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Heterogeneity in the Effects of Food Vouchers on Nutrition Among Low-Income Adults: A Quantile Regression Analysis.
Am J Health Promot. 2020 Sep 03 [Online ahead of print]AJ

Abstract

PURPOSE

To determine whether baseline fruit and vegetable (FV) intake or other predictors are associated with response to food vouchers (change in FV intake) among low-income adults.

DESIGN

Secondary analysis of a randomized, 2 x 2-factorial, community-based trial.

SETTING

San Francisco, California.

SUBJECTS

359 low-income adults aged ≥21 years old.

INTERVENTION

Participants were mailed $20 of food vouchers monthly for 6 months, and randomized to 1 of 4 arms according to: eligible foods (FV only or any foods) and redemption schedule (weekly or monthly).

MEASURES

Change in FV intake measured in cup equivalents between baseline and month 6 of the trial, based on 24-hour dietary recalls.

ANALYSIS

Quantile multivariate regressions were employed to measure associations between key predictors and change in FV intake across study arms.

RESULTS

FV-only weekly vouchers were associated with increased FV intake at the 25th percentile (0.24 cups/day, p = 0.048) and 50th percentile (0.37 cups/day, p = 0.02) of the distribution, but not at lower and higher quantiles. Response to the vouchers diminished 0.10 cups/day for each additional household member (p = 0.02).

CONCLUSION

Response to food vouchers varied along the FV intake distribution, pointing to some more responsive groups and others potentially needing additional support to increase FV intake. Larger households likely need vouchers of higher dollar value to result in similar changes in dietary intake as that observed in smaller households.

Authors+Show Affiliations

Philip R. Lee Institute for Health Policy Studies, 8785University of California San Francisco, CA, USA. Department of Epidemiology and Biostatistics, 8785University of California San Francisco, CA, USA.Department of Economics, 8788University of California, Irvine, CA, USA.Department of Economics, 8788University of California, Irvine, CA, USA.Stanford Prevention Research Center, 10624Stanford University School of Medicine, CA, USA.Stanford Prevention Research Center, 10624Stanford University School of Medicine, CA, USA.Collective Health, San Francisco, MA, USA. Center for Primary Care, 1811Harvard Medical School, MA, USA.Philip R. Lee Institute for Health Policy Studies, 8785University of California San Francisco, CA, USA. Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, CA, USA. Division of General Internal Medicine, Department of Medicine, 8785University of California San Francisco, CA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32878448

Citation

White, Justin S., et al. "Heterogeneity in the Effects of Food Vouchers On Nutrition Among Low-Income Adults: a Quantile Regression Analysis." American Journal of Health Promotion : AJHP, 2020, p. 890117120952991.
White JS, Vasconcelos G, Harding M, et al. Heterogeneity in the Effects of Food Vouchers on Nutrition Among Low-Income Adults: A Quantile Regression Analysis. Am J Health Promot. 2020.
White, J. S., Vasconcelos, G., Harding, M., Carroll, M. M., Gardner, C. D., Basu, S., & Seligman, H. K. (2020). Heterogeneity in the Effects of Food Vouchers on Nutrition Among Low-Income Adults: A Quantile Regression Analysis. American Journal of Health Promotion : AJHP, 890117120952991. https://doi.org/10.1177/0890117120952991
White JS, et al. Heterogeneity in the Effects of Food Vouchers On Nutrition Among Low-Income Adults: a Quantile Regression Analysis. Am J Health Promot. 2020 Sep 3;890117120952991. PubMed PMID: 32878448.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Heterogeneity in the Effects of Food Vouchers on Nutrition Among Low-Income Adults: A Quantile Regression Analysis. AU - White,Justin S, AU - Vasconcelos,Gabriel, AU - Harding,Matthew, AU - Carroll,Mandy M, AU - Gardner,Christopher D, AU - Basu,Sanjay, AU - Seligman,Hilary K, Y1 - 2020/09/03/ PY - 2020/9/4/pubmed PY - 2020/9/4/medline PY - 2020/9/4/entrez KW - food vouchers KW - fruit and vegetable intake KW - nutrition intervention KW - quantile regression SP - 890117120952991 EP - 890117120952991 JF - American journal of health promotion : AJHP JO - Am J Health Promot N2 - PURPOSE: To determine whether baseline fruit and vegetable (FV) intake or other predictors are associated with response to food vouchers (change in FV intake) among low-income adults. DESIGN: Secondary analysis of a randomized, 2 x 2-factorial, community-based trial. SETTING: San Francisco, California. SUBJECTS: 359 low-income adults aged ≥21 years old. INTERVENTION: Participants were mailed $20 of food vouchers monthly for 6 months, and randomized to 1 of 4 arms according to: eligible foods (FV only or any foods) and redemption schedule (weekly or monthly). MEASURES: Change in FV intake measured in cup equivalents between baseline and month 6 of the trial, based on 24-hour dietary recalls. ANALYSIS: Quantile multivariate regressions were employed to measure associations between key predictors and change in FV intake across study arms. RESULTS: FV-only weekly vouchers were associated with increased FV intake at the 25th percentile (0.24 cups/day, p = 0.048) and 50th percentile (0.37 cups/day, p = 0.02) of the distribution, but not at lower and higher quantiles. Response to the vouchers diminished 0.10 cups/day for each additional household member (p = 0.02). CONCLUSION: Response to food vouchers varied along the FV intake distribution, pointing to some more responsive groups and others potentially needing additional support to increase FV intake. Larger households likely need vouchers of higher dollar value to result in similar changes in dietary intake as that observed in smaller households. SN - 2168-6602 UR - https://www.unboundmedicine.com/medline/citation/32878448/Heterogeneity_in_the_Effects_of_Food_Vouchers_on_Nutrition_Among_Low_Income_Adults:_A_Quantile_Regression_Analysis_ L2 - https://journals.sagepub.com/doi/10.1177/0890117120952991?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -
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