Objective: To assess the impact of a new government-subsidized supermarket in a high-need area on household food availability and dietary habits in children. Design: A difference-in-difference study design was utilized. Setting: Two neighbourhoods in the Bronx, New York City. Outcomes were collected in Morrisania, the target community where the new supermarket was opened, and Highbridge, the comparison community.

Objective: To carry out a pilot study to determine if a supermarket double-dollar fruit and vegetable (F&V) incentive increases F&V purchases among low-income families Design: Randomized controlled design. Purchases were tracked using a loyalty card that provided participants with a 5% discount on all purchases during a 3-month baseline period followed by the 4-month intervention. Setting: A supermarket in a low-income rural Maine community Participants: 401 low-income and SNAP supermarket customers Intervention: Same day coupon at checkout for half-off eligible fresh, frozen or canned F&V over 4 months Main Outcome Measure: Weekly spending in dollars on eligible F&V Analysis: A linear model with random intercepts accounted for repeated transactions by individuals to estimate change in F&V spending per week from baseline to intervention. Secondary analyses examined changes among SNAP-eligible participants. Results: Coupons were redeemed among 53% of eligible baskets. Total weekly F&V spending increased in the intervention arm compared to control ($1.83, 95% CI=$0.29, 3.88). The largest increase was for fresh F&V ($1.97, 95% CI=$0.49, 3.44). Secondary analyses revealed greater increases in F&V spending among SNAP-eligible participants who redeemed coupons ($5.14, 95% CI =$1.93, 8.34) than among non-SNAP-eligible participants who redeemed coupons ($3.88, 95% CI =$1.67, 6.08). Conclusions and Implications: A double-dollar pricing incentive increased F&V spending in a low-income community despite the moderate uptake of the coupon redemption. SNAP-eligible customers saw the greatest F&V spending increases. Financial incentives for F&V are an effective strategy for food assistance programs to increase healthy purchases and improve dietary intake in low income families.

BackgroundHospitals serve millions of meals and snacks each year; however, hospital food is often unhealthy. Hospitals are ideal settings for modeling healthy eating, but few programs have sought to improve nutrition in all venues where food is served.Community ContextThe New York City Department of Health and Mental Hygiene created the Healthy Hospital Food Initiative (HHFI) to improve the healthfulness of food served in hospitals. The HHFI built on prior work implementing mandatory nutrition standards for patient meals and vending in public hospitals. Public hospitals joined the HHFI by voluntarily adopting standards for cafeterias and cafés. Private hospitals joined by implementing nutrition standards for patient meals, food and beverage vending machines, and cafeterias and cafés.MethodsHospitals were recruited from 2010 through 2014 and provided technical assistance from health department staff. Implementation in each of the 4 areas was monitored through on-site assessments and menu review. Twenty-eight hospital cafeterias and cafés were evaluated at baseline and at the end of the HHFI to assess changes.OutcomeSixteen public hospitals and 24 private hospitals joined the HHFI. Most (n = 18) private hospitals implemented standards in at least 2 areas. In cafeterias, most hospitals introduced a healthy value meal (n = 19), removed unhealthy items from the entrance and checkout (n = 18), increased whole grains to at least half of all grains served (n = 17), and reduced calories in pastries and desserts (n = 15).InterpretationMost New York City hospitals joined the HHFI and voluntarily adopted rigorous nutrition standards. Partnerships between hospitals and local government are feasible and can lead to significant improvements in hospital food environments.

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