Operational Challenges That May Affect Implementation of Evidence-based Interventions at Mobile Produce Markets

Introduction: Mobile produce markets are becoming an increasingly prevalent, accepted, and effective strategy for improving fruit and vegetable (F&V) access and consumption across underserved and lower-income communities. However, there is limited published research on mobile market operations. The goal of this research is to identify the challenges mobile markets face and ways to potentially mitigate those challenges. We will also discuss implications of our ndings on implementation of evidence-based interventions for mobile produce markets. Methods: We conducted 21 semi-structured key informant (KI) interviews to assess common practices of mobile market organizations that had been operating for 2 + years. We asked KIs about their organizational structure, operations, procurement and logistics, evaluation efforts, marketing and community engagement, success and challenges. All interviews were recorded, transcribed, and analyzed by two independent coders using ATLAS.ti 8.0 qualitative software. A secondary qualitative analysis identied subthemes related to common challenges and remedial practices. An inductive coding process was applied to match identied challenges to the appropriate Consolidated Framework for Implementation Research (CFIR). Results: The leading challenges cited by KIs correspond to the CFIR domains of inner setting (e.g., funding and resources), outer setting (e.g., navigating regulations), and process (e.g. engaging community partnership). Practices that may mitigate challenges include maximizing ancillary services, adopting innovative volunteer and stang structures, and formalizing agreements with community partners. Conclusion: Common and persistent challenges ought to be addressed to ensure and enhance the positive public health impacts of mobile produce markets. Contextual factors, particularly organizational factors, that impact implementation should also be considered when implementing an evidence-based-intervention at a mobile market. Further research is needed to determine which innovative solutions are the most effective in mitigating challenges, improving implementation, and enhancing sustainability of mobile markets.

Compared to typical "brick and mortar" retail stores, mobile markets have the advantage of being exible in where they locate and can adapt to changing food environments (9). In addition, mobile market are often managed by mission-driven, nonpro t organizations or residents and may have a deeper understanding of the communities in which they visit (2,(9)(10)(11). However, many mobile markets face challenges with sustainability within the organization and the communities they serve (12). There is little research on mobile market practices which limits our understanding of the conditions that need to be met in order to be effective (e.g., increased access, F&V consumption). To ll this gap, we started with the objective to identify common practices for mobile markets with an eventual goal of establishing standards of practice to tailor to the needs of different organizations and communities (2).
There is scant research on the processes of designing, operating, and sustaining mobile markets from the perspective of the organization. The available research indicates that issues surrounding nancial sustainability, lack of organizational capacity, and di culty attaining community buy-in can undermine the mobile markets' reach, impact, and longevity (10,11). There is a need to understand the persistent challenges that may undermine an organization's capacity to implement a mobile market so that we can ensure programs are using optimal practices.
Understanding contextual factors that either help or hinder mobile market operations is crucial in facilitating implementation and ensuring interventions have optimal public health impact. A review of over 500 studies evaluating prevention and health promotion programs found that the in uence of better implementation (e.g., delity, dosage, reach) on health outcomes has resulted in mean effects sizes that are two to three times higher in treatment groups compared to controls (13). Therefore, implementation in uences outcomes; in the case of mobile markets, this can translate to a reduced impact on dietary changes (i.e., F&V intake). Speci cally, implementation is mostly impacted by variables related to communities, implementers, intervention, organizational characteristics, and available support systems (i.e., training and technical assistance) (13). Identifying common challenges experienced by mobile market organizations is the rst step in understanding the contextual factors that may impede implementation of evidence-based interventions (EBI) at a mobile market.
This research is intended to raise awareness of the challenges that mobile markets face and encourage researchers, policymakers, funders, and stakeholders to offer their support in the areas of greatest need. Understanding innovative strategies can also provide a precedent for organizations to adopt, allowing them to circumvent potential challenges. The current study furthers existing research by focusing on mobile markets operating at least two years and identifying practices that may ameliorate challenges.
Through in-depth interviews with mobile market organizations, we seek to answer the following: 1) What are the challenges established mobile markets commonly face? 2) What are the implications of these challenges for future implementation of evidence-based interventions? and 3) What are the practices that potentially mitigate operational challenges?

