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WIC-Based Intervention to Promote Healthy Eating Among Low-Income Mothers

WIC-Based Intervention to Promote Healthy Eating Among Low-Income Mothers

Status
Completed
Phases
Unknown
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04038385
Enrollment
297
Registered
2019-07-30
Start date
2019-06-03
Completion date
2021-08-31
Last updated
2026-09-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Cancer Prevention, Diet Modification, Vegetable Intake

Brief summary

Whole grains, non-starchy vegetables, fruit, and beans are a consistent feature of diets associated with a lower risk of cancer and other diet-related diseases. For cancer risk reduction, the American Cancer Society recommendation is to consume at least 2.5 cups of a variety of fruits and vegetables daily. Other than dietary choices, weight control and physical activity levels are important modifiable determinants of cancer risk. This study finalized a novel, theory-driven farm-to-WIC intervention developed in preliminary work to promote vegetable intake among low-income adults served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). In New Jersey (the location of the study), WIC provides participants up to $30 in seasonal Farmers' Market Nutrition Program (FMNP) vouchers and monthly cash value vouchers or CVV (valued at $11 for adults and $8 for children at the time of the study) redeemable at farmers' markets. The program combined behaviorally focused nutrition education with the establishment of a WIC-based farmers' market (implemented in the summer of 2019 during the FMNP voucher issuance period). Content to address other modifiable determinants of cancer risk was added. To create additional opportunities for experiential and hands-on learning, monthly trips to an area farmers' market were held (between September 1, 2019 \[after the WIC-based market was discontinued\] and November 30, 2019 \[the end of the local growing season\]). The research employed an experimental design to initially test the intervention in 3 WIC agency sites (1 intervention and 2 control sites) with 297 urban, primarily Hispanic adults. Program effects on primary outcomes of vegetable intake (measured objectively using dermal carotenoids as a biomarker of intake and via self-report) and FMNP voucher redemption (objectively assessed using data provided by WIC) were examined at mid- and post-intervention (3 and 6 months post-baseline, respectively). Intervention effects on potential hypothesized mediators and the redemption of CVV at farmers' markets, participant satisfaction with the program, and the cost-effectiveness of the intervention also were examined.

Interventions

BEHAVIORALMultilevel Behavioral Intervention

Behaviorally-focused intervention grounded in the Social Ecological Model and Social Cognitive Theory to promote vegetable intake and the redemption of seasonal Farmers' Market Nutrition Program vouchers and monthly Cash Value Vouchers at farmers' markets.

Sponsors

William Paterson University of New Jersey
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Caregiver)

Eligibility

Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
Yes

Inclusion criteria

* English- or Spanish-speaking * Farmers' Market Nutrition Program (FMNP) voucher recipient or caregiver of a child FMNP voucher recipient * Not less than 3 months from expected delivery date (pregnant women) * Eligible to receive WIC benefits for 6 months after study entry

Exclusion criteria

● Restrictions of food intake (has food allergies or foods that cannot be eaten)

Design outcomes

Primary

MeasureTime frameDescription
Vegetable Intake Carotenoid Scores at 3 Months3 monthsVegetable intake was objectively assessed using a reflection spectroscopy device (the Veggie Meter) to measure the level of carotenoid pigments in participants' skin (scores can range from 0 to 800). Higher scores indicate a better outcomes (higher carotenoid levels).
Vegetable Intake Carotenoid Scores at 6 Months6 monthsVegetable intake was objectively assessed using a reflection spectroscopy device (the Veggie Meter) to measure the level of carotenoid pigments in participants' skin (scores can range from 0 to 800). Higher scores indicate a better outcomes (higher carotenoid levels).
Self-Reported Vegetable Intake at 3 Months3 monthsAssessed with one of two items in a screening instrument developed by the National Cancer Institute. Participants reported the number of cups of vegetables (including 100% vegetable juice) they ate or drank each day (range 0-7). Higher numbers represent a better outcome (higher cups/day of vegetables consumed).
Self-Reported Vegetable Intake at 6 Months6 monthsAssessed with one of two items in a screening instrument developed by the National Cancer Institute. Participants reported the number of cups of vegetables (including 100% vegetable juice) they ate or drank each day (range 0-7). Higher numbers represent a better outcome (higher cups/day of vegetables consumed).
Number of Participants Who Redeemed Any Farmers' Market Nutrition Program (FMNP) Vouchers at 6 Months6 monthsObjectively assessed using data provided by the collaborating WIC agency. WIC reported whether participants redeemed any FMNP vouchers (yes or no) from baseline to 6 months.

