1. In this study, a 4-week intensive program to remove barriers in caretaker access to healthy food increased fruit and vegetable intake of children within the household.

2. Gift cards given as part of program did not increase intake of unhealthy food.

Evidence rating level: 1 (Excellent)

Nutritious diet is an important component of healthy development. Therefore, measures to remove barriers in accessing healthy food for low-income households are vital. Several different strategies for removing barriers have been tried. However, the effectiveness of wrap-around programs that simultaneously address several barriers has not been directly tested.

This randomized control trial tested whether caregiver access to fresh produce and additional resources for 4 weeks would result in improvement in the diet of their children. The trial enrolled 68 low-income households in Texas, United States of America from May to July of 2021. Any family having at least 1 child in grades kindergarten through 5 were included. Any family with children with medical conditions precluding dietary changes were excluded. 31 families were in the intervention group, where they received food preparation tool and weekly boxes of fresh fruits and vegetables and $10.00 grocery gift cards for 4 weeks. The control group received an $80.00 gift card at the end of 8 weeks of data collection. The primary outcome was diet health measured using School Physical Activity and Nutrition (SPAN) Healthy Eating index at end of intervention period and 4 weeks after intervention.

Results demonstrated that compared to children in the control group, children in the intervention group had an average increase in times of eating fruits and vegetables by 2.07 times/day at end of intervention and 2.23 times/day at 4-weeks after intervention. However, this study was limited by the small sample size, which may preclude scaling up for future studies. Nonetheless, the maintenance of positive change in diet post intervention is promising and suggest these interventions should be considered as part of future strategies to improve nutrition in children in low-income households.

Click to read the study in JAMA Network Open

Image: PD

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