<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT02975232</url>
  </required_header>
  <id_info>
    <org_study_id>2016-68001-24961</org_study_id>
    <nct_id>NCT02975232</nct_id>
  </id_info>
  <brief_title>Supermarket Science: Multipronged Approaches to Increasing Fresh, Frozen and Canned Fruit and Vegetable Purchases</brief_title>
  <official_title>Supermarket Science: Multipronged Approaches to Increasing Fresh, Frozen and Canned Fruit and Vegetable Purchases</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>University of New England</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Harvard School of Public Health (HSPH)</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Harvard Medical School (HMS and HSDM)</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>University of New England</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      Through research, education and extension, this project will promote fruit and vegetable&#xD;
      (F&amp;V) purchases and consumption by families in under-resourced communities, thus reducing&#xD;
      health disparities, improving human nutrition, and preventing unhealthy weight gain among&#xD;
      children. Specifically, this project aims to evaluate the success of promoting F&amp;V purchases&#xD;
      among low- income and Supplemental Nutrition Assistance Program (SNAP)-eligible families and&#xD;
      children living in a rural Maine community through a double value coupon, supermarket- based&#xD;
      incentive program combined with Cooking Matters at the Store education. Education and&#xD;
      extension efforts based on the study findings will contribute to meeting USDA Childhood&#xD;
      Obesity Prevention Challenge Area Goals of generating new knowledge; developing, assessing&#xD;
      and expanding effective interventions; and increasing the number of skilled and informed&#xD;
      professionals and consumers to address the complex problem of childhood obesity. The research&#xD;
      team will partner with a large national retail grocery chain (Hannaford Brothers), Cooking&#xD;
      Matters, University of Maine Cooperative Extension, eXtension Communities of Practice, Maine&#xD;
      SNAP-Ed, and The Food Trust to accomplish the project objectives.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Through research, education and extension, this project will promote fruit and vegetable&#xD;
      (F&amp;V) purchases and consumption by families in under-resourced communities, thus reducing&#xD;
      health disparities, improving human nutrition, and preventing unhealthy weight gain among&#xD;
      children. Specifically, this project aims to evaluate the success of promoting F&amp;V purchases&#xD;
      among low- income and SNAP-eligible families and children living in a rural Maine community.&#xD;
      The project will use a multipronged approach in the supermarket setting, including&#xD;
      implementation methods from the highly effective, double value coupon incentive program used&#xD;
      at farmers' markets, as well as the Cooking Matters at the Store educational program to&#xD;
      incentivize the purchase and consumption of fresh produce, and healthful frozen and canned&#xD;
      F&amp;V (without syrup or salt), nutrient-rich and affordable year- round alternatives to fresh&#xD;
      produce.&#xD;
&#xD;
      Education and extension efforts based on the study findings will contribute to meeting United&#xD;
      States Department of Agriculture (USDA) Childhood Obesity Prevention Challenge Area Goals of&#xD;
      generating new knowledge; developing, assessing and expanding effective interventions; and&#xD;
      increasing the number of skilled and informed professionals and consumers to address the&#xD;
      complex problem of childhood obesity. The project team will partner with a large national&#xD;
      retail grocery chain (Hannaford Brothers), Cooking Matters, University of Maine (UMaine)&#xD;
      Cooperative Extension, eXtension Communities of Practice, Maine SNAP-Education (SNAP-Ed), and&#xD;
      The Food Trust to accomplish its objectives.&#xD;
&#xD;
      Methods:&#xD;
&#xD;
      Research Strategy: The study will enroll 600 shoppers (and assume 70% retention, with an&#xD;
      initial N of 600: n=210 per study arm) entering the store in months 6-7. If a customer has&#xD;
      interest in participating and meets enrollment criteria (having a child between ages 2 and 18&#xD;
      years of age living in the household, and use of the Hannaford store as the primary grocery&#xD;
      shopping venue), then the customer will be asked to enroll. At enrollment, research&#xD;
      assistants will obtain informed consent, instruct participants about how to join&#xD;
      &quot;MyHannaford&quot; in order to receive a unique study ID for tracking of all purchases, and give&#xD;
      participants a MyHannaford &quot;study loyalty&quot; card and Guiding Stars information. A short survey&#xD;
      will be administered to collect information about demographics (age, gender, family size,&#xD;
      ethnicity), shopping habits (e.g. percent of total grocery shopping done at this Hannaford&#xD;
      and person doing most of the shopping in the household), best method to communicate incentive&#xD;
      changes once randomization has occurred, and F&amp;V promotion reminders (e.g. text, email,&#xD;
      mail), SNAP eligibility, and SNAP participation. Through the loyalty card and study ID, all&#xD;
      participants will receive a 5% discount on all purchases at the participating Hannaford store&#xD;
      during months 6-16 of the project.&#xD;
&#xD;
      Semi-quantitative Food Frequency Questionnaire (FFQ): The FFQ consists of approximately 130&#xD;
      food items and is regularly updated to account for changes in the availability of foods. At&#xD;
      baseline and post intervention, participants will be emailed a link to the FFQ administered&#xD;
      online through Qualtrics, which will take approximately 20 minutes to complete. Participant&#xD;
      who complete the survey will be emailed an e-gift card. Participants will be asked to&#xD;
      identify one index child in the household closest to the age range of 6-10 yrs (where&#xD;
      children may be most receptive and influenced by parents eating patterns). Participants will&#xD;
      be provided an excerpted section of the FFQ with only F&amp;V listed for the respondent to&#xD;
      complete, representing the child's average at-home consumption.&#xD;
&#xD;
      Randomization: After the 2-month baseline run-in period, study participants will be randomly&#xD;
      assigned to double value coupon incentive program + Cooking Matters intervention, or control.&#xD;
&#xD;
