

Number of coupons redeemed

Percentage of coupons redeemed

Upham’s Corner Health

Center

$1,200 480 $645 258 53.8%

Roxbury Weigh-‐In

$450 180 $322.50 129 71.6%


$1,200 480 $520 208 43.3%


$900 360 $652.50 261 72.5%

Let’s Get Moving

$600 240 $522.50 209 87.1%

Dorchester House Multi-‐Service Center

$400 160 $215 86 53.8%

Boston Public Health

Commission

$250 100 $147.50 59 59.0%

Table 6. Redemption data for The Food Project’s Fruit & Vegetable Program.

The program directors of The Food Project’s Fruit & Vegetable also collected

surveys from their program participants on their shopping habits. The aggregate data from

the responses to the pre survey questions was analyzed are summarized in Tables 7 and 8.

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On average, how many servings of fruits and vegetables do you eat a day?

Where do you usually buy your fresh fruits and vegetables?

Less than 1 serving a day 9.1% Supermarket 89.8% 1-‐2 servings a day 56.8% Farmers’ market 13.6% 3-‐4 servings a day 28.4% Tropical fruit market 20.4% 5+ Servings a day 5.7% Corner Store 3.4%

Other 4.5% Table 7. Responses to pre survey from TFP’s Fruit & Vegetable Program participants.

Over the past year have you shopped at farmers’ markets in

Boston?

If you have shopped at a farmers’ market more than once in the past year, what factors influenced your

decision to shop there? Never 51.1% Quality and freshness of the food 27.3%

1-‐2 times 28.4% Price 15.9% 3-‐5 times 8.0% Variety 20.4%

More than 5 times 10.2% Convenience 29.5% No response 2.3%

Table 8. Responses to pre survey from TFP’s Fruit & Vegetable Program participants.

The responses to the post surveys on shopping habits of all participants in the Fruit

& Vegetable Program were also aggregated and analyzed. The data is described below in

Table 9.

Did you use the farmers’ market coupons that you

received?

If you used your farmers’ market coupons, did you shop additional times at a Boston

farmers’ market?

How has the amount of fresh fruits and vegetables changed as a result of this program?

Response Percentage of Respondents



All 70.5% Once 18.0% We eat more fruits and vegetables

75.4%

Some 23.0% 2-‐5 times 39.3% No change 19.7% None 6.5% More than 5

times 13.11% We eat less

fruits and vegetables

3.3%

No 16.2% No response 1.5% No response 3.1% Table 9. Responses to post survey from TFP’s Fruit & Vegetable Program participants.

Wholesome Wave’s Fruit and Veggie Prescription Program

Mass Farmers Market printed $20,000 worth of coupons for the Fruit and Veggie

Prescription Program. The redemption data for these coupons is summarized in Table 10

below.

22

Value of total coupons printed

Number of total coupons

printed

Value of total coupons redeemed

Number of total coupons redeemed

Total number of markets at which coupons were redeemed

$20,000 8,000 $12,497.50 4,999 27 Table 10. Redemption data of Fruit & Veggie Prescription Program coupons.

Of the total $20,000 printed in coupons for program, the 62.5% of the coupons were

redeemed at farmers’ markets in Massachusetts.

23

Impacts of Incentive Programs Massachusetts General Hospital Farmers’ Market Coupons

The Massachusetts General Hospital farmers’ market coupons had a total

redemption rate of 46%. The majority of the coupons were distributed at the Health &

Fitness Expo to attendees who received education around farmers’ markets, The Food

Project and Mass Farmers’ Markets; however, the education was brief. The traffic through

The Food Project’s booth at the Health & Fitness Expo was heavy, especially on the first

day, which explains the inconsistency in the number of coupons the attendees received.

Visitors to the booth on the first day of the expo received $5.00, while attendees who came

to the booth the next day got $10.00. Attendees at the expo interacted only fleetingly with

TFP and Mass Farmers Market staff about where to buy fresh, affordable food. With this

coupon distribution, there was also no physical introduction to a specific farmers’ market

or market staff.