Secondary

MeasureTime frameDescription
Knowledge of Vegetable Intake Recommendations at 3 Months3 monthsAssessed via self-report with an item from the National Cancer Institute's Food, Attitudes, and Behaviors (FAB) survey. Based on their responses, participants were classified as knowledgeable of the recommended cups per day (yes or no).
Knowledge of Vegetable Intake Recommendations at 6 Months6 monthsAssessed via self-report with an item from the National Cancer Institute's Food, Attitudes, and Behaviors (FAB) survey. Based on their responses, participants were classified as knowledgeable of the recommended cups per day (yes or no).
Home Vegetable Availability (Quantity) at 3 Months3 monthsAssessed with items from the Healthy Home Survey. Participants reported the number of fresh, frozen, and canned vegetables they had at home. Responses were summed across items to derive a total score (range 0-23). Higher scores indicate a better outcome (a higher number of vegetables at home).
Home Vegetable Availability (Quantity) at 6 Months6 monthsAssessed with items from the Healthy Home Survey. Participants reported the number of fresh, frozen, and canned vegetables they had at home. Responses were summed across items to derive a total score (range 0-23). Higher scores indicate a better outcome (a higher number of vegetables at home).
Home Vegetable Availability (Variety) at 3 Months3 monthsAssessed with items from the Healthy Home Survey. Participants reported the number of fresh, frozen, and canned vegetables they had at home. The number of different (unique) vegetables reported was summed across items to derive a total score (range 0-21). Higher scores indicate a better outcome (a greater variety of vegetables at home).
Home Vegetable Availability (Variety) at 6 Months6 monthsAssessed with items from the Healthy Home Survey. Participants reported the number of fresh, frozen, and canned vegetables they had at home. The number of different (unique) vegetables reported was summed to derive a total score (range 0-21). Higher scores indicate a better outcome (a greater variety of vegetables at home).
Vegetable Taste Preferences at 3 Months3 monthsAssessed with a single item (the Preference Rating Measure) querying overall, how much the participant likes the taste of vegetables (on a 7-point scale ranging from not at all to a lot). Scores can range from 1 to 7. Higher scores represent a better outcome (stronger vegetable taste preferences).
Vegetable Taste Preferences at 6 Months6 monthsAssessed with a single item (the Preference Rating Measure) querying overall, how much the participant likes the taste of vegetables (on a 7-point scale ranging from not at all to a lot). Scores can range from 1 to 7. Higher scores represent a better outcome (stronger vegetable taste preferences).
Vegetable Preparation Practices at 3 Months3 monthsAssessed via items from the Eating Among Teens and Young Adults Study (EAT)-II Survey (Laska et al., 2011). Participants reported how often, in the past month, they 1) bought fresh vegetables, 2) prepared a vegetable salad, and 3) prepared a dinner with vegetables. Responses were on a 5-point scale ranging from never to more than once a week. Ratings were summed across items to derive a total score. Scores can range from 1 to 15. Higher scores represent a better outcome (frequent use of the practices).
Vegetable Preparation Practices at 6 Months6 monthsAssessed via items from the Eating Among Teens and Young Adults Study (EAT)-II Survey (Laska et al., 2011). Participants reported how often, in the past month, they 1) bought fresh vegetables, 2) prepared a vegetable salad, and 3) prepared a dinner with vegetables. Responses were on a 5-point scale ranging from never to more than once a week. Ratings were summed across items to derive a total score. Scores can range from 1 to 15. Higher scores represent a better outcome (frequent use of the practices).
Vegetable Preparation Skills at 3 Months3 monthsAssessed via a single item (the Preparation Skills Rating Measure) querying how the participant would rate his or her overall skill in preparing vegetables (on a 7-point scale ranging from poor to excellent). Scores can range from 1 to 7. Higher scores represent a better outcome (greater vegetable preparation skills).
Vegetable Preparation Skills at 6 Months6 monthsAssessed via a single item (the Preparation Skills Rating Measure) querying how the participant would rate his or her overall skill in preparing vegetables (on a 7-point scale ranging from poor to excellent). Scores can range from 1 to 7. Higher scores represent a better outcome (greater vegetable preparation skills).
Social Support for Vegetable Consumption at 3 Months3 monthsAssessed via a single item (the Social Support Rating Measure) querying how much others support the participant to consume vegetables (on a 7-point scale ranging from not at all to a lot). Scores can range from 1 to 7. Higher scores represent a better outcome (greater social support for vegetable consumption).
Social Support for Vegetable Consumption at 6 Months6 monthsAssessed via a single item (the Social Support Rating Measure) querying how much others support the participant to consume vegetables (on a 7-point scale ranging from not at all to a lot). Scores can range from 1 to 7. Higher scores represent a better outcome (greater social support for vegetable consumption).
Self-efficacy for Vegetable Consumption at 3 Months3 monthsAssessed with a validated measure used to evaluate the Stellar Farmers' Market program (Dannefer et al., 2015). Participants rated how much they agreed or disagreed with statements designed to measure confidence in the ability to prepare and consume fresh produce. Item ratings are on a 4-point scale ranging from strongly disagree (1) to strongly agree (4). Ratings were summed across items to derive a total score. Scores can range from 5 to 20. Higher scores represent a better outcome (greater self-efficacy for vegetable consumption).
Self-efficacy for Vegetable Consumption at 6 Months6 monthsAssessed with a validated measure used to evaluate the Stellar Farmers' Market program (Dannefer et al., 2015). Participants rated how much they agreed or disagreed with statements designed to measure confidence in the ability to prepare and consume fresh produce. Item ratings are on a 4-point scale ranging from strongly disagree (1) to strongly agree (4). Ratings were summed across items to derive a total score. Scores can range from 5 to 20. Higher scores represent a better outcome (greater self-efficacy for vegetable consumption).
Body Mass Index at 3 Months3 monthsHeight and weight were measured by trained research staff with participants wearing light clothing without shoes. Body mass index was calculated as weight in kilograms divided by height in square meters.
Body Mass Index at 6 Months6 monthsHeight and weight were measured by trained research staff with participants wearing light clothing without shoes. Body mass index was calculated as weight in kilograms divided by height in square meters.
Number of Participants Who Met Physical Activity Guidelines at 3 Months3 monthsAssessed with a validated 2-item measure (the Brief Physical Activity Assessment Tool or BPAAT \[Marshall et al., 2005\]). The instrument consists of two questions, one that assesses the frequency and duration of vigorous intensity physical activity and one that assesses the frequency and duration of moderate intensity physical activity undertaken in a usual week. A scoring algorithm is used to derive a total score (scores can range from 0 to 8). Participants are classified as meeting current physical activity guidelines (yes or no) based on the scores (a score greater than or equal to 4 indicates that the participant is meeting current physical activity guidelines, whereas a score between 0 and 3 indicates that the participant is not).
Number of Participants Who Met Physical Activity Guidelines at 6 Months6 monthsAssessed with a validated 2-item measure (the Brief Physical Activity Assessment Tool or BPAAT \[Marshall et al., 2005\]). The instrument consists of two questions, one that assesses the frequency and duration of vigorous intensity physical activity and one that assesses the frequency and duration of moderate intensity physical activity undertaken in a usual week. A scoring algorithm is used to derive a total score (scores can range from 0 to 8). Participants are classified as meeting current physical activity guidelines (yes/no) based on the scores (a score greater than or equal to 4 indicates that the participant is meeting current physical activity guidelines, whereas a score between 0 and 3 indicates that the participant is not).

