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2014年一项全州范围政策变更对妇女、婴儿和儿童补充营养计划(WIC)参与者水果/蔬菜现金券兑换的影响。

Effects of a 2014 Statewide Policy Change on Cash-Value Voucher Redemptions for Fruits/Vegetables Among Participants in the Supplemental Nutrition Program for Women, Infants, and Children (WIC).

作者信息

Okeke Janice O, Ekanayake Ruwani M, Santorelli Melissa L

机构信息

Community Health and Wellness Unit, New Jersey Department of Health, 50 East State Street, Trenton, NJ, 08625-0364, USA.

Centers for Disease Control and Prevention (CDC)/Council of State and Territorial Epidemiologists (CSTE) Applied Epidemiology Fellowship, 2872 Woodcock Blvd, Suite 250, Atlanta, GA, 30341, USA.

出版信息

Matern Child Health J. 2017 Oct;21(10):1874-1879. doi: 10.1007/s10995-017-2339-3.

Abstract

Purpose In 2014, the New Jersey Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) began requiring WIC-authorized stores to stock at least two fresh fruits and two fresh vegetables. We aimed to evaluate the effect of this policy change on fruit and vegetable purchases among WIC-participating households and to assess variation by household access to a healthy food store such as a supermarket or large grocery store. Description Households with continuous WIC enrollment from June 2013 to May 2015 were included (n = 16,415). Participants receive monthly cash-value vouchers (CVVs) to purchase fruits and vegetables. For each household, the CVV redemption proportion was calculated for the period before and after the policy by dividing the total dollar amount redeemed by the total dollar amount issued. Complete redemption was defined as a proportion ≥90% and the change in complete redemption odds was assessed after adjusting for Supplemental Nutrition Assistance Program participation. Assessment We observed a small increase following the policy change [odds ratio (OR) 1.10, 95% confidence interval (CI) 1.04-1.17]; however, the effect varied by healthy food access (p = 0.03). The odds increased for households with access to at least one healthy food store (OR 1.13, 95% CI 1.06-1.20) while no effect was observed for households without such access (OR 0.91, 95% CI 0.76-1.10). Conclusion Policy change was associated with a small increase in purchasing, but only among households with healthy food access. The state is addressing this gap through technical assistance interventions targeting WIC-authorized small stores in communities with limited access.

摘要

目的 2014年,新泽西州妇女、婴儿和儿童特别补充营养计划(WIC)开始要求获得WIC授权的商店至少储备两种新鲜水果和两种新鲜蔬菜。我们旨在评估这一政策变化对参与WIC的家庭购买水果和蔬菜的影响,并评估因家庭能否进入超市或大型杂货店等健康食品商店而产生的差异。

描述 纳入了2013年6月至2015年5月持续参加WIC的家庭(n = 16,415)。参与者每月领取现金价值代金券(CVV)用于购买水果和蔬菜。对于每个家庭,通过将赎回的总金额除以发放的总金额来计算政策实施前后期间的CVV赎回比例。完全赎回定义为比例≥90%,并在调整补充营养援助计划参与情况后评估完全赎回几率的变化。

评估 政策变化后我们观察到有小幅增加[优势比(OR)1.10,95%置信区间(CI)1.04 - 1.17];然而,这种影响因能否获得健康食品而有所不同(p = 0.03)。能够进入至少一家健康食品商店的家庭几率增加(OR 1.13,95% CI 1.06 - 1.20),而无法进入此类商店的家庭未观察到影响(OR 0.91,95% CI 0.76 - 1.10)。

结论 政策变化与购买量的小幅增加相关,但仅在能够获得健康食品的家庭中出现。该州正在通过针对进入健康食品机会有限社区中获得WIC授权的小商店的技术援助干预措施来解决这一差距。

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