# Acceptability and effect on food choices of incentives promoting more sustainable diets among low-income consumers: A qualitative study

Basile Verdeau, Anaëlle Denieul-Barbot, Sandrine Monnery-Patris

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Basile Verdeau, Anaëlle Denieul-Barbot, Sandrine Monnery-Patris. Acceptability and effect on food choices of incentives promoting more sustainable diets among low-income consumers: A qualitative study. Appetite, 2025, 207, pp.107903. 10.1016/j.appet.2025.107903. hal-04971903

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# Acceptability and effect on food choices of incentives promoting more sustainable diets among low-income consumers: A qualitative study

Basile Verdeau<sup>a, ID</sup>, Anaëlle Denieul-Barbot<sup>b</sup>, Sandrine Monnery-Patris<sup>a, *</sup>

## ARTICLE INFO

**Keywords:**

Food insecurity

Food vouchers

Plant-based diet

Food aid

Semi-structured interviews

Process evaluation

Fruit and vegetables

Legumes

## ABSTRACT

In the context of rising food costs, low-income consumers are likely to lack financial access to a sustainable diet primarily composed of healthy plant-based food. To promote a change towards more sustainable food habits, vouchers for fruit, vegetables and legumes redeemable in supermarkets have been experimented in the urban area of Dijon (France). The objective of the study was to explore the acceptability of the intervention and the effects of the vouchers on food choices through participants' perceptions. Face-to-face semi-structured interviews were conducted with twenty-seven participants, three months after the end of the intervention. The transcripts were analysed through inductive then deductive content analysis, following a process evaluation framework with two themes related to the implementation and the mechanisms of impact of the intervention. Implementation issues and feelings of discrimination were mentioned, but satisfaction was high and vouchers were considered to improve the financial situation, although the restriction on the targeted products was not always understood. Regarding the mechanisms of impact, during the intervention period, two third of the participants, especially families with young children, attached greater importance to taste and curiosity for unfamiliar food and lesser importance to price. Vouchers thus led to food purchases of higher diversity and higher enjoyment. Other participants did not change their habits, mostly because of an improper use of the vouchers or the absence of motivation for a dietary change. These findings suggest that financial incentives not only increase access to sustainable food, but also influence food choice processes and contribute to greater acceptability of plant-based food in low-income families. The results call for financial incentives to be considered as an opportunity to support changes in dietary behaviour in low-income populations.

## 1. Introduction

Current food systems are threatening both human and planetary health (Afshin et al., 2019; Crippa et al., 2021; Willett et al., 2019). Feeding a growing world population while reducing diet-related mortality and morbidity, mitigating climate change and safeguarding natural resources will require a major transformation of our food systems, including a dietary shift towards more sustainable patterns (Springmann et al., 2018). Diets rich in healthy plant-based foods, such as fruit, vegetables, legumes, nuts and whole grains, have been consistently associated with health benefits (Aune et al., 2017; Rebello et al., 2014; Satija & Hu, 2018) and reduced environmental impact, in particular regarding climate change (Clark et al., 2019; Poore & Nemecek, 2018). Hence, multiple studies have concluded that sustainable diets should

include a large proportion of healthy plant-based foods and a limited proportion of animal-based foods such as meat (Chaudhary & Krishna, 2019; Wilson et al., 2019). In high-income countries, a significant gap has been observed between actual diets and such sustainable patterns (Willett et al., 2019). For instance, in France, less than half of the population meets the national recommendation of 5 servings of fruit and vegetables a day, whereas legume and wholegrain consumption is almost negligible (ANSES, 2017; ESEN, 2017; Seconda et al., 2021).

Changing eating behaviours at population-level is known to be difficult (Vermeir et al., 2020). Various individual factors have been identified as barriers to reducing meat and increasing plant-based foods (i.e. meat attachment, lack of environmental awareness or social representation of meat as the centre of the meal) (Graça et al., 2019; Muñoz-Martínez et al., 2024; Vermeir et al., 2020), but external factors,

<footnote><sup>a</sup> Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université Bourgogne Europe, F-21000, Dijon, France</footnote>

<footnote><sup>b</sup> CESAEER UMR1041, INRAE, Institut Agro, Université Bourgogne Europe, F-21000, Dijon, France</footnote>

<footnote>Abbreviations: SGS, Social grocery store.</footnote>

<footnote>* Corresponding author. Centre INRAE Bourgogne Franche-Comté, CSGA, 17 rue Sully, 21065, Dijon Cedex, France.</footnote>

<footnote>E-mail address: sandrine.monnery-patris@inrae.fr (S. Monnery-Patris).</footnote>
such as cost and accessibility, may be particularly significant for finan-
cially disadvantaged consumers (Briazu et al., 2024; Muñoz-Martínez
et al., 2024; Vos et al., 2022), such as those experiencing food insecurity
(i.e. inability or uncertainty to access acceptable and nutritionally
adequate food in acceptable ways (Anderson, 1990)). The dietary
change to be achieved is challenging for low-income consumers who
have diets of poorer nutritional quality than the rest of the population
and in particular consume fewer fruits and vegetables (Darmon &
Drewnowski, 2008; Kamphuis et al., 2006). This discrepancy has been
consistently reported regarding income level and food insecurity status
in France (Bocquier et al., 2015; Perignon et al., 2023).