Countries

United States

Contacts

PRINCIPAL_INVESTIGATORJennifer Di Noia, PhD

William Paterson University

Participant flow

Recruitment details

Recruitment occurred from June 3, 2019, to August 1, 2019. Participants were recruited via telephone (prior to forthcoming appointments with WIC) and in person at collaborating WIC agency sites.

Participants by arm

ArmCount
Intervention
This group will receive routine services provided by WIC and an intervention that will combine behaviorally-focused nutrition education with 1) the establishment of a WIC-based farmers' market (implemented in 2019 during the WIC Farmers' Market Nutrition Program voucher issuance period \[June 19 to August 19\]), and 2) monthly trips to an area farmers' market and local supermarket (between September 1, 2019 and November 30, 2019 \[the end of the local growing season\]). Multilevel Behavioral Intervention: Behaviorally-focused intervention grounded in the Social Ecological Model and Social Cognitive Theory to promote vegetable intake and the redemption of seasonal Farmers' Market Nutrition Program vouchers and monthly Cash Value Vouchers provided to WIC participants to purchase fruits and vegetables.
160
Control
This group will receive routine services provided by WIC only.
137
Total297

Baseline characteristics

CharacteristicControlInterventionTotal
Age, Continuous33.1 years
STANDARD_DEVIATION 6.9
30.5 years
STANDARD_DEVIATION 7.2
31.7 years
STANDARD_DEVIATION 7.2
Body Mass Index29.4 kg/m2
STANDARD_DEVIATION 6.8
29.5 kg/m2
STANDARD_DEVIATION 6.8
29.4 kg/m2
STANDARD_DEVIATION 6.8
Breastfeeding Status
Breastfeeding
44 Participants29 Participants73 Participants
Breastfeeding Status
Not breastfeeding
93 Participants131 Participants224 Participants
Car Access: Ease of Borrowing a Car (If Not Owned)
Difficult
18 Participants14 Participants32 Participants
Car Access: Ease of Borrowing a Car (If Not Owned)
Easy
10 Participants9 Participants19 Participants
Car Access: Ease of Borrowing a Car (If Not Owned)
Medium
7 Participants4 Participants11 Participants
Car Access: Ease of Borrowing a Car (If Not Owned)
Very difficult
14 Participants41 Participants55 Participants
Car Access: Ease of Borrowing a Car (If Not Owned)
Very Easy
3 Participants2 Participants5 Participants
Car Access: How Often Can Use Car (If Owned)
Always
47 Participants55 Participants102 Participants
Car Access: How Often Can Use Car (If Owned)
Never
6 Participants10 Participants16 Participants
Car Access: How Often Can Use Car (If Owned)
Often
14 Participants8 Participants22 Participants
Car Access: How Often Can Use Car (If Owned)
Rarely
6 Participants3 Participants9 Participants
Car Access: How Often Can Use Car (If Owned)
Sometimes
12 Participants14 Participants26 Participants
Car Ownership
Did not own a reliable car
52 Participants70 Participants122 Participants
Car Ownership
Owned a reliable car
85 Participants90 Participants175 Participants
Children in the Household Aged 2-5 Years
None
28 Participants28 Participants56 Participants
Children in the Household Aged 2-5 Years
One
97 Participants119 Participants216 Participants
Children in the Household Aged 2-5 Years
Two
12 Participants13 Participants25 Participants
Educational Attainment
High school diploma or equivalent
46 Participants57 Participants103 Participants
Educational Attainment
More than high school
55 Participants78 Participants133 Participants
Educational Attainment
Some high school or less
36 Participants25 Participants61 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
102 Participants115 Participants217 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
35 Participants45 Participants80 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Food Security Status
Food insecure
53 Participants65 Participants118 Participants
Food Security Status
Food secure
83 Participants91 Participants174 Participants
Food Security Status
Not reported
1 Participants4 Participants5 Participants
Language Preference (Foreign-Born)
English
22 Participants24 Participants46 Participants
Language Preference (Foreign-Born)
Other
3 Participants6 Participants9 Participants
Language Preference (Foreign-Born)
Spanish
76 Participants78 Participants154 Participants
Meeting Physical Activity Guidelines
No
64 Participants59 Participants123 Participants
Meeting Physical Activity Guidelines
Yes
73 Participants101 Participants174 Participants