      Intervention arm: Participants randomized to the intervention arm will receive 2 for 1 F&amp;V&#xD;
      (double value max $10 benefit per household per shopping day) for purchasing either fresh or&#xD;
      2 and 3-star-rated frozen and canned F&amp;V in months 10-13. These will be confirmed by linking&#xD;
      UPC codes with qualifying foods. All discounts (5% and incentive) will be given at checkout&#xD;
      through the use of the loyalty card with assigned study ID. Participants will be asked to&#xD;
      register and attend at least 1 of 5 Cooking Matters at the Store education program tours&#xD;
      scheduled during the first two months of the intervention period (months 10-11). On the day&#xD;
      and time of the Cooking Matters at the Store tour, there will be a Cooking Matters table set&#xD;
      up in the entrance of the lobby. All shoppers at the store, regardless of study&#xD;
      participation, are invited to join the tour. Study participants will be asked to sign in with&#xD;
      their name or study ID (for tracking purposes) and pick up their &quot;passport&quot; (a card that must&#xD;
      be stamped at each station in order to complete the tour) at the table in the lobby. The&#xD;
      passport must have stamps from each station in order for the participant to receive a&#xD;
      Hannaford gift card and participate in the $10 challenge (buying a healthy meal for a family&#xD;
      of four for under $10).&#xD;
&#xD;
      Control arm: Participants assigned to the control arm will not be eligible for F&amp;V incentives&#xD;
      and will not be asked to attend Cooking Matters at the Store.&#xD;
&#xD;
      Post-intervention, all participants will continue to receive the 5% discount and we will&#xD;
      continue tracking purchases for three additional months (months 14-16) using the study ID to&#xD;
      examine retention of purchasing habits. During month 14 (1 year after baseline assessment),&#xD;
      participants will be emailed a link to the FFQ, including the child portion, to assess&#xD;
      average daily intake over the previous year. Reminders to complete and return the FFQ will be&#xD;
      sent by text.&#xD;
&#xD;
      Data and analysis plan--F&amp;V Sales: Primary study outcomes will be compared within individuals&#xD;
      (pre- to post-intervention), and between individuals (intervention and control arms). Cooking&#xD;
      Matters education program attendance between intervention and control arms will be compared.&#xD;
      Mixed effects generalized linear models will be used to control for sex, primary household&#xD;
      shopper, family size, month of purchase, and SNAP status (ineligible, eligible, enrolled).&#xD;
&#xD;
      Education and Extension Activities (post research):&#xD;
&#xD;
      Maine SNAP-Ed: The Maine SNAP-Ed program will contribute to education and extension efforts&#xD;
      in years 3 and 4 of the grant by assisting with the development of resources, such as fact&#xD;
      sheets and webinar trainings. Direct education classes will be used to disseminate resource&#xD;
      materials developed through the grant. Maine SNAP-Ed can also help disseminate innovative&#xD;
      approaches to work with supermarkets and grocers through their work with the USDA Food and&#xD;
      Nutrition Service and the Association of SNAP Nutrition Education Administrators (ASNNA).&#xD;
&#xD;
      University of Maine Cooperative Extension: In year 3, UMaine Cooperative Extension staff will&#xD;
      work to develop and finalize educational materials that will be used in project dissemination&#xD;
      activities in year 4 of the project. In year 4, UMaine Cooperative Extension staff will&#xD;
      provide two webinars for two different Maine audiences. One webinar will be conducted for&#xD;
      Cooperative Extension's 4H Youth Development and nutrition staff, and the second will be&#xD;
      delivered to Healthy Maine Partnership/SNAP-Ed staff. UMaine Extension Staff will also assist&#xD;
      in creating and delivering an online training to both the eXtension Families, Food and&#xD;
      Fitness, and Community Nutrition Education Communities of Practice. Additionally, project&#xD;
      outcomes will be presented at the national Expanded Food and Nutrition Education Program&#xD;
      annual meeting in Washington, DC. The Community Nutrition Education Program Community of&#xD;
      Practice has also agreed to serve as host for materials developed through this project.&#xD;
&#xD;
      The Food Trust: In year 3, The Food Trust will prepare for education and extension efforts in&#xD;
      year 4. The Food Trust will use its experience as a national partner on a variety of healthy&#xD;
      food access policy and program efforts at the national, state, and local levels. In year 4,&#xD;
      The Food Trust will work with UNE and partners to lead the development of an educational&#xD;
      toolkit targeted at academic institutions, professional associations, and industry partners&#xD;
      (e.g. retail chains and industry associations) to support development and enhancement of&#xD;
      curricula and corresponding materials related to promoting healthy shopping behaviors in&#xD;
      low-income populations.&#xD;
&#xD;
      University of New England (UNE): The University of New England is in the late planning stages&#xD;
      of a Bachelor of Science in Nutrition degree. The study will provide a unique opportunity for&#xD;
      undergraduate students to be involved in the community on issues related to food access among&#xD;
      low-income populations.&#xD;
&#xD;
      Target Audiences Target audience for the research component: English-speaking, rural Maine&#xD;
      families with at least one child under 18 years of age living in the household, regularly&#xD;
      shopping at the study Hannaford store location. Westbrook is a low-income (median household&#xD;
      income was $44,465 compared to the state level of $48,453 in 2013), mostly white (92% white&#xD;
      in 2013), rural community in Southern Maine. The study Hannaford store in Westbrook has a&#xD;
      high SNAP-user customer base ($90+Million in sales and 10% SNAP sales representing ~20% of&#xD;
      UPC eligible sales in 2014).&#xD;
&#xD;
      Target audience for education and extension components: The Maine SNAP-Ed program staff;&#xD;
      Maine Cooperative Extension staff and partners, The Nutrition Education Program Community of&#xD;
      Practice, Food Trust staff and partners, University of New England Nutrition Program staff&#xD;
      and faculty and low income families shopping in supermarket settings.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date>April 2016</start_date>
  <completion_date type="Actual">March 31, 2021</completion_date>
