Health Education

A mobile farmers market brings nutrition education to low-income students

Devin Ellsworth Jenny Ernst Anastasia Snelling

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Devin Ellsworth Jenny Ernst Anastasia Snelling , (2015),"A mobile farmers market brings nutrition
education to low-income students", Health Education, Vol. 115 Iss 2 pp. 171 - 177
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A mobile farmers market

brings nutrition education to
low-income students
Devin Ellsworth and Jenny Ernst
American University, Washington, District of Columbia, USA, and

Anastasia Snelling

Downloaded by Mr Devin Ellsworth At 10:35 30 January 2015 (PT)

School of Education, Teaching, and Health, American University,

Washington, District of Columbia, USA

Nutrition
education to
low-income
students
171
Received 27 March 2014
Revised 5 May 2014
10 July 2014
6 August 2014
Accepted 9 August 2014

Abstract
Purpose The purpose of this paper is to examine the impact of a nutrition-education intervention
delivered at low-income middle schools in Washington, DC in the USA, using a mobile farmers market to
bring hands-on lessons to schools. The program was a partnership between a local farm and university
and was funded by the United States Department for Agriculture (USDA) Team Nutrition grant.
Design/methodology/approach Seven low-income middle schools received the intervention,
which included 45-minute lessons focussed on nutrition education and sustainable farming concepts.
The farmers market was delivered via a converted school bus, allowing for full market setup at each
school to provide local fruits and vegetables as teaching tools. The nutrition-education lesson focussed on
the USDA MyPlate and healthy meal planning. The farm education component focussed on organic
farming principles, sustainability of local food systems, and seasonality. A six question pre- and post-survey
was administered to 408 participating middle school students to assess changes in knowledge.
Findings Overall, average scores increased from 51 to 58 percent. Nutrition knowledge questions
increased from 58 to 74 percent, while agriculture questions remained constant at 43 percent.
Both increases significant using a two-sample t-test (p o0.001). This suggests that students gained
more nutrition education concepts in this format as compared to the agricultural concepts.
Originality/value Childhood obesity is a growing epidemic that affects low-income communities
disproportionally. Innovative strategies must be implemented to increase healthy food consumption.
This case study presents such an approach and its value in increasing student knowledge of
healthy behavior.
Keywords Children, Education, Schools, Nutrition, Health promotion, Health disparities, Obesity,
Childhood obesity, Farms, Agriculture, Health inequalities
Paper type Case study

Introduction
Farm-to-School-based programs have produced increases in student knowledge of
nutritional recommendations, food systems, healthy shopping habits, and attitudes
toward trying new foods (Azuma et al., 2008). Expanding dramatically in the USA from
fewer than ten in 1997 to more than 12,500 in 2012 (National Farm to School Network,
2013), Farm-to-School Programs involve sourcing local food for schools or preschools
and providing agriculture, health and nutrition education opportunities, such as school
gardens, farm field trips, and cooking lessons. (National Farm to School Network, 2014).
Approval was obtained from American Universitys Institutional Review Board. The authors
would like to thank the partners at Arcadia Center for Sustainable Agriculture and the Office of
the State Superintendent of Education, Washington, DC The authors would like to acknowledge
Benjamin Bartley for his contribution to the educational piece of the market visits, as well as
operating the market.

Health Education
Vol. 115 No. 2, 2015
pp. 171-177
Emerald Group Publishing Limited
0965-4283
DOI 10.1108/HE-03-2014-0031