Although some studies have explained this trend partly by a lack of nutrition knowledge (McKinnon et al., 2014; Wiig Dammann & Smith, 2009), others have highlighted that low-income consumers value the health benefits of plant-based food (Bell et al., 2022; Verdeau & Monnery-Patris, 2024) and perceive cost as the main barrier to consuming more fruit and vegetables (Bihan et al., 2010; Chapman et al., 2017; Dibsdall et al., 2003). Fruits and vegetables are indeed the food category with the highest cost per calorie (Darmon & Drewnowski, 2015) and have a higher risk of wastage because of their perishability and children's dislike in families (Daniel, 2016). This may be particularly significant in the current context of "cost of living crisis" (Hardman & Johnstone, 2024), characterised by an exceptional food inflation which could even widen the gap in achieving a sustainable diet for low-income consumers. In France, the cost of fruit and vegetables and, more generally, of food baskets meeting French dietary recommendations, rose by around 20% between 2021 and 2023 (Familles Rurales, 2023, 2024). Recent data indicate that consumers experiencing food insecurity adopt strategies that negatively affect diet quality, such as cutting back on fruit and vegetables (Bléhaut et al., 2023; Stone et al., 2024).

Financial incentives constitute a promising intervention to promote
sustainable choices for low-income consumers. Subsidies for fruit and
vegetables or farmers' markets have been successfully implemented in
different high-income countries such as the United States, the United
Kingdom and Canada (Aktary et al., 2023; Durward et al., 2019; Herman
et al., 2006; McFadden et al., 2014; Rummo et al., 2019). In France, two
previous randomised trials of vouchers for fruit and vegetables showed
positive results, albeit only on adults who initially consumed very few
fruits and vegetables (Bihan et al., 2012) or on children (Buscail et al.,
2018). Different qualitative studies have analysed such programmes
from the perspective of participants and provided insights into the
acceptability of the incentives, as well as the perceived benefits and
barriers (Caron-Roy et al., 2022; Garner et al., 2020; Riemer et al.,
2021). However, few studies have investigated the effects of such in-
centives on the psychological mechanism of food choices. Following the
"food choice process model" (Furst et al., 1996), food decisions result
from cognitive processes based on a negotiation between different food
values (or motives), namely the importance individuals attach to several
considerations when choosing food (e.g., cost, taste or health) (Sobal &
Bisogni, 2009). Several studies have employed this model to explore the
food choices of low-income consumers, showing that price and available
money are weighted against different motives, in particular satiety,
leading to choices of high energy density and low nutritional quality
(Burns et al., 2013). Financial incentives for sustainable food could in-
fluence the negotiation of choice motives. Two previous studies have
shown that vouchers for fruit and vegetables can be used in different
ways, for instance to save money while maintaining food habits, to
stockpile food or to improve dietary quality (Buscail et al., 2018; Ohly
et al., 2019). However, the first study reported few qualitative results
and the other one was focused on the Healthy Start programme in the
United Kingdom, which is a specific intervention targeting only preg-
nant women and mothers with young children.

In France, “sustainable food vouchers” have been considered by the
government as an innovative food policy to address food insecurity,
improve public health and encourage more sustainable choices (Brocard

& Saujot, 2022; Caillavet et al., 2022; JORF, 2021). Our study focuses on an innovative trial organised in the metropolitan area of Dijon, France, between 2022 and 2023, which promoted not only fruit and vegetables but also legumes, with amounts designed to fully cover dietary recommendations. As they constitute a source of protein of low environmental impact and good nutritional quality, legumes are a potential meat substitute in sustainable diets (Harwatt et al., 2017; Röös et al., 2020; Semba et al., 2021).

The aim of this study is two-fold. First, it aims to evaluate the acceptability of the vouchers. To the best of our knowledge, this is the first study on the acceptability of incentives subsidising not only fruit and vegetables but also legumes, with amounts for fruit and vegetables well above those of previous studies. Second, this study aims to explore the effect of the intervention on food choices. Also here, this is the first study to analyse the effect of financial incentives on the internal negotiation between food choice motives and how this may lead to dietary changes.

## 2. Methods

The description of the procedure follows the Consolidated criteria for Reporting Qualitative (COREQ) checklist (see Supplementary Material 1). The study was conducted in accordance with the Declaration of Helsinki and was approved by the ethical committee of INSERM (CEEI/IRB) n° 23–1004 (IRB00003888, IORG0003254, FWA00005831).

2.1. *Study design*

This study was based on an intervention trial conducted in the metropolitan area of Dijon, France, which is described in section 2.2. For the present study, a qualitative methodology was used. Indeed, qualitative methods are suitable for an in-depth exploration of perceptions (Bisogni et al., 2012; Burney et al., 2023). Given the focus on individual processes of food choices, face-to-face semi-structured interviews conducted in person were chosen instead of focus groups.

## 2.2. *Intervention*

Details about the intervention content are available elsewhere (Bellassen, 2022). A randomised controlled trial was organised to provide vouchers for fruit, vegetables and legumes to participants recruited from different social services and associations, including two social grocery stores (SGS, a type of food assistance where registered disadvantaged customers can access various products well below market prices). Participants were randomly allocated to either the intervention group (n = 132) and received paper vouchers every two weeks by postal shipment between December 2022 and April 2023, or to the control group (n = 134) and received the vouchers later. The amount was calculated so that every member of the participant's household could entirely rely on vouchers to meet the national dietary recommendations for fruit and vegetables (5 servings a day) and legumes (2 servings a week) (Delamaire et al., 2018). Vouchers were issued in denominations of €5 for fruit and vegetables (€2 for single-person households) and €2 for pulses. They were designed as gift vouchers widely used in France, so that they could be redeemed in most supermarkets, including the two partner SGSs for registered customers. Local retailers and participants were informed of the restriction on fruit, vegetables and legumes (pictures of authorised products and written mentions were displayed on the vouchers). Additionally, two booklets including 31 vegetable-based and 11 legume-based recipes along with general information on the health, environment and financial benefits of legumes were sent to the participants.

