Abstract
BackgroundThe Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides participants seasonal Farmers’ Market Nutrition Program (FMNP) vouchers to purchase fruits and vegetables (FV) at farmers’ markets and monthly cash value vouchers (CVV) redeemable at farmers’ markets. Despite the promise of FMNP vouchers and CVV for improving FV access among WIC participants, voucher redemption rates are low. This study evaluated WIC Fresh Start (WFS), a theory-driven, web-based lesson to promote FV intake, the redemption of CVV at farmers’ markets, FMNP voucher redemption, and farmers’ market-related knowledge, attitudes, and skills among women enrolled in WIC.MethodsThe lesson was evaluated in a four-arm randomized controlled trial. The setting was a large New Jersey-based WIC agency located in a densely populated, urban area. Participants (N = 744) were stratified based on FMNP voucher receipt and randomized to receive the WFS lesson or WIC online existing health education. Lesson effects on targeted outcomes were examined at posttest (2 weeks after the lesson) and 3 and 6 months after posttesting.ResultsReceipt of the WFS lesson was associated with FMNP voucher redemption (in the subset of participants preferring to speak Spanish); improvements in knowledge of the FMNP, locally grown seasonal items, seasonal items found at farmers’ markets in July, WIC-authorized farmers’ markets and food- and farmers’ market-specific knowledge; ever having purchased and intentions to purchase FV at a farmers’ market; FV food safety and preparation skills; and modest gains in the redemption of CVV at farmers’ markets. FV intake did not differ over time by trial arm.ConclusionsFindings aid understanding of effective approaches to promote farmers’ market use and farmers’ market-related knowledge and skills among WIC participants. Further research is needed to explore factors that may explain the lack of lesson effects on FV intake.Trial registrationNCT02565706
Highlights
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides participants seasonal Farmers’ Market Nutrition Program (FMNP) vouchers to purchase fruits and vegetables (FV) at farmers’ markets and monthly cash value vouchers (CVV) redeemable at farmers’ markets
Lesson effects on FV intake and secondary outcomes FV intake did not differ over time by trial arm or lesson
This study examined primary and secondary outcomes associated with exposure to the WIC Fresh Start (WFS) lesson relative to existing health education (EHE) among WIC-enrolled women who received FMNP vouchers and those who did not
Summary
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides participants seasonal Farmers’ Market Nutrition Program (FMNP) vouchers to purchase fruits and vegetables (FV) at farmers’ markets and monthly cash value vouchers (CVV) redeemable at farmers’ markets. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is designed to safeguard the health of low-income women, infants, and children up to age 5 who are nutritionally at risk by providing healthy foods to supplement diets (via WIC food packages), nutrition education, and counseling and referrals to health and other social services [1]. The packages were revised in 2009 to include the addition of a monthly cash value voucher (CVV) for fruit and vegetable (FV) purchases (vouchers were valued at $10 for women and $6 for children) [2]. The only FV subsidy available to WIC participants was provided through the WIC Farmers’ Market Nutrition Program (FMNP) [4]
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