The Use of Financial Incentives to Increase Fresh Fruit and Vegetable Purchases in Lower-Income Households: Results of a Pilot Study

Phipps, Etienne; Braitman, Leonard E.; Stites, Shana D.; Wallace, Samantha L.; Singletary, S. Brook; Hunt, Lacy H.

doi:10.1353/hpu.2013.0064

Cited by 11 publications

(12 citation statements)

References 12 publications

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“…In our study, no one FP component of TFVs appeared to have responded more strongly to the intervention in proportional terms. This contrasts with prior studies finding larger impacts of financial incentives for fruit than for vegetables (26,55), although those studies did not formally test for proportional differences.…”

Section: Tablecontrasting

confidence: 85%

Financial incentives increase fruit and vegetable intake among Supplemental Nutrition Assistance Program participants: a randomized controlled trial of the USDA Healthy Incentives Pilot

Olsho

Klerman

Wilde

et al. 2016

The American Journal of Clinical Nutrition

163

138

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Background: US fruit and vegetable (FV) intake remains below recommendations, particularly for low-income populations. Evidence on effectiveness of rebates in addressing this shortfall is limited.Objective: This study evaluated the USDA Healthy Incentives Pilot (HIP), which offered rebates to Supplemental Nutrition Assistance Program (SNAP) participants for purchasing targeted FVs (TFVs). Design: As part of a randomized controlled trial in Hampden County, Massachusetts, 7500 randomly selected SNAP households received a 30% rebate on TFVs purchased with SNAP benefits. The remaining 47,595 SNAP households in the county received usual benefits. Adults in 5076 HIP and non-HIP households were randomly sampled for telephone surveys, including 24-h dietary recall interviews. Surveys were conducted at baseline (1-3 mo before implementation) and in 2 follow-up rounds (4-6 mo and 9-11 mo after implementation). 2784 adults (1388 HIP, 1396 non-HIP) completed baseline interviews; data were analyzed for 2009 adults (72%) who also completed $1 follow-up interview. Results: Regression-adjusted mean TFV intake at follow-up was 0.24 cup-equivalents/d (95% CI: 0.13, 0.34 cup-equivalents/d) higher among HIP participants. Across all fruit and vegetables (AFVs), regression-adjusted mean intake was 0.32 cup-equivalents/d (95% CI: 0.17, 0.48 cup-equivalents/d) higher among HIP participants. The AFV-TFV difference was explained by greater intake of 100% fruit juice (0.10 cup-equivalents/d; 95% CI: 0.02, 0.17 cup-equivalents/d); juice purchases did not earn the HIP rebate. Refined grain intake was 0.43 ounce-equivalents/d lower (95% CI: 20.69, 20.16 ounce-equivalents/d) among HIP participants, possibly indicating substitution effects. Increased AFV intake and decreased refined grain intake contributed to higher Healthy Eating Index-2010 scores among HIP participants (4.7 points; 95% CI: 2.4, 7.1 points). Conclusions: The HIP significantly increased FV intake among SNAP participants, closing w20% of the gap relative to recommendations and increasing dietary quality. More research on mechanisms of action is warranted. The HIP trial was registered at clinicaltrials.gov as NCT02651064.Am J Clin Nutr 2016;104:423-35.

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Section: Tablecontrasting

confidence: 85%

Financial incentives increase fruit and vegetable intake among Supplemental Nutrition Assistance Program participants: a randomized controlled trial of the USDA Healthy Incentives Pilot

Olsho

Klerman

Wilde

et al. 2016

The American Journal of Clinical Nutrition

163

138

View full text Add to dashboard Cite

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“…The value of the discount for fruits and vegetables may have been an additional factor in shoppers’ decision about whether to purchase them. Randomized trials suggest that discounting fruits and vegetables works best when the discount is large (eg, 50%) (14,23,24,28), larger than the percentage savings we observed, especially for fruit.…”

Section: Discussioncontrasting

confidence: 60%

“…Purchase data were drawn from baseline data collected in 2 studies of financial incentives for the purchase of fruits and vegetables before any intervention took place: a pilot study conducted in April 2010 through August 2010 (study 1; n = 30) (14), and a full-scale study conducted in December 2010 through October 2011 (study 2; n = 58) (15). Six people who participated in both studies were counted only in study 2.…”

Section: Methodsmentioning

confidence: 99%

Buying Food on Sale: A Mixed Methods Study With Shoppers at an Urban Supermarket, Philadelphia, Pennsylvania, 2010–2012

Phipps¹,

Kumanyika²,

Stites³

et al. 2014

Prev. Chronic Dis.

Self Cite

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IntroductionThe obesity epidemic has drawn attention to food marketing practices that may increase the likelihood of caloric overconsumption and weight gain. We explored the associations of discounted prices on supermarket purchases of selected high-calorie foods (HCF) and more healthful, low-calorie foods (LCF) by a demographic group at high risk of obesity.MethodsOur mixed methods design used electronic supermarket purchase data from 82 low-income (primarily African American female) shoppers for households with children and qualitative data from focus groups with demographically similar shoppers.ResultsIn analyses of 6,493 food purchase transactions over 65 weeks, the odds of buying foods on sale versus at full price were higher for grain-based snacks, sweet snacks, and sugar-sweetened beverages (odds ratios: 6.6, 5.9, and 2.6, respectively; all P < .001) but not for savory snacks. The odds of buying foods on sale versus full price were not higher for any of any of the LCF (P ≥ .07). Without controlling for quantities purchased, we found that spending increased as percentage saved from the full price increased for all HCF and for fruits and vegetables (P ≤ .002). Focus group participants emphasized the lure of sale items and took advantage of sales to stock up.ConclusionStrategies that shift supermarket sales promotions from price reductions for HCF to price reductions for LCF might help prevent obesity by decreasing purchases of HCF.

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“…Nineteen studies examined the impact of supermarket fruit and vegetable subsidies, incentives, vouchers, or prescriptions targeted towards low-income households or individuals [ 47 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ]. Results from randomized trials and natural experiments consistently demonstrate increases in household fruit and vegetable purchases or adult fruit and vegetable intake when incentives are targeted towards SNAP participants [ 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ]; yet, few studies have been conducted with children [ 52 ]. Studies assessing substitution found little evidence that fruit and vegetable incentives changed unhealthful food intake or expenditures [ 51 , 52 , 53 , 59 ].…”

Section: Resultsmentioning

confidence: 99%

Associations between Governmental Policies to Improve the Nutritional Quality of Supermarket Purchases and Individual, Retailer, and Community Health Outcomes: An Integrative Review

Moran

Clynes

et al. 2020

IJERPH

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Supermarkets are natural and important settings for implementing environmental interventions to improve healthy eating, and governmental policies could help improve the nutritional quality of purchases in this setting. This review aimed to: (1) identify governmental policies in the United States (U.S.), including regulatory and legislative actions of federal, tribal, state, and local governments, designed to promote healthy choices in supermarkets; and (2) synthesize evidence of these policies’ effects on retailers, consumers, and community health. We searched five policy databases and developed a list of seven policy actions that meet our inclusion criteria: calorie labeling of prepared foods in supermarkets; increasing U.S. Department of Agriculture (USDA) Supplemental Nutrition Assistance Program (SNAP) benefits; financial incentives for the purchase of fruit and vegetables; sweetened beverage taxes; revisions to the USDA Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package; financial assistance for supermarkets to open in underserved areas; and allowing online purchases with SNAP. We searched PubMed, Econlit, PsycINFO, Web of Science, and Business Source Ultimate to identify peer-reviewed, academic, English-language literature published at any time until January 2020; 147 studies were included in the review. Sweetened beverage taxes, revisions to the WIC food package, and financial incentives for fruits and vegetables were associated with improvements in dietary behaviors (food purchases and/or consumption). Providing financial incentives to supermarkets to open in underserved areas and increases in SNAP benefits were not associated with changes in food purchasing or diet quality but may improve food security. More research is needed to understand the effects of calorie labeling in supermarkets and online SNAP purchasing.

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The Use of Financial Incentives to Increase Fresh Fruit and Vegetable Purchases in Lower-Income Households: Results of a Pilot Study

Cited by 11 publications

References 12 publications

Financial incentives increase fruit and vegetable intake among Supplemental Nutrition Assistance Program participants: a randomized controlled trial of the USDA Healthy Incentives Pilot

Financial incentives increase fruit and vegetable intake among Supplemental Nutrition Assistance Program participants: a randomized controlled trial of the USDA Healthy Incentives Pilot

Buying Food on Sale: A Mixed Methods Study With Shoppers at an Urban Supermarket, Philadelphia, Pennsylvania, 2010–2012

Associations between Governmental Policies to Improve the Nutritional Quality of Supermarket Purchases and Individual, Retailer, and Community Health Outcomes: An Integrative Review

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