2.3. *Recruitment*

Eligible participants for this study were participants of the
intervention group who completed a follow-up questionnaire (n = 114) (Bellassen, 2022) and who were fluent enough in French to answer questions about their food habits for 1 h. For logistical reasons, participants recruited from two social services could not be contacted for the present study (n = 24). The 90 remaining eligible participants had been recruited from SGS A (n = 47), SGS B (n = 21) and municipal social services (n = 22). Sociodemographic data previously collected was extracted to preselect 10 participants from each structure, as representative as possible of foodbank and SGS users in France in terms of age, gender, household type and immigration status (Accardo et al., 2022).

The staff of the social structures was asked to invite the 30 preselected individuals by telephone to take part in a 1-h interview about their experience of the programme. When participants could not be reached or declined (n = 8), were considered by the staff not fluent enough in French (n = 2) or were not users of the SGS anymore (n = 2), other participants with similar sociodemographic profiles were contacted. In total, 43/90 individuals were contacted and 27 (20% of the intervention group) actually participated in our study (n = 4 did not show up for the interview). Before the interview, written information about the study was handed over in person (SGSs) or sent by email (municipal social services). Information was explained again orally at the beginning of the interview and participants gave oral consent. The participants who completed the interview received a €20 voucher redeemable in most supermarkets for all types of products.

## 2.4. Data collection

A semi-structured interview guide was developed based on the research question and previous qualitative research on financial incentives for fruit and vegetables (Buscail et al., 2018; Caron-Roy et al., 2022; Ohly et al., 2019). The guide was structured as follows: eating habits and values (criteria when choosing food, evocations of “eating well”, perceived healthiness and enjoyment); use of vouchers (spontaneous memories, shops visited, products purchased, preparation of the products, rationale underlying the choices, perceived changes); feedback on the vouchers (satisfaction, feelings of restriction, suggestions); perception of other resources (booklets). Food insecurity was also measured during the interview using the 6-item Household Security Scale (Blumberg et al., 1999). Participants were finally asked to provide supplementary sociodemographic information (education, employment status and professional experiences). No data on income was collected as all participants had been recruited from social services and were thus considered as low-income. A complete version of the guide is available in Supplementary Material 2.

The interview guide was piloted with three participants from SGS A, then slightly modified (these participants were not included in the analysis). Twenty-seven other interviews were then conducted by BV between June and July 2023, with a duration of approximately 45–55 min. Interviews were conducted in a closed office located either in SGS A, SGS B or in a municipal office, where privacy was guaranteed. All participants orally agreed to the audio recording. Recordings were transcribed verbatim and completely anonymized.

## 2.5. Data analysis

After discussion between BV and SMP, redundancy appeared in the data with no additional information provided by the last interviews, thus saturation was considered to be reached. A first inductive content analysis was conducted by BV to identify meaningful categories throughout the corpus (Hsieh & Shannon, 2005). Five themes were developed: food values; experiences of food insecurity and barriers; food choices with the vouchers; use of the voucher; satisfaction (the first two themes will not be detailed in the present article as they do not regard the voucher intervention). Then, the themes generated throughout the inductive analysis were restructured in two themes following the process evaluation framework provided by the United Kingdom Medical

Research Council (Moore et al., 2015). This framework offers guidance for evaluating randomised trials around three themes: implementation (how the intervention was delivered to participants), mechanisms of impact (how the intervention produced change) and context (how external factors affected implementation and outcomes). We did not have enough data to elaborate on the context theme. We developed a coding tree composed of two themes and four subthemes: implementation, which included the subthemes related to fidelity (whether the intervention was implemented as intended, here from the participants’ perspective) and satisfaction (considered here as an indicator of the dose received by the participants (Saunders et al., 2005)); and mechanisms of impact, which included the subthemes related to the effect the intervention on food choice motives and the effect on diet and purchases. Three interviews were independently coded by BV and SMP. Given the high rate of agreement, the remaining 24 interviews were coded by the first author. The NVivo 14 software was used to assist the coding.

# 3. Results

## 3.1. Participants

Participant characteristics are presented in Table 1. Three main groups were identified. Participants living without children (n = 11: more frequently older, all male participants and participants recruited from municipal social services); lone mothers (n = 6; more frequently

