Cancer Prevention, Diet Modification, Vegetable Intake
Conditions
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
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
Study design
Eligibility
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
| Measure | Time frame | Description |
|---|---|---|
| Vegetable Intake Carotenoid Scores at 3 Months | 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). |
| Vegetable Intake Carotenoid Scores at 6 Months | 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). |
| Self-Reported Vegetable Intake at 3 Months | 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). |
| Self-Reported Vegetable Intake at 6 Months | 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). |
| Number of Participants Who Redeemed Any Farmers' Market Nutrition Program (FMNP) Vouchers at 6 Months | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Knowledge of Vegetable Intake Recommendations at 3 Months | 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). |
| Knowledge of Vegetable Intake Recommendations at 6 Months | 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). |
| Home Vegetable Availability (Quantity) at 3 Months | 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). |
| Home Vegetable Availability (Quantity) at 6 Months | 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). |
| Home Vegetable Availability (Variety) at 3 Months | 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). |
| Home Vegetable Availability (Variety) at 6 Months | 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). |
| Vegetable Taste Preferences at 3 Months | 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). |
| Vegetable Taste Preferences at 6 Months | 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). |
| Vegetable Preparation Practices at 3 Months | 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). |
| Vegetable Preparation Practices at 6 Months | 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). |
| Vegetable Preparation Skills at 3 Months | 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). |
| Vegetable Preparation Skills at 6 Months | 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). |
| Social Support for Vegetable Consumption at 3 Months | 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). |
| Social Support for Vegetable Consumption at 6 Months | 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). |
| Self-efficacy for Vegetable Consumption at 3 Months | 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). |
| Self-efficacy for Vegetable Consumption at 6 Months | 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). |
| Body Mass Index at 3 Months | 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. |
| Body Mass Index at 6 Months | 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. |
| Number of Participants Who Met Physical Activity Guidelines at 3 Months | 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). |
| Number of Participants Who Met Physical Activity Guidelines at 6 Months | 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). |
Countries
United States
Contacts
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
| Arm | Count |
|---|---|
| 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 |
| Total | 297 |
Baseline characteristics
| Characteristic | Control | Intervention | Total |
|---|---|---|---|
| Age, Continuous | 33.1 years STANDARD_DEVIATION 6.9 | 30.5 years STANDARD_DEVIATION 7.2 | 31.7 years STANDARD_DEVIATION 7.2 |
| Body Mass Index | 29.4 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 Participants | 29 Participants | 73 Participants |
| Breastfeeding Status Not breastfeeding | 93 Participants | 131 Participants | 224 Participants |
| Car Access: Ease of Borrowing a Car (If Not Owned) Difficult | 18 Participants | 14 Participants | 32 Participants |
| Car Access: Ease of Borrowing a Car (If Not Owned) Easy | 10 Participants | 9 Participants | 19 Participants |
| Car Access: Ease of Borrowing a Car (If Not Owned) Medium | 7 Participants | 4 Participants | 11 Participants |
| Car Access: Ease of Borrowing a Car (If Not Owned) Very difficult | 14 Participants | 41 Participants | 55 Participants |
| Car Access: Ease of Borrowing a Car (If Not Owned) Very Easy | 3 Participants | 2 Participants | 5 Participants |
| Car Access: How Often Can Use Car (If Owned) Always | 47 Participants | 55 Participants | 102 Participants |
| Car Access: How Often Can Use Car (If Owned) Never | 6 Participants | 10 Participants | 16 Participants |
| Car Access: How Often Can Use Car (If Owned) Often | 14 Participants | 8 Participants | 22 Participants |
| Car Access: How Often Can Use Car (If Owned) Rarely | 6 Participants | 3 Participants | 9 Participants |
| Car Access: How Often Can Use Car (If Owned) Sometimes | 12 Participants | 14 Participants | 26 Participants |
| Car Ownership Did not own a reliable car | 52 Participants | 70 Participants | 122 Participants |
| Car Ownership Owned a reliable car | 85 Participants | 90 Participants | 175 Participants |
| Children in the Household Aged 2-5 Years None | 28 Participants | 28 Participants | 56 Participants |
| Children in the Household Aged 2-5 Years One | 97 Participants | 119 Participants | 216 Participants |
| Children in the Household Aged 2-5 Years Two | 12 Participants | 13 Participants | 25 Participants |
