The Evaluation of the Revised Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on Consumption of Fruits and Vegetables in Tennessee

Abstract

The main purpose of this study was to examine the effect of providing cash value vouchers (CVVs) for fruits and vegetables on the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants’ consumption of fruits and vegetables. Participants were recruited from three health departments in Tennessee. The experimental group (n = 56) completed a fruit and vegetable inventory to assess attitudes and a fruit and vegetable checklist to examine consumption during their initial appointment for WIC certification at the health department. The experimental group was certified for WIC services; the group completed a pretest that consisted of a checklist and inventory to determine fruit and vegetable intake during the initial WIC clinic visit. They completed the same checklist and inventory (posttest) three months later during the follow-up WIC visit to determine changes in fruit and vegetable consumption.

A modified nonequivalent control group design was used to help measure the effectiveness of the vouchers since a true control group was not available because all qualifying women will receive the CVVs. A new group of WIC participants served as the wait-list control group (n = 37) and completed a pretest at same time the experimental group received their posttest. The pretest for the wait-list control was the same as the pretest and posttest for the experimental group. The wait-list control group was compared with the experimental group to check for selection bias to ensure both groups were similar in demographics.

The following indexes were developed from questions on both the fruit and vegetable inventory and fruit and vegetable checklist: perceived benefit, perceived control, self-efficacy, fruit and vegetable consumption, and fruit and vegetable amount. Three questions were examined individually from the questionnaires regarding readiness to eat more fruit, readiness to eat more vegetables, and perceived diet quality.

A repeated measures ANOVA was used to compare pretest and posttest scores on fruit and vegetable consumption in the experimental group. The mean score for fruit and vegetable consumption did increase in the experimental group, however, it was not a significant increase and it cannot be attributed to the CVVs.