Effect of price on WIC-eligible caregiver participation in a produce program: A randomized trial.

Objectives: This pilot randomized trial examined the associations between price, participation of WIC-eligible families in a produce delivery program and reported healthy eating behaviors.

Methods: Fifty caregivers of WIC-eligible children from an urban primary care center enrolled in an 8-week produce delivery program. Participants received free produce boxes for the first 4 weeks and were randomized to a cost of $5 or $10 per box for the remaining 4 weeks. Weekly orders were tracked, and longitudinal surveys were conducted to assess the program's impact on healthy eating.

Results: Forty-three caregivers (86%) participated in the study. An average of 35.3 (SD 5.74) participants ordered weekly during the free period with a significant drop-off to 18.3 (SD 0.96) ordering weekly during the paid period (P < 0.001); most (73%) participants paid with SNAP benefits. There was no significant difference in average orders between the $5 and $10 groups (12.25 [SD 4.4] vs. 14.5 [SD 5.63], P = 0.19). Participation was significantly associated with an increase in reported produce access (53% vs. 97%, P < 0.001) and ability to eat healthy (34% vs. 61%, P = 0.04).

Conclusion: Our study found that participation in a delivery-produce program decreased significantly with introduction of cost and use of food assistance benefits to purchase produce was common among sustained participants. Participants reported improvements in healthy eating and ability to access produce. Future study is needed to further evaluate price points to optimize program sustainability and participation and the impact of produce delivery programs on childhood produce intake.

Clinical trial registration: ClinicalTrials.gov, NCT05153577.