Key Informant Interviews Process
Two researchers conducted semi-structured interviews over the phone between May and November 2018. The interview guide was informed by the research team's collective experience operating and evaluating mobile markets. The initial interview was approximately 90 minutes and key informants (KI) were asked questions regarding market models, sta ng, nutrition education and ancillary services, business and nancial models, logistics and operations, community engagement and marketing strategies, procurement and pricing, and program impact and evaluation. Organizations recognized as possessing a certain strength or uniqueness were asked to complete a follow-up interview, for a total of up to four phone calls. Although the focus of the interview guide was to assess common practices among mobile market organizations, persistent challenges emerged as a dominant theme throughout data collection and analysis, leading us to generate a separate research question from the original research aim .
In addition, several practices that help ameliorate challenges among mobile market organizations emerged as a theme in the original formative work generating an additional research question that compliments the ndings on challenges. The ndings from the original research question, speci cally the common practices and important resources among mobile markets organizations, are reported elsewhere (2). KIs were compensated $50 for each interview they completed and offered access to the Veggie Van (VV) Toolkit. This study was approved by the University at Buffalo Institutional Review Board.

Data Analysis
All interviews were recorded, transcribed, and checked for accuracy. Data analysis was completed using the qualitative software program ATLAS.ti version 8.0. Transcripts were divided between two graduate research assistants to code utilizing a codebook of overarching themes informed by the interview guide. Reports were generated for all codes and summarized each theme (e.g., organizational structure) across all mobile market organizations. Memos were written to summarize each code report and frequency distributions were calculated for speci c themes.
Given that the original research aim was to identify common practices, a secondary analysis of the aforementioned code reports and memos was conducted in Microsoft Word and Excel to identify subthemes related to common challenges and remedial practices. Lastly, an inductive coding process was applied to match identi ed challenges to the appropriate Consolidated Framework for  (14,15). CFIR was a chosen framework due to its exibility to be used across the spectrum (pre-, during, post-implementation) of implementation, the inclusion of the most salient implementation factors, its strong theoretical foundation, and the ease in which it can be tailored to different interventions and settings (14)(15)(16). CFIR is comprised of 39 constructs within ve major domains that interact to in uence implementation of programs and interventions and their eventual effectiveness (14).

Organizational Demographics
Twenty-one mobile markets were represented by 25 KIs in interviews and no participants withdrew from the study once enrolled. Table 1 includes characteristics of the participating mobile market organizations. The KIs represented organizations from 16 states and 19 cities in the U.S. The majority of mobile markets serve predominantly or exclusively urban areas and are managed by a non-pro t organization.
Our ndings on common challenges are reported below, organized by the CFIR domain, construct, and sub-construct (if applicable). Figure 2 depicts the CFIR domains and constructs that were identi ed.
Domain/Construct: Outer Setting/Needs and Resources of those Served by the Organization Challenges that are associated with external in uences on mobile market operations fall within the domain of "outer setting." Within this domain, the challenges cited correspond to the construct "needs and resources of those served by the organization." Organizations commonly collect non-sales data (e.g., demographics, customer feedback) and many of the organizations have gone through some form of evaluation. The scope and rigor of the evaluations are highly variable and can be conducted internally by the organization (e.g. program evaluator) or in partnership with an outside organization such as a local university. KIs expressed concern surrounding data collection in regards to burdening their customers. Speci cally, organizations do not want to jeopardize the integrity and privacy of their customers or risk damaging the relationship and trust they have established.
"It's virtually impossible to do that (data collection)…our funding in the past for these things has been through health organizations and we found that that kind of tracking, it's not accurate, rst of all, and it's just really, really hard to actually collect and ... it alienates customers." Oregon Mobile Market Key Informant Domain/Construct: Outer Setting/External Policy and Incentives Also within the domain of "outer setting," the construct "external policy and incentives" includes challenges related to local and federal regulations. Nearly all organizations participate in at least one type of incentive program, usually a Supplemental Nutrition Assistance Program (SNAP) matching program; however, there are barriers to enrolling in the Women, Infants, and Children (WIC) and Seniors Farmers Market Nutrition Program (FMNP). Organizations that are unable to achieve the necessary classi cation (e.g., farm stand) or procure the minimum percentage of local produce are ineligible to participate in these programs. In addition, many organizations face regional barriers regarding food handling requirements that prevent or greatly hinder the ability to conduct food demonstrations at the market, which are a preferred form of nutrition education.

