Date Available


Year of Publication


Degree Name

Master of Science in Nutrition and Food Systems (MSNFS)

Document Type

Master's Thesis


Agriculture, Food and Environment


Dietetics and Human Nutrition

First Advisor

Dr. Dawn Brewer


Rural Appalachian populations have greater rates of obesity and chronic diseases attributed to lesser consumption of fruits and vegetables (F/V) and physical inactivity. Barriers to F/V consumption and physical activity include poor access and affordability. To help overcome these barriers, a community-initiated walking and farmers market F/V voucher program was implemented.

Participants were encouraged to walk (1.2 miles roundtrip) to the local farmers market to redeem a $10 voucher which could only be spent on F/V. The 16-week program (June – Sept) included 121 participants. Data was analyzed by creating two groups, low-engagers and high-engagers that differed significantly in the number of times walked to the market and redeemed vouchers, p ≤ 0.0001.

Among all participants’ significant decreases were seen in total cholesterol, LDL, ratio of total cholesterol/HDL cholesterol, 10-year risk of heart disease or stroke score, and hemoglobin A1c (p ≤ 0.05). Significant increases were seen in HDL, quantity and variety of F/V consumption among all participants and the high-engagers group. There were improvements in knowledge pertaining to participants’ awareness of the term “phytonutrient” with correctly identifying plant-based foods as the source (p=0.01).

Results demonstrate that a community-based walking and farmers market F/V voucher program can improve health in a Rural Appalachian population.

Digital Object Identifier (DOI)

Funding Information

Research reported was supported by the University of Kentucky Department of Dietetics and Human Nutrition; the University of Kentucky College of Agriculture Food, School of Human Environmental Sciences Research Activity Award; and NIEHS/NIH grant P42ES007380. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH.