Comparison of Fruit and Vegetable Intake Among Urban Low-Income US Adults Receiving a Produce Voucher in 2 Cities

Abstract

IMPORTANCE Fruit and vegetable vouchers have been implemented by cities and counties across the US to increase fruit and vegetable intake and thereby improve overall nutritional quality. OBJECTIVE To determine whether and why use of fruit and vegetable vouchers are associated with varied nutritional intake across different populations and environments. DESIGN, SETTING, AND PARTICIPANTS In a population-based pre-post cohort study of 671 adult participants with low income before and during (6 months after initiation) participation in a 6-month program, fruit and vegetable vouchers were distributed for redemption at local San Francisco and Los Angeles neighborhood grocery and corner stores between 2017 and 2019. A transportability analysis was performed to identify factors that may explain variation in voucher use between cities.

What Are the Relationships between Psychosocial Community Characteristics and Dietary Behaviors in a Racially/Ethnically Diverse Urban Population in Los Angeles County?

“…Prior research also suggests that F+V consumption is generally higher in LAC as compared to other jurisdictions. A study comparing F+V intake among low-income priority populations in LAC and San Francisco revealed that LAC study participants consumed more F+Vs than their counterparts in San Francisco [ 79 ].…”

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

“…The most common provider of F&V prescriptions (n 14) was community health centres, (26,28,29,32,33,38,(41)(42)(43)(44)(45)(46)(47)50,52) followed by nongovernmental organisations, other non-profit, and charitable foundations (30,39,40,46,48,49,51,54,55) (n 9). Other providers included federal/state programs (27,31,37,53) (n 4) and schools (34) (n 1). The produce mainly came from one of three sources: Farmers' markets (30,32,33,39,41,(47)(48)(49)(50)(51)(52)(53) (n 12), grocery stores (27)(28)(29)31,37,40,44,54) (n 8), or food banks and pantries…”

“…Other providers included federal/state programs (27,31,37,53) (n 4) and schools (34) (n 1). The produce mainly came from one of three sources: Farmers' markets (30,32,33,39,41,(47)(48)(49)(50)(51)(52)(53) (n 12), grocery stores (27)(28)(29)31,37,40,44,54) (n 8), or food banks and pantries (26,45,46) (n 3), with several (n 7) utilising a combination. (34)(35)(36)38,42,43,55)…”

“…Change in dietary quality was measured in the majority of studies (27,29,30,34,35,37,(40)(41)(42)(43)(44)(45)(46)49,50,51,53) (n 17), only one of which reported no statistically significant improvement in diet quality. (34) The number and type of instruments used to measure diet quality varied widely, as did their levels of reliability, these included food frequency questionnaire (FFQ) (35) (n 1), validated 24-hour recall methods (27,29,40,51) (n 4), HEI scores (27,51) (n 2), and nutritional biomarkers (29) (n 1).…”

“…Change in dietary quality was measured in the majority of studies (27,29,30,34,35,37,(40)(41)(42)(43)(44)(45)(46)49,50,51,53) (n 17), only one of which reported no statistically significant improvement in diet quality. (34) The number and type of instruments used to measure diet quality varied widely, as did their levels of reliability, these included food frequency questionnaire (FFQ) (35) (n 1), validated 24-hour recall methods (27,29,40,51) (n 4), HEI scores (27,51) (n 2), and nutritional biomarkers (29) (n 1). Several of the studies used externally validated screeners to measure F&V intake, including NCI dietary screener (37,41,49) (n 3), the Block screener (50) (n 1), and the Behavioural Risk Factor Surveillance System (BRFSS) (42) (n 1), in addition to other instruments not often cited in the literature (44,46,53) (n 3).…”