The Massachusetts General Hospital farmers’ market coupons were redeemed at

107 of 200 Massachusetts markets that participate in coupon nutrition programs. This is

not surprising because attendees at the Health & Fitness Expo were from a number of

communities across the Commonwealth. Although the redemption was widespread, the

volume of total coupons redeemed was under 50%. This may be due to the hurried nature

of the coupon distribution and the lack of personal interaction and follow-‐up with each

individual booth coupon recipient.

Of the 5,486 total MGH coupons redeemed, the parents and families of TFP Youth

redeemed 292 coupons of these coupons. This was 29% of the approximately 1,000

coupons were distributed to these families. The recipients of the coupons received little

education around farmers’ markets or nutrition; families simply received a letter

explaining the intent behind the coupon distribution and inviting them to redeem them at a

local farmers’ market. This letter is shown in the Appendix. Considering the goals of the

youth programs at The Food Project, to educate youth about healthy, local and affordable

food, a higher redemption rate from the families and parents of TFP youth was expected.

24


Each of the nine farmers’ markets that received funding for market promotion used

varied approaches to distributing their coupons. Dorchester House, Boston Medical

Center, East Boston Farmers’ Markets and Community Servings redeemed the most

coupons, with redemption rates above 80%.

Dorchester House allocated $1,700 for market coupons and was able to redeem this

total amount at their market. Only first-‐time customers received the coupons, which were

accompanied by information about the Boston Bounty Bucks program and SNAP usage at

the farmers’ market. Information about coupon distribution for new shoppers was spread

quickly by word of mouth in the community. In addition, Dorchester House staff reached

out to Cape Verdean and Vietnamese community members by hiring two workers who

provided translation services at the market. The redemption of farmers’ market coupons

was high at Dorchester House because customers received and redeemed the coupons in

the same place. Many new customers built a rapport with the market manager who

reported seeing these new shoppers return multiple times throughout the market season.

When customers learned of the Boston Bounty Bucks/SNAP program, they found even

more incentives to shop at farmers’ markets for fresh produce.

Boston Medical Center had a 92% redemption rate of their farmers’ market coupons

by using a similar method of distribution as Dorchester House. BMC gave coupons to

families of their clients at Health Leads and to WIC clients on their appointment days that

coincided with market dates. Health Leads is a project of the Boston Medical Center and

the South End WIC Office is within two blocks of the farmers’ market; so it was very

convenient for clients to visit the market and redeem their coupons after appointments.

The distribution at the Cathedral Housing Development was slightly less successful than

distribution at the medical center, but this is most likely explained by the distribution being

off-‐site. Residents at Cathedral Housing would have had to take an extra trip to the market

to spend their coupon dollars.

East Boston Farmers’ Market did incredibly strong outreach to the elder community

to increase their presence at the market. The farmers’ market redeemed 98% of their

coupons. The high redemption rate at this market was due to the comprehensive approach

in which they informed the elder community about the benefits of the market and fresh,

25

local food. Another major factor in the rate of redemption was the transportation

assistance that market staff secured for senior customers. The market staff encouraged

seniors to attend the market each week by providing clear nutrition information, a means

to get to the market and back home again, and a way to build community around the

market experience. Seniors were even further incentivized when they received extra

coupons by bring friends to the market. The market manager at East Boston felt that their

coupon program was successful because it provided necessary services for seniors,

particularly transportation, which is often a serious barrier for the elder community. This

program also helped build community for seniors because of the shared experience of

participating in presentations and subsequently visiting the market.

Community Servings Farmers’ Market redeemed 81% of the coupon they

distributed. The market manager at Community Servings gave coupons to low-‐income

and senior housing facilities, but did not do the outreach at these sites. There was no

detailed report on the success of these events or the responses of participants. The most

constructive forms of education given to recipients of the Community Servings Farmers’

Market coupons were the “Kitchen Talk” seminars and the six-‐week cooking course. Both

the seminars and course helped participants develop lasting skills for how to prepare

healthy meals with fresh and local food. The attendees at the “Kitchen Talk” seminars

varied from week to week; however, attendance at the cooking course was consistent each

week.

South Boston Farmers’ Market had success in their coupon promotion programs.