Nativity
Foreign-born
101 Participants108 Participants209 Participants
Nativity
US-born
36 Participants52 Participants88 Participants
Past 7-Day Exposure to Secondhand Smoke
No
124 Participants127 Participants251 Participants
Past 7-Day Exposure to Secondhand Smoke
Not reported
2 Participants0 Participants2 Participants
Past 7-Day Exposure to Secondhand Smoke
Yes
11 Participants33 Participants44 Participants
Place of Birth (Foreign-Born)
Dominican Republic
12 Participants57 Participants69 Participants
Place of Birth (Foreign-Born)
Ecuador
25 Participants2 Participants27 Participants
Place of Birth (Foreign-Born)
Mexico
19 Participants7 Participants26 Participants
Place of Birth (Foreign-Born)
Other birthplace
45 Participants42 Participants87 Participants
Pregnancy Status
Not pregnant
113 Participants130 Participants243 Participants
Pregnancy Status
Pregnant
24 Participants30 Participants54 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants0 Participants1 Participants
Race (NIH/OMB)
Asian
6 Participants12 Participants18 Participants
Race (NIH/OMB)
Black or African American
16 Participants26 Participants42 Participants
Race (NIH/OMB)
More than one race
5 Participants4 Participants9 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants0 Participants1 Participants
Race (NIH/OMB)
Unknown or Not Reported
79 Participants111 Participants190 Participants
Race (NIH/OMB)
White
29 Participants7 Participants36 Participants
Region of Enrollment
United States
137 participants160 participants297 participants
Self-Reported Vegetable Intake1.52 Cups per day of vegetables consumed
STANDARD_DEVIATION 1.07
1.46 Cups per day of vegetables consumed
STANDARD_DEVIATION 1.07
1.49 Cups per day of vegetables consumed
STANDARD_DEVIATION 1.07
Sex: Female, Male
Female
137 Participants159 Participants296 Participants
Sex: Female, Male
Male
0 Participants1 Participants1 Participants
Smoking Status
Every day
4 Participants3 Participants7 Participants
Smoking Status
Not at all
127 Participants147 Participants274 Participants
Smoking Status
Not reported
4 Participants3 Participants7 Participants
Smoking Status
Some days
2 Participants7 Participants9 Participants
Social Desirability Trait3.22 units on a scale
STANDARD_DEVIATION 1.51
1.41 units on a scale
STANDARD_DEVIATION 1.75
2.25 units on a scale
STANDARD_DEVIATION 1.88
Supplement Use
Not taking supplements
61 Participants84 Participants145 Participants
Supplement Use
Taking supplements
76 Participants76 Participants152 Participants
Vegetable Intake Carotenoid Scores274.61 units on a scale
STANDARD_DEVIATION 105.5
265.17 units on a scale
STANDARD_DEVIATION 87.57
269.54 units on a scale
STANDARD_DEVIATION 96.24
Weight Status
Normal (BMI 18.5 to < 25)
26 Participants28 Participants54 Participants
Weight Status
Obese (BMI ≥ 30)
40 Participants53 Participants93 Participants
Weight Status
Overweight (BMI 25 to < 30)
44 Participants44 Participants88 Participants
Weight Status
Underweight (BMI < 18.5)
3 Participants4 Participants7 Participants
Years in U.S. (Foreign-Born)11.3 years
STANDARD_DEVIATION 7.3
10.4 years
STANDARD_DEVIATION 8
10.9 years
STANDARD_DEVIATION 7.6

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 1600 / 137
other
Total, other adverse events
0 / 1600 / 137
serious
Total, serious adverse events
0 / 1600 / 137

Outcome results

Primary

Number of Participants Who Redeemed Any Farmers' Market Nutrition Program (FMNP) Vouchers at 6 Months

Objectively assessed using data provided by the collaborating WIC agency. WIC reported whether participants redeemed any FMNP vouchers (yes or no) from baseline to 6 months.

Time frame: 6 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
InterventionNumber of Participants Who Redeemed Any Farmers' Market Nutrition Program (FMNP) Vouchers at 6 Months139 Participants
ControlNumber of Participants Who Redeemed Any Farmers' Market Nutrition Program (FMNP) Vouchers at 6 Months38 Participants
p-value: <0.0195% CI: [8.64, 35.02]Regression, Logistic
Primary

Self-Reported Vegetable Intake at 3 Months

Assessed with one of two items in a screening instrument developed by the National Cancer Institute. Participants reported the number of cups of vegetables (including 100% vegetable juice) they ate or drank each day (range 0-7). Higher numbers represent a better outcome (higher cups/day of vegetables consumed).

