Abstract
BackgroundThis research evaluated the effects of financial incentives and purchase restrictions on food purchasing in a food benefit program for low income people.MethodsParticipants (n=279) were randomized to groups: 1) Incentive- 30% financial incentive for fruits and vegetables purchased with food benefits; 2) Restriction- no purchase of sugar-sweetened beverages, sweet baked goods, or candies with food benefits; 3) Incentive plus Restriction; or 4) Control- no incentive or restrictions. Participants received a study-specific debit card where funds were added monthly for 12-weeks. Food purchase receipts were collected over 16 weeks. Total dollars spent on grocery purchases and by targeted food categories were computed from receipts. Group differences were examined using general linear models.ResultsWeekly purchases of fruit significantly increased in the Incentive plus Restriction ($4.8) compared to the Restriction ($1.7) and Control ($2.1) groups (p <.01). Sugar-sweetened beverage purchases significantly decreased in the Incentive plus Restriction(−$0.8 per week) and Restriction ($-1.4 per week) groups compared to the Control group (+$1.5; p< .0001). Sweet baked goods purchases significantly decreased in the Restriction (−$0.70 per week) compared to the Control group (+$0.82 per week; p < .01).ConclusionsPaired financial incentives and restrictions on foods and beverages purchased with food program funds may support more healthful food purchases compared to no incentives or restrictions.Clinical trial registrationClinicaltrials.gov Identifier: NCT02643576.
Highlights
This research evaluated the effects of financial incentives and purchase restrictions on food purchasing in a food benefit program for low income people
The present study examined the effects of the provision of financial incentives for the purchase of fruits and vegetables, restriction of the purchase of sugar-sweetened beverages, candy, and sweet baked goods, or both, on food purchases among lower income adults
Participants were randomized to one of four groups: 1) Incentive- 30% financial incentive for fruits and vegetables purchased with food benefits; 2) Restriction- no purchase of sugarsweetened beverages, sweet baked goods, or candies with food benefits; 3) Incentive plus Restriction; or 4) Control- no incentive or restrictions on foods purchased with food benefits
Summary
This research evaluated the effects of financial incentives and purchase restrictions on food purchasing in a food benefit program for low income people. Poor dietary quality, including low fruit and vegetable and high sugar-sweetened beverage intake, is especially prevalent among lower income Americans [1, 2]. Food purchasing behavior has received little research attention as an intervention target to improve diet quality among low-income families [9,10,11,12]. Randomized trials to evaluate interventions to improve the nutritional quality of foods and beverages purchased among lower-income people are French et al International Journal of Behavioral Nutrition and Physical Activity (2017) 14:127 few. The results showed that those receiving financial incentives for fruit and vegetable purchases purchased and consumed more fruits and vegetables than those in the comparison group
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