The market saw a redemption rate of 73%. The coupons for this market were distributed

at several Boston Housing Authority developments in South Boston. While the market had

a fairly high redemption rate for its coupons, Dorchester House, Boston Medical Center,

East Boston and Community Servings achieved greater rates of redemption. The majority

of the coupons were distributed off-‐site while the other programs distributed coupons at

the market and very close to the market site; or provided transportation to get to and from

the market. The market manager went to meetings at the housing developments and

spoke to the attendees in person, and then she distributed coupons to them. She believed

that her outreach at the housing developments also helped to dispel stigmas about SNAP

26

and those who receive benefits. She thought this contributed to increased traffic at the

market.

Grove Hall Farmers’ Market had a 65.5% redemption rate for its coupons. The

education accompanied by the coupons was limited. The talks that the market manager

gave to attendees of block association meetings in the community were brief and each

attendee received only a $5 coupon. This may not have been a great enough incentive for

some recipients to go to the market.

Bowdoin-‐Geneva Farmers’ Market performed market outreach similar to the Boston

Medical Center and East Boston markets. The market manager informed members of the

elder community, low-‐income customers, and clients at the Bowdoin Street Health Center

of the nutritional value in eating fresh, local produce as well as where it can be found in

their communities. The market manager believed that the workshops given at housing

developments and community centers were most effective because they provided a

personal connection to the market. This coupon program, however, had markedly less

success than either the Boston Medical Center or East Boston market programs. The

Bowdoin-‐Geneva market only redeemed 40% of their coupons.

The Allston Farmers’ Market distributed coupons to a number of community groups

including housing complexes, senior centers and youth programs. The total redemption

rate for all coupons at the Allston Market was 39%. Residents of Charlesview Apartments

received coupons through mailings, which did not provide the opportunity to form

relationships with market staff. The residents were never physically introduced to the

market nor any of the produce or other benefits available there. In total, Charlesview

Apartments residents redeemed only 13% of coupons distributed to them. Youth from the

Gardner Pilot Academy and the Honan-‐Allston Library EcoKids both received a cooking

demonstration, but the GPA students also participated in a tour of the farmers’ market. The

Library EcoKids group redeemed none of their coupons while the GPA students or their

families redeemed 81% of the coupons given to them. The students in the GPA program

were able to redeem their coupons immediately at the market, while the youth with the

Library EcoKids group did not have this opportunity. Those coupons were also given

directly to the youth, not to members of their families of parents. The Veronica Smith

Senior Center had the most successful redemption rate of all the groups who received

27

Allston Farmers’ Market coupons. Many seniors in this population had been unable to

receive Senior Farmers’ Market Nutrition Program Coupons, for which there is a long

waiting list. Seniors from this group redeemed 76% of the coupons distributed at this site.

The Mattapan Farmers’ Market distributed $1,200 worth of $5 coupons to seniors at

two senior centers in Mattapan. The market manager at the farmers’ market reported that

redemption was low for these coupons, but was unsure of the specific value of redeemed

coupons. She believed that the Mattapan Farmers’ Market needs a stronger sense of

community ownership for the market, which completed its fourth year this past season.

The Mattapan Center for Life is located across the street from the farmers’ market, but

seniors at Foley Senior Residence had to travel a greater distance to get to the market. The

market staff attempted to set up transportation for market customers at Foley, but funds

for this were limited. The Mattapan market manager also felt that there is still a strong

stigma against farmers’ markets and the prices of food there.


Up to $5,000 worth of coupons were distributed for TFP’s Fruit & Vegetable Coupon

Program. Mass Farmers Market reported redemption of $2827.50 worth of coupons for a

rate of 56.5%. Each of the seven programs varied in their distribution methods and

redemption rates.

Let’s Get Moving had a redemption rate of 87.1%, the highest of the seven programs.

With Let’s Get Moving, families were able to visit the market at Central Square in East

Boston and learn about the produce and the benefits of shopping there. They were given

coupons to spend while at the market, and the visit gave families a chance to hear about the

Boston Bounty Bucks program and using SNAP benefits at farmers’ markets. For twenty

families, the coupons provided a strong introduction to the advantages of getting fresh

produce from farmers’ markets and other incentives that are associated with buying food

there. The families and children could also pair their new market education with other

opportunities for physical fitness, nutrition and healthcare. Alison Smizer and Eleanor

Chandler, coordinators of the Let’s Get Moving Program at East Boston Neighborhood

Health Center said, “When people visit the market first, they see activities, friendly farmers,

and when there is more incentive attached, they are more likely to come back.” Both

28

believed that being able to walk around the market, talk to farmers and the market

manager without pressure helped to give families an unbiased opinion of the market. This

program had a high rate of redemption because families were encouraged to spend their

coupons while they were physically at the market. The coupons were distributed to them

on-‐site so they were able to find what they liked, then purchase those items immediately.

