Factors Associated With Uptake of an Open Access Health Center-Based Mobile Produce Market: A Case for Expanded Eligibility.

Background: Health care-based food assistance programs show promise but are underutilized. Strict eligibility requirements and program scheduling may dampen reach and outcomes.

Objective: To explore factors associated with uptake of a health center-based mobile produce market with no eligibility requirements and few barriers to entry.

Design: A cross-sectional analysis of medical record, sociodemographic, environmental, and market attendance data was used.

Participants/setting: The study sample consisted of 3071 adults (18+ years) who were patients of an urban health center in eastern Massachusetts and registered for the mobile market during the study period of August 2016 to February 2020.

Main Outcome Measures: The main outcome measure was monthly market attendance over the study period.

Statistical Analyses: T-tests and χ tests were used to compare market users and never-users. Multiple logistic regression was used to analyze variables associated with market attendance each month.

Results: In multiple variable analyses, Supplemental Nutrition Assistance Program enrollment was associated with slightly less frequent monthly market use (odds ratio [OR], 0.989; 95% CI, 0.984-0.994). Day-of, on-site market registration was associated with more frequent monthly use than self-registration on nonmarket days (OR, 1.08; 95% CI, 1.07-1.08). Having a psychiatric or substance use disorder diagnosis was associated with slightly less frequent market attendance (OR, 0.99; 95% CI, 0.98-0.99; and OR, 0.96; 95% CI, 0.95-0.97, respectively) compared with registrants without these diagnoses.

Conclusions: Individual, community-level, and organizational factors are associated with uptake of a free mobile produce market and should be considered when designing programs.