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A Supermarket Double-Dollar Incentive Program Increases Purchases of Fresh Fruits and Vegetables Among Low-Income Families With Children: The Healthy Double Study.
J Nutr Educ Behav. 2018 03; 50(3):217-228.e1.JN

Abstract

OBJECTIVE

To carry out a pilot study to determine whether a supermarket double-dollar fruit and vegetable (F&V) incentive increases F&V purchases among low-income families.

DESIGN

Randomized controlled design. Purchases were tracked using a loyalty card that provided participants with a 5% discount on all purchases during a 3-month baseline period followed by the 4-month intervention.

SETTING

A supermarket in a low-income rural Maine community.

PARTICIPANTS

A total of 401 low-income and Supplemental Nutrition Assistance Program (SNAP) supermarket customers.

INTERVENTION

Same-day coupon at checkout for half-off eligible fresh, frozen, or canned F&V over 4 months.

MAIN OUTCOME MEASURE

Weekly spending in dollars on eligible F&V.

ANALYSIS

A linear model with random intercepts accounted for repeated transactions by individuals to estimate change in F&V spending per week from baseline to intervention. Secondary analyses examined changes among SNAP-eligible participants.

RESULTS

Coupons were redeemed among 53% of eligible baskets. Total weekly F&V spending increased in the intervention arm compared with control ($1.83; 95% confidence interval [CI], $0.29 to $3.88). The largest increase was for fresh F&V ($1.97; 95% CI, $0.49 to $3.44). Secondary analyses revealed greater increases in F&V spending among SNAP-eligible participants who redeemed coupons ($5.14; 95% CI, $1.93 to $8.34) than among non-SNAP eligible participants who redeemed coupons ($3.88; 95% CI, $1.67 to $6.08).

CONCLUSIONS AND IMPLICATIONS

A double-dollar pricing incentive increased F&V spending in a low-income community despite the moderate uptake of the coupon redemption. Customers who were eligible for SNAP saw the greatest F&V spending increases. Financial incentives for F&V are an effective strategy for food assistance programs to increase healthy purchases and improve dietary intake in low-income families.

Authors+Show Affiliations

Westbrook College of Health Professions, University of New England, Portland, ME. Electronic address: mpolacsek@une.edu.Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA.Harvard Medical School, Boston, MA.Muskie School of Public Service, University of Southern Maine, Portland, ME.Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA.Hannaford Supermarkets, Scarborough, ME.Hannaford Supermarkets, Scarborough, ME.Department of Medicine, Harvard Medical School, Boston, MA.Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29126661

Citation

Polacsek, Michele, et al. "A Supermarket Double-Dollar Incentive Program Increases Purchases of Fresh Fruits and Vegetables Among Low-Income Families With Children: the Healthy Double Study." Journal of Nutrition Education and Behavior, vol. 50, no. 3, 2018, pp. 217-228.e1.
Polacsek M, Moran A, Thorndike AN, et al. A Supermarket Double-Dollar Incentive Program Increases Purchases of Fresh Fruits and Vegetables Among Low-Income Families With Children: The Healthy Double Study. J Nutr Educ Behav. 2018;50(3):217-228.e1.
Polacsek, M., Moran, A., Thorndike, A. N., Boulos, R., Franckle, R. L., Greene, J. C., Blue, D. J., Block, J. P., & Rimm, E. B. (2018). A Supermarket Double-Dollar Incentive Program Increases Purchases of Fresh Fruits and Vegetables Among Low-Income Families With Children: The Healthy Double Study. Journal of Nutrition Education and Behavior, 50(3), 217-e1. https://doi.org/10.1016/j.jneb.2017.09.013
Polacsek M, et al. A Supermarket Double-Dollar Incentive Program Increases Purchases of Fresh Fruits and Vegetables Among Low-Income Families With Children: the Healthy Double Study. J Nutr Educ Behav. 2018;50(3):217-228.e1. PubMed PMID: 29126661.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Supermarket Double-Dollar Incentive Program Increases Purchases of Fresh Fruits and Vegetables Among Low-Income Families With Children: The Healthy Double Study. AU - Polacsek,Michele, AU - Moran,Alyssa, AU - Thorndike,Anne N, AU - Boulos,Rebecca, AU - Franckle,Rebecca L, AU - Greene,Julie C, AU - Blue,Dan J, AU - Block,Jason P, AU - Rimm,Eric B, Y1 - 2017/11/07/ PY - 2017/03/02/received PY - 2017/09/19/revised PY - 2017/09/21/accepted PY - 2017/11/12/pubmed PY - 2019/11/14/medline PY - 2017/11/12/entrez KW - SNAP KW - SNAP policy KW - behavioral economics KW - financial incentives for fruit and vegetable purchase promotion KW - randomized controlled trial SP - 217 EP - 228.e1 JF - Journal of nutrition education and behavior JO - J Nutr Educ Behav VL - 50 IS - 3 N2 - OBJECTIVE: To carry out a pilot study to determine whether a supermarket double-dollar fruit and vegetable (F&V) incentive increases F&V purchases among low-income families. DESIGN: Randomized controlled design. Purchases were tracked using a loyalty card that provided participants with a 5% discount on all purchases during a 3-month baseline period followed by the 4-month intervention. SETTING: A supermarket in a low-income rural Maine community. PARTICIPANTS: A total of 401 low-income and Supplemental Nutrition Assistance Program (SNAP) supermarket customers. INTERVENTION: Same-day coupon at checkout for half-off eligible fresh, frozen, or canned F&V over 4 months. MAIN OUTCOME MEASURE: Weekly spending in dollars on eligible F&V. ANALYSIS: A linear model with random intercepts accounted for repeated transactions by individuals to estimate change in F&V spending per week from baseline to intervention. Secondary analyses examined changes among SNAP-eligible participants. RESULTS: Coupons were redeemed among 53% of eligible baskets. Total weekly F&V spending increased in the intervention arm compared with control ($1.83; 95% confidence interval [CI], $0.29 to $3.88). The largest increase was for fresh F&V ($1.97; 95% CI, $0.49 to $3.44). Secondary analyses revealed greater increases in F&V spending among SNAP-eligible participants who redeemed coupons ($5.14; 95% CI, $1.93 to $8.34) than among non-SNAP eligible participants who redeemed coupons ($3.88; 95% CI, $1.67 to $6.08). CONCLUSIONS AND IMPLICATIONS: A double-dollar pricing incentive increased F&V spending in a low-income community despite the moderate uptake of the coupon redemption. Customers who were eligible for SNAP saw the greatest F&V spending increases. Financial incentives for F&V are an effective strategy for food assistance programs to increase healthy purchases and improve dietary intake in low-income families. SN - 1878-2620 UR - https://www.unboundmedicine.com/medline/citation/29126661/A_Supermarket_Double_Dollar_Incentive_Program_Increases_Purchases_of_Fresh_Fruits_and_Vegetables_Among_Low_Income_Families_With_Children:_The_Healthy_Double_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1499-4046(17)30896-5 DB - PRIME DP - Unbound Medicine ER -