Adoption and Acceptability of a Fruit and Vegetable Subsidy in Low-Income Households in Urban Chile: The Bolsillo Saludable Pilot Feasibility Study

IF 4.2 Q2 NUTRITION & DIETETICS

Current Developments in Nutrition Pub Date : 2026-07-01 Epub Date: 2026-06-13 DOI:10.1016/j.cdnut.2026.109394

Isabel Pemjean, Daniela Montes de Oca, Jonathan Lara-Arévalo, Shu Wen Ng, Lindsey Smith Taillie, Camila Corvalán

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Abstract

Background

Low-quality diets disproportionally affect low-income populations, limiting access to healthy foods.

Objectives

This feasibility study evaluated the adoption and acceptability of Bolsillo Saludable (BS), a smartphone app-based subsidy designed to incentivize fruit and vegetable (FV) purchases at Ferias Libres (open markets) in Chile.

Methods

In an 8-wk pilot study, 30 low-income families received monthly benefits to purchase FV at a Feria Libre in Santiago, with outcomes assessed using a multimethod approach. Qualitative data from focus groups with beneficiaries (n = 15) and vendors (n = 6) explored acceptability and appropriateness. Quantitative data from the subsidy platform were used to assess adoption. Secondary outcomes (FV expenditure, purchases, dietary diversity) were assessed through app data records and pre–post surveys. Thematic and pre–post analyses were conducted.

Results

The study demonstrated high adoption and acceptability of the program. All beneficiaries utilized their benefits, with at least 1 use each month. Qualitative results showed high satisfaction among beneficiaries and vendors, who appreciated the program’s focus on healthy food and the ease of the payment system. Participants perceived the restriction to FV and delivery through Ferias Libres as consistent with their purchasing practices, suggesting high appropriateness of the intervention. Over half of beneficiaries perceived positive changes in their family diet, including increased FV consumption and vendors noted increased sales of a wider FV variety. Quantitative results suggested a 38% increase in mean FV expenditure, with improvements in dietary diversity indicators. However, qualitative results identified challenges related to variety of products offered, participating vendors, and invoicing difficulties.

Conclusions

This feasibility pilot demonstrated high adoption, acceptability, and appropriateness of the BS program with preliminary evidence of positive dietary changes among vulnerable populations. Addressing operational challenges, particularly limited vendor participation and invoicing barriers will be essential for scale-up. These findings provide key insights for scaling this intervention in Chile and adapting similar programs across similar settings.

This trial was registered at University of Chile Protocol Record 5128637 as NCT06865157; https://clinicaltrials.gov/study/NCT06865157

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智利城市低收入家庭水果和蔬菜补贴的采用和可接受性：Bolsillo可行试点可行性研究。

背景：低质量饮食对低收入人群的影响不成比例，限制了他们获得健康食品的机会。目的：本可行性研究评估了Bolsillo Saludable （BS）的采用和可接受性，这是一项基于智能手机应用程序的补贴，旨在激励智利Ferias librres（开放市场）的水果和蔬菜（FV）购买。方法：在一项为期8周的试点研究中，30个低收入家庭每月在圣地亚哥的Feria Libre获得购买FV的福利，并使用多方法方法评估结果。来自受益人（n = 15）和供应商（n = 6）的焦点小组的定性数据探讨了可接受性和适当性。来自补贴平台的定量数据被用来评估采用情况。次要结果（FV支出、购买、饮食多样性）通过应用程序数据记录和前后调查进行评估。进行了专题和前后分析。结果：研究表明该方案具有较高的采用率和可接受性。所有受益人都使用了他们的福利，每月至少使用一次。定性结果显示，受益人和供应商的满意度很高，他们对该计划对健康食品的关注和支付系统的便利性表示赞赏。参与者认为限制FV和通过Ferias Libres交付与他们的购买行为是一致的，这表明干预是高度适当的。超过一半的受益人认为他们的家庭饮食发生了积极变化，包括增加了FV消费，供应商注意到更广泛的FV品种的销售增加。定量结果表明，随着膳食多样性指标的改善，平均FV消耗增加了38%。然而，定性结果确定了与提供的各种产品、参与的供应商和发票困难相关的挑战。结论：该可行性试点显示了BS计划的高采用率、可接受性和适当性，初步证据表明弱势群体的饮食发生了积极的变化。解决运营方面的挑战，特别是有限的供应商参与和发票障碍，将是扩大规模的关键。这些发现为在智利扩大这一干预措施以及在类似环境中调整类似方案提供了关键见解。该试验注册于智利大学协议记录5128637，编号为NCT06865157；https://clinicaltrials.gov/study/NCT06865157。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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