Grant: Project Grant

Background: In British Columbia (BC), 16.2% of households cannot afford to buy enough food. This is called household food insecurity. The BC Farmers' Market Nutrition Coupon Program (FMNCP) is trying to reduce food insecurity and improve people's diets by giving low-income households coupons to buy healthy foods in farmers' markets. In a previous study, we found that the FMNCP reduced household food insecurity, but it did not improve the diet quality of adults. We think this is because parents used the money to buy food for their children and not for themselves. The FMNCP may need to give households more money to buy enough food for parents and their children. Goals: We will do a randomized controlled trial to study the impact of three higher healthy food subsidies, compared to the usual FMNCP subsidy, on the diet quality, food insecurity and other health-related outcomes of 380 parent-child pairs. Methods: 380 low-income households will be randomly put into a group that gets the usual FMNCP subsidy of $27/household/week or a group that gets a subsidy that is 1.5 ($40.50/household/week), 2 ($54/household/week) or 2.5 times ($67.50/household/week) higher. Participants will get 16 weeks of coupons that they can spend over 26 weeks. They can also attend optional food skills education. We will collect information from one parent (18-64 years) and one child (6-12 years) in each household about what they eat, their food insecurity, and other health-related outcomes. This information will be collected at baseline (0 weeks), midway through (13 weeks) and at the end of the intervention (26 weeks). We will also calculate whether the four subsidies are cost-effective. Significance: This will be the first study to examine how different doses of a healthy food subsidy affect what parents and their children eat and their food insecurity. It will help governments to know how much money low-income households need to buy enough healthy food for parents and children.