The coupons that were distributed through South End Health Center had a

redemption rate of 72.5%. Clients of the South End Health Center received coupons during

counseling sessions as an incentive to eat more fruits and vegetables. Recipients of these

coupons had the option of participating in supplemental activities to tour farmers’ markets,

learn more about nutrition and health, and meet with support groups. Compared to other

health centers that distributed coupons directly to patients, South End Health Center had a

fairly high redemption rate. This may have been due to the additional education available

to the clients around farmers’ markets. They provided a larger context for how to access

produce and use their coupons. These Lela Silverstein, a nutritionist at South End Health

Center who counsels patients about health conditions such as diabetes, anemia and obesity,

distributed coupons to her patients. She believed that most of her patients redeemed their

coupons but she stated, “$5 in coupons are not a great enough incentive, but $10 may be

closer.” Coupons are a great incentive for an initial or spontaneous visit to a farmers’

market, but the incentive may not be great enough for some customers. It also may not be

a strong enough motivation for customers to continue to shop at markets after their

coupons have run out. One patient of South End Health Center revealed that he has a

grocery store close to him so he finds little need to go multiple places to buy his produce.

He also added, “It’s more convenient to shop at Stop and Shop. There is not much that could

change with farmers’ markets to make me shop there.”

Participants of the Roxbury Weigh-‐In program redeemed 72% of the coupon

distributed to them. The members of the Roxbury Weigh-‐In behavior intervention

program were self-‐selected, and all had the goal of improving their health through better

nutrition and physical activity, so this may have contributed to their motivation to redeem

coupons for fresh produce at Boston markets. According to Lula Christopher, the

coordinator of this program, many of the participants went to Dudley Town Common in

Dorchester as well as Roslindale, Community Servings and the Cambridge Farmers’ Market

29

at Central Square. Even though a high number of the coupons were redeemed at markets,

she further attested that women in the program experienced disparities between market

prices and available produce in different communities. “The farmers’ markets are

expensive, but they also want to use the vegetables to better their diets,” Ms. Christopher

said about participants in the program.

The Boston Public Health Commission purchased coupons from The Food Project to

use as prizes for several community health programs. The redemption rate for these

coupons was 59%. While the recipients of this set of coupons did partake in a behavior

intervention program around health, the specific goal was not to increase fruit and

vegetable consumption. No targeted outreach to this group of individuals providing

specific information about the benefits of shopping at Boston farmers’ markets was

accompanied by the coupon distribution, so these program participants may have had less

enthusiasm for redeeming their coupons.

The coupons distributed to clients at Upham’s Corner Health Center had a

redemption rate of approximately 54%. The coupons were distributed during counseling

sessions where they offered as an incentive to consume more fruits and vegetables to

improve diets for themselves and their families. The redemption rates for this group was

more than half, though Peri Levin-‐McKenna, a diabetes and asthma nurse, at the health

center believes that, “If prices were lower at markets, then her patients might shop at

farmers’ markets more.” Families had the option to come back to the health center and get

more coupons, but only one family took advantage of this. This suggests that because there

was no specific education around farmers’ markets, this program has less chance of being

effective.

Dorchester House also had a redemption rate of 54%. While the group targeted was

pre-‐natal teens, the program and its benefits were also extended to teenager mothers.

Mary Lynch, the director of this program and a nutritionist at Dorchester House, counseled

between three to five pre-‐natal teenagers a week, but their attendance at programmatic

sessions was inconsistent. The program was more popular with teenage mothers who

wished to learn more about how to care for their babies. Mary Lynch said, “It’s a market

and it is expensive from their perspective for vegetables. They don’t necessarily perceive

the value of vegetables and them being important.” She believed the program was more

30

popular with teenage mothers than pre-‐natal teens because teenage mothers were already

vulnerable and isolated. They came to the meetings for support. During the informational

sessions, teenagers were able to learn about nutrition, breastfeeding and other pertinent

topics for new mothers. The teenagers also made trips to the market, which was on-‐site, to

see produce and use their coupons. Though program participants had the option to visit

the market and redeem their coupons, the redemption rate for this program still was not

high. This could be attributed to inconsistent attendance by many of the teens. Many of

teens in the program also seemed to disregard the significance of fruit and vegetable

consumption.