Domain/Construct: Inner Setting/Structural Characteristics
The majority of the challenges cited by KIs fall within the CFIR domain of inner setting, which includes implementation factors related to the structure of an organization which corresponds to the construct "structural characteristics." KIs expressed that operating a mobile market is an "expensive business model" due to not being able to break-even and cover operating costs solely through sales revenue. The leading expenses that were mentioned by KIs were the cost of produce, sta ng, and the vehicle and related expenses (e.g., repairs, fuel). The percentage of operating costs covered by sales ranged from 10-75%, requiring organizations to seek additional funding sources. Supplemental funding comes from a combination of sources including national and regional grants (n = 19), support from parent (e.g., food bank, city/municipality) and/or partner (e.g., health department or network) organization (n = 8), foundation funding (n = 7), corporate sponsorship (n = 6), fee-for-service events (n = 2), and philanthropy and donations (n = 3). The pressures of acquiring and maintaining funding to support mobile market operations are persistent challenges among organizations. Most KIs expressed it is di cult to be selfsu cient because selling produce at a low cost reduces pro tability, making them dependent on supplemental funds.
"I think another challenge is having long term funding to staff the program, whereas I said we're working towards increasing our program generated revenue. But it's an expensive business model and we're not close to covering our costs. I don't think that we will get there at [that] scale anytime soon and so having long term funding to support the sta ng to run this program, is huge." Massachusetts Mobile Market Key Informant KIs commonly mentioned sta ng challenges; market staff levels are highly variable across organizations, with KI's reporting 0-8 full-time staff, 1-6 part-time staff, and 1-30 volunteers within the parent organization at-large and 1-3 paid and 1-5 volunteers for the direct mobile market staff. Staff are often shared with other programs run by the parent organization, work in administrative roles related to the market, or complete a multitude of direct market tasks (e.g., running the market, cashing out customers, driving the vehicle). In addition, the seasonal nature of most positions and the lack of nancial means to pay staff as much as organizations would like increases staff turnover. Although volunteers are a valued asset among organizations, the very nature of these unpaid, often temporary positions can make them more of a liability than a bene t; some organizations limit their numbers to a core group of reliable volunteers to avoid misallocating training resources.

Domain/Construct: Inner Setting/Implementation Climate
Within the domain of "inner setting" challenges that relate to an organization's capacity and receptivity for change and exibility correspond to the construct "implementation climate." Within this construct, challenges related to upholding an organization's values fall within the sub-construct of "compatibility."

Sub-construct: Compatibility
All organizations prioritize sourcing locally, but other factors need to be considered when making sourcing decisions, which presents challenges for reconciling missions (i.e., support local farmers vs. sell low-cost produce). For example, the climate or geography of a region may result in certain produce to be prohibitively expensive to purchase because the organization would either be forced to price out of their customers' means or take a complete loss over the sale. Organizations tend to prioritize affordability and therefore may look to other produce sources (e.g., regional, neighboring state, import) if it ensures that they can meet customers' needs while remaining nancially viable. In addition, some organizations are open to sourcing imported produce to provide culturally relevant produce (e.g., plantains, yucca root) that increases customer acceptability. However, a few organizations have a more in exible overarching mission (e.g., support local farmers) that governs sourcing decisions even when wholesale prices increase or customers request non-local produce. These organizations may receive pushback from regarding the lack of imported produce, but see an opportunity to educate the community about the importance of sourcing locally. The push-and-pull between con icting factors may lead organizations to compromise their priorities for supporting local agriculture, honoring customers' cultures, or achieving nancial sustainability.
"During the growing season we source from local farmers as much as we can but it's challenging because the cost of the food is higher with local farmers…. [the percentage from local farmers has been] higher in past years but we kept losing money. So we had to make a change unfortunately, it breaks my heart to do it." Minnesota Mobile Market Key Informant Domain/Construct: Inner Setting/Readiness for Implementation The construct "readiness for implementation" includes challenges that may undermine an organization's commitment and capacity to implement an intervention. The sub-constructs "available resources" and "access to knowledge and information" include challenges associated with the level of resources available for operations and implementation and the ease of access to information and knowledge, respectively.