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172

These programs provide tremendous benefits to schools and their students, yet some
low-income urban schools face additional challenges implementing them due to limited
space, tight budgets, and academic underperformance. Urban schools are typically
geographically farther from local farms. Following other mobile delivery models for
services, such as mobile dental clinics, libraries, and blood donation centers, a mobile
farmers market provides a convenient alternative for urban schools, bringing
educational programs and fresh local produce right to the schoolyard.
In the USA, more than one-third of school-age children are overweight or obese
(Ogden et al., 2014) and only one in five consume five or more fruits and vegetables
daily (Krebs-Smith et al., 1996). These figures are higher in Washington, DC where
43 percent of school-age children are overweight or obese and 81 percent of children do
not get the United States Department for Agriculture (USDA)-recommended five fruits
and vegetables a day (DC Healthy Schools Act, 2013). Obesity disproportionally affects
low-income communities and poverty is associated with low fruit and vegetable
consumption (Drewnowski and Specter, 2004). In the USA, obesity disproportionally
affects African-Americans and low-income individuals (Flegal et al., 2010; Drewnowski
and Darmon, 2005). These disparities exist in Washington, DC as well, with just
11.3 percent of non-Hispanic white residents obese, while 38.1 percent of African-American
residents are obese (United States Department of Human Health and Services Office on
Womens Health, 2013). Likewise, 35.6 percent of non-Hispanic white residents consume
five or more daily fruits and vegetables, while 25.1 percent of African-Americans meet this
same measure. The mobile market targeted low-income minority schools throughout
Washington, DC
Evidence suggests that knowledge of nutritional recommendations may be
predictive of increased fruit and vegetable intake among adolescents (Blanchette and
Brug, 2005). Farm-based programs promote the benefits of fruit and vegetable
consumption and provide hands-on nutrition education experiences. Research from
a US Farm-To-School program found significant increases in vegetable consumption
among school-age children as a result of improved knowledge of nutritional
recommendations and agriculture education (Moss et al., 2013).
Washington, DC school health policy supports efforts to help reduce childhood
obesity through various means including nutrition education. The mobile farmers
market project addresses three of the eight key priority provisions of the DC Healthy
Schools Act of 2010: promotion of healthy eating to students; Farm-to-School programs;
and health education by expanding minutes of nutrition education (DC Healthy Schools
Act, 2013). Increasing knowledge of fruit and vegetable recommendations can promote
healthier eating patterns among low-income and minority students at greater risk for
poorer diets, obesity, and other chronic conditions.
Program description
The mobile market program was a part of a larger project funded by a USDA Team
Nutrition Training Grant for middle schools. The Team Nutrition Grant targeted three
goals: train teachers to be wellness champions in their schools; train foodservice workers
to nudge healthy eating behaviors in cafeterias; and provide Farm-to-School-based
education opportunities. The grant required participating middle schools to have
a minimum of 80 percent of students on free and reduced school lunch. Implementation
of the grant involved many partners and stakeholders, including the Office of the
State Superintendent of Education for Washington, DC, American University, Howard

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University, and Arcadia Center for Sustainable Agriculture. Program implementation

took place over the course of academic year 2012-2013, involving 14 schools, all of
which received mobile market visits. Pre and post data were only collected during the
spring 2013 mobile farmers market visits to seven of the participating Team Nutrition
middle schools. Three schools were public charter schools ranging from 16 to 73 middle
school students; four schools were slightly bigger with middle school populations
ranging from 78 to 316 students. Teachers signed up for a market visit time slot in
advance and the program could accommodate up to six classes of students in one day.
The mobile farmers market had three educational objectives: first, exposing
students to local, fresh produce via a demonstration farmers market, second, nutrition
education focussed on the USDA MyPlate, seasonality, and taste tests, and third,
agricultural education emphasizing sustainable farming practices and characteristics
of local farming. The Arcadia Center for Sustainable Food and Agriculture provided
the mobile market, the produce, a farm educator, and the educational materials, while
American University provided a nutrition educator, contributed to program design,
and evaluated the program.
The Arcadia Mobile Market operates out of a converted school bus that is painted
with a green background and fruits and vegetables (Plate 1). Shelves hang from the
side of the bus to hold crates of fresh, locally grown produce and an awning shades
the area. The market design allows for easy transportation of teaching materials,
including fresh local fruits and vegetables, and easy setup in the school parking lot.
The spaces on both sides of the bus are utilized for activities and lessons.
Middle school students participated in two distinct lessons during the 45-minute
visit. The nutrition education lessons took place on the market side of the bus under the