  <primary_completion_date type="Actual">September 2018</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Prevention</primary_purpose>
    <masking>Single (Participant)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Before discount spending (in dollars) on eligible fresh, frozen and canned F&amp;V</measure>
    <time_frame>through study completion, one year</time_frame>
    <description>average change from baseline weekly and per transaction before discount spending (in dollars) on eligible fresh, frozen and canned F&amp;V</description>
  </primary_outcome>
  <primary_outcome>
    <measure>nutrition behavior: shopper and 1 index child</measure>
    <time_frame>at 1 month and up to 15 months</time_frame>
    <description>change from baseline</description>
  </primary_outcome>
  <other_outcome>
    <measure>Frequencies of shopper nutrition behaviors practiced over the past week related to shopping and food preparation</measure>
    <time_frame>at 1 month and up to 15 months</time_frame>
    <description>self-reported nutrition behavior</description>
  </other_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">605</enrollment>
  <condition>Pediatric Obesity</condition>
  <arm_group>
    <arm_group_label>Treatment</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>F&amp;V economic incentive with Cooking Matters store tour</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Control</arm_group_label>
    <arm_group_type>No Intervention</arm_group_type>
    <description>no intervention</description>
  </arm_group>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>F&amp;V economic incentive</intervention_name>
    <description>50% off eligible fresh, frozen and canned fruits and vegetables (up to $10/day)</description>
    <arm_group_label>Treatment</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Cooking Matters Store Tour</intervention_name>
    <description>Participants will be asked to attend one Coking Matters store tour during January or February 2017</description>
    <arm_group_label>Treatment</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  18 years of age or older&#xD;
&#xD;
          -  at least one child in household aged 18 or younger&#xD;
&#xD;
          -  at least 50% of grocery shopping done at study store location&#xD;
&#xD;
          -  active cell phone accepting text messages&#xD;
&#xD;
          -  active email address&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  non-English speaker&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Michele Polacsek, PhD MHS</last_name>
    <role>Principal Investigator</role>
    <affiliation>University of New England</affiliation>
  </overall_official>
  <results_reference>
    <citation>Moran A, Thorndike A, Franckle R, Boulos R, Doran H, Fulay A, Greene J, Blue D, Block JP, Rimm EB, Polacsek M. Financial Incentives Increase Purchases Of Fruit And Vegetables Among Lower-Income Households With Children. Health Aff (Millwood). 2019 Sep;38(9):1557-1566. doi: 10.1377/hlthaff.2018.05420. Erratum In: Health Aff (Millwood). 2021 Jan;40(1):179.</citation>
    <PMID>31479362</PMID>
  </results_reference>
  <verification_date>May 2021</verification_date>
  <study_first_submitted>November 16, 2016</study_first_submitted>
  <study_first_submitted_qc>November 28, 2016</study_first_submitted_qc>
  <study_first_posted type="Estimate">November 29, 2016</study_first_posted>
  <last_update_submitted>May 3, 2021</last_update_submitted>
  <last_update_submitted_qc>May 3, 2021</last_update_submitted_qc>
  <last_update_posted type="Actual">May 6, 2021</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>University of New England</investigator_affiliation>
    <investigator_full_name>Michele Polacsek</investigator_full_name>
    <investigator_title>Associate Professor</investigator_title>
  </responsible_party>
  <keyword>nutrition disparities</keyword>
  <keyword>SNAP population</keyword>
  <keyword>behavioral economics</keyword>
  <keyword>retail setting</keyword>
  <keyword>point of purchase education</keyword>
  <keyword>pediatric obesity</keyword>
  <keyword>rural population</keyword>
  <keyword>fruit and vegetable purchases</keyword>
  <keyword>fruit and vegetable consumption</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Pediatric Obesity</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT02975232
org study id: 2016-68001-24961
nct id: NCT02975232
lead sponsor: 
collaborator: 
collaborator: 
has dmc: No
Through research, education and extension, this project will promote fruit and vegetable
      (F&V) purchases and consumption by families in under-resourced communities, thus reducing
      health disparities, improving human nutrition, and preventing unhealthy weight gain among
      children. Specifically, this project aims to evaluate the success of promoting F&V purchases
      among low- income and Supplemental Nutrition Assistance Program (SNAP)-eligible families and
      children living in a rural Maine community through a double value coupon, supermarket- based
      incentive program combined with Cooking Matters at the Store education. Education and
      extension efforts based on the study findings will contribute to meeting USDA Childhood
      Obesity Prevention Challenge Area Goals of generating new knowledge; developing, assessing
      and expanding effective interventions; and increasing the number of skilled and informed
      professionals and consumers to address the complex problem of childhood obesity. The research
      team will partner with a large national retail grocery chain (Hannaford Brothers), Cooking
      Matters, University of Maine Cooperative Extension, eXtension Communities of Practice, Maine
      SNAP-Ed, and The Food Trust to accomplish the project objectives.
Through research, education and extension, this project will promote fruit and vegetable
      (F&V) purchases and consumption by families in under-resourced communities, thus reducing
      health disparities, improving human nutrition, and preventing unhealthy weight gain among
      children. Specifically, this project aims to evaluate the success of promoting F&V purchases
      among low- income and SNAP-eligible families and children living in a rural Maine community.
      The project will use a multipronged approach in the supermarket setting, including
      implementation methods from the highly effective, double value coupon incentive program used
      at farmers' markets, as well as the Cooking Matters at the Store educational program to
      incentivize the purchase and consumption of fresh produce, and healthful frozen and canned
      F&V (without syrup or salt), nutrient-rich and affordable year- round alternatives to fresh
      produce.

