Online WIC Nutrition Education to Promote Farmers' Market Fruit and Vegetable Purchases and Consumption
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 744
- Locations
- 2
- Primary Endpoint
- Quantity of Fruit and Vegetable Intake
Study Overview
Brief Summary
This study is evaluating the WIC Fresh Start program, a theory-driven, web-based nutrition education lesson to promote farmers' market fruit and vegetable purchases and consumption among women enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC).
Detailed Description
This study is evaluating the WIC Fresh Start program, a theory-driven, web-based nutrition education lesson to promote fruit and vegetable (FV) consumption among women enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). Designed to leverage vouchers provided to WIC participants for FV purchases through the Farmers' Market Nutrition Program (FMNP) and monthly cash value vouchers (CVVs) redeemable at farmers' markets, the lesson is conceptually grounded in formative research on knowledge, attitudes and skills influencing farmers' market FV purchases and consumption and theoretical understanding of approaches for modifying them. Lesson content delivery is primarily through short video segments and audio output to increase accessibility for low-literate learners. Informed by a community-based participatory research approach, WIC participants are engaged as full partners in the development of the lesson and the delivery of content (videos feature WIC participants). The setting is a large WIC agency serving three New Jersey counties. Separate samples of women were recruited to participate in 1) focus groups for guiding lesson content development (N = 56 participants) and pretesting the resulting content (N = 52 participants), 2) cognitive testing to assess the clarity and interpretability of items and response formats in measures of knowledge, attitudes and skills developed for the study (N = 15), 3) one-on-one sessions to assess reactions to initial versions of video segments developed for the lesson (N = 20), and 4) the outcome evaluation (N = 744). Stratified based on FMNP voucher receipt, participants are randomized to receive the lesson or existing online health education. Outcome measures (administered orally to reduce literacy demands of the response task) are completed at pretest (immediately before the lesson), posttest (two weeks after the lesson), and 3 and 6 months after posttesting. Short- and long-term lesson effects on FV intake, FMNP voucher redemption and the redemption of CVVs at farmers' markets will be evaluated. Evidence for mediation by knowledge, attitudes, and skills of lesson effects on FV intake and voucher redemption, dose-response relationships, and user satisfaction with the lesson also will be examined.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- Double (Participant, Outcomes Assessor)
Eligibility Criteria
- Sex
- Female
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Pregnant or postpartum WIC participant
- •Female caregiver of infant/child WIC participant
Exclusion Criteria
- •Restrictions on food intake
- •Classified by WIC as high risk/requiring an individualized nutrition care plan
Outcomes
Primary Outcomes
Quantity of Fruit and Vegetable Intake
Time Frame: Pretest, posttest, and 3- and 6-month follow-up
Cups per day consumed of fruits and vegetables as assessed by a validated fruit and vegetable screener.
Number of Participants Who Redeemed FMNP Vouchers
Time Frame: 6 months (2015 farmers' market season [June to November 2015])
The state WIC agency is providing data on FMNP voucher redemption.
Frequency of Fruit and Vegetable Intake
Time Frame: Pretest, posttest (2 weeks after pretest), and 3- and 6-month follow-up
Times per day fruits and vegetable are consumed as assessed by a validated food frequency questionnaire.
Secondary Outcomes
- Response to an Item Assessing Knowledge of WIC-authorized Farmers' Markets Using a Yes/no Format.(Pretest, posttest, and 3- and 6-month follow-up)
- Response to Survey Items Assessing Attitudes Towards Farmers' Market Fruits and Vegetables Using 7-point Likert Rating Scales.(Pretest, posttest, and 3- and 6-month follow-up)
- Response to Survey Items Assessing Fruit and Vegetable Food Safety Skills Using 7-point Likert Rating Scales.(Pretest, posttest, and 3- and 6-month follow-up)
- Response to Survey Items Assessing Awareness of Locally Grown, Seasonal Fruits and Vegetables Using a Yes/no Format.(Pretest, posttest, and 3- and 6-month follow-up)
- Response to Survey Items Assessing Farmers' Market Asking Skills Using a Yes/no Format.(Pretest, posttest, and 3- and 6-month follow-up)
- Response to Survey Items Assessing Knowledge of Locally Grown Seasonal Fruits and Vegetables Found at Farmers' Markets in July Using a Yes/no Format.(Pretest, posttest, and 3- and 6-month follow-up)
- Number of Participants Who Redeemed Cash Value Vouchers at Farmers' Markets(6 months (2015 farmers' market season [June to November 2015]))
- Response to Survey Items Assessing Knowledge of the WIC Farmers' Market Nutrition Program Using a True/False Format.(Pretest, posttest, and 3- and 6-month follow-up)
- Response to an Item Assessing Whether the Participant Purchased Fruits and Vegetables at a Farmers' Market in the Past Two Weeks Using a Yes/no Format.(Pretest, posttest, and 3- and 6-month follow-up)
- Response to Survey Items Assessing Positive Outcome Expectations for Consuming Locally Grown Fruits and Vegetables Using a Yes/no Format.(Pretest, posttest, and 3- and 6-month follow-up)
- Response to Survey Items Assessing Food-specific Knowledge Using a True/False Format(Pretest, posttest, and 3- and 6-month follow-up)
- Response to an Item Assessing Whether the Participant Ever Purchased Fruits and Vegetables at a Farmers' Market Using a Yes/no Format.(Pretest, posttest, and 3- and 6-month follow-up)
- Response to an Item Assessing Behavioral Intentions to Purchase Fruits and Vegetables at a Farmers' Market in the Next Two Weeks Using a Yes/no Format.(Pretest, posttest, and 3- and 6-month follow-up)
- Response to Survey Items Assessing Farmers' Market Fruit and Vegetable Preparation Skills Using 7-point Likert Rating Scales.(2 weeks)
- Response to Survey Items Assessing Knowledge of Area Farmers' Markets(Pretest, posttest, and 3- and 6-month follow-up)
Investigators
Jennifer Di Noia
Professor
William Paterson University of New Jersey