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Health Aff (Millwood). 2019 Apr;38(4):577-584. doi: 10.1377/hlthaff.2018.05405.

Effects Of Alternative Food Voucher Delivery Strategies On Nutrition Among Low-Income Adults.

Author information

1
Sanjay Basu ( basus@stanford.edu ) is an assistant professor of medicine in the Center for Primary Care and Outcomes Research and the Center for Population Health Sciences, both in the Department of Medicine, Stanford University School of Medicine, in California.
2
Christopher D. Gardner is a professor of medicine at the Stanford University School of Medicine.
3
Justin S. White is an assistant professor at the Philip R. Lee Institute for Health Policy Studies, University of California San Francisco (UCSF).
4
Joseph Rigdon is a senior biostatistician in the Quantitative Sciences Unit at the Stanford University School of Medicine.
5
Mandy M. Carroll is a study coordinator in the Department of Medicine, Stanford University School of Medicine.
6
Melissa Akers is a study coordinator in the Division of General Internal Medicine at UCSF.
7
Hilary K. Seligman is an associate professor of medicine at UCSF.

Abstract

Nutrition assistance programs are the subject of ongoing policy debates. Two proposals remain uninformed by existing evidence: whether restricting benefits to allow only fruit and vegetable purchases improves overall dietary intake, and whether more frequent distribution of benefits (weekly versus monthly) induces more fruit and vegetable consumption and less purchasing of calorie-dense foods. In a community-based trial, we randomly assigned participants to receive food vouchers that differed in what foods could be purchased (fruit and vegetables only or any foods) and in distribution schedule (in weekly or monthly installments, holding total monthly value constant). The use of vouchers for fruit and vegetables only did not yield significantly greater improvements than the unrestricted voucher did in terms of fruit and vegetable consumption or Healthy Eating Index (HEI) score. Weekly vouchers also failed to yield significantly greater improvements than monthly vouchers did. Proposed policies to make assistance more restricted or more frequent, while holding benefit value constant, might not improve nutrition among low-income Americans.

PMID:
30933599
DOI:
10.1377/hlthaff.2018.05405

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