      Education and extension efforts based on the study findings will contribute to meeting United
      States Department of Agriculture (USDA) Childhood Obesity Prevention Challenge Area Goals of
      generating new knowledge; developing, assessing and expanding effective interventions; and
      increasing the number of skilled and informed professionals and consumers to address the
      complex problem of childhood obesity. The project team will partner with a large national
      retail grocery chain (Hannaford Brothers), Cooking Matters, University of Maine (UMaine)
      Cooperative Extension, eXtension Communities of Practice, Maine SNAP-Education (SNAP-Ed), and
      The Food Trust to accomplish its objectives.

      Methods:

      Research Strategy: The study will enroll 600 shoppers (and assume 70% retention, with an
      initial N of 600: n=210 per study arm) entering the store in months 6-7. If a customer has
      interest in participating and meets enrollment criteria (having a child between ages 2 and 18
      years of age living in the household, and use of the Hannaford store as the primary grocery
      shopping venue), then the customer will be asked to enroll. At enrollment, research
      assistants will obtain informed consent, instruct participants about how to join
      "MyHannaford" in order to receive a unique study ID for tracking of all purchases, and give
      participants a MyHannaford "study loyalty" card and Guiding Stars information. A short survey
      will be administered to collect information about demographics (age, gender, family size,
      ethnicity), shopping habits (e.g. percent of total grocery shopping done at this Hannaford
      and person doing most of the shopping in the household), best method to communicate incentive
      changes once randomization has occurred, and F&V promotion reminders (e.g. text, email,
      mail), SNAP eligibility, and SNAP participation. Through the loyalty card and study ID, all
      participants will receive a 5% discount on all purchases at the participating Hannaford store
      during months 6-16 of the project.

