Date of Award

January 2021

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Debbie Humphries

Abstract

Introduction and background: Higher F&V intake are associated with healthier BMI in children, but cost of F&V has been found to be a barrier to access for some families. To mitigate this barrier, Wholesome Wave (WW) implemented a six-month F&V incentive program that included a $25 weekly financial incentive for families to spend on F&V in three U.S. cities. The primary objectives of this paper are to assess whether this program significantly impacted child F&V consumption and child anthropometry from baseline to end-of-program and to assess whether F&V intake and food insecurity and end-of-program are significant predictors of healthy child anthropometry at end-of-program.Methods: Data for this analysis came from WW’s 2017 Multi-City FVRx program and utilized a pre-/post-program design with no control group. Across all three cities, 1,164 children and their families were enrolled in the program. We used a combination of Wilcoxon Sign Rank tests and McNemar-Bowker tests to determine whether there were significant changes in pediatric F&V intake and anthropometry from baseline to end-of-program. We also ran a logistic regression to determine if F&V intake and food insecurity at end-of-program were significant predictors of healthy anthropometry at end-of-program. Analyses conducted on child anthropometry were conducted on all participants with available data and then conducted stratifying by age. Results: Children enrolled in the program saw significant increases in F&V intake from baseline to end-of-program but did not see significant changes in anthropometry. F&V intake and food insecurity at end-of-program were not significant predictors of healthy anthropometry at end-of program. Discussion: Our findings suggest that a $25/week F&V incentive for six months is sufficient to significantly increase F&V intake among children. This is consistent with evaluations of other F&V incentive programs. However, changes in intake did not translate to significant anthropometric changes in all participants. There were significant changes in child anthropometry in children under 5, suggesting age might modify the program’s impact on anthropometry.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 06/01/2022

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