Intervention Study of Cost-Offset Community Supported Agriculture (CO-CSA)

NCT02770196 | Completed

• 2 other identifiers: IRB #: 15010052662015-68001-23230
• Study Type: interventional
• Target: 305
• Locations: 1 country
• Sites: 29

Brief Summary

The purpose of this study is to better understand how participation in cost-subsidized community supported agriculture programs paired with tailored education can affect diet quality and energy balance among children in low-income households.

Conditions

Pediatric Obesity; Child Nutrition Disorders

Keywords

Community-Supported Agriculture; Local Food System; Vegetable; Fruit; Childhood Obesity

Outcome Measures

Primary Outcomes (7)

• Change in child's fruit and vegetable intake as measured by short dietary screener

  Data collected using the National Cancer Institute's All-Day Fruit and Vegetable Screener.

  Baseline to 4 months, 12 month follow-up, 16-month follow-up, 24-month follow-up, and 28-month follow-up

• Change in child's fruit and vegetable intake as measured by 24-hour dietary recall

  Data collected with dietary recalls using the online Automated Self-Administered 24-Hour Dietary Recall (ASA24) system

  Baseline to 4 months, 16-month follow-up, and 28-month follow-up

• Change in child's intake of sugar-sweetened beverages and processed snacks as measured by short dietary questionnaire

  Data collected using the Fred Hutchison Cancer Research Center's 'Beverage and Snack Questionnaire 2'

  Baseline to 4 months, 12-month follow-up, 16-month follow-up, 24-month follow-up, and 28-month follow-up

• Change in child's intake of sugar-sweetened beverages and processed snacks as measured by 24-hour dietary recall

  Data collected with dietary recalls using the online Automated Self-Administered 24-Hour Dietary Recall (ASA24) system

  Baseline to 4 months, 16-month follow-up, and 28-month follow-up

• Change in child's caloric intake as a percent of estimated energy requirements

  Data collected with dietary recalls using the online Automated Self-Administered 24-Hour Dietary Recall (ASA24) system

  Baseline to 4 months, 16-month follow-up, and 28-month follow-up

• Change in child's dermal carotenoid levels

  Carotenoid levels measured by resonance Raman spectroscopy using the Bio-Photonic Scanner (NuSkin Enterprises)

  Baseline to 4 months, 16-month follow-up, and 28-month follow-up

• Change in child's diet quality

  Data collected with dietary recalls using the online Automated Self-Administered 24-Hour Dietary Recall (ASA24) system

  Baseline to 4 months, 16-month follow-up, and 28-month follow-up

Secondary Outcomes (12)

• Change in child's BMI percentile

  Baseline to 4 months, 16-month follow-up, and 28-month follow-up

• Change in child's physical activity

  Baseline to 4 months, 12 month follow-up, 16-month follow-up, 24-month follow-up, and 28-month follow-up

• Change in child's sedentary behavior

  Baseline to 4 months, 12 month follow-up, 16-month follow-up, 24-month follow-up, and 28-month follow-up

• Changes in parent's ability to select, store, and prepare CSA produce

  Baseline to 4 months, 16-month follow-up, and 28-month follow-up

• Changes in parent's ability to prepare foods to minimize added (solid) fat and sugar

  Baseline to 4 months, 16-month follow-up, and 28-month follow-up

Study Arms (4)

Group One (Two-year Intervention, 2016 Enrollment)

EXPERIMENTAL

Group one intervention participants in CO-CSA plus nutrition education will receive a subsidized share of CSA produce (50% standard member price) weekly for approximately 20 weeks each year in 2016 and 2017. During the 2016 season they will attend nine skill-based, nutrition education sessions focused on use of CSA produce.

Behavioral: CO-CSA plus Nutrition Education

Group Two (Delayed Two-year Intervention, 2016 Enrollment)

EXPERIMENTAL

Group two intervention participants in CO-CSA plus nutrition education will receive a subsidized share of CSA produce (50% standard member price) weekly for approximately 20 weeks each year in 2017 and 2018. During the 2017 season they will attend nine skill-based, nutrition education sessions focused on use of CSA produce.

