Abstract: Factors Affecting Health Communication Outcomes for Increased Fruit and Vegetable Consumption in Louisville’s West End

◆ Lindsay J. Della, University of Louisville

◆ Margaret U. D'Silva, University of Alabama

◆ Ozioma Omah, University of Alabama

◆ Elle Hazlett, University of Alabama

Background: Research shows that increased fruit and vegetable (F&V) intake reduces the negative health outcomes such as obesity (Ledoux, et al., 2011), type 2 diabetes (Carter, et al. 2010), and cancer (Aune, et al, 2017). In Kentucky, Blacks are disproportionately affected by obesity, diabetes, and cancer (Kentucky Cabinet for Health and Family Services, 2017). Study Introduction: This study sought to examine social and ecological factors (Elder, et. al, 2007) affecting F&V consumption in the West End of Louisville, Kentucky among its predominantly Black population in order to better identify and understand important local audiences for F&V communication and social-ecological advocacy. RQ1: What structural barriers/enablers for increased F&V consumption exist in West Louisville? RQ2: What effect do intrapersonal, interpersonal, and situational characteristics have on F&V consumption rates among Blacks living in West Louisville? Method: Transect walks with resident informants from the community resulted in audio recordings of informant conversations (173 minutes), field notes, and artifacts (e.g., maps/photos). These data were compiled to create a “landscape” of F&V access and were thematically analyzed to identify structural and economic resources impacting availability and food quality in West Louisville. A survey was administered at gathering places in the West Louisville community (e.g., churches, barbershops). Participants (N = 153) identified as Black, were +18 years old, and reported BMI greater than 25 (overweight or higher). The survey measured: social support, beliefs, health information access, the influence of powerful others, along with demographics and F&V consumptions behavior. Bivariate correlations and multiple linear regression were used to identify predictors of F&V consumption. Results: The transect walks showed convenience stores dominated food access options in the West End, with constrained variety and low-quality F&Vs. Only three grocery outlets served West Louisville (~ 62,000 people). Quantitative results showed that worrying about health was positively related to food insecurity (p = .002) and inversely related to accessing health information (p = .047). Powerful others externality was positively related to accessing health information (p = .000) and familial social support (p = .002). Multicollinearity between predictors resulted in different regression models depending on the inclusion of food security status (FSS). Without FSS, familial social support and accessing health information significantly predicted F&V intake (adj. R2 = .153). When included, worry about health, educational attainment, powerful others and accessing health information predicted F&V consumption (adj. R2 = .173). Discussion: These findings highlight the need for increased advocacy at local government levels to incentivize and support availability of quality F&Vs in the West End. Increased availability, however, does not necessarily translate to increased F&V consumption (Ollberding, et. al., 2012). Therefore, structural changes should be accompanied by health communication efforts from local powerful others such as community health workers, church pastors, family physicians, healthy family friends about how, when, and why residents should consume F&Vs. For planned communication efforts to be successful, our findings indicate that information about F&Vs needs to be accessible, meet community members at current health literacy and educational attainment levels, and help members support one another’s consumption behavior.