{"doi":"10.1001/jamanetworkopen.2025.27601","title":"Healthy Food Benefit Programs, Fruit and Vegetable Consumption, and Food Security","abstract":"Importance: Diet quality, including fruit and vegetable intake, is a determinant of health, yet fresh fruits and vegetables are inaccessible to many lower-income and marginalized households. Healthy food benefit programs may reduce health disparities by increasing fruit and vegetable consumption. Objectives: To estimate the outcomes of a $40 per month healthy food benefit program on food security and diet. Design, Setting, and Participants: Cohort study with randomly assigned treatment groups composed of participants seeking enrollment in Fresh Bucks, a healthy food benefit program for lower-income populations in Seattle, Washington. Participants were randomly assigned to enrollment in the program and to a waiting list. Outcomes were examined at baseline (October 2021) and follow-up (June 2022). Exposure: Two exposure groups were examined. First, random assignment to newly receive program benefits for 6 months vs assignment to a waiting list. Second, random assignment to be disenrolled from program benefits vs continued enrollment for 6 months. Main Outcomes and Measures: A modified version of the Behavioral Risk Factor Surveillance System Fruit and Vegetable Screening Questionnaire was used to calculate daily frequency of fruit and vegetable consumption as a continuous outcome and a binary indicator of consuming less than 3 vs 3 or more times per day. Food security was measured using the 2-item Hunger Vital Signs screener. Results: A total of 1973 participants were included, with 757 who received the program and 1216 who were disenrolled (1339 [68%] aged ≥60 years; 1007 [51%] Asian; 209 [11%] Black; 523 [27%] White). The program was associated with a 5.5 percentage point (pp) (95% CI, 0.05-10.91 pp) increase in food security and a 7.5 pp (95% CI, 0.39-14.52 pp) increase in the proportion of participants consuming fruit and vegetables 3 or more times per day. Continuous fruit and vegetable consumption changes were null; however, differential outcomes by income, language, and race and ethnicity were found. Examining these same outcomes in a population assigned to disenrollment, lower fruit and vegetable intake and food security were found vs those who remained in the program. Conclusions and Relevance: This cohort study of a healthy food benefit program found reduced food insecurity and improved fruit and vegetable consumption in a lower-income population randomly assigned to program enrollment.","journal":"JAMA Network Open","year":2025,"id":532804,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9557,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":735959,"name":"Jamie Wallace","orcid":"0000-0002-7886-4699","position":1,"is_corresponding":false},{"id":596063,"name":"Bárbara Baquero","orcid":"0000-0003-4652-7484","position":2,"is_corresponding":false},{"id":1101998,"name":"KeliAnne K. Hara-Hubbard","orcid":null,"position":3,"is_corresponding":false},{"id":342579,"name":"Jones-Smith,","orcid":"0000-0001-8962-1695","position":4,"is_corresponding":false},{"id":890844,"name":"Melissa A. Knox","orcid":"0000-0001-7525-0854","position":0,"is_corresponding":true}],"reference_count":20,"raw_metadata":null,"created_at":"2026-07-19T02:51:27.893975Z","pmid":"40828533","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}