Time frame: 3 months

ArmMeasureValue (MEAN)Dispersion
InterventionSelf-Reported Vegetable Intake at 3 Months1.78 Cups per dayStandard Error 0.11
ControlSelf-Reported Vegetable Intake at 3 Months1.84 Cups per dayStandard Error 0.12
p-value: 0.66295% CI: [-0.33, 0.21]Mixed Models Analysis
Primary

Self-Reported Vegetable Intake at 6 Months

Assessed with one of two items in a screening instrument developed by the National Cancer Institute. Participants reported the number of cups of vegetables (including 100% vegetable juice) they ate or drank each day (range 0-7). Higher numbers represent a better outcome (higher cups/day of vegetables consumed).

Time frame: 6 months

ArmMeasureValue (MEAN)Dispersion
InterventionSelf-Reported Vegetable Intake at 6 Months1.83 Cups per dayStandard Error 0.11
ControlSelf-Reported Vegetable Intake at 6 Months1.55 Cups per dayStandard Error 0.12
p-value: 0.04795% CI: [0, 0.55]Mixed Models Analysis
Primary

Vegetable Intake Carotenoid Scores at 3 Months

Vegetable intake was objectively assessed using a reflection spectroscopy device (the Veggie Meter) to measure the level of carotenoid pigments in participants' skin (scores can range from 0 to 800). Higher scores indicate a better outcomes (higher carotenoid levels).

Time frame: 3 months

Population: For vegetable intake carotenoid scores, analysis sample sizes were 137 in the intervention group and 124 in the control group. In the intervention group, 13 of the original 160 participants competed the baseline assessment only, 4 moved out of the area, and 6 discontinued their study involvement. In the control group, 10 of the original 137 participants completed the baseline assessment only, 2 moved out of the area, and 1 discontinued their study involvement).

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
InterventionVegetable Intake Carotenoid Scores at 3 Months227.11 units on a scaleStandard Error 9.91
ControlVegetable Intake Carotenoid Scores at 3 Months269.98 units on a scaleStandard Error 10.06
p-value: 0.00195% CI: [-65.25, -20.49]Mixed Models Analysis
Primary

Vegetable Intake Carotenoid Scores at 6 Months

Vegetable intake was objectively assessed using a reflection spectroscopy device (the Veggie Meter) to measure the level of carotenoid pigments in participants' skin (scores can range from 0 to 800). Higher scores indicate a better outcomes (higher carotenoid levels).

Time frame: 6 months

Population: For vegetable intake carotenoid scores, sample sizes were 137 in the intervention group and 124 in the control group. In the intervention group, 13 of the original 160 participants competed the baseline assessment only, 4 moved out of the area, and 6 discontinued their study involvement. In the control group, 10 of the original 137 participants completed the baseline assessment only, 2 moved out of the area, and 1 discontinued their study involvement.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
InterventionVegetable Intake Carotenoid Scores at 6 Months236.01 units on a scaleStandard Error 9.77
ControlVegetable Intake Carotenoid Scores at 6 Months212.10 units on a scaleStandard Error 9.79
p-value: 0.03195% CI: [2.21, 45.62]Mixed Models Analysis
Secondary

Body Mass Index at 3 Months

Height and weight were measured by trained research staff with participants wearing light clothing without shoes. Body mass index was calculated as weight in kilograms divided by height in square meters.

Time frame: 3 months

Population: For weight status, sample sizes were 137 in the intervention group and 124 in the control group. In the intervention group, 13 of the original 160 participants competed the baseline assessment only, 4 moved out of the area, and 6 discontinued their study involvement. In the control group, 10 of the original 137 participants completed the baseline assessment only, 2 moved out of the area, and 1 discontinued their study involvement.

ArmMeasureValue (MEAN)Dispersion
InterventionBody Mass Index at 3 Months30.3 kg/m2Standard Error 0.4
ControlBody Mass Index at 3 Months29.4 kg/m2Standard Error 0.4
p-value: 0.05395% CI: [0, 1.8]Mixed Models Analysis
Secondary

Body Mass Index at 6 Months

Height and weight were measured by trained research staff with participants wearing light clothing without shoes. Body mass index was calculated as weight in kilograms divided by height in square meters.

Time frame: 6 months

Population: For weight status, sample sizes were 137 in the intervention group and 124 in the control group. In the intervention group, 13 of the original 160 participants competed the baseline assessment only, 4 moved out of the area, and 6 discontinued their study involvement. In the control group, 10 of the original 137 participants completed the baseline assessment only, 2 moved out of the area, and 1 discontinued their study involvement.

ArmMeasureValue (MEAN)Dispersion
InterventionBody Mass Index at 6 Months29.9 kg/m2Standard Error 0.4
ControlBody Mass Index at 6 Months29.9 kg/m2Standard Error 0.4
p-value: 0.98695% CI: [-0.9, 0.9]Mixed Models Analysis
Secondary

Home Vegetable Availability (Quantity) at 3 Months

Assessed with items from the Healthy Home Survey. Participants reported the number of fresh, frozen, and canned vegetables they had at home. Responses were summed across items to derive a total score (range 0-23). Higher scores indicate a better outcome (a higher number of vegetables at home).

