Increasing Affordable Fruits and Vegetables for Families With Food Insecurity

Caregivers will complete a 3-day food record for their child's dietary intake. Child diet quality will then be assessed using the Healthy Eating Index.

Caregivers will complete a 3-day food record for their dietary intake. Caregiver diet quality will then be assessed using the Healthy Eating Index.

The Children's Eating Behavior Questionnaire will be used to assess children's food fussiness. The food fussiness sub-scale consists of 5-pt Likert scale items ranging from Never (1) to Always (5). The mean of the response values is calculated. Higher score indicating a greater degree of food fussiness.

Process metrics will examine the reach of families who received brief education during clinic visits at each site, utilization of the free trial, use of home delivery, and families who cycled off SNAP within the study duration (%, #, timing).

Semi-structured phone interviews and surveys will be administered to caregivers to elicit perceptions on intervention components, barriers/facilitators to intervention use, and suggestions for future dissemination.

Focus groups and online surveys will be administered to key informants to assess barriers and facilitators to intervention implementation and sustainability.

The United States Department of Agriculture Household Food Security Module (18-item) will be administered. Higher scores indicate less food security.

The Perceived Limited Availability scale will be administered (6-items). Items are summed to create a total score for food stores (3-items) and food pantries (3 items). Each total score ranges 0-3. Higher scores are considered less desirable.

The Utilization Barriers scale (8-items) will be administered. Items are summed to create a score ranging 0-8. Higher scores are considered less desirable.

The Food Insecurity Stability scale (12-items) will be administered. Participants receive 4 scores, each ranging from 0-3 for chronic, seasonal, monthly, and intermittent food insecurity. Higher scores indicate a greater degree of chronic, seasonal, monthly, and intermittent food insecurity.

Nutrition security will be measured using the Household Nutrition Security scale (4-items). Item scores range 0 ("Always") to 4 ("Never"). The mean of item scores is calculated. Higher scores indicate a greater degree of nutrition security.

The Household Healthfulness Choice (3-items) survey will be administered. Items are scored from 4 ("Always") to 0 ("Never"). The mean of the item scores is calculated. Higher scores indicate a greater degree healthfulness choice.

The Dietary Choice (3-items) survey will be administered. Item scores range from 0 ("Always") to 4 ("Never"). The mean of the item scores is calculated. Higher scores indicate a greater degree of dietary choice.

Purchasing data will be used to quantify the number and type of produce boxes purchased as part of the Supplemental Nutrition Assistance Program (SNAP) fruit and vegetable incentive program in South Carolina.