abstract: 'Introduction: Patient participation in healthcare system-sponsored

  efforts to address food insecurity varies widely. This mixed-methods

  study sought to understand the patient sociodemographic factors

  associated with and barriers and facilitators to the use of a monthly

  produce market held at Cambridge Health Alliance in partnership with The

  Greater Boston Food Bank.

  Methods: Baseline surveys (N=715) were conducted from February 2019 to

  March 2020 before market attendance, followed by 1-year follow-up

  surveys (n=514) and qualitative interviews (n=45). Robust Poisson

  regression estimated associations between sociodemographic

  characteristics and market attendance. Analyses were conducted from 2021

  to 2022.

  Results: A total of 37.1\% attended the market >= 1 time. Market

  attendance was associated with being aged 30-49 years (Risk Ratio

  (RR)=1.36, 95\% CI=1.00, 1.86), having a monthly household income

  <\$1,000 (RR=1.73, 95\% CI=1.29, 2.32), identifying as Asian (RR=2.48,

  95\% CI=1.58, 3.89), having a preferred language for medical care other

  than English (RR=1.35, 95\% CI=1.03, 1.76), being retired (RR=1.90, 95\%

  CI=1.17, 3.08), and living in the city of the market''s location

  (RR=1.36, 95\% CI=1.12, 1.63). Barriers included limited time (28\%),

  work conflict (23\%), forgetfulness (23\%), and not knowing market

  location/date (22\%). Interviews revealed that accessibility barriers

  (e.g., limited market hours, transportation issues, competing demands,

  medical conditions, long lines) were obstacles to attendance, whereas

  access to novel, healthy foods motivated attendance.

  Conclusions: Healthcare-based food distributions have the potential to

  reach patients with unmet food needs who cannot or would not access

  other forms of food assistance. Time constraints, physical limitations,

  and transportation challenges impact attendance; program modifications

  are necessary to improve accessibility. (C) 2022 Published by Elsevier

  Inc. on behalf of American Journal of Preventive Medicine.'
affiliation: 'Zack, RM (Corresponding Author), Greater Boston Food Bank, 70 South
  Bay Ave, Boston, MA 02118 USA.

  Zack, Rachel M.; Nguyen, Tra; Weil, Rachel; Fiechtner, Lauren, Greater Boston Food
  Bank, 70 South Bay Ave, Boston, MA 02118 USA.

  Bronico, Jackie V. Rodriguez; Babbin, Molly; Granick, Jean, Cambridge Hlth Alliance,
  Community Hlth Improvement Dept, Cambridge, MA USA.

  Fiechtner, Lauren, Mass Gen Hosp Children, Div Gen Acad Pediat, Boston, MA USA.

  Fiechtner, Lauren, Mass Gen Hosp Children, Div Gastroenterol \& Nutr, Boston, MA
  USA.

  Mulugeta, Wudeneh, Cambridge Hlth Alliance, Revere, MA USA.

  Odayar, Varshini; Cortes, Dharma E., Cambridge Hlth Alliance, Hlth Equ Res Lab,
  Cambridge, MA USA.'
author: Zack, Rachel M. and Bronico, Jackie V. Rodriguez and Babbin, Molly and Nguyen,
  Tra and Weil, Rachel and Granick, Jean and Fiechtner, Lauren and Mulugeta, Wudeneh
  and Odayar, Varshini and Cortes, Dharma E.
author-email: rmzack@gmail.com
author_list:
- family: Zack
  given: Rachel M.
- family: Bronico
  given: Jackie V. Rodriguez
- family: Babbin
  given: Molly
- family: Nguyen
  given: Tra
- family: Weil
  given: Rachel
- family: Granick
  given: Jean
- family: Fiechtner
  given: Lauren
- family: Mulugeta
  given: Wudeneh
- family: Odayar
  given: Varshini
- family: Cortes
  given: Dharma E.
da: '2023-09-28'
doi: 10.1016/j.amepre.2022.03.034
earlyaccessdate: AUG 2022
eissn: 1873-2607
files: []
issn: 0749-3797
journal: AMERICAN JOURNAL OF PREVENTIVE MEDICINE
keywords-plus: FOOD INSECURITY; PERCEPTIONS
language: English
month: SEP
number: 3, 2
number-of-cited-references: '43'
orcid-numbers: 'Zack, Rachel/0000-0003-1048-8938

  Odayar, Varshini/0000-0002-0284-814X'
pages: S131-S143
papis_id: c44478efe25a774460e6ace92c0ef771
ref: Zack2022facilitatorsbarriers
researcherid-numbers: 'Cortés, Dharma E/JCE-0305-2023

  '
times-cited: '1'
title: Facilitators and Barriers to Patient Attendance at a Free Health Center Produce
  Market
type: Article
unique-id: WOS:000873173600004
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '63'
web-of-science-categories: 'Public, Environmental \& Occupational Health; Medicine,
  General \&

  Internal'
year: '2022'