***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective Small food store interventions show promise to increase healthy food access in under-re source d areas . However , none have tested the impact of price discounts on healthy food supply and dem and . We tested the impact of store-directed price discounts and communications strategies , separately and combined , on the stocking , sales and prices of healthier foods and on storeowner psychosocial factors . Design Factorial design r and omized controlled trial . Setting Twenty-four corner stores in low-income neighbourhoods of Baltimore City , MD , USA . Subjects Stores were r and omized to pricing intervention , communications intervention , combined pricing and communications intervention , or control . Stores that received the pricing intervention were given a 10–30 % price discount by wholesalers on selected healthier food items during the 6-month trial . Communications stores received visual and interactive material s to promote healthy items , including signage , taste tests and refrigerators . Results All interventions showed significantly increased stock of promoted foods υ . control . There was a significant treatment effect for daily unit sales of healthy snacks ( β = 6·4 , 95 % CI 0·9 , 11·9 ) and prices of healthy staple foods ( β = −0·49 , 95 % CI −0·90 , −0·03 ) for the combined group υ . control , but not for other intervention groups . There were no significant intervention effects on storeowner psychosocial factors . Conclusions All interventions led to increased stock of healthier foods . The combined intervention was effective in increasing sales of healthier snacks , even though discounts on snacks were not passed to the consumer . Experimental research in small stores is needed to underst and the mechanisms by which store-directed price promotions can increase healthy food supply and dem and Objectives This study examined associations between high school students ' lunch patterns and vending machine purchases and the school food environment and policies . Methods A r and omly selected sample of 1088 high school students from 20 schools completed surveys about their lunch practice s and vending machine purchases . School food policies were assessed by principal and food director surveys . The number of vending machines and their hours of operation were assessed by trained research staff . Results Students at schools with open campus policies during lunchtime were significantly more likely to eat lunch at a fast food restaurant than students at schools with closed campus policies ( 0.7 days/week vs. 0.2 days/week , p < .001 ) . Student snack food purchases at school were significantly associated with the number of snack machines at schools ( p < .001 ) and policies about the types of food that can be sold . In schools with policies , students reported making snack food purchases an average of 0.5 ± 1.1 days/week as compared to an average of 0.9 ± 1.3 days/week in schools without policies ( p < .001 ) . In schools in which soft drink machines were turned off during lunch time , students purchased soft drinks from vending machines 1.4 ± 1.6 days/week as compared to 1.9 ± 1.8 days/week in schools in which soft drink machines were turned on during lunch ( p = .040 ) . ConclusionS chool food policies that decrease access to foods high in fats and sugars are associated with less frequent purchase of these items in school among high school students . Schools should examine their food-related policies and decrease access to foods that are low in nutrients and high in fats and sugars OBJECTIVES Financial constraint is the underpinning determinant of household food insecurity ; however , there has been little research examining the impact that increasing the ‘ money available ’ to food-insecure households could have on food purchasing . The main objective of the present study was to examine the effect of additional money ( in the form of supermarket vouchers ) on food expenditure in food-insecure households with children . DESIGN A parallel r and omized controlled trial with a 4-week baseline phase followed by a 4-week intervention phase . Households were r and omized to either receive vouchers ( coupons ) for 4 weeks or a control group that did not receive any vouchers . SETTING Dunedin , New Zeal and . SUBJECTS Low-income households with children ≥ 18 years ) reporting food insecurity ( n 214 ) . RESULTS The mean monetary value of the vouchers received by households was $ NZ 17?00 per week . The voucher group spent ≥ NZ 15.20 ( 95 % CI 1.46 , 28.94 ) more per week on food during the intervention phase compared with the control group ( P50.030 ) . There were no differences in expenditure between