      Semi-quantitative Food Frequency Questionnaire (FFQ): The FFQ consists of approximately 130
      food items and is regularly updated to account for changes in the availability of foods. At
      baseline and post intervention, participants will be emailed a link to the FFQ administered
      online through Qualtrics, which will take approximately 20 minutes to complete. Participant
      who complete the survey will be emailed an e-gift card. Participants will be asked to
      identify one index child in the household closest to the age range of 6-10 yrs (where
      children may be most receptive and influenced by parents eating patterns). Participants will
      be provided an excerpted section of the FFQ with only F&V listed for the respondent to
      complete, representing the child's average at-home consumption.

      Randomization: After the 2-month baseline run-in period, study participants will be randomly
      assigned to double value coupon incentive program + Cooking Matters intervention, or control.

      Intervention arm: Participants randomized to the intervention arm will receive 2 for 1 F&V
      (double value max $10 benefit per household per shopping day) for purchasing either fresh or
      2 and 3-star-rated frozen and canned F&V in months 10-13. These will be confirmed by linking
      UPC codes with qualifying foods. All discounts (5% and incentive) will be given at checkout
      through the use of the loyalty card with assigned study ID. Participants will be asked to
      register and attend at least 1 of 5 Cooking Matters at the Store education program tours
      scheduled during the first two months of the intervention period (months 10-11). On the day
      and time of the Cooking Matters at the Store tour, there will be a Cooking Matters table set
      up in the entrance of the lobby. All shoppers at the store, regardless of study
      participation, are invited to join the tour. Study participants will be asked to sign in with
      their name or study ID (for tracking purposes) and pick up their "passport" (a card that must
      be stamped at each station in order to complete the tour) at the table in the lobby. The
      passport must have stamps from each station in order for the participant to receive a
      Hannaford gift card and participate in the $10 challenge (buying a healthy meal for a family
      of four for under $10).

      Control arm: Participants assigned to the control arm will not be eligible for F&V incentives
      and will not be asked to attend Cooking Matters at the Store.

      Post-intervention, all participants will continue to receive the 5% discount and we will
      continue tracking purchases for three additional months (months 14-16) using the study ID to
      examine retention of purchasing habits. During month 14 (1 year after baseline assessment),
      participants will be emailed a link to the FFQ, including the child portion, to assess
      average daily intake over the previous year. Reminders to complete and return the FFQ will be
      sent by text.

      Data and analysis plan--F&V Sales: Primary study outcomes will be compared within individuals
      (pre- to post-intervention), and between individuals (intervention and control arms). Cooking
      Matters education program attendance between intervention and control arms will be compared.
      Mixed effects generalized linear models will be used to control for sex, primary household
      shopper, family size, month of purchase, and SNAP status (ineligible, eligible, enrolled).

      Education and Extension Activities (post research):

      Maine SNAP-Ed: The Maine SNAP-Ed program will contribute to education and extension efforts
      in years 3 and 4 of the grant by assisting with the development of resources, such as fact
      sheets and webinar trainings. Direct education classes will be used to disseminate resource
      materials developed through the grant. Maine SNAP-Ed can also help disseminate innovative
      approaches to work with supermarkets and grocers through their work with the USDA Food and
      Nutrition Service and the Association of SNAP Nutrition Education Administrators (ASNNA).