<table><caption>**Table 1**
Sociodemographic information.</caption><thead><tr><th></th><th>Total (%)</th><th>Social grocery stores (%)</th><th>Municipal social services (%)</th></tr></thead><tbody><tr><td><strong>Gender</strong></td><td></td><td></td><td></td></tr><tr><td>Female</td><td>21 (78)</td><td>18 (90)</td><td>3 (43)</td></tr><tr><td>Male</td><td>6 (22)</td><td>2 (10)</td><td>4 (57)</td></tr><tr><td><strong>Household situation</strong></td><td></td><td></td><td></td></tr><tr><td>Alone</td><td>7 (26)</td><td>3 (15)</td><td>4 (57)</td></tr><tr><td>Family or couple without children &lt;18</td><td>7 (26)</td><td>4 (20)</td><td>3 (43)</td></tr><tr><td>Single-parent family with children &lt;18</td><td>4 (15)</td><td>4 (20)</td><td>0 (0)</td></tr><tr><td>Two-parent family with children &lt;18</td><td>9 (33)</td><td>9 (45)</td><td>0 (0)</td></tr><tr><td><strong>Age</strong></td><td></td><td></td><td></td></tr><tr><td>&lt;30</td><td>2 (7)</td><td>2 (10)</td><td>0 (0)</td></tr><tr><td>30–39</td><td>9 (33)</td><td>8 (40)</td><td>1 (14)</td></tr><tr><td>40–49</td><td>6 (22)</td><td>4 (20)</td><td>2 (28)</td></tr><tr><td>50–64</td><td>9 (33)</td><td>6 (30)</td><td>3 (43)</td></tr><tr><td>&gt;65</td><td>1 (4)</td><td>0 (0)</td><td>1 (14)</td></tr><tr><td><strong>Occupation</strong></td><td></td><td></td><td></td></tr><tr><td>Paid job</td><td>6 (22)</td><td>4 (20)</td><td>2 (28)</td></tr><tr><td>Unemployed (disability, disease)</td><td>9 (33)</td><td>6 (30)</td><td>3 (43)</td></tr><tr><td>Unemployed (job search, unknown, housewife)</td><td>6 (22)</td><td>6 (30)</td><td>0 (0)</td></tr><tr><td>Retired</td><td>4 (15)</td><td>2 (10)</td><td>2 (28)</td></tr><tr><td>Student</td><td>2 (7)</td><td>2 (10)</td><td>0 (0)</td></tr><tr><td><strong>Education</strong></td><td></td><td></td><td></td></tr><tr><td>University or Higher Technical Qualifications</td><td>8 (29)</td><td>5 (25)</td><td>3 (43)</td></tr><tr><td>Youth training, Vocational Qualification</td><td>10 (37)</td><td>8 (40)</td><td>2 (28)</td></tr><tr><td>&lt; High school diploma</td><td>8 (29)</td><td>6 (30)</td><td>2 (28)</td></tr><tr><td>Unknown</td><td>1 (4)</td><td>1 (5)</td><td>0 (0)</td></tr><tr><td><strong>Region of birth</strong></td><td></td><td></td><td></td></tr><tr><td>France</td><td>13 (48)</td><td>10 (50)</td><td>3 (43)</td></tr><tr><td>North Africa</td><td>8 (29)</td><td>5 (25)</td><td>3 (43)</td></tr><tr><td>Sub-Saharan Africa</td><td>3 (11)</td><td>2 (10)</td><td>1 (14)</td></tr><tr><td>Eastern Europe, Middle East</td><td>3 (11)</td><td>3 (15)</td><td>0 (0)</td></tr><tr><td><strong>Food insecurity</strong></td><td></td><td></td><td></td></tr><tr><td>No food insecurity (0–1/6)</td><td>14 (52)</td><td>9 (45)</td><td>5 (71)</td></tr><tr><td>Low food security (2–4/6)</td><td>8 (30)</td><td>7 (35)</td><td>1 (14)</td></tr><tr><td>Very low food security (5–6/6)</td><td>5 (18)</td><td>4 (20)</td><td>1 (14)</td></tr></tbody></table>
employed and native French); mothers in couples (n = 10; more frequently unemployed and born outside France, often large families). In total, 8 (30%) participants were classified as experiencing low food security and 5 (18%) were classified as experiencing very low food security.

## 3.2. Implementation

### 3.2.1. Fidelity

All participants indicated that they had received the vouchers during the intervention period. However, improper use was reported by 14 participants (52%): seven declared they had bought any food with the vouchers and other seven declared they had bought mainly fruit, vegetables and legumes but also a few extras which were not supposed to be eligible. This improper use was made possible as no automatic match between the vouchers and the basket contents could be guaranteed at the checkout by scanning the barcode, so cashiers and participants had to visually check which food the voucher was being used for. Yet, in reality, participants indicated that, depending on the store and the cashier, the basket contents were not accurately checked, while some participants themselves did not understand well the incentives. Some participants indeed evoked vouchers for “fresh produce” or “canned food”, mentioned potatoes (which were not supposed to be eligible) or did not notice the difference between the two types of vouchers and bought vegetables with the legume vouchers.

What I remember is that I know very well, pertinently that on some it's marked fresh produce. [...] And when I go to my butcher for example, he doesn't take it. And ... well, I don't understand how that happens. (Woman living alone, 35-39, municipal social services)

I thought it wouldn't work, but it worked. [...] Erm, I said we're only going to start on vegetables and fruit, that's good ... The moment I went the shop, I saw that they didn't say 'you can't pay because you've bought more stuff than vegetables and fruit'. (Mother in couple with 3 young children and living with her son's family, 40-44, SGS B)

### 3.2.2. Satisfaction

Participants were highly satisfied with the financial opportunity they were given. Twenty participants (74%) rated the vouchers above 8/10 and had no negative comment. The intervention was considered as a “gift” and a “generous” and “useful” initiative. Several participants expressed a financial relief, vouchers were perceived as a “helping hand in the budget” or even “life-saving”. Some participants having used the voucher unproperly declared that they would still have been satisfied if the restriction had been more accurately controlled. On the contrary, the seven other participants were quite sceptical about the restriction on fruits, vegetables and legumes because financial assistance was deemed to be a support for all food products including meat, fish or dairy. This was the case of participants in severe food insecurity:

Because, well, if we're restricted, we're already restricted in terms of budget, whether it's me or someone else, if on top of that you give use vouchers and then we're restricted again, we can't buy ... again, not what we'd like, well then, it's not worth it. (Man living alone, 45-49, municipal social services)

Three participants also complained that as vouchers could not be redeemed in hard discount stores, they used them in small convenience stores, which was less profitable due to higher prices. However, most participants were used to shopping in different stores and reported little impact on their shopping habits. Participants with fewer constraints often considered that they did not need such incentives to eat healthy. Three of them were rather buying their vegetables at the market, where vouchers were not redeemable, and another one was growing her own vegetables and used the voucher for all products except fruit and vegetables.