Nutrition
education to
low-income
students
173

Plate 1.
Crates of produce
hang from Arcadias
Mobile Market

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awning where the students could see, feel, and smell the produce. The nutrition
education content included the health benefits of consuming whole, unprocessed fruits
and vegetables, and the USDA MyPlate icon to emphasize that half of your plate should
be fruits and vegetables. The agriculture lessons took place on the backside of the
bus where students could spread out to participate in activities focussed on sustainable
farming practices and seasonality of local foods. The program concluded with a taste
test of a local fruit or vegetable.
Program objectives were to increase student knowledge of sustainable farming
practices, seasonality of local foods, USDA MyPlate recommendations with an
emphasis on making half the plate fruits and vegetables, and the health benefits
of shopping at farmers markets.
Nutrition concepts were taught using the USDA MyPlate diagram and a seasonality
chart. The primary learning outcome for the MyPlate lesson was an understanding that
half of every plate at every meal should be made up of fruits and vegetables. Discussion
centered on how a standard American meal (a cheeseburger) fits into the MyPlate, and
ways to improve upon this meal. The students were able to relate easily to the meal
of a cheeseburger, and were able to put the various components into the MyPlate
categories. Upon discussion, the students were able to quickly understand that the
small sliver of tomato and lettuce that may accompany a traditional sandwich did not
come close to making up half of the plate for that meal. The nutrition educator
explained how one may improve upon this meal, with suggestions and inputs from
the students.
A seasonality chart for the Washington, DC region was used to illustrate the
availability of food at the market during the spring. Students were able to see visually
how the variety and availability of produce at the market expands dramatically in the
summer and fall months, providing many choices to plan a complete diet and fill half
their plate with fruits and vegetables. Students were then asked to work in pairs to
create a healthy meal that met all components of the MyPlate using only products
they could find at the market that day, highlighting that even in the limited spring
market, ample produce was available. The meals were reviewed as a group to
determine if they met the MyPlate recommendations and if not, students were
asked as a group to help improve their classmates meals. The lesson concluded with
a discussion of how to fill the MyPlate recommendation of fruits and vegetables
when a farmers market is not available, pointing out that grocery stores are
a means to filling the MyPlate with fresh fruits and vegetables, as well as canned
and frozen options.
Agricultural lessons focussed on differences between local and non-local food
systems. Sustainable farming concepts were taught by creating two different food
webs to illustrate how food travels from the farm to the store for consumer purchase.
In the first web, students took hold of a section of rope, one-by-one, as they imagined
the food being sprayed with pesticides, then traveling from the field, to containment
units, then food manufacturers, shipping vessels, processing plants, and finally to
stores. By the end of the demonstration, all students were connected to the rope
showing a complex process of farm to store transport. The second food web illustrated
the much simpler process of the local food web, with fewer steps for getting food to the
store including just the farm and farmers market.
The final objective was for children to taste the produce that had come from the
Arcadia Farm, exposing them to a variety of fruits and vegetables and enabling them
to taste them.

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Results
The mobile market program reached 408 middle school students at seven middle
schools from ages ten to 14 years, boys and girls. Five of the seven middle schools
served over 90 percent African-American student populations. The remaining two
schools were roughly equal African-American and Hispanic students. All schools had
student bodies with 80 percent or more receiving free or reduced school lunch, and
schools were considered high-needs.
Student knowledge was measured using a six question multiple choice pre- post-survey
targeting two educational objectives relating to nutrition and agriculture. The pre- and
post-test design has been used to evaluate increases in student knowledge in farm-to-school
programs, and previous studies have shown increases in knowledge of nutritional
recommendations and local food systems ( Joshi and Azuma, 2006; The Food Trust,
2007). The pre-test was administered by the school teacher before leaving the classroom.
The post-test was administered immediately following the mobile market experience
by the American University nutrition educator. Tests were collected and analyzed by
American University using a two-sample t-test.
Three questions tested agricultural education objectives and three questions tested
nutrition education objectives. Questions from the pre-test are listed in Figure 1.
The overall average score on the pre-test was 51 percent, increasing to 58 percent in
post-test results. This increase was significant using a two sample t-test (p o 0.001).
When sustainable farming and nutrition questions were analyzed separately, scores on
the environmental questions held constant at 43 percent for pre- and post-tests.
The nutrition-related scores increased from 58 percent in the pre-test to 74 percent in
the post-test, also significant (p o 0.001). This suggests that the mobile market was an
effective environment for teaching nutrition concepts and the concepts chosen were age
appropriate. Lessons related to food production and sustainability may have been too
complex, introducing concepts and vocabulary that were too unfamiliar to urban
students to effectively teach in a 20-minute session.