the voucher and the control group for the food groups ‘ fruit and vegetables ’ ( mean difference : ≥ NZ 0?46 ; 95 % CI 21.97 , 2.89 ; P50.709 ) , ‘ meat and poultry ’ ( mean difference : ≥ NZ 0.29 ; 95 % CI 23.07 , 3.64 ; P50.866 ) and ‘ dairy ’ ( mean difference : ≥ NZ 0.82 ; 95 % CI 20.75 , 2.42 ; P50.302 ) . CONCLUSIONS Providing money via supermarket vouchers to food-insecure result ed in an increase in overall expenditure on food Importance Strategies to improve the nutritional status of those participating in the Supplemental Nutrition Assistance Program ( SNAP ) are of interest to policymakers . Objective To evaluate whether the proposed policy of incentivizing the purchase of fruits and vegetables and prohibiting the purchase of less nutritious foods in a food benefit program improves the nutritional quality of participants ' diets . Design , Setting , and Participants Lower income participants ( n = 279 ) not currently enrolled in SNAP were r and omized to 1 of 4 experimental financial food benefit conditions : ( 1 ) incentive ( 30 % financial incentive for fruits and vegetables purchased using food benefits ) ; ( 2 ) restriction ( not allowed to buy sugar sweetened beverages , sweet baked goods , or c and ies with food benefits ) ; ( 3 ) incentive plus restriction ( 30 % financial incentive on fruits and vegetables and restriction of purchase of sugar sweetened beverages , sweet baked goods , or c and y with food benefits ) ; or ( 4 ) control ( no incentive or restrictions on foods purchased with food benefits ) . Participants in all conditions were given a study -specific debit card where funds were added every 4 weeks for a 12-week period . Outcome measures were collected at baseline and in the final 4 weeks of the experimental period . Main Outcomes and Measures Primary outcomes ( from 24-hour dietary recalls ) included intake of energy , discretionary calories , and overall diet quality . Results A number of favorable changes were observed in the incentive plus restriction condition that were significantly different from changes in the control condition . These included ( 1 ) reduced intake of energy ( -96 kcal/d , st and ard error [ SE ] , 59.9 ) ; ( 2 ) reduced intake of discretionary calories ( -64 kcal/d , SE 26.3 ) ; ( 3 ) reduced intake of sugar sweetened beverages , sweet baked goods , and c and ies ( -0.6 servings/d , SE 0.2 ) ; ( 4 ) increased intake of solid fruit ( 0.2 servings/d , SE 0.1 ) ; and ( 5 ) improved Healthy Eating Index score ( 4.1 points , SE 1.4 ) . Fewer improvements were observed in the incentive only and restriction only arms . Conclusions and Relevance A food benefit program that pairs incentives for purchasing more fruits and vegetables with restrictions on the purchase of less nutritious foods may reduce energy intake and improve the nutritional quality of the diet of participants compared with a program that does not include incentives or restrictions . Clinical Trial Registration clinical trials.gov Identifier : NCT02643576 Background Amateur sporting clubs represent an attractive setting for health promotion . This study assesses the impact of a multi-component intervention on the availability , promotion and purchase of fruit and vegetable and non sugar -sweetened drink products from community sporting club canteens . We also assessed the impact the intervention on sporting club revenue from the sale of food and beverages . Method A repeat cross-sectional , parallel group , cluster r and omized controlled trial was undertaken with amateur community football clubs in New South Wales , Australia . The intervention was conducted over 2.5 winter sporting seasons and sought to improve the availability and promotion of fruit and vegetables and non sugar-sweetened drinks in sporting club canteens . Trial outcomes were assessed via telephone surveys of sporting club representatives and members . Results Eighty five sporting clubs and 1143 club members participated in the study . Relative to the control group , at follow-up , clubs allocated to the intervention were significantly more likely to have fruit and vegetable products available at the club canteen ( OR = 5.13 ; 95 % CI 1.70 - 15.38 ) , were more likely to promote fruit and vegetable selection using reduced pricing and meal deals ( OR = 34.48 ; 95 % CI 4.18 - 250.00 ) and members of intervention clubs were more likely to report purchase of fruit and vegetable ( OR = 2.58 95 % CI ; 1.08 - 6.18 ) and non sugar -sweetened drink ( OR = 1.56 ; 95 % CI 1.09 - 2.25 ) products . There was no significant difference between groups in the annual club revenue from food and non-alcoholic beverage sales . Conclusion The findings demonstrate that the intervention can improve the