Adequate fruit and vegetable consumption is associated with reduced risk of cardiovascular disease but few New York City (NYC) adults report consuming recommended amounts. Both fruit and vegetable consumption have been reported as lower among adults with low income vs high income. Increased availability of financial incentives for farmers' market purchases could reduce barriers to affordable produce, thereby potentially increasing consumption. Research is limited on the factors influencing fruit and vegetable consumption among food assistance program participants, especially for large, urban populations.
This study aimed to offer a preliminary evaluation of the Health Bucks year-round expansion to assess possible short-term effects on fruit and vegetable purchasing and consumption.
Study Design, Setting, Participants
Two cross-sectional surveys of NYC farmers market shoppers were conducted, immediately before (June 2016) and 1 year after (June 2017) implementation of year-round expansion of the Health Bucks incentive program. Eligible respondents were individuals aged 18+ enrolled in the Supplemental Nutrition Assistance Program (SNAP) and able to complete an interviewer-administered survey in English or Spanish. A convenience sample of respondents was surveyed each year (n = 425 and n = 453).
The survey separately assessed total daily fruit and vegetable consumption among people with SNAP, measured through validated dietary screening questions. Adjusted multivariable logistic regression models, including fixed effects for year, market location and demographics, were conducted. Significance was determined at P < .05.
Mean daily intake (servings) of fruit remained constant between years (0.7 vs 0.7, P = .708); mean vegetable intake increased (2.3 vs 2.6, P = .004).
Expansion of Health Bucks from 5 to 12 months was associated with increased vegetable consumption among people with SNAP at NYC farmers markets. Future program priorities may include additional promotion to increase awareness among people with SNAP and expansion to supermarkets, which may be more opportune venues for utilizing incentives.