Time frame: 3 months

ArmMeasureValue (MEAN)Dispersion
InterventionHome Vegetable Availability (Quantity) at 3 Months5.3 Number of vegetables at homeStandard Error 0.3
ControlHome Vegetable Availability (Quantity) at 3 Months7.1 Number of vegetables at homeStandard Error 0.3
p-value: 0.00195% CI: [-2.5, -1]Mixed Models Analysis
Secondary

Home Vegetable Availability (Quantity) at 6 Months

Assessed with items from the Healthy Home Survey. Participants reported the number of fresh, frozen, and canned vegetables they had at home. Responses were summed across items to derive a total score (range 0-23). Higher scores indicate a better outcome (a higher number of vegetables at home).

Time frame: 6 months

ArmMeasureValue (MEAN)Dispersion
InterventionHome Vegetable Availability (Quantity) at 6 Months5.6 Number of vegetables at homeStandard Error 0.3
ControlHome Vegetable Availability (Quantity) at 6 Months6.3 Number of vegetables at homeStandard Error 0.3
p-value: 0.08295% CI: [-1.4, 0.1]Mixed Models Analysis
Secondary

Home Vegetable Availability (Variety) at 3 Months

Assessed with items from the Healthy Home Survey. Participants reported the number of fresh, frozen, and canned vegetables they had at home. The number of different (unique) vegetables reported was summed across items to derive a total score (range 0-21). Higher scores indicate a better outcome (a greater variety of vegetables at home).

Time frame: 3 months

ArmMeasureValue (MEAN)Dispersion
InterventionHome Vegetable Availability (Variety) at 3 Months5.0 Number of different vegetables at homeStandard Error 0.3
ControlHome Vegetable Availability (Variety) at 3 Months6.5 Number of different vegetables at homeStandard Error 0.3
p-value: 0.00195% CI: [-2.2, -0.8]Mixed Models Analysis
Secondary

Home Vegetable Availability (Variety) at 6 Months

Assessed with items from the Healthy Home Survey. Participants reported the number of fresh, frozen, and canned vegetables they had at home. The number of different (unique) vegetables reported was summed to derive a total score (range 0-21). Higher scores indicate a better outcome (a greater variety of vegetables at home).

Time frame: 6 months

ArmMeasureValue (MEAN)Dispersion
InterventionHome Vegetable Availability (Variety) at 6 Months5.2 Number of different vegetables at homeStandard Error 0.3
ControlHome Vegetable Availability (Variety) at 6 Months5.9 Number of different vegetables at homeStandard Error 0.3
p-value: 0.03995% CI: [-1.4, 0]Mixed Models Analysis
Secondary

Knowledge of Vegetable Intake Recommendations at 3 Months

Assessed via self-report with an item from the National Cancer Institute's Food, Attitudes, and Behaviors (FAB) survey. Based on their responses, participants were classified as knowledgeable of the recommended cups per day (yes or no).

Time frame: 3 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
InterventionKnowledge of Vegetable Intake Recommendations at 3 Months10 Participants
ControlKnowledge of Vegetable Intake Recommendations at 3 Months4 Participants
p-value: 0.05695% CI: [1, 16.1]Mixed Models Analysis
Secondary

Knowledge of Vegetable Intake Recommendations at 6 Months

Assessed via self-report with an item from the National Cancer Institute's Food, Attitudes, and Behaviors (FAB) survey. Based on their responses, participants were classified as knowledgeable of the recommended cups per day (yes or no).

Time frame: 6 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
InterventionKnowledge of Vegetable Intake Recommendations at 6 Months10 Participants
ControlKnowledge of Vegetable Intake Recommendations at 6 Months4 Participants
p-value: 0.0595% CI: [1, 16.3]Mixed Models Analysis
Secondary

Number of Participants Who Met Physical Activity Guidelines at 3 Months

Assessed with a validated 2-item measure (the Brief Physical Activity Assessment Tool or BPAAT \[Marshall et al., 2005\]). The instrument consists of two questions, one that assesses the frequency and duration of vigorous intensity physical activity and one that assesses the frequency and duration of moderate intensity physical activity undertaken in a usual week. A scoring algorithm is used to derive a total score (scores can range from 0 to 8). Participants are classified as meeting current physical activity guidelines (yes or no) based on the scores (a score greater than or equal to 4 indicates that the participant is meeting current physical activity guidelines, whereas a score between 0 and 3 indicates that the participant is not).

Time frame: 3 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
InterventionNumber of Participants Who Met Physical Activity Guidelines at 3 Months94 Participants
ControlNumber of Participants Who Met Physical Activity Guidelines at 3 Months83 Participants
p-value: 0.8195% CI: [0.6, 2.2]Mixed Models Analysis
Secondary

Number of Participants Who Met Physical Activity Guidelines at 6 Months

Assessed with a validated 2-item measure (the Brief Physical Activity Assessment Tool or BPAAT \[Marshall et al., 2005\]). The instrument consists of two questions, one that assesses the frequency and duration of vigorous intensity physical activity and one that assesses the frequency and duration of moderate intensity physical activity undertaken in a usual week. A scoring algorithm is used to derive a total score (scores can range from 0 to 8). Participants are classified as meeting current physical activity guidelines (yes/no) based on the scores (a score greater than or equal to 4 indicates that the participant is meeting current physical activity guidelines, whereas a score between 0 and 3 indicates that the participant is not).

