Abstract A033: Barriers to eating fruits and vegetables among a low-income ethnically diverse population
Authors: Brown Caprice , Hull Pam , Selove Rebecca , Schlundt David G. , Silsby Joscelyn 
Published: August 2020

Abstract
A high-quality diet that includes recommended daily amounts of fruits and vegetables (FV) is associated with reduced risk for cancer and improved health outcomes for cancer survivors. There is evidence that some cancer disparities among minorities are associated with diet quality, and there is persistent evidence of poor nutrition and food insecurity among low-income minorities in the U.S. This has led to federal efforts to increase fresh fruit and vegetable consumption among Supplemental Nutrition Assistance Program (SNAP) participants. As part of an evaluation of an intervention to increase fresh fruit and vegetable (FFV) consumption in SNAP households, this study asked: How do perceived barriers to eating more FVs vary by age, gender, race/ethnicity, and level of education? The AARP Foundation implemented the United States Department of Agriculture (USDA)'s Food Insecurity Nutrition Incentive (FINI) Grant Program in two southeastern states. SNAP participants could receive financial incentives through their SNAP cards in the form of coupons or tokens for purchasing FFVs or SNAP items at grocery stores and farmers' markets in selected communities. Individual households in these communities were randomly selected and invited to respond to an evaluation survey via the internet or a telephone survey. The survey included seven questions from the National Cancer Institute Food Attitudes and Behaviors Study about barriers to eating FVs, with ratings on a scale of strongly agree to strongly disagree. Responses were summed to create composite barriers scores. Completed baseline surveys were received from 1,459 households in Tennessee and Mississippi. There were significant age differences for three barriers, with survey respondents aged 65 and older being more likely to report the following barriers: hard to find FVs where I shop (p&lt;.023), cost too much (p&lt;0.001), and I do not like (p&lt;0.029). Respondents 18-29 years reported time to prepare as a barrier more often than other age groups (p&lt;0.05). Males gave a higher barrier rating for knowing how to prepare (p&lt;0.044) and females for costing too much (p&lt;0.034). Whites gave the lowest barrier rating for difficult to prepare (p&lt;0.002) and the highest rating for cost (p&lt;0.001), while Hispanics gave the highest rating for personal dislike of FVs (p&lt;0.006). Those with high school or less education tended to rate the following barriers higher than participants who had gone to college: don't know how to prepare (p&lt;0.001), don't have time to prepare (p&lt;0.008), hard to find where I shop (p&lt;0.006), family dislikes (p&lt;0.001), personal dislike (p&lt;0.001), and average barrier rating (p&lt;0.001). Across all demographic groups, cost was reported as the biggest barrier.
Conclusions: The results suggest that interventions to increase FV consumption for cancer prevention and improved outcomes for minority cancer survivors may need to be tailored to address different needs based on age, gender, ethnicity, and level of education.
Citation Format: Caprice Brown, Pam Hull, Rebecca Selove, David G. Schlundt, Joscelyn Silsby. Barriers to eating fruits and vegetables among a low-income ethnically diverse population [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A033.