Diet
Conditions
Keywords
food insecurity, diet, Supplemental Nutrition Assistance Program, fruit, vegetable, healthy eating, pediatrician
Brief summary
Investigator will test an intervention to increase use of a fruit and vegetable incentive program in South Carolina for families in the Supplemental Nutrition Assistance Program (SNAP) experiencing food insecurity. Caregivers are randomized to an intervention or an education-only, wait-list control group. The investigators hypothesize the intervention will improve diet-related outcomes, above and beyond the education-only wait-list control.
Detailed description
This study will test an intervention to increase use of a fruit and vegetable incentive program for families in the Supplemental Nutrition Assistance Program (SNAP) using a randomized controlled trial design. Caregivers are randomized to the intervention or an education-only wait-list control group. All caregivers are given brief education about a SNAP fruit and vegetable incentive program. Caregivers in the intervention are also given an initial free trial of this program and free home delivery. The primary aim is to examine intervention efficacy on diet-related outcomes.
Interventions
BEHAVIORALVeggie Vouchers
Caregivers will receive brief education about a SNAP fruit and vegetable incentive program in South Carolina during their child's pediatrician visit. Following the visit, caregivers will receive a free trial of this SNAP program to encourage first-time use. After the free trial, caregivers can continue purchasing the same fruit and vegetable boxes at a steeply discounted price using their SNAP card. Free home delivery during the free trial and for all subsequent boxes purchased at a discounted rate will be offered during the full study duration.
Sponsors
Virginia Commonwealth University
Cornell University
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
University of South Carolina
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
2 Years to 10 Years
Healthy volunteers
Yes
Inclusion criteria
* Primary caregiver 18+ years of age * Has a child 2-10 years of age * Speaks English * Screens positive for food insecurity * Currently enrolled in the Supplemental Nutrition Assistance Program (SNAP) * Lives with a feasible radius for home delivery * Consistent access to a phone that receives text messages
Exclusion criteria
* Anticipate no longer being enrolled in SNAP during the study duration * Recent use of the SNAP fruit and vegetable incentive program * Caregiver or child has a medical condition that impacts their ability to eat fruits and vegetables * Caregiver or child has a significant food allergy, preference, or intolerance that impacts their ability to eat fruits and vegetables
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Child diet quality | Baseline, 6, 18, and 30 weeks | Caregivers will complete a 3-day food record for their child's dietary intake. Child diet quality will then be assessed using the Healthy Eating Index. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Child Eating Behaviors | Baseline, 6, 18, and 30 weeks | The Children's Eating Behavior Questionnaire will be used to assess children's food fussiness. The food fussiness sub-scale consists of 5-pt Likert scale items ranging from Never (1) to Always (5). The mean of the response values is calculated. Higher score indicating a greater degree of food fussiness. |
| Process metrics | Through study completion, an average of 3 years | Process metrics will examine the reach of families who received brief education during clinic visits at each site, utilization of the free trial, use of home delivery, and families who cycled off SNAP within the study duration (%, #, timing). |
| Intervention utilization | Through study completion, an average of 3 years | Semi-structured phone interviews and surveys will be administered to caregivers to elicit perceptions on intervention components, barriers/facilitators to intervention use, and suggestions for future dissemination. |
| Perspectives of the intervention | Through study completion, an average of 3 years | Focus groups and online surveys will be administered to key informants to assess barriers and facilitators to intervention implementation and sustainability. |
| Food security | Baseline, 6, 18, and 30 weeks | The United States Department of Agriculture Household Food Security Module (18-item) will be administered. Higher scores indicate less food security. |
| Availability Pillar of Food Security | Baseline, 6, 18, and 30 weeks | The Perceived Limited Availability scale will be administered (6-items). Items are summed to create a total score for food stores (3-items) and food pantries (3 items). Each total score ranges 0-3. Higher scores are considered less desirable. |
| Caregiver diet quality | Baseline, 6, 18, and 30 weeks | Caregivers will complete a 3-day food record for their dietary intake. Caregiver diet quality will then be assessed using the Healthy Eating Index. |
| Stability Pillar of Food Security | Baseline, 6, 18, and 30 weeks | The Food Insecurity Stability scale (12-items) will be administered. Participants receive 4 scores, each ranging from 0-3 for chronic, seasonal, monthly, and intermittent food insecurity. Higher scores indicate a greater degree of chronic, seasonal, monthly, and intermittent food insecurity. |
| Nutrition Security | Baseline, 6, 18, and 30 weeks | Nutrition security will be measured using the Household Nutrition Security scale (4-items). Item scores range 0 (Always) to 4 (Never). The mean of item scores is calculated. Higher scores indicate a greater degree of nutrition security. |
| Household Healthfulness Choice | Baseline, 6, 18, and 30 weeks | The Household Healthfulness Choice (3-items) survey will be administered. Items are scored from 4 (Always) to 0 (Never). The mean of the item scores is calculated. Higher scores indicate a greater degree healthfulness choice. |
| Dietary Choice | Baseline, 6, 18, and 30 weeks | The Dietary Choice (3-items) survey will be administered. Item scores range from 0 (Always) to 4 (Never). The mean of the item scores is calculated. Higher scores indicate a greater degree of dietary choice. |
| SNAP fruit and vegetable incentive program utilization | Through study completion, an average of 3 years | Purchasing data will be used to quantify the number and type of produce boxes purchased as part of the Supplemental Nutrition Assistance Program (SNAP) fruit and vegetable incentive program in South Carolina. |
| Utilization Pillar of Food Security | Baseline, 6, 18, and 30 weeks | The Utilization Barriers scale (8-items) will be administered. Items are summed to create a score ranging 0-8. Higher scores are considered less desirable. |
Countries
United States
Contacts
Primary ContactElizabeth Adams, PhD
Outcome results
None listed