      University of Maine Cooperative Extension: In year 3, UMaine Cooperative Extension staff will
      work to develop and finalize educational materials that will be used in project dissemination
      activities in year 4 of the project. In year 4, UMaine Cooperative Extension staff will
      provide two webinars for two different Maine audiences. One webinar will be conducted for
      Cooperative Extension's 4H Youth Development and nutrition staff, and the second will be
      delivered to Healthy Maine Partnership/SNAP-Ed staff. UMaine Extension Staff will also assist
      in creating and delivering an online training to both the eXtension Families, Food and
      Fitness, and Community Nutrition Education Communities of Practice. Additionally, project
      outcomes will be presented at the national Expanded Food and Nutrition Education Program
      annual meeting in Washington, DC. The Community Nutrition Education Program Community of
      Practice has also agreed to serve as host for materials developed through this project.

      The Food Trust: In year 3, The Food Trust will prepare for education and extension efforts in
      year 4. The Food Trust will use its experience as a national partner on a variety of healthy
      food access policy and program efforts at the national, state, and local levels. In year 4,
      The Food Trust will work with UNE and partners to lead the development of an educational
      toolkit targeted at academic institutions, professional associations, and industry partners
      (e.g. retail chains and industry associations) to support development and enhancement of
      curricula and corresponding materials related to promoting healthy shopping behaviors in
      low-income populations.

      University of New England (UNE): The University of New England is in the late planning stages
      of a Bachelor of Science in Nutrition degree. The study will provide a unique opportunity for
      undergraduate students to be involved in the community on issues related to food access among
      low-income populations.

      Target Audiences Target audience for the research component: English-speaking, rural Maine
      families with at least one child under 18 years of age living in the household, regularly
      shopping at the study Hannaford store location. Westbrook is a low-income (median household
      income was $44,465 compared to the state level of $48,453 in 2013), mostly white (92% white
      in 2013), rural community in Southern Maine. The study Hannaford store in Westbrook has a
      high SNAP-user customer base ($90+Million in sales and 10% SNAP sales representing ~20% of
      UPC eligible sales in 2014).

      Target audience for education and extension components: The Maine SNAP-Ed program staff;
      Maine Cooperative Extension staff and partners, The Nutrition Education Program Community of
      Practice, Food Trust staff and partners, University of New England Nutrition Program staff
      and faculty and low income families shopping in supermarket settings.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Prevention
masking: Single (Participant)
measure: Before discount spending (in dollars) on eligible fresh, frozen and canned F&V
time frame: through study completion, one year
description: average change from baseline weekly and per transaction before discount spending (in dollars) on eligible fresh, frozen and canned F&V
measure: nutrition behavior: shopper and 1 index child
time frame: at 1 month and up to 15 months
description: change from baseline
measure: Frequencies of shopper nutrition behaviors practiced over the past week related to shopping and food preparation
time frame: at 1 month and up to 15 months
description: self-reported nutrition behavior
arm group label: Treatment
arm group type: Experimental
description: F&V economic incentive with Cooking Matters store tour
arm group label: Control
arm group type: No Intervention
description: no intervention
intervention type: Behavioral
intervention name: F&V economic incentive
description: 50% off eligible fresh, frozen and canned fruits and vegetables (up to $10/day)
arm group label: Treatment
intervention type: Behavioral
intervention name: Cooking Matters Store Tour
description: Participants will be asked to attend one Coking Matters store tour during January or February 2017
arm group label: Treatment
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: Accepts Healthy Volunteers
last name: Michele Polacsek, PhD MHS
role: Principal Investigator
affiliation: University of New England
citation: Moran A, Thorndike A, Franckle R, Boulos R, Doran H, Fulay A, Greene J, Blue D, Block JP, Rimm EB, Polacsek M. Financial Incentives Increase Purchases Of Fruit And Vegetables Among Lower-Income Households With Children. Health Aff (Millwood). 2019 Sep;38(9):1557-1566. doi: 10.1377/hlthaff.2018.05420. Erratum In: Health Aff (Millwood). 2021 Jan;40(1):179.
PMID: 31479362
responsible party type: Principal Investigator
investigator affiliation: University of New England
investigator full name: Michele Polacsek
investigator title: Associate Professor
mesh term: Pediatric Obesity
sharing ipd: No