Behavioral: CO-CSA plus Nutrition Education

Group Three (One-year Intervention, 2017 Enrollment)

EXPERIMENTAL

Group three intervention participants in CO-CSA plus nutrition education will receive a subsidized share of CSA produce (50% standard member price) weekly for approximately 20 weeks in 2017 and will attend nine skill-based, nutrition education sessions focused on use of CSA produce.

Behavioral: CO-CSA plus Nutrition Education

Group Four (Delayed One-year Intervention, 2017 Enrollment)

EXPERIMENTAL

Group four delayed intervention participants in CO-CSA plus nutrition education will receive a subsidized share of CSA produce (50% standard member price) weekly for approximately 20 weeks in 2018 and will attend nine skill-based, nutrition education sessions focused on use of CSA produce.

Behavioral: CO-CSA plus Nutrition Education

Interventions

CO-CSA plus Nutrition Education BEHAVIORAL

Participants will receive subsidized share of CSA produce (50% standard member price) weekly for approximately 20 weeks each year. In addition, they will attend nine skill-based, nutrition education sessions focused on use of CSA produce.

Group Four (Delayed One-year Intervention, 2017 Enrollment); Group One (Two-year Intervention, 2016 Enrollment); Group Three (One-year Intervention, 2017 Enrollment); Group Two (Delayed Two-year Intervention, 2016 Enrollment)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• English-speaking
• Parent or legal guardian of a child in the household between the ages of two and 12 years
• Self-reported income less than 185% of the Federal Poverty Level or report enrollment in SNAP, WIC, or Head Start
• Has access to a computer from which s/he can complete on-line data collection
• Has an active e-mail account or willing to create an e-mail account
• Has not participated in CSA in the past three years
• Willing to purchase the 50% CO-CSA share (can use SNAP benefits if desired and available)
• Willing to attend CSA-tailored education sessions
• Willing to make a firm commitment to three years of participation (2016 enrollment) or two years of participation (2017 enrollment), with timing of the off-set benefit determined by randomization
• Complete baseline survey
• Pay deposit to farm

You may not qualify if:

• Non-English-speaking
• Not the parent or legal guardian of a child in the household between the ages of two and 12 years
• Self-reported income equal to or greater than 185% of the Federal Poverty Level and no report of SNAP, WIC, or Head Start enrollment
• Does not have access to a computer from which s/he can complete on-line data collection
• Does not have an active e-mail account or is not able or willing to create an e-mail account
• Has participated in CSA in the past three years
• Not able or willing to purchase the 50% CO-CSA share
• Not able or willing to attend CSA-tailored education sessions
• Not able or willing to make a firm commitment to three years of participation (for 2016 enrollment) or two years of participation (2017 enrollment), with timing of the off-set benefit determined by randomization
• Not able or willing to complete baseline survey
• Not able or willing to pay deposit to farm

Sponsors & Collaborators

• Cornell University: lead
• University of Vermont: collaborator
• University of North Carolina, Chapel Hill: collaborator
• The Evergreen State College: collaborator

Study Sites (29)