Time frame: 6 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
InterventionNumber of Participants Who Met Physical Activity Guidelines at 6 Months97 Participants
ControlNumber of Participants Who Met Physical Activity Guidelines at 6 Months91 Participants
p-value: 0.59195% CI: [0.4, 1.7]Mixed Models Analysis
Secondary

Self-efficacy for Vegetable Consumption at 3 Months

Assessed with a validated measure used to evaluate the Stellar Farmers' Market program (Dannefer et al., 2015). Participants rated how much they agreed or disagreed with statements designed to measure confidence in the ability to prepare and consume fresh produce. Item ratings are on a 4-point scale ranging from strongly disagree (1) to strongly agree (4). Ratings were summed across items to derive a total score. Scores can range from 5 to 20. Higher scores represent a better outcome (greater self-efficacy for vegetable consumption).

Time frame: 3 months

ArmMeasureValue (MEAN)Dispersion
InterventionSelf-efficacy for Vegetable Consumption at 3 Months15.4 units on a scaleStandard Error 0.2
ControlSelf-efficacy for Vegetable Consumption at 3 Months15.3 units on a scaleStandard Error 0.2
p-value: 0.7595% CI: [-0.4, 0.6]Mixed Models Analysis
Secondary

Self-efficacy for Vegetable Consumption at 6 Months

Assessed with a validated measure used to evaluate the Stellar Farmers' Market program (Dannefer et al., 2015). Participants rated how much they agreed or disagreed with statements designed to measure confidence in the ability to prepare and consume fresh produce. Item ratings are on a 4-point scale ranging from strongly disagree (1) to strongly agree (4). Ratings were summed across items to derive a total score. Scores can range from 5 to 20. Higher scores represent a better outcome (greater self-efficacy for vegetable consumption).

Time frame: 6 months

ArmMeasureValue (MEAN)Dispersion
InterventionSelf-efficacy for Vegetable Consumption at 6 Months15.8 units on a scaleStandard Error 0.2
ControlSelf-efficacy for Vegetable Consumption at 6 Months16.0 units on a scaleStandard Error 0.2
p-value: 0.45595% CI: [-0.7, 0.3]Mixed Models Analysis
Secondary

Social Support for Vegetable Consumption at 3 Months

Assessed via a single item (the Social Support Rating Measure) querying how much others support the participant to consume vegetables (on a 7-point scale ranging from not at all to a lot). Scores can range from 1 to 7. Higher scores represent a better outcome (greater social support for vegetable consumption).

Time frame: 3 months

ArmMeasureValue (MEAN)Dispersion
InterventionSocial Support for Vegetable Consumption at 3 Months5.9 units on a scaleStandard Error 0.2
ControlSocial Support for Vegetable Consumption at 3 Months5.8 units on a scaleStandard Error 0.2
p-value: 0.51495% CI: [-0.3, 0.5]Mixed Models Analysis
Secondary

Social Support for Vegetable Consumption at 6 Months

Assessed via a single item (the Social Support Rating Measure) querying how much others support the participant to consume vegetables (on a 7-point scale ranging from not at all to a lot). Scores can range from 1 to 7. Higher scores represent a better outcome (greater social support for vegetable consumption).

Time frame: 6 months

ArmMeasureValue (MEAN)Dispersion
InterventionSocial Support for Vegetable Consumption at 6 Months6.0 units on a scaleStandard Error 0.2
ControlSocial Support for Vegetable Consumption at 6 Months5.9 units on a scaleStandard Error 0.2
p-value: 0.33595% CI: [-0.2, 0.6]Mixed Models Analysis
Secondary

Vegetable Preparation Practices at 3 Months

Assessed via items from the Eating Among Teens and Young Adults Study (EAT)-II Survey (Laska et al., 2011). Participants reported how often, in the past month, they 1) bought fresh vegetables, 2) prepared a vegetable salad, and 3) prepared a dinner with vegetables. Responses were on a 5-point scale ranging from never to more than once a week. Ratings were summed across items to derive a total score. Scores can range from 1 to 15. Higher scores represent a better outcome (frequent use of the practices).

Time frame: 3 months

ArmMeasureValue (MEAN)Dispersion
InterventionVegetable Preparation Practices at 3 Months12.6 units on a scaleStandard Error 0.2
ControlVegetable Preparation Practices at 3 Months13.0 units on a scaleStandard Error 0.2
p-value: 0.15595% CI: [-1, 0.2]Mixed Models Analysis
Secondary

Vegetable Preparation Practices at 6 Months

Assessed via items from the Eating Among Teens and Young Adults Study (EAT)-II Survey (Laska et al., 2011). Participants reported how often, in the past month, they 1) bought fresh vegetables, 2) prepared a vegetable salad, and 3) prepared a dinner with vegetables. Responses were on a 5-point scale ranging from never to more than once a week. Ratings were summed across items to derive a total score. Scores can range from 1 to 15. Higher scores represent a better outcome (frequent use of the practices).