Sub-construct: Available Resources
Most organizations utilize 1-2 trucks, vans, or busses to transport produce to market sites. Although most set up the market on the vehicle's perimeter or within the host site (i.e. community partner hosting the market), organizations retro t the vehicle(s) to suit their speci c needs (e.g., storage, refrigeration).
The expenses associated with the initial vehicle purchase, upgrades, and maintaining the vehicle(s) are a costly and ongoing challenge. Finding quali ed experts to service and retro t the vehicle(s) can be di cult, particularly with de-commissioned vehicles that require a particular expertise (e.g., transit or school bus). The inconvenience from a disabled vehicle deeply impacts the market patrons and the viability of the market due to lost sales.
"…there's always a crisis… whether it's the bus breaking down or the walk-in cooler going out…" Minnesota Mobile Market Key Informant All organizations have access to dry and cold storage at their operations' hub or nearby storage; however, some KIs expressed their organization's storage is not ideal due to inadequate or shared space. Most organizations invest in some type of refrigeration (e.g., coolers, refrigerators, Cool-bot system) for the vehicle and/or their hub; many mention that a refrigerated truck would be optimal, yet out of reach for most.
Organizations are largely satis ed with their current sales tracking methods, with most using Point-of Sale (POS) software (e.g., Square ®) compared to handwritten sales ledgers. However, some feel that their current sales tracking system is outdated, but costs limit their ability to upgrade. Chosen POS software may not be ideal for capturing and viewing data, particularly when processing incentive program transactions, and organizations would like a more functional and streamlined platform.
Depending on the market setup and weatherization, extreme temperatures can impact customer comfort, produce quality, and functionality of POS technology. For example, a market enclosed in a vehicle where customers enter to shop may still be too cold for customers. Alternatively, a market that operates outside of the vehicle may experience wilting produce and malfunctions with POS technology due to extreme heat.
Most of the organizations work with partner organizations (e.g., local Extension o ce, local college nutrition students/interns) to offer regular nutrition education. Organizations offer their own informal nutrition education such as distributing recipes, but due to sta ng and time constraints, more comprehensive education (e.g., mini-lessons, cooking demonstrations) are typically left to the partner organizations. Many organizations would like to offer more nutrition education activities, but are unable to do so for the aforementioned policy and sta ng barriers along with a lack of space.
Sub-construct: Access to Knowledge and Information The majority of market sites are chosen based on partnerships with community sites that serve a similar target market as the mobile market organization (e.g., low-income housing, libraries, community centers, etc.). While the breadth of sites is largely the same between organizations, there is variability in the types of sites that are busiest. Therefore, predicting which potential market sites will be viable is an ongoing challenge as is optimizing the mobile market schedule.
Prices are often set informally based on trial-and-error or comparing prices to local retailers. This approach typically leads to a retail price that is a 10-20% markup over wholesale cost. However, it can be challenging to set price points on perishable items that regularly uctuate in cost and availability while ensuring affordability and nancial sustainability. KIs expressed interest in establishing a better and easier pricing system. Organizations would also like to improve their inventory management to avoid produce shortages and minimize waste.
Among organizations that are able to provide their own form of nutrition education, KIs underscore the importance of culturally relevant education. However, some lack the means (e.g., translation services) to tailor their education to different languages and cultures.
The most common marketing strategies to build awareness and interest in the market include print (e.g., yers, signs), social media (e.g., Facebook), broadcast (e.g., TV, radio), and digital media (e.g., email, text). Word-of-mouth, networking, and canvassing are commonly cited as more successful strategies. However, few organizations have a formal marketing plan or track their marketing efforts, and therefore can only speak to the effectiveness of their strategies anecdotally.