nutrition environment of sporting clubs and the purchasing behaviour of members . Trial registration Australian New Zeal and Clinical Trials Registry : ACTRN12609000224224 Background U.S. adults are at unprecedented risk of becoming overweight or obese , and most scientists believe the primary cause is an obesogenic environment . Worksites provide an opportunity to shape the environments of adults to reduce obesity risk . The goal of this group-r and omized trial was to implement a four-component environmental intervention at the worksite level to positively influence weight gain among employees over a two-year period . Environmental components focused on food availability and price , physical activity promotion , scale access , and media enhancements . Methods Six worksites in a U.S. metropolitan area were recruited and r and omized in pairs at the worksite level to either a two-year intervention or a no-contact control . Evaluations at baseline and two years included : 1 ) measured height and weight ; 2 ) online surveys of individual dietary intake and physical activity behaviors ; and 3 ) detailed worksite environment assessment . Results Mean participant age was 42.9 years ( range 18 - 75 ) , 62.6 % were women , 68.5 % were married or cohabiting , 88.6 % were white , 2.1 % Hispanic . Mean  baseline BMI  was 28.5 kg/m2 ( range 16.9 - 61.2 kg/m2 ) . A majority of intervention components were successfully implemented . However , there were no differences between sites in the key outcome of weight change over the two-year study period ( p = .36 ) . Conclusions Body mass was not significantly affected by environmental changes implemented for the trial . Results raise questions about whether environmental change at worksites is sufficient for population weight gain prevention . Trial Registration Clinical Trials.gov : Peer education has become a popular strategy for health promotion interventions with adolescents , but it has not been used widely in school-based nutrition education . This paper describes and reports on the feasibility of the peer leader component of a school-based nutrition intervention for young adolescents design ed to increase fruit and vegetable intakes and lower fat foods .  About 1,000 seventh- grade students in eight schools received the nutrition intervention .  Of these , 272 were trained as peer leaders to assist the teacher in implementing the activities . Results from a multicomponent process evaluation based on peer leader and classroom student feedback , direct classroom observation , and teacher ratings and interviews are presented . Results show that peer-led nutrition education approaches in schools are feasible and have high acceptability among peer leaders , classroom students , and teachers OBJECTIVE To examine the effectiveness of two methods of increasing fruit and fruit juice intake in pregnancy :  midwives ' advice and vouchers exchangeable for juice . DESIGN Pregnant women were r and omly allocated to three groups : a control group , who received usual care ; an advice group , given advice and leaflets promoting fruit and fruit juice consumption ; and a voucher group , given vouchers exchangeable for fruit juice from a milk delivery firm . Dietary question naires were administered at ~16 , 20 and 32 weeks of pregnancy . Serum beta-carotene was measured at 16 and 32 weeks . SETTING An antenatal clinic in a deprived area . SUBJECTS Pregnant women aged 17 years and over . RESULTS The study comprised 190 women .  Frequency of fruit consumption declined during pregnancy in all groups , but that of fruit juice increased substantially in the voucher group . Serum beta-carotene concentration increased in the voucher group , from 106.2 to 141.8 micromol l(-1 ) in women with measurements on both occasions ( P = 0.003 ) , decreased from 120.0 to 99.8 micromol l(-1 ) in the control group ( P = 0.005 ) , and was unchanged in the advice group . CONCLUSIONS Pregnant women drink more fruit juice if they receive vouchers exchangeable for juice supplied by the milk delivery service . Midwives ' advice to eat more fruit has no great effect . Providing vouchers for fruit juice is a simple method of increasing its intake in a deprived population and may be useful for other sections of the community OBJECTIVE To pilot the design and methodology for a large r and omised controlled trial ( RCT ) of two interventions to 
    Output:
    
Most studies assessed promotions of fresh fruits and vegetables ( n = 20 ) ; however , these foods may be hard to source , have high perishability , and raise concerns about safety and h and ling .
Pricing interventions generally increased stocking , sales , purchasing , and consumption of promoted foods and beverages .