A few participants complained about issues at the checkout. Indeed, they experienced unpleasant comments from cashiers, unexpected refusals or restrictions on the number of vouchers that could be used for a transaction. Five participants reported explicit situations of stigma or shame:

> But sometimes they wonder what it is! They call the manager. So, people wait. "Here we go again ...". Yes, I once got a comment, it's true. Someone told me "Ah well, that's it, another person being helped." But I said nothing, I turned a deaf ear. [...] Customers. It hurts. But that's the way it is. (Woman living alone, 45-49, SGS A)

Nevertheless, the majority of the participants considered that paying with vouchers in supermarkets was more dignified than using food banks and SSGs:

> The social grocery store, the first ones in get everything. [...] There are priority cards, they find everything. [...] And then, there's nothing. I mean, all you get are crumbs. And for me, the crumbs, I do have a certain dignity, I think that ... with the vouchers, it allows me ... to go there, when I want, I buy with my vouchers, I have no problem. (Man living in couple without children, 70-74, municipal social services, also user of SGS A)

## 3.3. Mechanisms of impact

### 3.3.1. Effect on food choice motives

The most common food choice motive when using the vouchers was *pleasure*. Participants took the opportunity of a higher food budget to give more importance to their sensory preferences (freshness, taste) when choosing food. This motive was mentioned by 17 participants (63%), especially family mothers who wanted to treat themselves and their children, notably with expensive fruits. For instance, six participants declared going more often in a relatively expensive supermarket to find highly appealing fresh fruit and vegetables:

> Tomatoes, cucumbers ... nectarines ... I had bought strawberries. Raspberries. Well, things I wasn't used to buying. I once splurged on a punnet of raspberries, because they were €9 at [supermarket chain specialised in fresh produce] and then I thought, well, why not ... (Lone mother with one child, 35-39, SGS B)

We take more pleasure in making a small menu, going to see what we need and ... that's it ... we had, price-wise, well, we didn't have to calculate. It was a bit more ... well more of a pleasure menu, seeing what we could buy. (Mother with 4 children, 45-49, SGS B)

Secondly, many participants reported a lesser importance of *price* in food decisions. Vouchers enabled the participants to be less dependent on low-cost products, but also less dependent on what was available on special offers and in food assistance. Noticeably, more than half of the participants who had access to a SGS declared not spending the vouchers there. Indeed, since the SGSs were only open for a few hours on weekdays and offered a range of products of uncertain quantity and freshness, participants felt free to go shopping elsewhere. Moreover, given the price of fresh fruit and vegetables in the social shops (€0.70 per kg), one €5 denomination without change would require to buy more than 7 kg, which was deemed inconvenient. Some participants reported a reduction in the mental burden of finding food:

> With the vouchers, vouchers like that, it took me a lot of things away, thinking, "this is expensive", all that ... Yes, I was comfortable. (Mother with 4 children, 50-54, SGS A)

Interestingly, a mother described her daughter as a picky eater and explained that the vouchers made her less reluctant to feed her daughter vegetables. She explained that without vouchers, she used to avoid buying vegetables for the family in order to prevent waste, as her
daughter doesn't like them, but that vouchers removed this constraint:

Me I told myself “Well, we’re gonna do it anyway, never mind, she’s not happy, she won’t eat them”, and then … I was more motivated, that’s for sure. Saying to myself “well come on, we’re not paying, we’re gonna enjoy ourselves and if she doesn’t eat it, too bad for her”, yeah that’s true. But then … otherwise, under normal circumstances … (Lone mother with 3 children, 25–29, SGS A)

However, for other participants choices were still mainly motivated by price. They were aware that the voucher experiment would not last and used them to stockpile food or spent them sparingly. Six participants still had vouchers at the time of the study, three months after the end of the intervention. Other participants reported having used the vouchers strategically for cheaper options (special offers, SGS, anti-waste baskets):

Anyway, I used to look a bit at the offers to make the most of them and not to use all my vouchers for anything and everything, saving them so I could buy … buy other things when I had other offers. [...] Yes, to buy more at a lower cost. (Mother with 2 children, 35–39, social shop A)

Third, the *familiarity* motive seemed to be less important for several participants who expressed curiosity to try unfamiliar fruits, vegetables and legumes. Participants expressed willingness to try novel foods, as vouchers gave the opportunity to break out of shopping routines and to seek diversity in the supermarket shelves, as illustrated by the following quote.

- [I bought] kidney beans, I didn't even know that existed! (laughs). Yeah. Er ... Jerusalem artichoke, things like that ... dragon fruit, I didn't know that. [...]

- You said that you didn't know about kidney beans, how did you discover them?

- Well in the store. Looking at the cans, that's how. Sometimes I don't pay attention, of course ... (Mother with 3 children, 35–39, SGS A)

However, familiarity remained a strong choice motive during the intervention, especially for participants living without children. Sixteen participants (59%) explicitly declared that they had not changed their habits during the 3-month intervention period.

- How did you decide what to buy with the vouchers?

- Well, it just happens naturally when you go shopping. [...] It's not because there are vouchers, that I ... that the family ... I mean my mother and I, are going to change our eating habits. (Man living with his parents, 60–64, municipal social services)

The *health* motive was important for most participants. A few of them perceived the vouchers as incentives to take greater account of health in their choices and thought they had been designed by the public authorities to meet the national recommendation for fruit and vegetables. However, as vouchers were supposed to be restricted on healthy food categories, vouchers did not seem to have an effect on the negotiation between health and other choice motives, but rather directly on healthy behaviours through restriction:

It's not that I had no choice, but I really forced myself to take more vegs and fruits, as much for myself besides, well it's healthy too. But yes, it really helped me stick to vegs and fruits. That was my initial goal in itself. (Woman living alone, 35–39, municipal social services)

Although natural food was highly valued in the sample, food choices with the vouchers did not imply a higher importance of other motives such as *naturalness*, *ethics* or *environmental impact*. For instance, no participant declared having paid more attention to labels or composition. As an exception, one participant managed to redeem vouchers once with a local vegetable farmer, whereas another one tried to pay more

attention to the provenance of fruit and vegetables. When asked about organic and local food, one participant declared valuing such products but considered they were not affordable even with the vouchers:

[Organic food] allows us to have no pesticides in our fruit and vegetables. And to eat healthy. [...] Really, there when we say healthy food, that's really healthier, that's why it's more expensive. And that's why we can afford it, us. Well, those who have food vouchers and those who go to the [social] grocery store. (Mother in couple with 2 children, 30–34, SGS A)

