Nutritional and Metabolic Diseases

Symptoms and General Pathology

All Conditions

Gland and Hormone Related Diseases

Obesity

Diabetes Mellitus

Diabetes Mellitus, Type 2

Micronutrients

All Drugs and Chemicals

Bone Density Conservation Agents

Iron

Calcium

Calcium, Dietary

Participants in this arm receive the Fresh Start program.

Participants in this arm receive existing online WIC health education.

Participants in this arm receive the Fresh Start program and WIC Farmers' Market Nutrition Program (FMNP) vouchers redeemable at farmers' markets.

Participants in this arm receive existing online WIC health education and WIC Farmers' Market Nutrition Program (FMNP) vouchers redeemable at farmers' markets.

The intervention is an online lesson to promote farmers' market FV purchases and consumption. The lesson comprises three modules, each consisting of 1) behavior change content presented through a video segment featuring WIC participants, and 2) an interactive activity to build targeted knowledge, attitudes, and skills.

WIC Fresh Start Program

Any of seven existing online WIC health education lessons (lessons are available on breastfeeding, being active, fruits and vegetables, calcium, cholesterol, oral health and iron). The lessons consist of an introductory segment presented with online text and graphics. After reading this material, viewers have the option to complete one of four lesson activities. The activities provide opportunities for viewers to read further on the topic and are designed to reinforce key points of the lesson.

Existing Online Health Education

Jennifer Di Noia, PhD

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).

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.

Online WIC Nutrition Education to Promote Farmers' Market Fruit and Vegetable Purchases and Consumption

The data sets used and/or analyzed during this study are available from the corresponding author on reasonable request.

The state WIC agency is providing data on FMNP voucher redemption.

Times per day fruits and vegetable are consumed as assessed by a validated food frequency questionnaire.

Cups per day consumed of fruits and vegetables as assessed by a validated fruit and vegetable screener.

The state WIC agency is providing data on cash value voucher redemption.

Index of Knowledge of the FMNP Score range: 0-6 Higher scores indicates greater knowledge

Knowledge of a farmers' market with farmers approved by WIC to accept WIC farmers' Market Nutrition Program and Cash Value vouchers Scores: No (0) and yes (1). Higher scores (yes responses) indicate that the respondent knows of a farmers' market with farmers approved by WIC to accept WIC farmers' Market Nutrition Program and Cash Value vouchers. Odds ratios and 95% confidence intervals indicate the likelihood of the outcome (knowledge of such markets) among those in the WIC Fresh Start (FMNP) arm relative to the comparator arm.

Attitudes towards Farmers' Market Fruits and Vegetables Score range: 6-42 Higher scores indicate more favorable attitudes

Familiarity with Locally Grown Seasonal Items Score range: 0-3 Higher scores indicate greater familiarity

Fruit and Vegetable Food Safety Skills Score range: 19-85 Higher scores indicate greater skills

Farmers' Market Asking Skills Score range: 0-3 Higher scores indicate greater skills

Positive Outcome Expectations for Consuming Locally Grown Fruit and Vegetables Score range:0-3 Higher scores indicate more favorable ratings

Lifetime Farmers' Market Fruit and Vegetable Purchases Scores: No (0), Yes (1). Higher scores (yes responses) indicate indicate that the respondent has ever purchased fruits and vegetables at a farmers' market. Odds ratios and 95% confidence intervals indicate the likelihood of the outcome (having ever purchased fruits and vegetables at a farmers' market) among those in the WIC Fresh Start (FMNP) arm relative to the comparator arm.

Farmers' Market Fruit and Vegetable Preparation Skills Score range:12-84 Higher scores indicate greater skills

Recent Farmers' Market Fruit and Vegetable Purchases Scores: No (0), Yes (1). Higher scores (yes responses) indicate that the respondent purchased fruits and vegetables at a farmers' market in the past two weeks. Odds ratios and 95% confidence intervals indicate the likelihood of the outcome (having purchased fruits and vegetables at a farmers' market in the past two weeks) among those in the WIC Fresh Start (FMNP) arm relative to the comparator arm.

Intentions to Purchase Fruits and Vegetables at a Farmers' Market Scores: no (0), Yes (1). Higher scores (yes responses) indicate that the respondent intends to purchase fruits and vegetables at a farmers' market in the next two weeks. Odds ratios and 95% confidence intervals indicate the likelihood of the outcome (intending to purchase fruits and vegetables at a farmers' market in the next two weeks) among those in the WIC Fresh Start (FMNP) arm relative to the comparator arm.

Knowledge of Locally Grown Seasonal Fruits and Vegetables found at Farmers' Markets in July Score range:0-9 Higher scores indicate greater knowledge

Food-specific Knowledge Score range: 2-13 Higher scores indicate greater knowledge

Farmers' Market-specific Knowledge Score range:0-2 Higher scores indicate greater knowledge

USDA Food and Nutrition Service

William Paterson University of New Jersey

Professor

Participants in this arm receive the Fresh Start program.

WIC Fresh Start Program: The intervention is an online lesson to promote farmers' market FV purchases and consumption. The lesson comprises three modules, each consisting of 1) behavior change content presented through a video segment featuring WIC participants, and 2) an interactive activity to build targeted knowledge, attitudes, and skills.

Participants in this arm receive existing online WIC health education.

