Clinical trial NCT02565706: Online WIC Nutrition Education to Promote Farmers' Market Fruit and Vegetable Purchases and Consumption
Official title: Online WIC Nutrition Education to Promote Farmers' Market Fruit and Vegetable Purchases and Consumption
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Cardiovascular Diseases
Cancer
Type 2 Diabetes
Obesity
Keywords: Fruit, vegetables, income, WIC program, farmers' market
Lead sponsor: William Paterson University of New Jersey
Sponsor class: OTHER
Collaborators: name: USDA Food and Nutrition Service
First posted: 2015-10-01
Enrollment: 744
Sex: FEMALE
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

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.

Eligibility criteria: 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

Primary outcomes:
measure: Number of Participants Who Redeemed FMNP Vouchers
timeFrame: 6 months (2015 farmers' market season [June to November 2015])
measure: Frequency of Fruit and Vegetable Intake
timeFrame: Pretest, posttest (2 weeks after pretest), and 3- and 6-month follow-up
measure: Quantity of Fruit and Vegetable Intake
timeFrame: Pretest, posttest, and 3- and 6-month follow-up
Secondary outcomes:
measure: Number of Participants Who Redeemed Cash Value Vouchers at Farmers' Markets
timeFrame: 6 months (2015 farmers' market season [June to November 2015])
measure: Response to Survey Items Assessing Knowledge of the WIC Farmers' Market Nutrition Program Using a True/False Format.
timeFrame: Pretest, posttest, and 3- and 6-month follow-up
measure: Response to an Item Assessing Knowledge of WIC-authorized Farmers' Markets Using a Yes/no Format.
timeFrame: Pretest, posttest, and 3- and 6-month follow-up
measure: Response to Survey Items Assessing Attitudes Towards Farmers' Market Fruits and Vegetables Using 7-point Likert Rating Scales.
timeFrame: Pretest, posttest, and 3- and 6-month follow-up
measure: Response to Survey Items Assessing Awareness of Locally Grown, Seasonal Fruits and Vegetables Using a Yes/no Format.
timeFrame: Pretest, posttest, and 3- and 6-month follow-up
measure: Response to Survey Items Assessing Fruit and Vegetable Food Safety Skills Using 7-point Likert Rating Scales.
timeFrame: Pretest, posttest, and 3- and 6-month follow-up
measure: Response to Survey Items Assessing Farmers' Market Asking Skills Using a Yes/no Format.
timeFrame: Pretest, posttest, and 3- and 6-month follow-up
measure: Response to Survey Items Assessing Positive Outcome Expectations for Consuming Locally Grown Fruits and Vegetables Using a Yes/no Format.
timeFrame: Pretest, posttest, and 3- and 6-month follow-up
measure: Response to an Item Assessing Whether the Participant Ever Purchased Fruits and Vegetables at a Farmers' Market Using a Yes/no Format.
timeFrame: Pretest, posttest, and 3- and 6-month follow-up
measure: Response to Survey Items Assessing Farmers' Market Fruit and Vegetable Preparation Skills Using 7-point Likert Rating Scales.
timeFrame: 2 weeks
measure: 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.
timeFrame: Pretest, posttest, and 3- and 6-month follow-up
measure: 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.
timeFrame: Pretest, posttest, and 3- and 6-month follow-up
measure: Response to Survey Items Assessing Knowledge of Locally Grown Seasonal Fruits and Vegetables Found at Farmers' Markets in July Using a Yes/no Format.
timeFrame: Pretest, posttest, and 3- and 6-month follow-up
measure: Response to Survey Items Assessing Food-specific Knowledge Using a True/False Format
timeFrame: Pretest, posttest, and 3- and 6-month follow-up
measure: Response to Survey Items Assessing Knowledge of Area Farmers' Markets
timeFrame: Pretest, posttest, and 3- and 6-month follow-up
Other outcomes:
Locations:
city: Paterson
country: United States
facility: Saint Joseph's WIC Program
state: New Jersey
Study officials:
affiliation: Professor, Department of Sociology, William Paterson University
name: Jennifer Di Noia, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Di Noia J, Monica D, Sikorskii A, Cullen KW. Outcomes of a randomized controlled trial of nutrition education 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). BMC Nutr. 2017 Jun 21;3:48. doi: 10.1186/s40795-017-0172-0. eCollection 2017.
citation: Di Noia J, Monica D, Cullen KW, Perez-Escamilla R, Gray HL, Sikorskii A. Differences in Fruit and Vegetable Intake by Race/Ethnicity and by Hispanic Origin and Nativity Among Women in the Special Supplemental Nutrition Program for Women, Infants, and Children, 2015. Prev Chronic Dis. 2016 Aug 25;13:E115. doi: 10.5888/pcd13.160130.
citation: Di Noia J, Cullen KW, Monica D. Social Desirability Trait Is Associated with Self-Reported Vegetable Intake among Women Enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children. J Acad Nutr Diet. 2016 Dec;116(12):1942-1950. doi: 10.1016/j.jand.2016.07.008. Epub 2016 Sep 21.
citation: Di Noia J, Monica D, Cullen KW, Thompson D. Perceived Influences on Farmers' Market Use among Urban, WIC-enrolled Women. Am J Health Behav. 2017 Sep 1;41(5):618-629. doi: 10.5993/AJHB.41.5.11.
citation: Di Noia J, Monica D, Gray HL, Cullen KW. The Special Supplemental Nutrition Program for Women, Infants, and Children Fresh Start Randomized Controlled Trial: Baseline Participant Characteristics and Reliability of Measures. J Acad Nutr Diet. 2016 Dec;116(12):1899-1913. doi: 10.1016/j.jand.2016.07.020. Epub 2016 Sep 20.