Improving Access to Fresh Fruit and Vegetables among Inner‐City Residents: The NEAT Trial
Authors: Segura‐Perez Sofia , Perez‐Escamilla Rafael , Damio Grace 
Published: November 2023

The primary aim of the Nutrition Education, Access and Texting (NEAT) trial was to assess the impact of distribution of incentive coupons along with a texting‐based marketing campaign promoting usage of a Mobile Market (MM), on increasing access to, and purchase and intake of fruit and vegetables among SNAP‐Ed participants. 193 non‐pregnant adult Hartford residents, with children 5 years old and under, attending a SNAP‐Ed “My Plate” educational session, were included in the trial. Participants also needed to have an unlimited texting plan and be willing to receive daily text messages for a 4‐week period. NEAT followed a randomized trial design. Participants were recruited and screened for eligibility at WIC offices and other community settings, and invited to participate in a one‐hour My Plate group session. Before the session, participants were consented; they then completed a 30‐minute baseline survey including data on socio‐demographics and fruit and vegetable shopping, purchasing and eating habits. Pre‐t and post‐tests were applied before and after the educational session to assess changes in nutrition knowledge and attitudes due to the session. Immediately after the nutrition education session, participants were randomly assigned. Those in the experimental group received four $5 coupons for use at the MM during the next 6 weeks, plus a month of daily text messages, informing them about MM stop locations, tips on preparing/eating more fruit and vegetables, and reminders to use their coupons (n=100). Control group participants received only text messages for a month, informing them about free family events within the community (n=93). After the 4‐week intervention period, participants from both groups completed a 6‐week follow‐up phone interview to document fruit and vegetable shopping, purchasing practice and intake habits, as well as their experience using the MM and text message satisfaction. Both groups had similar socio‐demographic characteristics, with a mean age of 32±8.81 years, 79% were Hispanic, mostly female (96%), and receiving SNAP benefits (80%). They also had similar baseline fruit and vegetable shopping, purchasing and consumption practices. Findings from the follow‐up survey (n=169) showed that participants from the intervention group spent significantly more on fruits than those in the control group ($42 vs. $30, p=0.027), and a significantly higher percentage of participants from the intervention group reported buying their produce at the MM than participants from the control group (46% vs. 23%, p=0.002). There was a significant increase in fruit intake (p=0.001) in the intervention group, but not in the control group. Both groups were highly satisfied with their respective text messages. MM customer satisfaction was also very high. Pre and post test results showed significant improvements in knowledge (59.64±20.29 vs 71.14±21.99) p=0.000 as a result of the nutrition education session. NEAT was successfully implemented and it lead to higher use of the MM, more money spent on fruits, and higher intake of produce.Support or Funding InformationUSDA Food and Nutrition Service via Cornell University