James E. Allen

Do Community Supported Agriculture programmes encourage change to food lifestyle behaviours and health outcomes? New evidence from shareholders

ABSTRACT Community Supported Agriculture (CSA) programmes have recently received attention for their potential to influence food lifestyle behaviours and health outcomes, though studies have mostly drawn from small samples (n < 25). Therefore, we designed a survey to test whether CSA participation links to changes in food lifestyle behaviours and health outcomes, and assess if the magnitude of changes varies based on respondent characteristics. A detailed survey was distributed to existing shareholders from three midsized CSAs near Lexington, Kentucky, and produced 151 usable responses. Through 20 paired questions, respondents reported on their food lifestyle behaviours and health outcomes both prior to joining a CSA and then after CSA participation. Paired two-sided t-tests assess if paired means are statistically different, and multiple regressions of paired differences on socioeconomic factors, self-reported health, and years of CSA enrolment estimate the effect of respondent characteristics on behaviour change. The results strongly suggest that CSAs have the potential to positively impact shareholders’ food lifestyle behaviours and health outcomes, and that those reporting ‘poor health’ prior to CSA enrolment exhibited the most change overall. These results should be taken as an initial, yet promising, analysis of the impact of CSA participation on shareholder food lifestyle behaviours and health outcomes.

Residents' willingness-to-pay for attributes of rural health care facilities.

CONTEXT As todays rural hospitals have struggled with financial sustainability for the past 2 decades, it is critical to understand their value relative to alternatives, such as rural health clinics and private practices. PURPOSE To estimate the willingness-to-pay for specific attributes of rural health care facilities in rural Kentucky to determine which services and operational characteristics are most valued by rural residents. METHODOLOGY We fitted choice experiment data from 769 respondents in 10 rural Kentucky counties to a conditional logit model and used the results to estimate willingness-to-pay for attributes in several categories, including hours open, types of insurance accepted, and availability of health care professionals and specialized care. FINDINGS Acceptance of Medicaid/Medicare with use of a sliding fee scale versus acceptance of only private insurance was the most valued attribute. Presence of full diagnostic services, an emergency room, and 24-hour/7-day-per-week access were also highly valued. Conversely, the presence of specialized care, such as physical therapy, cancer care, or dialysis, was not valued. In total, respondents were willing to pay

Restaurant tax feasibility: determinants of restaurant threshold price

225 more annually to support a hospital relative to a rural health clinic. CONCLUSION Rural Kentuckians value the services, convenience, and security that rural hospitals offer, though they are not willing to pay more for specialized care that may be available in larger medical treatment centers. The results also inform which attributes might be added to existing rural health facilities to make them more valuable to local residents.

Constructing a multi-dimensional measure of local entrepreneurial culture

This study examines the determinants of threshold price for restaurant meal cost increase. Threshold price is defined as the required level of cost increase that would cause households to eat in restaurants less frequently or decrease the amount they would typically purchase. The study uses Tobit models to examine the threshold price by differing social, economic and demographic characteristics of households in Kentucky. The empirical estimates suggest that households which have dinner at restaurants more frequently, households with higher incomes and households that strongly prefer full-service restaurants have a higher threshold price-range and are thus more willing to pay an additional cost increase in restaurant meals. Conversely, households that always notice taxes before paying their checks, households close to retirement-age, and households that do not strongly prefer local-food restaurants have a lower threshold price-range and are consequently less willing to pay an additional cost increase in restaurant meals.

CSA shareholder food lifestyle behaviors: a comparison across consumer groups

This article proposes a scale that measures the local entrepreneurial culture of a place based on residents’ perceptions. The initial 36-item pool was developed through semi-structured interviews with entrepreneurs and non-entrepreneurs in Kentucky (USA) and then reviewed by a focus group composed of entrepreneurship coaches. These items were included in an extensive survey of rural and urban Kentuckians. Factor analysis resulted in a 17-item scale with four major components. To ascertain the predictive validity of the subscales, a series of analysis of covariance (ANCOVA) models evaluated their correlations with county-level rates of entrepreneurship obtained from an independent data set. The analysis confirmed that perceptions of the local entrepreneurial culture do correlate with entrepreneurial activity. In line with the theoretical model presented in this article, the ANCOVAs also controlled for the modulating effect of important individual-level characteristics and regional factors. The proposed scale is recommended for use by entrepreneurship support programs that provide one-on-one assistance for small businesses, yet seldom assess nor consider how they might improve the entrepreneurial culture of the place where these businesses operate. Furthermore, this measure is an important contribution to entrepreneurship research. Existing measures of entrepreneurial culture focus mostly on the regional and national levels, overlooking the role of local cultural characteristics; they also tend to focus on general cultural attributes rather than on residents’ perceptions of the entrepreneurial climate. This entrepreneurship culture scale opens the door to new directions in research.