Healthy Kids, Healthy Futures had the lowest redemption rate of all the groups.

Participants in this program only redeemed 43% of the coupons distributed to families and

caregivers. Healthy Kids, Healthy Futures’ aim is to increase physical activity and the

consumption of fruits and vegetables for children and families. There were approximately

forty participants in the walking challenge, thirty in the strategy training and six in the

healthy eating tours. Each participant in those sessions received coupons, but only one

group actually received their coupons to spend immediately at the farmers’ market. The

strategy training and healthy eating tours both offered similar information about where to

access healthy and fresh foods. Families received even more education around accessing

fresh, local food at farmers’ market at the Open Gyms and farmers’ fresh market weeks.

Tara Agrawal, the project manager of Healthy Kids, Healthy Futures, said, “It is really

beneficial to make a direct connection with tours and markets so that people can meet the

manager and gain access to the world of markets…” The families were introduced to new

fresh produce as well as some familiar ones during the Open Gyms, but there was an

obvious disconnect between seeing that produce and going to a market to use the coupons.


The Fruit & Veggie Prescription Program had a total redemption rate of 62.5%. The

goals of the prescription program were to change behavior and increase fruit and vegetable

consumption. While this program had a higher redemption rate than the Massachusetts

General Hospital Coupons, another program with a broader reach, Dr. Shikha Anand still

stated about the program, “Fruit & Veggie may need to be more focused, rather than any

31

doctor just handing out a coupon to a patient.” She also wanted to measure the impact of

the nutrition education piece by standardizing amounts better. Ultimately, some families

received more coupons based on size or the prerogative of the health care provider who

distributed the coupons.

32

Recommendations These various coupon programs used a number of outreach methods to increase

access to Boston farmers’ markets. The programs that showed the greatest success had

similar education or distribution methods. Programs that chose to hand coupons out at the

market where customers could immediately redeem were incredibly successful. Boston

Medical Center, Community Servings, Dorchester House and Let’s Get Moving all used this

approach to distributing their coupons. These programs scheduled their nutrition and

cooking classes or market tours during market hours so that participants could transition

from the specific activity to the market to spend their coupon dollars. Another effective

way to ensure redemption of coupons was to provide transportation to and from the

market. East Boston Farmers’ Market secured transportation for seniors who may have

otherwise had difficulty accessing the market. East Boston’s outreach approach was

incredibly comprehensive. The market identified a target population then devoted all

promotion efforts to making sure those customers were able to see the market, meet its

staff and connect nutrition education with the actual produce. Other successful programs

were ones that encouraged building social relationships around the market. For example,

Dorchester House showed great effort in doing outreach to the Cape Verdean and

Vietnamese populations in its community. A potential way for farmers’ markets to sustain

their increases in customers is to keep providing a sense of community at the markets by

engaging with new customers and recognizing regular customers. Providing incentives to

consistent shoppers might also help to maintain sales.

Programs that were the least effective were ones that provided little education or

personal connection to farmers’ markets. The Massachusetts General Hospital coupons

reached a large number of people in Boston, but the coupons had the weakest connection

from consumers to actual farmers’ markets. For these coupons to have greater impact,

there needs to be a stronger association among nutrition, fresh and local foods, and

farmers’ markets. This association could form by distributing coupons to smaller groups

at a time so that recipients can learn about the benefits of farmers’ markets and where

specifically they can use their coupons. Community organizations that address health,

33

fitness, food access or hunger could potentially distribute farmers’ market coupons to their

members. Various forms of nutrition and farmers’ market education would need to

accompany the coupons.