Q1: What is a sustainable

farm?
1. A farm that sprays
chemicals to kill bugs and
fertilize plants
2. A farm that grows one
type of food all year long
3. A farm that is
environmentally friendly
4. A farm that is California
Q4: Why is it healthy for
customers to shop at farmers
markets?
1. Farmers markets sell lots
of healthy foods (fruits,
vegetables, dairy, etc.)
2. The people who shop at
farmers markets are
generally healthy
3. The customers have to
help with the farming
4. The markets are usually
outside

Q2: Why is diversity so

important for a sustainable,
organic farm?
1. The soil is healthy when the
crops are different from season
to season
2. The plants are healthy when
they are grown in natural ways
3. Growing many types of crops
protects the farm from insects
4. All of the above
Q5: According to the USDA
MyPlate, how much of every
plate should be fruits and
vegetables?
1. 10%
2. 25%
3. 50%
4.75%

Nutrition
education to
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students
175

Q3: Where can I buy food that is in

season or local?
1. Farmers markets
2. Arcadia's Mobile Market Bus
3. Grocery Stores (Safeway, Giant
etc.)
4. All of the above

Q6: If local foods are not in season,

how can we fill the MyPlate with
fruits and vegetables?
1. You have to wait until local
produce is in season again
2. Travel south until you find a
farmers market
3. Buy produce from a grocery store
4. Eat potato chips and fruit snacks

Figure 1.
Pre-Survey for
mobile market

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Discussion
The mobile farmers market format is a creative way to bring Farm-to-School
educational programs to students living in urban, low-income communities.
The mobility of the market allows for delivery to urban schools otherwise located
a great distance from local farms, with little need for space, just a small parking lot.
Likewise, schools do not need to arrange and pay for a costly field trip.
Survey results suggest this model may be an effective method to increase nutrition
knowledge. The USDA MyPlate tools provided a reliable and easy visual for the
students to understand and recall. At the middle school level, students are familiar with
basic pie chart graphical representation, and the lesson demonstrating the middle
dividing line separating the fruits and vegetables section was easy for students to
comprehend and associate with 50 percent in the post-test.
However, sustainable agriculture concepts may be too advanced or unfamiliar to
teach in this short format. The concept of sustainability is an advanced concept often
not addressed until secondary or post-secondary education. The survey questions
asked required an understanding of the words sustainable, diversity and organic
as they relate to farming methods concepts that may have been too difficult for
that setting.
Increasing student knowledge of nutritional recommendations via the USDA
MyPlate and exposing students to fresh produce may help encourage increased fruit
and vegetable consumption as shown by Blanchette and Brug (2005). Observations
from the market suggest that students were engaged and excited about the opportunity
to learn where food comes from, how to follow a healthy diet and to taste fruits and
vegetables. Leveraging partnerships and grant funding reduces costs for these schools,
and hosting the market visit on school grounds eliminates the need for field trip resources.
Overall this model offers a unique cost and time effective approach to exposing students
to local produce in a farmers market setting, and hands-on, experiential nutrition and
agricultural education for students in low-income communities.
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About the authors

Devin Ellsworth is a Masters of Science Candidate in Health Promotion Management. His work
focusses on nutrition education and health coaching to address health disparities at the
elementary and middle school level and in health care settings. Last year, he worked in 14
low-income middle schools in Washington, DC on a USDA grant funded project Team Nutrition.
This year, his work is in elementary schools, promoting vegetable consumption in school lunch
through behavioral economics strategies, as well as health coaching for low-income community
health clinic members. Devin Ellsworth is the corresponding author and can be contacted at:
de9430a@student.american.edu
Jenny Ernst received her Master of Science Degree in Nutrition Education and Counselling
from the Teachers College, Columbia University. Her primary career focus has been working
with low-income communities to increase healthy behaviors and access the healthy food and
physical activity. Most recently Ms Ernst was the Director of Community Voices for Health at the
American University where she developed a program that addressed health disparities in
low-income middle schools by training key teacher to be nutrition champions and empowering
students to speak up for change. She is the author of Untangling the nutrition web in career
development: a resource for nutritionists, dietitians, and public health professionals.
Dr Anastasia Snelling is an Associate Professor and the Associate Dean in the School of
Education, Teaching, and Health at the American University. She has been a member of the
Academy of Nutrition and Dietetics as a Registered Dietitian for over 30 years and a fellow in
the American College of Nutrition. Her research focusses on methods of behavior change
in nutrition education to manage risk factors related to chronic disease. She has written over
50 articles, book chapters and other publications, as well as presented over 100 speeches to
regional, national, and international audiences. Her current research is in the area of childhood
obesity and the role of schools in promoting healthful foods and lifestyles.

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