Abstract

Conduct a randomized controlled study to determine if a supermarket double-dollar fruit and vegetable (FV) incentive program increases FV purchases among low income families. We enrolled 401 customers from a supermarket in a low-income rural community. Purchases were tracked using a loyalty card system that provided study participants with a 5% discount on all purchases during a 3-month baseline period followed by the four-month intervention. The intervention group received half-off fresh, frozen or canned FV; the control group received no incentives. Primary outcomes were changes in weekly spending on FV between baseline and intervention periods. Secondary analyses examined changes among SNAP-eligible participants. Weekly spending on total FV increased in the intervention arm, compared to control (15% increase; $1.83, 95% CI=$0.28-3.84). The largest increase was for fresh FV (18% increase: $1.97, 95% CI=$0.49-3.44) with little change for canned and frozen FV. Secondary analyses revealed even greater increases in weekly FV spending among SNAP-eligible participants compared to non-SNAP-eligible participants (45% increase; $2.37, 95% CI=$-0.04-4.78) compared to (11% increase; $1.57, 95% CI=$-0.36-3.50), and increased fresh FV spending among SNAP-eligible participants (53% increase; $2.55, 95% CI=$0.23-4.87) compared to non-SNAP eligible participants (13% increase; $1.68, 95% CI=$-0.15-3.52). A double-dollar pricing incentive increased FV supermarket purchases in a low-income community. SNAP-eligible customers had the greatest improvements. These results suggest that financial incentives could be an effective strategy for the SNAP program to improve healthy food choices.

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