Grove Hall, Allston, Mattapan and Bowdoin-‐Geneva Farmers’ Markets were also

programs that did not have deep enough contact with participants to see high redemption

rates. More surprisingly, some program participants that received coupons through health

centers did not redeem them at high rates either. Upham’s Corner did limited outreach to

the patients who received coupons. The Fruit & Veggie Prescription program, however,

had very extensive and deep outreach and education components around farmers’ markets

and fruit and vegetable consumption yet the program only resulted in a 62.5% redemption

rate. The prescription program provided large amounts of coupons consistently over an

extended period of time, optional cooking classes and market tours, and advisement from

health professional about the importance of fruit and vegetable consumption to

participants. We would expect a much higher redemption rate from a program with such

comprehensive outreach methods. It is unclear which families redeemed their farmers’

market coupons and in what quantity, so a few families could have distributed a majority of

them or many families could have distributed a few of their coupons. A recommendation

for the Fruit & Veggie Prescription program is to further incorporate farmer’s market and

food preparation education into patient counseling sessions. More encouragement should

be given to patients in their families to participate in support groups, market tours and

classes. These were all successful tools for high market redemption with other programs.

These activities will also help families build personal relationships with other families and

market staff as well as learn valuable skills for improving health and changing behavior

around food consumption.

Some obvious barriers to increasing access to farmers’ markets and fresh, local

produce are convenience and price. These two factors are hindrances in obtaining high

redemption rate of coupons for TFP’s Fruit & Vegetable Program. Participants in several

programs stated they wished farmers’ markets were open at different hours or on alternate

days. Three women from Healthy Kids, Healthy Futures said they would prefer to visit

farmers’ markets on Saturdays, particularly Fields Corner Farmers’ Market, but they are

often crowded; or the most convenient markets for them are only open on weekdays. A

34

client at Upham’s Corner Health Center thought that it was too difficult to get to farmers’

markets with her work schedule. She said, “ I would rather go to a farmers’ market, but

workdays are inconvenient.”

Many program directors heard their participants and clients say that markets are

expensive and cost is major deterrent for shopping regularly at farmers’ markets for

produce. One patient at Upham’s Corner Health Center reported that she used the $10

worth of coupons that she received and thought the produce was pricey. “It was easier to

go to the market with coupons, but was still only a little help,” she claimed.

Though this data is not statistically significant, survey data collected from TFP’s

Fruit & Vegetable Coupon Program showed that coupons did allow participants to increase

their fruit and vegetable consumption. Prior to the coupon programs, approximately 51%

of survey respondents said they hadn’t shopped at a Boston farmers’ market in the past

year. After the conclusion of the programs, 75% of survey respondents reported that they

started to eat more fruits and vegetables. Many respondents indicated that they shopped

at markets multiple times even after they used all their coupons. Approximately 39%

shopped at the markets two to five more times and 13% of respondents shopped at the

market more than five times. It is unclear whether coupon programs have greatly changed

behavior around fruit and vegetable consumption and farmers’ markets, but they have

definitely provided introductions and helped improve access to Boston farmers’ markets

this past season.

In addition to having successful coupon redemption and nutrition education, many

of these programs did valuable outreach for the Boston Bounty Bucks program and SNAP.

South Boston, Allston, East Boston, Dorchester House and Boston Medical Center Farmers’

Market managers all reported increased numbers of EBT transactions at their markets this

past season. Mary Lynch at Dorchester House said that she “saw the impact of people

starting to use their EBT cards,” and that it greatly increased traffic at the farmers’ markets.

The Boston Bounty Bucks program is an incredible incentive for SNAP recipients and can

be a huge factor in increasing access to farmers’ markets. Programs should continue to

include this information in future market promotion efforts and coupon programs.

35

Sources Consulted Literature:

