Abstract

ObjectivesVouchers 4 Veggies (V4V) is a transformative healthy food voucher program aimed at increasing access to and affordability of healthy food in the most vulnerable communities. Between 2015–2018, over 2600 ethnically diverse low-income individuals were enrolled in the program with the goal to increase their fruit and vegetable intake, improve food security status and change health perception. MethodsV4V partners with local community-based organizations and clinics that serve as voucher distribution sites as well as neighborhoods stores, grocery stores, and famer’s markets where participants can redeem their vouchers. Participants receive $20-$40 worth of vouchers per month for 6 months. Data for this evaluation were collected using pre- and post- surveys (at 0 and 4–6 months) that included a validated fruit and vegetable intake screener, the USDA 7-item food security screener, demographic questions and health perception questions. ResultsData from 862 matched surveys indicate that mean fruit and vegetable intake increased from 2.49 to 3.52 servings daily, corresponding to a 1.03 servings increase after six months in the program (0.89,1.77; P < .001). In addition, V4V participants’ food security scores improved, decreasing 0.88 points (−1.07, −0.71; P < 0.001) on a 6 point scale (0 being the most food secure and 6 being very food insecure), from a mean of 5.53 to 4.65 using the USDA validated 6-item scale. When stratified by race, food security improved significantly for all major racial groups except Black/African Americans. Finally, participants reported a statistically significant improvement in self-reported health status (P < 0.001), with a 14% change in status from poor/fair health to good/very good/excellent health. ConclusionsThis evaluation suggests that a modest supplement for fruits and vegetables may be able to improve dietary intake, support food security, and improve health perception among vulnerable residents of San Francisco. More research is needed to understand differences in maintaining long-term health and behavior changes among program participants. Funding SourcesV4V received funding from the SF Department of Public Health, Hellman Foundation, AARP Foundation, and Kaiser Permanente Community Benefits Program.

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