| Educational Attainment High school diploma or equivalent | 46 Participants | 57 Participants | 103 Participants |
| Educational Attainment More than high school | 55 Participants | 78 Participants | 133 Participants |
| Educational Attainment Some high school or less | 36 Participants | 25 Participants | 61 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 102 Participants | 115 Participants | 217 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 35 Participants | 45 Participants | 80 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Food Security Status Food insecure | 53 Participants | 65 Participants | 118 Participants |
| Food Security Status Food secure | 83 Participants | 91 Participants | 174 Participants |
| Food Security Status Not reported | 1 Participants | 4 Participants | 5 Participants |
| Language Preference (Foreign-Born) English | 22 Participants | 24 Participants | 46 Participants |
| Language Preference (Foreign-Born) Other | 3 Participants | 6 Participants | 9 Participants |
| Language Preference (Foreign-Born) Spanish | 76 Participants | 78 Participants | 154 Participants |
| Meeting Physical Activity Guidelines No | 64 Participants | 59 Participants | 123 Participants |
| Meeting Physical Activity Guidelines Yes | 73 Participants | 101 Participants | 174 Participants |
| Nativity Foreign-born | 101 Participants | 108 Participants | 209 Participants |
| Nativity US-born | 36 Participants | 52 Participants | 88 Participants |
| Past 7-Day Exposure to Secondhand Smoke No | 124 Participants | 127 Participants | 251 Participants |
| Past 7-Day Exposure to Secondhand Smoke Not reported | 2 Participants | 0 Participants | 2 Participants |
| Past 7-Day Exposure to Secondhand Smoke Yes | 11 Participants | 33 Participants | 44 Participants |
| Place of Birth (Foreign-Born) Dominican Republic | 12 Participants | 57 Participants | 69 Participants |
| Place of Birth (Foreign-Born) Ecuador | 25 Participants | 2 Participants | 27 Participants |
| Place of Birth (Foreign-Born) Mexico | 19 Participants | 7 Participants | 26 Participants |
| Place of Birth (Foreign-Born) Other birthplace | 45 Participants | 42 Participants | 87 Participants |
| Pregnancy Status Not pregnant | 113 Participants | 130 Participants | 243 Participants |
| Pregnancy Status Pregnant | 24 Participants | 30 Participants | 54 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Asian | 6 Participants | 12 Participants | 18 Participants |
| Race (NIH/OMB) Black or African American | 16 Participants | 26 Participants | 42 Participants |
| Race (NIH/OMB) More than one race | 5 Participants | 4 Participants | 9 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 79 Participants | 111 Participants | 190 Participants |
| Race (NIH/OMB) White | 29 Participants | 7 Participants | 36 Participants |
| Region of Enrollment United States | 137 participants | 160 participants | 297 participants |
| Self-Reported Vegetable Intake | 1.52 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 Participants | 159 Participants | 296 Participants |
| Sex: Female, Male Male | 0 Participants | 1 Participants | 1 Participants |
| Smoking Status Every day | 4 Participants | 3 Participants | 7 Participants |
| Smoking Status Not at all | 127 Participants | 147 Participants | 274 Participants |
| Smoking Status Not reported | 4 Participants | 3 Participants | 7 Participants |
| Smoking Status Some days | 2 Participants | 7 Participants | 9 Participants |
| Social Desirability Trait | 3.22 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 Participants | 84 Participants | 145 Participants |
| Supplement Use Taking supplements | 76 Participants | 76 Participants | 152 Participants |
| Vegetable Intake Carotenoid Scores | 274.61 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 Participants | 28 Participants | 54 Participants |
| Weight Status Obese (BMI ≥ 30) | 40 Participants | 53 Participants | 93 Participants |
| Weight Status Overweight (BMI 25 to < 30) | 44 Participants | 44 Participants | 88 Participants |
| Weight Status Underweight (BMI < 18.5) | 3 Participants | 4 Participants | 7 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 type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 160 | 0 / 137 |
| other Total, other adverse events | 0 / 160 | 0 / 137 |
| serious Total, serious adverse events | 0 / 160 | 0 / 137 |
Outcome results
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
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Intervention | Number of Participants Who Redeemed Any Farmers' Market Nutrition Program (FMNP) Vouchers at 6 Months | 139 Participants |
| Control | Number of Participants Who Redeemed Any Farmers' Market Nutrition Program (FMNP) Vouchers at 6 Months | 38 Participants |
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
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Self-Reported Vegetable Intake at 3 Months | 1.78 Cups per day | Standard Error 0.11 |
| Control | Self-Reported Vegetable Intake at 3 Months | 1.84 Cups per day | Standard Error 0.12 |
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
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Self-Reported Vegetable Intake at 6 Months | 1.83 Cups per day | Standard Error 0.11 |
| Control | Self-Reported Vegetable Intake at 6 Months | 1.55 Cups per day | Standard Error 0.12 |
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).
