Anderson J V, Bybee D I, Brown R M, McLean D F, Garcia E M, Breer M L, Schillo B A
Michigan Department of Community Health, Division of Chronic Disease and Injury Control, 3423 N M.L. King Blvd, PO Box 30195, Lansing, MI 48909, USA.
J Am Diet Assoc. 2001 Feb;101(2):195-202. doi: 10.1016/S0002-8223(01)00052-9.
This study evaluated the Michigan Farmers' Market Nutrition Program in one Michigan county to determine its effect on fruit and vegetable consumption behavior.
SUBJECTS/SETTING: Subjects were selected from WIC and Community Action Agency populations: 564 low income women completed the pretest; 455 completed the posttest. Attrition rate was 19.3%.
Subjects were assigned to one of 4 interventions: education about the use, storage and nutritional value of fruits and vegetables, distribution of farmers' market coupons, both education and coupons, or no intervention.
Education-only and coupon and education groups were randomly assigned; clinic appointment timing determined assignment to no-intervention and coupon-only groups.
A self-administered questionnaire before and after intervention measured attitudes about fruit and vegetable consumption and intake of fruits and vegetables. WIC records documented redemption of coupons.
Data analysis included 2-way multivariate analysis of covariance, univariate analysis of covariance, logistic regression, and covariance structure modeling.
Both the education interventions and the coupon interventions had positive effects. Coupons had a direct effect on increasing fruit and vegetable consumption behavior but no effect on attitudes. Education had a direct effect on attitudes and seemed to exert an effect on consumption behavior through attitudes. The maximum impact of the intervention was achieved through a combination of education and coupons.
This study demonstrated that a low-income population may be more likely to increase its fruit and vegetable consumption behavior when incentives such as coupons improve affordability.
本研究对密歇根州一个县的密歇根农贸市场营养项目进行评估，以确定其对水果和蔬菜消费行为的影响。
对象/背景：研究对象选自妇女、婴儿与儿童营养补充计划（WIC）和社区行动机构人群：564名低收入女性完成了预测试；455名完成了后测试。损耗率为19.3%。
研究对象被分配到4种干预措施之一：关于水果和蔬菜的使用、储存及营养价值的教育、农贸市场优惠券发放、教育与优惠券发放兼具，或不进行干预。
仅接受教育组以及优惠券与教育组被随机分配；诊所预约时间决定了不干预组和仅发放优惠券组的分配。
干预前后通过一份自填式问卷测量对水果和蔬菜消费的态度以及水果和蔬菜的摄入量。WIC记录了优惠券的兑换情况。
数据分析包括双向多变量协方差分析、单变量协方差分析、逻辑回归和协方差结构建模。
教育干预措施和优惠券干预措施均产生了积极影响。优惠券对增加水果和蔬菜消费行为有直接影响，但对态度没有影响。教育对态度有直接影响，且似乎通过态度对消费行为产生影响。通过教育与优惠券相结合的方式实现了干预的最大效果。
本研究表明，当优惠券等激励措施提高了可承受性时，低收入人群可能更有可能增加其水果和蔬菜的消费行为。