Domain/Construct: Characteristics of Individuals/Other Personal Attributes
The domain "characteristics of individuals" re ects the qualities of the individuals within an organization; the construct "personal attributes" includes individuals' personality traits. KIs expressed that staff are expected to "wear a lot of hats," and this presents a challenge in nding diverse and quali ed employees that are suited for working at a mobile market. Subsequently, this can lead to staff burnout and high turnover rates. Organizations also struggle with hiring staff that are representative of the communities that the mobile market serves.
"I think running a program like this is somewhat unusual just in the diversity of functions that everybody is doing. So, like, even when we hire market staff…we need people who are comfortable with physical labor, and driving a truck, and also incredibly charming, and good at customer service which aren't always the same people." Rhode Island Mobile Market Key Informant Domain/Construct: Process/Engaging (External Change Agents, Innovation Participants) The domain "process" includes constructs related to the process of implementation; the construct "engaging" refers to attracting and involving the appropriate individuals throughout implementation. The sub-construct "stakeholders/external change agents" includes engagements with in uential individuals outside of the implementing organization. The sub-construct "innovation participants" includes engagements with those served by the organization (e.g., mobile market customers).

Sub-construct: Engaging Stakeholders/External Change Agents
Most organizations have an informal agreement with host sites, while some draft a memorandum of understanding (MOU) or similar contract with partners. Organizations adjust their expectations of community partners' involvement in the mobile market based on each site's capacity; however, KIs expressed that a lack of clarity on the roles of partners can lead to frustration. Some organizations would like to outline more robust expectations and encourage partners to take a more active role in supporting the market (e.g., promotion, provide space). Organizations procure produce from a combination of sources, but predominantly source directly from farms. However, securing an agreement with a farm can be a challenge due to di culties in identifying a farmer that is willing to work with a mobile market, as well as effectively negotiating for high quality produce at a fair price.

Sub-construct: Engaging Innovation Participants
Most organizations are actively engaged with the communities they serve through attending community events, meetings, speaking engagements, and engaging with policymakers-but few have a community advisory board. Most are interested in forming or reviving a community advisory board speci cally for the mobile market, but have other competing priorities.
Most organizations feel they are adequately reaching their target market, but this belief is mainly based on sales data that indicates what percentage of customers receive SNAP bene ts. Organizations are less con dent in assessing their reach with the "hard-to-reach" subset of the lower-income population (e.g., individuals not participating in assistance programs). KIs expressed it can be a lengthy and delicate process to earn trust when expanding the mobile market to new communities. There may be confusion among community members surrounding whether the mobile market is a charity, a service, or both. KIs underscored the importance of persistence and patience for community members to accept the concept of a mobile market and to cultivate trust. Earning recognition and buy-in from community partners and government entities can also be a challenge.
"...literally it took six months before we had customers. Every single week for an hour[for] six months, but if you think about it it's a rough neighborhood [and] they don't trust anybody, 'who is this new person?' ….So it's again you have to show up every single week and you have to say hello to every single person that walks by." Michigan Mobile Market Key Informant

Biggest Challenges Faced by Mobile Markets
KIs were asked which of the challenges that organizations face in operating a mobile market are the most formidable. The most frequently cited challenges were related to sta ng, funding and nancial sustainability, effectively engaging with community partners and residents, vehicle acquisition and maintenance, and weather conditions. "De nitely the biggest for us is sta ng, keeping [staff] … One of the reasons why I think our program is successful is because of our customer experience. So customers come to us and they have a really positive experience and part of that is having enough staff there to make it work and to keep it a positive place…And that's always tough that's the biggest part of our budget is sta ng." Pennsylvania Mobile Market Key Informant

Practices that May Address Common Challenges
Many practices employed by organizations may help to address some of the persistent challenges that organizations face. For example, organizations that are experimenting with different pricing models and scaling up other ventures may be offsetting nancial burdens and working toward sustainability. Table 2 lists additional linkages between innovative practices and common challenges that were reported.