### 3.3.2. Effect on purchases and diet

Overall, nineteen participants (70%) declared having bought and eaten more fruit and vegetables than usual during the intervention period. This effect was mostly reported by the participants who complied with the instructions. When participants put more emphasis onus on the *pleasure* motive and less on the *familiarity* motive, a higher dietary diversity was also reported. For fifteen participants (55%), mostly mothers, the vouchers enabled to include different varieties of fruit (or vegetables) in their diet. They perceived the intervention as an opportunity to no longer rely solely on the cheapest varieties available in food assistance or special offers but to afford new ones (e.g., nuts, exotic fruits, broccoli, cherry tomatoes):

We thought, well … we’ve got vouchers so we can take a bit more of the things we don’t usually take, that we don’t usually eat, so yes it’s true that we feel a little bit different. Less than buying the usual kilo of bananas, the kilo of apples … (Mother with 2 children, 30–34, SGS A)

Overall, choices motivated more by *pleasure* and less by *price* led to choices of higher sensory quality. A few participants wanted to eat “good stuff” and bought branded canned goods, more complex ready meals or fresh vegetables instead of canned ones. Twelve participants also reported having saved money for meat and fish or having bought some directly with the vouchers. Some of them reported having bought better quality meat, while others prioritised quantity:

Yes, we used to buy more cold meats too. Because normally, now it's too expensive, we buy only white, simple cold meats. [...] We buy white cured meats, white salamis, because they're cheap at €1.40, €2–3. I used to buy more, when I had vouchers, I used to buy a bit more. (Mother in couple with 3 young children and living with her son's family, 40–44, SGS B)

On the contrary, when *familiarity* remained the most important motive along with *price* (in particular for the participants without children or those who used the vouchers improperly), few qualitative dietary changes were reported. In this case, vouchers were perceived as a means to stabilise the shopping strategies:

Yes, I'm sticking to my guns. I don't see why because of some vouchers I would change my diet. It doesn't make sense. (Man living in couple, 60–64, municipal social services)

Well when it comes to food it doesn't change with me. I buy what I buy anyway. With those vouchers I didn't buy more and different food than what I usually eat. But yes, on the budget I feel it. It relieved me a lot. (Mother with 4 children, 35–39, SGS B)

Only six participants claimed to have bought legumes more often thanks to the vouchers. However, since legumes are bought dry or canned, higher purchases could have not led to a higher consumption. Indeed, some participants declared having stockpiled canned legumes or frozen vegetables. Two older female participants from France, despite experiencing severe food insecurity, did not use any legume voucher because they were not used to eating them:

No, I think that the €2 voucher [for legumes], for me it's pointless, I don't know what you've been told by the others … Well I don't have
the Algerian culture where I'd eat red beans and ... that's it. Well, my sister likes lentils, I don't, so I'm not going to make them myself on purpose to use a voucher. (Mother living with an adult child, 60–64, SGS B)

## 4. Discussion

The present study aimed to evaluate the acceptability and the effect on food choices of an intervention promoting sustainable diets through financial incentives for healthy plant-based options (fruit, vegetables, legumes), in a sample of low-income consumers. Our findings show that the intervention mainly helped stabilise the budget for fruit and vegetables and increased the opportunity to buy various and/or unfamiliar fruit and vegetables (and, to a lesser extent, legumes) outside of food assistance services.

### 4.1. Acceptability

Our results indicate that incentivising fruit, vegetables and legumes was relatively well received, as the majority of the participants expressed gratitude and enjoyment. This provides food for thought regarding the question of dignity in the context of the initiatives addressing food insecurity in high-income countries. The dignity of the vouchers can be assessed drawing on the five dimensions conceptualised by a recent review on food aid (Andriessen & Van Der Velde, 2023). First, regarding access to food aid, vouchers could be used in most supermarkets without time restrictions and were perceived to make healthy eating more affordable. However, several participants were refused vouchers at checkout, which led to embarrassment and wasted time. Second, in terms of social interactions, the relation between cashiers and participants could foster a sense of social hierarchy leading to shame or stigma. This is consistent with previous research: stigma has been mentioned by participants in the Healthy Start, where mothers felt judgment or even “humiliation” when paying with the vouchers (Lucas et al., 2015; McFadden et al., 2014), or by participants of fruit and vegetable incentive programmes in North America, who also reported difficulty at checkout due to the confusion and the lack of training of cashiers, leading to uncertainty, embarrassment and stigmatisation (Bertmann et al., 2014; Caron-Roy et al., 2022; Riemer et al., 2021). Third, as for the food dimension, participants could buy fruit, vegetables and legumes from supermarkets. They expressed satisfaction to be able to buy appealing fruit and vegetables in supermarkets specialised in fresh produce. Fourth, in terms of physical space, on the contrary to previous studies which reported lack of physical access (distance, transportation, opening hours) to the locations where vouchers can be redeemed (Freedman et al., 2016; Garner et al., 2020; Riemer et al., 2021; Savoie Roskos et al., 2017), here the vouchers were redeemable in most supermarkets of an urban area with a high density of food outlets. Notably, vouchers were not accepted by hard discount stores, which are among the main sources of food supply for consumers experiencing food insecurity in France (Gressier et al., 2023). However, few participants complained about this restriction since they were used to shopping in multiple supermarkets. Fifth, regarding needs beyond food, participants did not take part in the conception of the voucher. In particular, they did not choose the targeting on fruit, vegetables and legumes, which was considered as too restrictive by several participants. However, other participants approved this restriction for health reasons. This is in line with a recent survey in the United States showing that though a large majority of low-income adults prefer vouchers for all foods over restricted vouchers, those who have already experienced vouchers for fruit and vegetables tend to prefer these vouchers more frequently (Banerjee et al., 2024).

