The Effect of a Fresh Produce Incentive Paired with Cooking and Nutrition Education on Healthy Eating in Low-income Households: a Pilot Study

Overview

Journal Public Health Nutr

Publisher Cambridge University Press

Date 2021 Jan 12

PMID 33431079

Citations 2

Authors

Angela R Fertig

Xuyang Tang

Heather M Dahlen

Affiliations

Soon will be listed here.

Abstract

Objective: This study pilot-tested combining financial incentives to purchase fruits and vegetables with nutrition education focused on cooking to increase the consumption of fruits and vegetables and improve attitudes around healthy eating on a budget among low-income adults. The goal of the pilot study was to examine implementation feasibility and fidelity, acceptability of the intervention components by participants and effectiveness.

Design: The study design was a pre-post individual-level comparison without a control group. The pilot intervention included two components, a scan card providing free produce up to a weekly maximum dollar amount for use over a 2-month period, and two sessions of tailored nutrition and cooking education. Outcomes included self-reported attitudes about healthy eating and daily fruit and vegetable consumption from one 24-h dietary recall collected before and after the intervention.

Setting: Greater Minneapolis/St. Paul area in Minnesota.

Participants: Adults (n 120) were recruited from five community food pantries.

Results: Findings indicated that the financial incentive component of the intervention was highly feasible and acceptable to participants, but attendance at the nutrition education sessions was moderate. Participants had a statistically significant increase in the consumption of fruit, from an average of 1·00 cup/d to 1·78 cups/d (P < 0·001), but no significant change in vegetable consumption or attitudes with respect to their ability to put together a healthy meal.

Conclusions: While combining financial incentives with nutrition education appears to be acceptable to low-income adult participants, barriers to attend nutrition education sessions need to be addressed in future research.

Citing Articles

An environmental scan of financial incentives to increase access to healthy foods: How, how much, and how often?.

Quach A, Yohannes S, Olstad D, Campbell D, Corrigan C, Beall R BMC Public Health. 2025; 25(1):689.

PMID: 39972336 PMC: 11841262. DOI: 10.1186/s12889-025-21855-9.

Community-based fruit and vegetable prescription programs: a scoping review.

Greatorex Brooks E, McInerney M J Nutr Sci. 2023; 12:e99.

PMID: 37744640 PMC: 10511821. DOI: 10.1017/jns.2023.81.

Evaluating Moderation of Parent-Teen Overweight/Obesity Relation by Household Socioeconomic Status.

Conrad Z, Hatfield D, Hennessy E, Maneval E, Ty E, Pankey C Curr Dev Nutr. 2021; 5(4):nzab030.

PMID: 33959690 PMC: 8085476. DOI: 10.1093/cdn/nzab030.

References

Hartmann C, Dohle S, Siegrist M . Importance of cooking skills for balanced food choices. Appetite. 2013; 65:125-31. DOI: 10.1016/j.appet.2013.01.016. View

Dauchet L, Amouyel P, Hercberg S, Dallongeville J . Fruit and vegetable consumption and risk of coronary heart disease: a meta-analysis of cohort studies. J Nutr. 2006; 136(10):2588-93. DOI: 10.1093/jn/136.10.2588. View

Virudachalam S, Long J, Harhay M, Polsky D, Feudtner C . Prevalence and patterns of cooking dinner at home in the USA: National Health and Nutrition Examination Survey (NHANES) 2007-2008. Public Health Nutr. 2013; 17(5):1022-30. PMC: 10282260. DOI: 10.1017/S1368980013002589. View

Blakely T, Ni Mhurchu C, Jiang Y, Matoe L, Funaki-Tahifote M, Eyles H . Do effects of price discounts and nutrition education on food purchases vary by ethnicity, income and education? Results from a randomised, controlled trial. J Epidemiol Community Health. 2011; 65(10):902-8. DOI: 10.1136/jech.2010.118588. View

Hebert J, Clemow L, Pbert L, Ockene I, Ockene J . Social desirability bias in dietary self-report may compromise the validity of dietary intake measures. Int J Epidemiol. 1995; 24(2):389-98. DOI: 10.1093/ije/24.2.389. View

Geliebter A, Ang I, Bernales-Korins M, Hernandez D, Ochner C, Ungredda T . Supermarket discounts of low-energy density foods: effects on purchasing, food intake, and body weight. Obesity (Silver Spring). 2013; 21(12):E542-8. DOI: 10.1002/oby.20484. View

