The British Columbia Farmers’ Market Nutrition Coupon Program Reduces Short-Term Household Food Insecurity Among Adults With Low Incomes: A Pragmatic Randomized Controlled Trial - 18/03/24
Abstract |
Background |
The British Columbia Farmers’ Market Nutrition Coupon Program (BC FMNCP) provides households with low incomes with coupons to purchase healthy foods from farmers’ markets.
Objective |
To examine the impact of the BC FMNCP on the short-term household food insecurity, malnutrition risk, mental well-being, sense of community (secondary outcomes), and subjective social status (exploratory outcome) of adults with low incomes post-intervention and 16 weeks post-intervention.
Design |
Secondary analyses from a pragmatic randomized controlled trial conducted in 2019 that collected data at baseline, post-intervention, and 16 weeks post-intervention.
Participants/setting |
Adults ≥18 years with low incomes were randomized to an FMNCP group (n = 143) or a no-intervention control group (n = 142).
Intervention |
Participants in the FMNCP group received 16 coupon sheets valued at $21 Canadian dollars (CAD)/sheet over 10 to 15 weeks to purchase healthy foods from farmers’ markets and were eligible to participate in nutrition skill-building activities.
Main outcome measures |
Outcomes included short-term household food insecurity (modified version of Health Canada’s 18-item Household Food Security Survey Module), malnutrition risk (Malnutrition Universal Screening Tool), mental well-being (Warwick-Edinburgh Mental Well-Being Scale), sense of community (Brief Sense of Community Scale), and subjective social status (MacArthur Scale of Subjective Social Status community scale).
Statistical analysis |
Mixed-effects linear regression and multinomial logistic regression examined between-group differences in outcomes post-intervention and 16 weeks post-intervention.
Results |
The risk of marginal and severe short-term household food insecurity was lower among those in the FMNCP group compared with those in the control group (relative risk ratio [RRR] 0.15, P = 0.01 and RRR 0.16, P = 0.02) post-intervention, with sustained reductions in severe household food insecurity 16 weeks post-intervention (RRR 0.11, P = 0.01). No statistically significant differences were observed in malnutrition risk, mental well-being, sense of community, or subjective social status post-intervention or 16 weeks post-intervention.
Conclusions |
The BC FMNCP reduced short-term household food insecurity but was not found to improve malnutrition risk or psychosocial well-being among adults with low incomes compared with a no-intervention control group.
Le texte complet de cet article est disponible en PDF.Keywords : Household food insecurity, Psychosocial well-being, Low-income, Healthy food subsidy, Randomized controlled trial
Plan
| Supplementary materials:Supplementary Table 2, Supplementary Table 3, Supplementary Table 4, Supplementary Table 5, Supplementary Table 6, Supplementary Table 8, Supplementary Table 9, Supplementary Table 10, Supplementary Table 11, Supplementary Table 12, Supplementary Table 13, and Supplementary Table 14 and Supplementary Figure 1 are available at www.jandonline.org/. |
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| STATEMENT OF POTENTIAL CONFLICT OF INTEREST H. O. is the Executive Director of the British Columbia Association of Farmers' Markets. P. L. is the Program Manager for the British Columbia Farmers’ Market Nutrition Coupon Program. All other authors (M. L. A., S. D., T. S., G. R. M., S. C. R., Y. Y. L., R. A. R., L. M. M., K. D. R., J. G., S. D., C. I. J. N., and D. L. O.) report no conflicts of interest. |
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| FUNDING/SUPPORT This work was funded by the Canadian Institutes of Health Research (reference number 155916). MA received scholarship support from the Maple Leaf Board Scholarship in Food Insecurity, the Carl O. Nickle Graduate Scholarship, the Alberta Graduate Excellence Scholarship, and the Rebecca Holmes Memorial Master's Scholarship. |
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| ACKNOWLEDGMENT The research team would like to extend our sincere appreciation to the managers and staff of the British Columbia Association of Farmers’ Markets, the Farmers’ Market Nutrition Coupon Program, and the BC Ministry of Health for their partnership and collaboration on this research study. We would additionally like to thank the community partners, farmers’ market vendors, and participants for their valuable contributions. We are also grateful to our research assistants, Sayeeda Amber Sayed, Anjola Adeboye, Jennifer Fry, Jennis Jiang, Justin Ancheta, Grant Tkachyk, Toyin Ogunyannwo, and Payge Dirk for their contributions to the study. We have received written permission from all those named in this acknowledgement. The Warwick–Edinburgh Mental Well-being Scale was funded by the Scottish Government National Programme for Improving Mental Health and Wellbeing, commissioned by NHS Health Scotland, developed by the University of Warwick and the University of Edinburgh, and is jointly owned by NHS Health Scotland, the University of Warwick and the University of Edinburgh. |
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| AUTHOR CONTRIBUTIONS M. L. A. and D. L. O. wrote the manuscript; P. L. delivered the intervention; M. L. A., S. D., S. C. R., and Y. Y. L. collected the data; M. L. A. and T. S. conducted the statistical analyses; all authors (M. L. A., S. D., T. S., H. O., P. L., G. R. M., S. C. R., Y. Y. L., R. A. R., L. M. M., K. D. R., J. G., S. D., C. I. J. N., and D. L. O.) contributed to study design, interpreted the data, and critically edited and approved the final manuscript. |
Vol 124 - N° 4
P. 466 - avril 2024 Retour au numéro
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