Lauren Olsho|Jacob Alex Klerman|Parke Wilde|Susan Bartlett
Financial incentives increase fruit and vegetable intake among Supplemental Nutrition Assistance Program participants: a randomized controlled trial of the USDA Healthy Incentives Pilot
Abt Associates (United States)|Abt Associates (United States)|Tufts University|Abt Associates (United States)
us fruit vegetable fv intake remains recommendations particularly lowincome populations evidence effectiveness rebates addressing shortfall limitedthis study evaluated usda healthy incentives pilot hip offered rebates supplemental nutrition assistance program snap participants purchasing targeted fvs tfvsas part randomized controlled trial hampden county massachusetts 7500 randomly selected snap households received 30 rebate tfvs purchased snap benefits remaining 47595 snap households county received usual benefits adults 5076 hip nonhip households randomly sampled telephone surveys including 24h dietary recall interviews surveys conducted baseline 13 mo implementation 2 followup rounds 46 mo 911 mo implementation 2784 adults 1388 hip 1396 nonhip completed baseline interviews data analyzed 2009 adults 72 also completed 1 followup interviewregressionadjusted mean tfv intake followup 024 cupequivalentsd 95 ci 013 034 cupequivalentsd higher among hip participants across fruit vegetables afvs regressionadjusted mean intake 032 cupequivalentsd 95 ci 017 048 cupequivalentsd higher among hip participants afvtfv difference explained greater intake 100 fruit juice 010 cupequivalentsd 95 ci 002 017 cupequivalentsd juice purchases earn hip rebate refined grain intake 043 ounceequivalentsd lower 95 ci 069 016 ounceequivalentsd among hip participants possibly indicating substitution effects increased afv intake decreased refined grain intake contributed higher healthy eating index2010 scores among hip participants 47 points 95 ci 24 71 pointsthe hip significantly increased fv intake among snap participants closing 20 gap relative recommendations increasing dietary quality research mechanisms action warranted hip trial registered clinicaltrialsgov nct02651064