Mujcic R, Oswald A . Evolution of Well-Being and Happiness After Increases in Consumption of Fruit and Vegetables. Am J Public Health. 2016; 106(8):1504-10. PMC: 4940663. DOI: 10.2105/AJPH.2016.303260. View

Moran A, Thorndike A, Franckle R, Boulos R, Doran H, Fulay A . Financial Incentives Increase Purchases Of Fruit And Vegetables Among Lower-Income Households With Children. Health Aff (Millwood). 2019; 38(9):1557-1566. DOI: 10.1377/hlthaff.2018.05420. View

Brimblecombe J, Ferguson M, Chatfield M, Liberato S, Gunther A, Ball K . Effect of a price discount and consumer education strategy on food and beverage purchases in remote Indigenous Australia: a stepped-wedge randomised controlled trial. Lancet Public Health. 2017; 2(2):e82-e95. DOI: 10.1016/S2468-2667(16)30043-3. View

10.

Kral T, Bannon A, Moore R . Effects of financial incentives for the purchase of healthy groceries on dietary intake and weight outcomes among older adults: A randomized pilot study. Appetite. 2016; 100:110-7. PMC: 4799756. DOI: 10.1016/j.appet.2016.02.022. View

11.

Thompson F, Dixit-Joshi S, Potischman N, Dodd K, Kirkpatrick S, Kushi L . Comparison of Interviewer-Administered and Automated Self-Administered 24-Hour Dietary Recalls in 3 Diverse Integrated Health Systems. Am J Epidemiol. 2015; 181(12):970-8. PMC: 4462333. DOI: 10.1093/aje/kwu467. View

12.

Fertig A, Loth K, Trofholz A, Tate A, Miner M, Neumark-Sztainer D . Compared to Pre-prepared Meals, Fully and Partly Home-Cooked Meals in Diverse Families with Young Children Are More Likely to Include Nutritious Ingredients. J Acad Nutr Diet. 2019; 119(5):818-830. PMC: 6487205. DOI: 10.1016/j.jand.2018.12.006. View

13.

Bowling A, Moretti M, Ringelheim K, Tran A, Davison K . Healthy Foods, Healthy Families: combining incentives and exposure interventions at urban farmers' markets to improve nutrition among recipients of US federal food assistance. Health Promot Perspect. 2016; 6(1):10-6. PMC: 4847109. DOI: 10.15171/hpp.2016.02. View

14.

Steptoe A, Perkins-Porras L, McKay C, Rink E, Hilton S, Cappuccio F . Psychological factors associated with fruit and vegetable intake and with biomarkers in adults from a low-income neighborhood. Health Psychol. 2003; 22(2):148-55. View

15.

Reicks M, Kocher M, Reeder J . Impact of Cooking and Home Food Preparation Interventions Among Adults: A Systematic Review (2011-2016). J Nutr Educ Behav. 2017; 50(2):148-172.e1. DOI: 10.1016/j.jneb.2017.08.004. View

16.

Wardle J, Steptoe A . Socioeconomic differences in attitudes and beliefs about healthy lifestyles. J Epidemiol Community Health. 2003; 57(6):440-3. PMC: 1732468. DOI: 10.1136/jech.57.6.440. View

17.

Moore L, Thompson F . Adults Meeting Fruit and Vegetable Intake Recommendations - United States, 2013. MMWR Morb Mortal Wkly Rep. 2015; 64(26):709-13. PMC: 4584842. View

18.

Cassady D, Jetter K, Culp J . Is price a barrier to eating more fruits and vegetables for low-income families?. J Am Diet Assoc. 2007; 107(11):1909-15. DOI: 10.1016/j.jada.2007.08.015. View

19.

Pooler J, Morgan R, Wong K, Wilkin M, Blitstein J . Cooking Matters for Adults Improves Food Resource Management Skills and Self-confidence Among Low-Income Participants. J Nutr Educ Behav. 2017; 49(7):545-553.e1. DOI: 10.1016/j.jneb.2017.04.008. View

20.

Mills S, White M, Brown H, Wrieden W, Kwasnicka D, Halligan J . Health and social determinants and outcomes of home cooking: A systematic review of observational studies. Appetite. 2016; 111:116-134. DOI: 10.1016/j.appet.2016.12.022. View