Discussion
This paper summarizes the shared operational challenges among established mobile market organizations in the U.S. Past research also indicates that lower-income individuals may have limited awareness and reluctance to trust mobile markets (6, 8), and this aligns with our nding that organizations experience challenges with engaging communities and securing trust and "buy-in." Robinson et al. similarly cited the struggle among organizations to reconcile the desire to meet the needs of communities with the need to be strategic in where they choose to establish sites to ensure that they yield su cient sales or volume to be economically viable. Lack of infrastructure (e.g., storage, refrigeration) and the negative impact of climate and seasonality on produce procurement have also been previously reported (11).
Our ndings support past concerns surrounding how well organizations are reaching low-income populations (11). Robinson et al. described this nding within the context of mobile markets serving too low a number of customers to make a meaningful impact on food disparities or to be nancially sustainable (11); whereas the KIs in the present study described their limited reach in terms of subsets of the low-income population they may not be reaching (e.g., non-SNAP customers). Since the time of the KI interviews, our ongoing work with mobile market operators has revealed new challenges related to community reach as a result of the COVID-19 pandemic. Operators have described the need for online ordering systems that are integrated with POS software, and text-based ordering systems to enable organizations to serve those without internet or smartphones. Robinson et al. also reported an inability to expand mobile market operations due to a lack of capacity or competition with other mobile markets (11). Similarly, we found that many of the challenges reported here were hindrances to growing their operations despite demand from communities to expand.
This research raises the question of what nancial sustainability means within the context of mobile markets. For example, how does a mobile market organization reconcile their mission (e.g., improve food access through the sale of reduced cost produce) with entrepreneurship and good business practices? Our nding that market sales are unable to cover operating expenses, thus leading organizations to seek out external funding often through grant or foundation money, supports past research with mobile markets (2,10,11). Past research also highlights this con ict between a mobile market's mission and its economic viability and questions what sustainability looks like for a mobile market organization (10,11).
Many KIs interviewed in the present study desire nancial autonomy and feel the ideal nancial model would be that sales sustain the mobile market; unfortunately, the needed changes (e.g., raise prices, lower wages, reduce staff, purchase non-local produce, etc.) would undermine their mission. Several organizations accept that self-sustainability is not possible with a mobile market and have no qualms with depending on supplemental funding as long as they are ful lling their mission. However, some organizations continue to work toward becoming less reliant on supplemental funds, even if progress is incremental. One KI expressed that they have "a long way to go" to be truly nancially sustainable.
Several KIs raised the question of whether mobile markets are intended to be a long-term solution or if successful sites should be transitioned to a more permanent food retailer. One KI from a New York mobile market suggested volunteers or champions from the community could spearhead the establishment of a brick-and-mortar store or farmers' market, but they have not had success in empowering the community yet. Past research has indicated that merely improving the food retail environment in underserved communities (i.e., opening a grocery store) may not translate to improvements in healthy food purchasing and consumption (17). However, the community-engaged process of selecting host sites coupled with a mobile market's longstanding presence and success in a community may have a decidedly different outcome if transitioned to a permanent retailer. Furthermore, the introduction of a new mobile market generally leads to a positive effect on F&V consumption compared to no effect by introducing a larger supermarket (3). This research's limitations include that these challenges may not be wholly representative of all mobile market organizations given that we recruited more established organizations that serve predominantly urban regions. Therefore, there may be operational challenges that are unique to more nascent organizations that are not presented here. Also, the practices that are highlighted for their potential to address challenges may not be suitable or available to newer mobile markets. In addition, although CFIR is exible and intended to be used across all phases of evaluation, including formative evaluation and capacity/needs assessments, this research was not designed to assess an organization's capacity in relation to an innovation. Despite this, applying CFIR during data analysis provides meaningful information on potential barriers to implementation of an EBI. Furthermore, a systematic review of the use of CFIR found that the majority of studies that used CFIR applied the framework during-or postimplementation and the authors identi ed a need for the use of CFIR prior to innovation implementation to help inform implementation efforts (15).

Conclusions
Implications for Implementation of Evidence-Based Interventions at Mobile Markets When mobile markets are limited by barriers to implementation it undermines their potential public health impact and reach; this also has implications for the successful implementation of evidence-based models among mobile markets, including an EBI intended for mobile markets known as the Veggie Van (VV) model. The VV model has been shown to increase F&V intake (5); the model is currently being evaluated for its effectiveness through a Type 1 hybrid effectiveness-implementation study across ve states. Assuming that the VV model proves to be effective on a broader scale, the model holds great potential to be adopted by mobile markets across the U.S. to enhance their public health impact.
The practices presented here can potentially prevent or counter operational challenges; but great attention should also be paid toward an organization's points of weakness when considering implementing an EBI at a mobile market. Our ndings on the CFIR domains and constructs highlight the most salient factors to implementation at a mobile market. For example, sta ng and funding barriers (structural characteristics), limited resources (readiness for implementation), and low receptiveness to change (implementation climate) will likely remain persistent challenges upon introduction of an EBI and may undermine its effectiveness. Therefore, strategies are needed to help overcome these challenges in order to preserve the effectiveness of EBIs, including the VV model.
The ndings on CFIR constructs will guide the selection and inclusion of domains and constructs in the development of an interview guide for implementation interviews in the VV effectiveness study. This will ensure that the most relevant factors are explored and the selection of domains/constructs used in future data collection and analyses can be properly justi ed, which is lacking in the available research utilizing CFIR (15).