Time frame: 6 months

ArmMeasureValue (MEAN)Dispersion
InterventionVegetable Preparation Practices at 6 Months12.5 units on a scaleStandard Error 0.2
ControlVegetable Preparation Practices at 6 Months12.4 units on a scaleStandard Error 0.2
p-value: 0.7495% CI: [-0.5, 0.7]Mixed Models Analysis
Secondary

Vegetable Preparation Skills at 3 Months

Assessed via a single item (the Preparation Skills Rating Measure) querying how the participant would rate his or her overall skill in preparing vegetables (on a 7-point scale ranging from poor to excellent). Scores can range from 1 to 7. Higher scores represent a better outcome (greater vegetable preparation skills).

Time frame: 3 months

ArmMeasureValue (MEAN)Dispersion
InterventionVegetable Preparation Skills at 3 Months5.7 units on a scaleStandard Error 0.1
ControlVegetable Preparation Skills at 3 Months6.0 units on a scaleStandard Error 0.1
p-value: 0.12295% CI: [-0.5, 0.1]Mixed Models Analysis
Secondary

Vegetable Preparation Skills at 6 Months

Assessed via a single item (the Preparation Skills Rating Measure) querying how the participant would rate his or her overall skill in preparing vegetables (on a 7-point scale ranging from poor to excellent). Scores can range from 1 to 7. Higher scores represent a better outcome (greater vegetable preparation skills).

Time frame: 6 months

ArmMeasureValue (MEAN)Dispersion
InterventionVegetable Preparation Skills at 6 Months5.6 units on a scaleStandard Error 0.1
ControlVegetable Preparation Skills at 6 Months5.8 units on a scaleStandard Error 0.1
p-value: 0.17795% CI: [-0.5, 0.1]Mixed Models Analysis
Secondary

Vegetable Taste Preferences at 3 Months

Assessed with a single item (the Preference Rating Measure) querying overall, how much the participant likes the taste of vegetables (on a 7-point scale ranging from not at all to a lot). Scores can range from 1 to 7. Higher scores represent a better outcome (stronger vegetable taste preferences).

Time frame: 3 months

ArmMeasureValue (MEAN)Dispersion
InterventionVegetable Taste Preferences at 3 Months6.3 score on a 7-point scaleStandard Error 0.1
ControlVegetable Taste Preferences at 3 Months6.3 score on a 7-point scaleStandard Error 0.1
p-value: 0.96295% CI: [-0.3, 0.3]Mixed Models Analysis
Secondary

Vegetable Taste Preferences at 6 Months

Assessed with a single item (the Preference Rating Measure) querying overall, how much the participant likes the taste of vegetables (on a 7-point scale ranging from not at all to a lot). Scores can range from 1 to 7. Higher scores represent a better outcome (stronger vegetable taste preferences).

Time frame: 6 months

ArmMeasureValue (MEAN)Dispersion
InterventionVegetable Taste Preferences at 6 Months6.3 score on a 7-point scaleStandard Error 0.1
ControlVegetable Taste Preferences at 6 Months6.5 score on a 7-point scaleStandard Error 0.1
p-value: 0.27795% CI: [-0.4, 0.1]Mixed Models Analysis
Other Pre-specified

Number of Participants Who Redeemed Any Cash Value Vouchers or CVV at Farmers' Markets at 6 Months

Objectively assessed using data provided by the collaborating WIC agency. WIC reported whether participants redeemed any cash value vouchers at farmers' markets (yes or no) between baseline and 6 months.

Time frame: 6 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
InterventionNumber of Participants Who Redeemed Any Cash Value Vouchers or CVV at Farmers' Markets at 6 Months12 Participants
ControlNumber of Participants Who Redeemed Any Cash Value Vouchers or CVV at Farmers' Markets at 6 Months0 Participants
Other Pre-specified

Overall Satisfaction With Intervention

Assessed via a single item (the Overall Satisfaction Rating Measure) querying how satisfied intervention recipients were with the intervention (on a 7-point scale ranging from very dissatisfied to very satisfied). Scores can range from 1 to 7. Higher scores represent a better outcome (greater overall satisfaction).

Time frame: 6 months

Population: Satisfaction was measured among the subgroup of participants who received the intervention (n = 160). Of this number, 128 completed the measure of overall satisfaction with program.

ArmMeasureValue (MEAN)Dispersion
InterventionOverall Satisfaction With Intervention6.8 units on a scaleStandard Deviation 0.6
Other Pre-specified

Satisfaction With Intervention

Assessed with a 5-item measure developed by the investigators querying how satisfied intervention recipients were with the intervention. Item responses were on a 7-point scale ranging from strongly disagree to strongly agree. Scores were averaged across items to derive a total score. Scores can range from 1 to7. Higher scores represent a better outcome (greater satisfaction with the intervention).

Time frame: 6 months

Population: Satisfaction was measured among the subgroup of participants who received the intervention (n = 160). Of this number, 128 completed the satisfaction measure.

ArmMeasureValue (MEAN)Dispersion
InterventionSatisfaction With Intervention6.8 units on a scaleStandard Deviation 0.5

Source: ClinicalTrials.gov · Data processed: Sep 11, 2026