Overall, our findings show that vouchers could raise dignity issues but were generally considered a more dignified form of food aid than social stores. Indeed, although the two SGSs located in the Dijon area

offer a wide range of fresh fruit and vegetables at a highly discounted price, they also have limitations in terms of access (limited opening hours, random number drawn to define waiting time), food (variable offer from day to day and depending on the number drawn) and physical space (only one small store accessible). Participants therefore felt the intervention as an opportunity to release from these constraints. Whereas using food banks has been associated to a perceived lack of autonomy (Bell et al., 2022; Middleton et al., 2018), the vouchers seemed to alleviate the mental burden of food procurement with a tight budget.

### 4.2. Effect on food choices

Our results suggest the existence of two main profiles with different responsiveness to the intervention: on the one hand, mothers living with children and participants perceiving a gap between their values and their actual eating habits, who effectively modified their food choices; on the other hand, participants living without children and participants experiencing no food insecurity (in particular those recruited from municipal social services), who reported little effect on their food choices. The first profile was characterised by a change in the negotiation process between food choice motives (Sobel & Bisogni, 2009), as participants put more weight on pleasure and health and less on price and familiarity. Therefore, financial incentives for fruit, vegetables and legumes can have a positive impact not only on the nutritional quality of the diet, but also on the acceptability of plant-based food. Indeed, families used the vouchers to break the monotony and to buy more appealing fruit and vegetables, possibly leading to a higher exposure to a variety of healthy plant-based food. These results are consistent with previous research showing that targeted financial support for healthy food can prompt participants to try higher-quality and unfamiliar foods (Caron-Roy et al., 2022; Garner et al., 2020; Lucas et al., 2015; Savoie Roskos et al., 2017). Exposure has been identified as a strong determinant of food preferences development during childhood (Nicklaus, 2016; Wardle et al., 2003). Increasing children's exposure to different plant-based foods may thus be decisive for the transition towards more sustainable food habits, since previous research has shown that the financial risk of wasting vegetables is too high for low-income parents (Daniel, 2016). The experience of financial scarcity is known to be associated with cognitive load and “tunnelling”, namely an attentional focus on costs (de Bruijn & Antonides, 2022; van der Veer et al., 2024). Here, the temporary financial relief not only reduced the cognitive load of shopping, but also broadened the focus on other characteristics such as taste or novelty and improved the attentional capacity in the supermarket shelves beyond price tags. Some interviews also suggested that vouchers may help reduce risk aversion. As for the second profile, price and familiarity remained the major motives. Some participants had a less constraint financial situation and did not perceive the intervention as an opportunity to change their diet. Others on the contrary were experiencing severe food insecurity but declared having used the voucher to stabilise their budget.

This study focused on an innovative programme where not only fruit and vegetables but also legumes were targeted. However, in our study, few participants reported buying or eating legumes more frequently during the intervention. As legumes are not widely consumed in France and are a low-cost food category (Drewnowski & Conrad, 2024; Maillot et al., 2007), financial incentives may have little effect. Different barriers to legume consumption have been identified in the literature and do not include cost, but rather preparation, dislike and digestion issues (Henn et al., 2022; Melendrez-Ruiz et al., 2019). Financial incentives still could be relevant to promote other healthy plant-based foods, as whole grains are more expensive than refined grains, nuts and seeds have high costs per weight and fruit and vegetables have high costs per calorie (Darmon & Drewnowski, 2015). However, such incentives could also have adverse effects on the overall dietary environmental impact. Notably, in our study, half of the sample reported savings for meat
and/or fish. This observation had been qualitatively made in a previous study in France (Buscail et al., 2018) but the effect of subsidies for fruit and vegetables on the overall diet has been rarely assessed (An, 2013). In conclusion, financial incentives alone may not be sufficient to encourage sustainable choices. Beyond incentivisation, other intervention strategies (e.g. environmental restructuring, education, training) should be combined to promote a transition towards more plant-based diets (Onwezen, 2022).

In a previous study, it has been shown that SGS users in France value
several dimensions of sustainable diets, such as healthy, natural and
local food or frugality, and that they value natural food for health and
taste, but not for the environment (Verdeau & Monnery-Patris, 2024). In
the current study, although financial incentives for fruit, vegetables and
especially legumes intended to promote sustainable diets, thus not only
healthy but also environmentally friendly choices, the environment was
never spontaneously mentioned by the participants during the in-
terviews. In comparison to incentives implemented in North America for
farmers' markets, where participants enjoyed accessing locally-grown
food (Savoie Roskos et al., 2017), the vouchers experimented in Dijon
did not play any role in other food motives such as naturalness or ethics.
A previous study reported that users of a SGS in Dijon showed little trust
in food industry and supermarkets, and high trust in local farmers
(Verdeau & Monnery-Patris, 2024). Therefore, drawing inspiration from
farmers' markets programmes in North America and incentivising
farmers' markets or community-supported agriculture might be of in-
terest in the French context.

4.3. Implications for research and practice

Our findings show that financial incentives can impact not only
purchases but also food choice motives. Future research could quanti-
tatively investigate the impact of incentives for sustainable diets on
multiple psychosocial variables such as food choice motives (Marty
et al., 2021). Previous studies have also shown that incentives for
healthy food can impact attitudes, self-efficacy and autonomous moti-
vations (Gardiner & Bryan, 2017; Hanson et al., 2022), but further
research on low-income populations with consistent measures is
necessary.