Barker

Barker, New York, 14012, United States

Location

Corning

Corning, New York, 14830, United States

Location

Gasport

Gasport, New York, 14067, United States

Location

Lockport

Lockport, New York, 14094, United States

Location

Medina

Medina, New York, 14103, United States

Location

Newfane

Newfane, New York, 14108, United States

Location

Watertown

Watertown, New York, 13601, United States

Location

Chapel Hill

Chapel Hill, North Carolina, 27510; 27514; 27515, United States

Location

Chapel Hill

Chapel Hill, North Carolina, 27516; 27517; 27599; 27707, United States

Location

Pittsboro

Pittsboro, North Carolina, 23712, United States

Location

Siler City

Siler City, North Carolina, 27344, United States

Location

Bristol

Bristol, Vermont, 05443; 05472, United States

Location

Burlington

Burlington, Vermont, 05401; 05402; 05405, United States

Location

Burlington

Burlington, Vermont, 05406; 05408, United States

Location

Cuttingsville

Cuttingsville, Vermont, 05738, United States

Location

Hinesburg

Hinesburg, Vermont, 05461; 05462; 05445, United States

Location

Ludlow

Ludlow, Vermont, 05149, United States

Location

Rutland

Rutland, Vermont, 05701; 05702; 05736, United States

Location

Rutland

Rutland, Vermont, 05759; 05765, United States

Location

South Burlington

South Burlington, Vermont, 05407; 05403; 05482, United States

Location

Starksboro

Starksboro, Vermont, 05461; 05473, United States

Location

Starksboro

Starksboro, Vermont, 05487; 05469; 05443, United States

Location

Vergennes

Vergennes, Vermont, 05491, United States

Location

Winooski

Winooski, Vermont, 05404; 05439; 05446; 05449, United States

Location

La Conner

La Conner, Washington, 98257, United States

Location

Mount Vernon

Mount Vernon, Washington, 98274, United States

Location

Olympia

Olympia, Washington, 98502, United States

Location

Rochester

Rochester, Washington, 98579, United States

Location

Sedro Woolley

Sedro-Woolley, Washington, 98284, United States

Location

Related Publications (4)

• Garner JA, Hanson KL, Jilcott Pitts SB, Kolodinsky J, Sitaker MH, Ammerman AS, Kenkel D, Seguin-Fowler RA. Cost analysis and cost effectiveness of a subsidized community supported agriculture intervention for low-income families. Int J Behav Nutr Phys Act. 2023 Jul 10;20(1):84. doi: 10.1186/s12966-023-01481-7.

  PMID: 37430305 DERIVED

• Seguin-Fowler RA, Hanson KL, Jilcott Pitts SB, Kolodinsky J, Sitaker M, Ammerman AS, Marshall GA, Belarmino EH, Garner JA, Wang W. Community supported agriculture plus nutrition education improves skills, self-efficacy, and eating behaviors among low-income caregivers but not their children: a randomized controlled trial. Int J Behav Nutr Phys Act. 2021 Aug 31;18(1):112. doi: 10.1186/s12966-021-01168-x.

  PMID: 34461931 DERIVED

• Lu I, Hanson KL, Jilcott Pitts SB, Kolodinsky J, Ammerman AS, Sitaker M, Wang W, Volpe LC, Belarmino EH, Garner J, Gonsalves L, Seguin RA. Perceptions of nutrition education classes offered in conjunction with a community-supported agriculture intervention among low-income families. Public Health Nutr. 2021 Jul;24(10):3028-3036. doi: 10.1017/S1368980020002773. Epub 2020 Aug 24.

  PMID: 32830626 DERIVED

• Seguin RA, Morgan EH, Hanson KL, Ammerman AS, Jilcott Pitts SB, Kolodinsky J, Sitaker M, Becot FA, Connor LM, Garner JA, McGuirt JT. Farm Fresh Foods for Healthy Kids (F3HK): An innovative community supported agriculture intervention to prevent childhood obesity in low-income families and strengthen local agricultural economies. BMC Public Health. 2017 Apr 8;17(1):306. doi: 10.1186/s12889-017-4202-2.

  PMID: 28390403 DERIVED

MeSH Terms

Conditions

Pediatric Obesity; Child Nutrition Disorders

Interventions

Nutrition Assessment

Condition Hierarchy (Ancestors)

Obesity; Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Data Collection; Epidemiologic Methods; Investigative Techniques; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Epidemiologic Measurements; Public Health; Environment and Public Health

Study Officials

• Rebecca A. Seguin, PhD

  Cornell University

  PRINCIPAL INVESTIGATOR

• Karla Hanson, PhD

  Cornell University

  PRINCIPAL INVESTIGATOR

• Jane Kolodinsky, PhD

  University of Vermont

  PRINCIPAL INVESTIGATOR

• Marilyn Sitaker, PhD

  The Evergreen State College

  PRINCIPAL INVESTIGATOR

• Alice Ammerman, PhD

  University of North Carolina, Chapel Hill

  PRINCIPAL INVESTIGATOR

• Stephanie Jilcott-Pitts, PhD

  East Carolina University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 5, 2016
• First Posted: May 12, 2016
• Study Start: April 1, 2015
• Primary Completion: December 6, 2018
• Study Completion: March 14, 2021
• Last Updated: February 9, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (29)