Utility of Produce Ratios to Track Fruit and Vegetable Consumption in a Rural Community, Church-Based 5 A Day Intervention Project

Abstract

Previous research suggests that grocery store characteristics may be useful in evaluating community-based dietary interventions. We undertook a study to determine whether produce ratios (ratios of produce sales to total grocery sales) were a useful indicator of fruit and vegetable (F & V) consumption in a church-based, community intervention trial that promoted 5 A Day guidelines within 10 rural counties of North Carolina. Produce ratios were collected from stores identified by participants in the Black Churches United for Better Health Project. Baseline and study period data for 21 stores in intervention counties and 18 stores in nonintervention counties were compared using repeated-measures analysis of variance. Produce ratios were significantly associated with seasonality (p < 0.0001), but no differences were seen between the two groups of stores. These findings do not support data from individual telephone surveys, which showed significant differences in F & V consumption between participants in the two groups. Our inability to detect differences at the store level may have been due to 1) the incapacity of produce ratios to capture F & V purchases that were juice, frozen, or canned products; 2) shifts in procuring F & Vs from grocery stores to other sources (i.e., gleaning and produce cooperatives); 3) the modest proportion of shoppers that received the full intervention dose; and 4) a general lack of power to detect differences at the store level. Therefore, although produce ratios did not serve as a valid measure for this project, if their limitations are recognized and compensated for, they may have applicability for future investigations that monitor F & V consumption.