Implications for Future Research and Practice
Beyond the practices described here, organizations will bene t from additional strategies that help overcome barriers while maximizing the mobile market's effectiveness and longevity. Namely, assistance with nancial planning and achieving a point of nancial sustainability is a high priority among organizations. The majority of organizations interviewed do not have a formal business plan or the existing plan needs updating, highlighting the potential need for business advisement. Guidance on establishing more streamlined pricing systems and identifying the most viable sites can help organizations work toward nancial sustainability while maintaining affordability and adequate reach to target communities.
Many challenges that mobile market organizations face center on limited capacity, leading to constraints on necessary resources (e.g., sta ng, vehicle). Securing additional funding may help to increase capacity, but innovative strategies are needed to build capacity without the need for external funding. For example, establishing community ambassador programs can build sta ng capacity. Options that minimize vehicle expenses, such as leasing arrangements and permitting grant funds to be spent on vehicle maintenance, ought to be widely available and utilized.
Balancing an organization's mission with customer demand and regional availability of produce can be an intractable struggle that undermines an organization's ability to be sustainable. External funding may allow an organization to absorb more of the loss when selling produce at a reduced cost, but several practices (e.g., differential pricing, corporate events) aimed at self-subsidizing operations may reduce an organization's reliance on outside funding; however, it remains to be seen if these strategies are effective in the long-term. Sustainability analyses of different mobile market models may help elucidate how organizations can increase the likelihood of sustaining operations. In addition, the regional policy landscape should be explored to ensure that organizations interested in crop production to supply produce to their mobile market are unencumbered to do so. Solutions that make local produce more accessible and affordable to mobile markets, such as food hubs, may also help organizations uphold their mission while ensuring affordability.
Organizations may also need support in navigating policy related to food demonstrations, parking, and nutrition assistance and incentive programs. Food policy councils may serve as a resource for navigating and updating local policies to re ect the unique nature of mobile markets which are neither farmers' markets or food trucks.(18) Furthermore, we ought to advocate for expansion of healthy food incentive programs (e.g. SNAP matching) to novel retail options such as mobile markets and improvement of program delivery. The Healthy Incentives Program (HIP) serves as a unique case study of a well-received and streamlined SNAP matching program implemented in Massachusetts; one KI reported an unintended consequence of overutilization leading to long lines and selling out of produce at mobile markets. This highlights the immense potential of mobile markets coupled with a well-designed incentive program to enhance these programs' reach and utilization.
Future research should explore the factors that impact communities' awareness and willingness to utilize a mobile market. Organizations may need support to better reach those that are less aware or less willing to visit a mobile market. Furthermore, demonstrating the bene ts of advisory boards and providing organizations with guides and resources to facilitate their establishment may enhance market reach and engagement with communities. Lastly, supporting mobile market entrepreneurs (e.g., small business development loans) that identify with the communities served can enhance the representativeness of the organization and cultivate trust with communities.   Commercial kitchen (small food business incubator), food hub, and community supported "We have a shared commercial kitchen and food business incubator so that is basically a commercial kitchen facility that we've built to support new and agriculture (CSA) shares; expand food production (e.g. high value crops) and/or aggregation and distribute to restaurants and institutions.

List Of Abbreviations
existing small food businesses: so they pay by the hour to rent our space and run whatever business it is they run. Establishing prices based on the type of community site (e.g. lower-income versus mixed/higher income community) or the customer (e.g. SNAP-eligible versus SNAP ineligible).
"We set our retail price as close to double wholesale as possible and as reasonable...and so then full priced customers will pay retail and then anyone who received the [SNAP] match will pay essentially the wholesale cost...So that enables us to lose less money on our -using our match program.  Selected CFIR Domains and Constructs Identi ed