WIC-Based Intervention to Promote Healthy Eating Among Low-Income Mothers
Whole grains, non-starchy vegetables, fruit, and beans are a consistent feature of diets associated with a lower risk of cancer and other diet-related diseases. For cancer risk reduction, the American Cancer Society recommendation is to consume at least 2.5 cups of a variety of fruits and vegetables (FV) daily. Other than dietary choices, weight control and physical activity levels are important modifiable determinants of cancer risk. The proposed research will finalize a novel, theory-driven intervention developed in preliminary work to promote access to fresh, unprepared, locally grown FV and build knowledge and skills to increase purchases and consumption of these foods among low-income adults served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). In New Jersey (the location of the study), WIC provides participants up to $30 in seasonal Farmers' Market Nutrition Program (FMNP) vouchers and monthly cash value vouchers or CVV (valued at $11 for adults and $8 for children) redeemable at farmers' markets. The intervention will be finalized based on lessons learned in preliminary work. The program combines behaviorally-focused nutrition education with the establishment of a WIC-based farmers' market (to be implemented in 2019 during the FMNP voucher issuance period [June 19 to August 19]). Content to address other modifiable determinants of cancer risk will be added. To create additional opportunities for experiential and hands-on learning, monthly trips to an area farmers' market also are planned (between September 1, 2019 [after the WIC-based market is discontinued] and November 30, 2019 [the end of the local growing season]). The research will employ an experimental design to initially test the intervention in a sample of 244 adults. Program effects on objective biomarkers of FV intake, FMNP voucher redemption, and the redemption of CVV at farmers' markets will be examined 3 and 6 months after intervention. Mediation of intervention effects by targeted secondary outcomes, participant satisfaction with the program, and the cost-effectiveness of the intervention also will be examined.
Start: June 2019