Justin S White1,2, Gabriel Vasconcelos3, Matthew Harding3, Mandy M Carroll4, Christopher D Gardner4, Sanjay Basu5,6, Hilary K Seligman1,7,8. 1. Philip R. Lee Institute for Health Policy Studies, 8785University of California San Francisco, CA, USA. 2. Department of Epidemiology and Biostatistics, 8788University of California San Francisco, CA, USA. 3. Department of Economics, 8788University of California, Irvine, CA, USA. 4. Stanford Prevention Research Center, 10624Stanford University School of Medicine, CA, USA. 5. Collective Health, San Francisco, MA, USA. 6. Center for Primary Care, 1811Harvard Medical School, MA, USA. 7. Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, CA, USA. 8. Division of General Internal Medicine, Department of Medicine, 8785University of California San Francisco, CA, USA.
Abstract
PURPOSE: To determine whether baseline fruit and vegetable (FV) intake or other predictors are associated with response to food vouchers (change in FV intake) among low-income adults. DESIGN: Secondary analysis of a randomized, 2 x 2-factorial, community-based trial. SETTING: San Francisco, California. SUBJECTS: 359 low-income adults aged ≥21 years old. INTERVENTION: Participants were mailed $20 of food vouchers monthly for 6 months, and randomized to 1 of 4 arms according to: eligible foods (FV only or any foods) and redemption schedule (weekly or monthly). MEASURES: Change in FV intake measured in cup equivalents between baseline and month 6 of the trial, based on 24-hour dietary recalls. ANALYSIS: Quantile multivariate regressions were employed to measure associations between key predictors and change in FV intake across study arms. RESULTS: FV-only weekly vouchers were associated with increased FV intake at the 25th percentile (0.24 cups/day, p = 0.048) and 50th percentile (0.37 cups/day, p = 0.02) of the distribution, but not at lower and higher quantiles. Response to the vouchers diminished 0.10 cups/day for each additional household member (p = 0.02). CONCLUSION: Response to food vouchers varied along the FV intake distribution, pointing to some more responsive groups and others potentially needing additional support to increase FV intake. Larger households likely need vouchers of higher dollar value to result in similar changes in dietary intake as that observed in smaller households.
PURPOSE: To determine whether baseline fruit and vegetable (FV) intake or other predictors are associated with response to food vouchers (change in FV intake) among low-income adults. DESIGN: Secondary analysis of a randomized, 2 x 2-factorial, community-based trial. SETTING: San Francisco, California. SUBJECTS: 359 low-income adults aged ≥21 years old. INTERVENTION: Participants were mailed $20 of food vouchers monthly for 6 months, and randomized to 1 of 4 arms according to: eligible foods (FV only or any foods) and redemption schedule (weekly or monthly). MEASURES: Change in FV intake measured in cup equivalents between baseline and month 6 of the trial, based on 24-hour dietary recalls. ANALYSIS: Quantile multivariate regressions were employed to measure associations between key predictors and change in FV intake across study arms. RESULTS: FV-only weekly vouchers were associated with increased FV intake at the 25th percentile (0.24 cups/day, p = 0.048) and 50th percentile (0.37 cups/day, p = 0.02) of the distribution, but not at lower and higher quantiles. Response to the vouchers diminished 0.10 cups/day for each additional household member (p = 0.02). CONCLUSION: Response to food vouchers varied along the FV intake distribution, pointing to some more responsive groups and others potentially needing additional support to increase FV intake. Larger households likely need vouchers of higher dollar value to result in similar changes in dietary intake as that observed in smaller households.
Entities:
Keywords:
food vouchers; fruit and vegetable intake; nutrition intervention; quantile regression
Authors: Sanjay Basu; Christopher D Gardner; Justin S White; Joseph Rigdon; Mandy M Carroll; Melissa Akers; Hilary K Seligman Journal: Health Aff (Millwood) Date: 2019-04 Impact factor: 6.301
Authors: Lisa Harnack; J Michael Oakes; Brian Elbel; Timothy Beatty; Sarah Rydell; Simone French Journal: JAMA Intern Med Date: 2016-11-01 Impact factor: 21.873