As the prevalence of food insecurity is known to be increasing in France (Bléhaut & Gressier, 2023; C-WAYS, 2023), policies are needed to improve the affordability of sustainable diets for the most vulnerable consumers. Our research contributes to the debate about “sustainable food vouchers” in France (Brocard & Saujot, 2022). First, targeting healthy plant-based food is perceived by beneficiaries as a safety net to buy fruit and vegetables, confirming previous research showing that financial incentives are among the most preferred interventions by low-income consumers (Vos et al., 2022; Waterlander et al., 2010). Second, we show that even when vouchers are restrictive, they can contribute to alleviating the mental burden of finding acceptable food in food assistance structures. Therefore, they may constitute a relevant alternative or complement to food aid. Third, vouchers require robust implementation to improve fidelity and avoid improper use. Indeed, in the present study half of the participants declared having bought foods which were not eligible because they misunderstood the instructions or because cashiers did not check the contents of the baskets. Although local supermarkets were informed of the experiment, it is likely that few cashiers received training on voucher management for this 3-month scientific experiment. Finally, particular attention should be paid to the risk of shame and stigmatisation when implementing future vouchers for sustainable food. Although only few participants reported such issues, incentives should be issued in a non-discriminatory and easily manageable way for cashiers, for instance by means of a specialised and discreet payment card (Garner et al., 2020).

4.4. Strengths and limitations

This study has several strengths. Its qualitative nature allows to
investigate the perception of those most concerned by financial in-
centives. Our recruitment process reached participants from three
different social structures, avoiding as far as possible interviewing only
the most motivated participants. Beyond the description of the experi-
ence of the intervention by participants, our results give insights into the
mechanisms of impact of such incentives, based on a theoretical
framework of food choice processes. As such, this study enhances the
understanding of the quantitative results of the intervention, which will
be published elsewhere. Finally, this study focuses on a trial where not
only fruit and vegetables but also legumes were targeted. Unlike fruit
and vegetables, legumes are rich in protein and can play a major role in
reducing meat consumption. Moreover, the amounts were much higher
than in previous experiments and completely addressed the financial
barrier. For instance, in a previous study conducted in France, vouchers
amount fulfilled the cost of one serving of fruit and vegetables per day
for each member of the family (Buscail et al., 2018), whereas in the
present study it was five times higher.

This study also has different limitations. First, due to the qualitative
nature of the study, results based on perceptions should also be taken
with caution. In particular, this study does not quantify whether the
intervention resulted in an increase in purchasing of fruit, vegetables or
legumes. Second, as we used explicit methods, we could identify only
conscious processes with possible memory and desirability bias (Köster,
2009). Participants' satisfaction with the intervention can be ques-
tioned, as it is likely that they did not want to complain about this
financial support in front of the interviewer. However, many partici-
pants evoked precise strategies and had an overall very accurate
recording of the prices, whereas others severely criticised the vouchers.
Third, the food insecurity assessment could be biased as questions were
asked orally. We assume that a possible embarrassment in answering
questions about hunger or skipping meals and a misunderstanding of
some questions, in front of the interviewer, could have led to an un-
derestimation of food insecurity in the sample. However, almost all
participants clearly mentioned experiences of food insecurity and used
food assistance, which can be considered as a proxy for food insecurity.

5. Conclusions

Healthy plant-based foods are a key food category in the shift to-
wards more sustainable diets. Socioeconomic gaps in fruit and vegetable
consumption could be addressed through financial interventions. Food
vouchers incentivising fruit, vegetables and legumes increased the
affordability of sustainable food choices among low-income consumers.
Despite the restriction, such incentives were perceived as an acceptable
intervention by participants. They used the vouchers in different ways,
either to maintain their habits or to improve the diversity of their diet.
Many of them experienced the possibility of choosing more according to
their preferences and curiosity, rather than cost and availability. In-
centives could not only improve the affordability of fruit and vegetables
but also the acceptability of sustainable diets, through a facilitated
exposure to a higher diversity of plant-based food.

CRediT authorship contribution statement

**Basile Verdeau:** Writing – review & editing, Writing – original draft, Methodology, Investigation, Formal analysis, Data curation, Conceptualization. **Anaëlle Denieul-Barbot:** Writing – review & editing, Resources, Conceptualization. **Sandrine Monnery-Patris:** Writing – review & editing, Supervision, Project administration, Methodology, Funding acquisition, Formal analysis, Conceptualization.
## Funding source

This research was supported by grants from the Ministère de l'Enseignement Supérieur et de la Recherche (Ecole Doctorale Environnements-Santé of the University Bourgogne Franche-Comté). This research was also supported by the Institut Olga Triballat. The funding source did not play any role in the study design, the collection and interpretation of data, the writing of the report and the decision to submit the article for publication.

## Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Sandrine Monnery-Patris reports financial support was provided by Institut Olga Triballat. The Institut provided financial support which has been used to compensate the participants. The Institut did not play any role in the study design, the collection and analysis of data, in the writing of the report nor in the decision to submit the article for publication.

The Institut Olga Triballat is an endowment fund set up in 2013 by Triballat Noyal, a French food company marketing organic dairy, cereal and soya products, as well as nutritional ingredients. The Institute's aim is to support "the development of initiatives to increase knowledge and progress towards a diet conducive to sustainable health. In practice, this means supporting research programmes." (website of the institute: https://institut-olgatriballat.org). Through annual calls for projects, it provides financial support for projects relating to various themes: the impact of food on human health, the transition of food systems (waste, food innovations, the environmental impact of food, sociology of food, food education, food behaviour) and the agroecological transition.

## Acknowledgements

The authors would like to thank the staff of the SGSs and municipal social services who participated in the recruitment of the participants. The authors also would like to thank Valentin Bellassen for the organisation and coordination of the intervention and the sharing of data, and Sylvie Issanchou for the support in planning the study. We would like to thank all the participants who took part in the interviews. This study was conducted within the ProDij project of Dijon Métropole.

## Appendix A. Supplementary data

Supplementary data to this article can be found online at https://doi.org/10.1016/j.appet.2025.107903.

## Data availability

Data will be made available on request.

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