Bell, Judith & Standish, Marion. (2010) Building Healthy Communities Through Equitable Food Access. Community Development Investment Review. Federal Reserve Bank of San Francisco. Retrieved from http://www.frbsf.org/publications/community/review/ vol5_issue3/bell_standish.pdf. Commonwealth of Massachusetts. (2010). Electronic Benefit Transfer. Health and Human Services: SNAP Benefits. Retrieved for http://www.mass.gov/Eeohhs2/docs/dta/ebt_e.pdf. Cunningham, Kathy. Chronic Disease Control and Prevention Presentation. (2010). Boston Public Health Commission. Retrieved from http://www.bphc.org/programs/cib/ civicengagement/outreach/faithbasedleaders/Forms%20%20Documents/Orientation%20Materials/Chronic%20Disease%20Prevention%20and%20Control%20ppt.pdf. Fisher, Andy. (1999) Hot Peppers and Parking Lot Peaches: Evaluating Farmers’ Markets in Low Income Communities. Community Food Security Coalition. Retrieved from http://www.foodsecurity.org/HotPeppersPeaches.pdf. Learn how you accept SNAP Benefits at Farmers’ Markets. (2010). United States Department of Agriculture – Food and Nutrition Service. Retrieved from http://www.fns.usda.gov/snap/ebt/fm.htm. Senior Farmers’ Market Nutrition Program. (2010). United States Department of Agriculture – Food and Nutrition Service. Retrieved from http://www.fns.usda.gov/ wic/seniorFMNP/seniorfmnpoverview.htm. United States Department of Agriculture. (2009). Access to Affordable and Nutritious Food - Measuring and Understanding Food Deserts and Their Consequences: Report to Congress. (Administrative Publication No. AP-‐036). Washington, DC: Ver Ploeg, Michele, et al. Retrieved from http://www.ers.usda.gov/Publications/AP/AP036/. WIC Farmers’ Market Nutrition Program. (2010). United States Department of Agriculture – Food and Nutrition Service. Retrieved from http://www.fns.usda.gov/wic/fmnp/ fmnpfaqs.htm#1. Winne, Mark. (2003). Community Food Security: Promoting Food Security and Building Healthy Food Systems. Community Food Security Coalition. Retrieved from http://www.foodsecurity.org/PerspectivesOnCFS.pdf.

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Personal Communication: Agrawal, Tara. Boston Center for Youth and Families. October 2010. Brissette, Alison. Allston Farmers’ Market. November 2010. Chandler, Eleanor. East Boston Neighborhood Health Center. October 2010. Christopher, Lula. Roxbury Community Alliance for Health. October 2010. Cunningham, Kathy. Boston Public Health Commission. October 2010. Iceland, Michael. The Food Project. October 2010. Flynt, Nicole. Grove Hall Farmers’ Market. December 2010. Gregory, Bradley. Upham’s Corner Health Center. October 2010. Harrison, Jay. The Food Project. October 2010. Kelsey-‐Watts, Vera. The Food Project. September 2010. Levin-‐McKenna, Peri. Upham’s Corner Health Center. October 2010. Lynch, Mary. Dorchester House Multi-‐Service Center. December 2010. Morris, Vivien. Boston Medical Center. December 2010. Ostrander, Meghan. Community Servings. November 2010. Rosher, Mary Lou. South Boston Farmers’ Market. December 2010. Silverstein, Lela. South End Health Center. October 2010. Smileye, Johnothan. Healthy Kids, Healthy Futures. October 2010. Smizer, Allison. East Boston Neighborhood Health Center. October 2010. Wirth, Cathy. Bowdoin Street Health Center. November 2010.

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Appendix

38

The Food Project 10 Lewis Street Lincoln, MA 01773 July 30, 2010 Dear Parent(s)/Guardian(s) of TFP Youth, At the close of the fourth week of our Summer Youth Program, your youth are fully engaged in working with us – on the land, at their hunger relief organizations, and at our farmer’s markets. I hope they are sharing their stories and insights with you, and now we have the opportunity to help you connect to more local and healthy food. I am delighted to be able to offer you and your family 15 dollars in Massachusetts Farmer’s Market vouchers. We are very thankful to Massachusetts General Hospital for generously providing us with vouchers for every family of youth in our program. These vouchers can be redeemed at any farmer’s market in Massachusetts for fruits and vegetables. During the summer we provide the opportunity to your youth to eat what they grow on our land, and we wanted to make sure you also had the opportunity to sample fresh local produce from around the state. Our hope is to introduce you and your family to a variety of fruits and vegetables through all of Massachusetts’ growing season. You may also redeem these vouchers at our farmer’s markets (we have several in Boston and the North Shore please check our website for locations and times http://thefoodproject.org/farmers-‐markets). Thank you for entrusting us with your children this summer. I hope visiting local farmer’s markets will provide a positive shared experience for you and your youth! Sincerely,

Julien Goulet Director of Youth Programs