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Vegetable Intake Carotenoid Scores at 3 Months | 227.11 units on a scale | Standard Error 9.91 |
| Control | Vegetable Intake Carotenoid Scores at 3 Months | 269.98 units on a scale | Standard Error 10.06 |
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.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Vegetable Intake Carotenoid Scores at 6 Months | 236.01 units on a scale | Standard Error 9.77 |
| Control | Vegetable Intake Carotenoid Scores at 6 Months | 212.10 units on a scale | Standard Error 9.79 |
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.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Body Mass Index at 3 Months | 30.3 kg/m2 | Standard Error 0.4 |
| Control | Body Mass Index at 3 Months | 29.4 kg/m2 | Standard Error 0.4 |
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.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Body Mass Index at 6 Months | 29.9 kg/m2 | Standard Error 0.4 |
| Control | Body Mass Index at 6 Months | 29.9 kg/m2 | Standard Error 0.4 |
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
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Home Vegetable Availability (Quantity) at 3 Months | 5.3 Number of vegetables at home | Standard Error 0.3 |
| Control | Home Vegetable Availability (Quantity) at 3 Months | 7.1 Number of vegetables at home | Standard Error 0.3 |
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
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Home Vegetable Availability (Quantity) at 6 Months | 5.6 Number of vegetables at home | Standard Error 0.3 |
| Control | Home Vegetable Availability (Quantity) at 6 Months | 6.3 Number of vegetables at home | Standard Error 0.3 |
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
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Home Vegetable Availability (Variety) at 3 Months | 5.0 Number of different vegetables at home | Standard Error 0.3 |
| Control | Home Vegetable Availability (Variety) at 3 Months | 6.5 Number of different vegetables at home | Standard Error 0.3 |
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
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Home Vegetable Availability (Variety) at 6 Months | 5.2 Number of different vegetables at home | Standard Error 0.3 |
| Control | Home Vegetable Availability (Variety) at 6 Months | 5.9 Number of different vegetables at home | Standard Error 0.3 |
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
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Intervention | Knowledge of Vegetable Intake Recommendations at 3 Months | 10 Participants |
| Control | Knowledge of Vegetable Intake Recommendations at 3 Months | 4 Participants |
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
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Intervention | Knowledge of Vegetable Intake Recommendations at 6 Months | 10 Participants |
| Control | Knowledge of Vegetable Intake Recommendations at 6 Months | 4 Participants |
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
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Intervention | Number of Participants Who Met Physical Activity Guidelines at 3 Months | 94 Participants |
| Control | Number of Participants Who Met Physical Activity Guidelines at 3 Months | 83 Participants |
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
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Intervention | Number of Participants Who Met Physical Activity Guidelines at 6 Months | 97 Participants |
| Control | Number of Participants Who Met Physical Activity Guidelines at 6 Months | 91 Participants |
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
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Self-efficacy for Vegetable Consumption at 3 Months | 15.4 units on a scale | Standard Error 0.2 |
| Control | Self-efficacy for Vegetable Consumption at 3 Months | 15.3 units on a scale | Standard Error 0.2 |
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
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Self-efficacy for Vegetable Consumption at 6 Months | 15.8 units on a scale | Standard Error 0.2 |
| Control | Self-efficacy for Vegetable Consumption at 6 Months | 16.0 units on a scale | Standard Error 0.2 |
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
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Social Support for Vegetable Consumption at 3 Months | 5.9 units on a scale | Standard Error 0.2 |
| Control | Social Support for Vegetable Consumption at 3 Months | 5.8 units on a scale | Standard Error 0.2 |
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
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Social Support for Vegetable Consumption at 6 Months | 6.0 units on a scale | Standard Error 0.2 |
| Control | Social Support for Vegetable Consumption at 6 Months | 5.9 units on a scale | Standard Error 0.2 |
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
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Vegetable Preparation Practices at 3 Months | 12.6 units on a scale | Standard Error 0.2 |
| Control | Vegetable Preparation Practices at 3 Months | 13.0 units on a scale | Standard Error 0.2 |
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
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Vegetable Preparation Practices at 6 Months | 12.5 units on a scale | Standard Error 0.2 |
| Control | Vegetable Preparation Practices at 6 Months | 12.4 units on a scale | Standard Error 0.2 |
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
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Vegetable Preparation Skills at 3 Months | 5.7 units on a scale | Standard Error 0.1 |
| Control | Vegetable Preparation Skills at 3 Months | 6.0 units on a scale | Standard Error 0.1 |
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
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Vegetable Preparation Skills at 6 Months | 5.6 units on a scale | Standard Error 0.1 |
| Control | Vegetable Preparation Skills at 6 Months | 5.8 units on a scale | Standard Error 0.1 |
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
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Vegetable Taste Preferences at 3 Months | 6.3 score on a 7-point scale | Standard Error 0.1 |
| Control | Vegetable Taste Preferences at 3 Months | 6.3 score on a 7-point scale | Standard Error 0.1 |
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
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Vegetable Taste Preferences at 6 Months | 6.3 score on a 7-point scale | Standard Error 0.1 |
| Control | Vegetable Taste Preferences at 6 Months | 6.5 score on a 7-point scale | Standard Error 0.1 |
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
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Intervention | Number of Participants Who Redeemed Any Cash Value Vouchers or CVV at Farmers' Markets at 6 Months | 12 Participants |
| Control | Number of Participants Who Redeemed Any Cash Value Vouchers or CVV at Farmers' Markets at 6 Months | 0 Participants |
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.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Overall Satisfaction With Intervention | 6.8 units on a scale | Standard Deviation 0.6 |
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.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention | Satisfaction With Intervention | 6.8 units on a scale | Standard Deviation 0.5 |