Which Program Implementation Factors Lead to more Fruit and Vegetable Purchases? An Exploratory Analysis of Nutrition Incentive Programs across the United States

Courtney A Parks; Elise Mitchell; Carmen Byker Shanks; Nadine Budd Nugent; Megan Reynolds; Kiki Sun; Nanhua Zhang; Amy L Yaroch

doi:10.1016/j.cdnut.2023.102040

Which Program Implementation Factors Lead to more Fruit and Vegetable Purchases? An Exploratory Analysis of Nutrition Incentive Programs across the United States

Curr Dev Nutr. 2023 Nov 22;7(12):102040. doi: 10.1016/j.cdnut.2023.102040. eCollection 2023 Dec.

Authors

Courtney A Parks¹, Elise Mitchell¹, Carmen Byker Shanks¹, Nadine Budd Nugent¹, Megan Reynolds¹, Kiki Sun², Nanhua Zhang^{2

3}, Amy L Yaroch¹

Affiliations

¹ Gretchen Swanson Center for Nutrition, Omaha, NE United States.
² Division of Biostatistics & Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
³ Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.

Abstract

Background: Nutrition incentive (NI) programs help low-income households better afford fruits and vegetables (FVs) by providing incentives to spend on FVs (e.g., spend $10 to receive an additional $10 for FVs). NI programs are heterogeneous in programmatic implementation and operate in food retail outlets, including brick-and-mortar and farm-direct sites.

Objective: This study aimed to explore NI program implementation factors and the amount of incentives redeemed.

Methods: A total of 28 NI projects across the United States including 487 brick-and-mortar and 1078 farm-direct sites reported data between 2020 and 2021. Descriptive statistics and linear regression analyses (outcome: incentives redeemed) were applied.

Results: Traditional brick-and-mortar stores had 0.48 times the incentives redeemed compared with small brick-and-mortar stores. At brick-and-mortar sites, automatic discounts had 3.47 times the incentives redeemed compared with physical discounts; and auxiliary services and marketing led to greater redemption. Farm-direct sites using multilingual and direct promotional marketing had greater incentives redeemed.

Conclusions: To our knowledge, this is the first national study to focus on NI program implementation across sites nationwide. Factors identified can help inform future programming and research.

Keywords: brick-and-mortar; farm direct; food security; nutrition incentives; program implementation.