Existing Online Health Education: Any of seven existing online WIC health education lessons (lessons are available on breastfeeding, being active, fruits and vegetables, calcium, cholesterol, oral health and iron). The lessons consist of an introductory segment presented with online text and graphics. After reading this material, viewers have the option to complete one of four lesson activities. The activities provide opportunities for viewers to read further on the topic and are designed to reinforce key points of the lesson.

Participants in this arm receive the Fresh Start program and WIC Farmers' Market Nutrition Program (FMNP) vouchers redeemable at farmers' markets.

WIC Fresh Start Program: The intervention is an online lesson to promote farmers' market FV purchases and consumption. The lesson comprises three modules, each consisting of 1) behavior change content presented through a video segment featuring WIC participants, and 2) an interactive activity to build targeted knowledge, attitudes, and skills.

WIC Fresh Start Program (FMNP)

Participants in this arm receive existing online WIC health education and WIC Farmers' Market Nutrition Program (FMNP) vouchers redeemable at farmers' markets.

Existing Online Health Education: Any of seven existing online WIC health education lessons (lessons are available on breastfeeding, being active, fruits and vegetables, calcium, cholesterol, oral health and iron). The lessons consist of an introductory segment presented with online text and graphics. After reading this material, viewers have the option to complete one of four lesson activities. The activities provide opportunities for viewers to read further on the topic and are designed to reinforce key points of the lesson.

Existing Online Health Education (FMNP)

Total

Age, Continuous

Sex: Female, Male

African American

Hispanic

White or other

Two or more races

Missing

Race/Ethnicity, Customized

United States

Region of Enrollment

Jennifer Di Noia

Number of Participants Who Redeemed FMNP Vouchers

Posttest

3-month follow-up

6-month follow-up

Frequency of Fruit and Vegetable Intake

Data are reported for the 6-month follow-up assessment.

Quantity of Fruit and Vegetable Intake

Participants in this arm receive the Fresh Start program (includes those who receive WIC Farmers' Market Nutrition Program \[FMNP\] vouchers and those who do not).

WIC Fresh Start Program: The intervention is an online lesson to promote farmers' market FV purchases and consumption. The lesson comprises three modules, each consisting of 1) behavior change content presented through a video segment featuring WIC participants, and 2) an interactive activity to build targeted knowledge, attitudes, and skills.

Participants in this arm receive existing online WIC health education (includes those who receive WIC Farmers' Market Nutrition Program \[FMNP\] vouchers and those who do not).

Existing Online Health Education: Any of seven existing online WIC health education lessons (lessons are available on breastfeeding, being active, fruits and vegetables, calcium, cholesterol, oral health and iron). The lessons consist of an introductory segment presented with online text and graphics. After reading this material, viewers have the option to complete one of four lesson activities. The activities provide opportunities for viewers to read further on the topic and are designed to reinforce key points of the lesson.

Number of Participants Who Redeemed Cash Value Vouchers at Farmers' Markets

Response to Survey Items Assessing Knowledge of the WIC Farmers' Market Nutrition Program Using a True/False Format.

The WIC Fresh Start Program (FMNP) arm is being compared with each other study arm for this analysis.

Response to an Item Assessing Knowledge of WIC-authorized Farmers' Markets Using a Yes/no Format.

Response to Survey Items Assessing Attitudes Towards Farmers' Market Fruits and Vegetables Using 7-point Likert Rating Scales.

Response to Survey Items Assessing Awareness of Locally Grown, Seasonal Fruits and Vegetables Using a Yes/no Format.

Response to Survey Items Assessing Fruit and Vegetable Food Safety Skills Using 7-point Likert Rating Scales.

Response to Survey Items Assessing Farmers' Market Asking Skills Using a Yes/no Format.

Response to Survey Items Assessing Positive Outcome Expectations for Consuming Locally Grown Fruits and Vegetables Using a Yes/no Format.

The WIC Fresh Start (FMNP) arm is being compared with the three other study arms.

Response to an Item Assessing Whether the Participant Ever Purchased Fruits and Vegetables at a Farmers' Market Using a Yes/no Format.

Response to Survey Items Assessing Farmers' Market Fruit and Vegetable Preparation Skills Using 7-point Likert Rating Scales.

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.

The WIC Fresh Start Program (FMNP) arm is being compared with the three other study arms.

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.

Response to Survey Items Assessing Knowledge of Locally Grown Seasonal Fruits and Vegetables Found at Farmers' Markets in July Using a Yes/no Format.

Response to Survey Items Assessing Food-specific Knowledge Using a True/False Format

Response to Survey Items Assessing Knowledge of Area Farmers' Markets

Participants in this arm receive the Fresh Start program.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Fresh Start Program: The intervention is an online lesson to promote farmers' market fruit and vegetable (FV) purchases and consumption. The lesson comprises three modules, each consisting of 1) behavior change content presented through a video segment featuring WIC participants, and 2) an interactive activity to build targeted knowledge, attitudes, and skills.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Online WIC Nutrition Education to Promote Farmers' Market Fruit and Vegetable Purchases and Consumption	NCT02565706	Cardiovascular ... Cancer Type 2 Diabetes Obesity	WIC Fresh Start... Existing Online...	-	William Paterson University of New Jersey
Online WIC Nutrition Education to Promote Farmers' Market Fruit and Vegetable Purchases and Consumption	NCT02565706	Cardiovascular ... Cancer Type 2 Diabetes Obesity	WIC Fresh Start... Existing Online...	-	William Paterson University of New Jersey

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