Improving Health Outcomes and Advancing Health Equity in Imperial County Rural Communities through Increasing Healthy Food Access

About This Grant

Rural communities experience higher food insecurity prevalence and residents face challenges in obtaining food due to a number of barriers, including economic and financial instability, transportation limitations, and lack of or limited access to stores that offer varied, healthy, and affordable food options. Supermarkets are not readily accessible and independently- owned small markets, corner, liquor, and convenience stores are more prevalent. While these small stores generally offer limited healthy food options, they are existing assets in the community that are already serving community residents and can become an important source of healthy food access that increases the visibility and variety of nutritious foods within rural communities. The long-term goal of this project is to test the effectiveness of the introduction of a produce distribution service into small stores on increasing healthy food access, reducing health disparities, and improving psychosocial health outcomes among low-income, primarily Hispanic rural community residents in Imperial County, CA. This project will accomplish three specific aims: Specific Aim 1: Assess and characterize the food environment in Imperial County, CA. The food environment will be evaluated by creating a Geographic Information System that captures existing food retailers, conducting in-store observational audits of all food retailers to assess current healthy food accessibility and availability, and analyzing the data to identify healthy food access gaps and potential small store partners for produce distribution services. Specific Aim 2: Adapt and implement the produce distribution service. The produce distribution service will be adapted based on input from a community advisory board and small store owners. Quantitative and qualitative data will assess the feasibility and acceptability of the service and indicate if its elements met the needs of small store owners and community residents, and were acceptable, feasible, cost-effective, and contextually-relevant. Specific Aim 3: Evaluate the preliminary multi-level effectiveness of produce distribution services to partner stores. Multi-method, longitudinal data will be analyzed to evaluate the effectiveness of the produce distribution service in improving produce accessibility and availability and food security, and changing food acquisition and dietary intake behaviors. By adapting and implementing a produce distribution service for rural communities that has been successful in urban communities, this project has the potential to inform approaches for leveraging existing assets in the community to increase healthy food access within rural communities that face considerable barriers in improving the food environment.