title: Gender and age are associated with healthy food purchases via grocery voucher redemption.
abstract: BACKGROUND
  Grocery vouchers that specifically target foods associated with reduced cardiovascular disease (CVD) risk result in increased consumption of those foods. In regions with disproportionately high CVD rates, there is little research concerning the impact of vouchers on purchases of risk-reducing foods when there are no restrictions placed on grocery voucher redemption. Since many food assistance programs place few restrictions on type of foods that can be purchased, identifying demographic factors associated with purchasing habits is a prerequisite to promoting healthy eating. The purpose of this study was to determine the associations of age, gender, education and income level with purchasing of healthful foods through the use of a grocery voucher in a rural food desert (poverty rate of ≥20% and ≥33% of residents living >16 km from a large grocery store) with high rates of chronic disease.
  
  
  METHODS
  The effectiveness of an intervention that included a media campaign, a $5 grocery voucher, local heart healthy food branding and a grocery store event was tested. Brief nutritional articles were published in both local newspapers during four consecutive weeks. These articles explained the physiological actions of healthy foods and listed a health-promoting recipe. During the fourth week of the media campaign, a voucher for a $5 grocery gift card redeemable at one of either community grocery stores was also printed in both local newspapers. In each store, foods that are known to be associated with a reduced risk of CVD were marked with a blue logo. Participants (N=311) completed a questionnaire that assessed demographics and usual servings of fruits, vegetables and grains. Participants received a $5 grocery card and a list of labelled foods. Returned grocery receipts were stapled to the questionnaires to analyse the relationship between demographics and food choices.
  
  
  RESULTS
  Participants who bought at least one labelled food item were older (M=48.5, SD=14.7) than those who did not buy any of these items (M=42.3, SD=16.4; p=0.0008). There was a significant association between labelled food purchases and gender, with 47% of male participants purchasing at least one labelled food item compared with 63% of females in the study (p = 0.008). There were no significant associations between purchase of labelled food items and either education or income. The significant predictors were age (p=0.003) and gender (p=0.01). For every 10 year increase in age, there was a 29% increase in the likelihood that at least one labelled food item would be purchased. Male participants were 48% less likely to purchase at least one designated food item than female participants were.
  
  
  CONCLUSIONS
  Younger adults and men may be less responsive to media-based educational strategies, heart-healthy food labelling and grocery vouchers to defray the cost of healthy eating than older adults and women. Previous studies show that concerns about cost and availability of foods are greater factors in the decision to purchase these foods than demographic characteristics. However, age and gender are associated with the likelihood of using grocery vouchers for the purchase of healthful foods. Additional research is needed to determine whether different educational strategies paired with food labelling and grocery vouchers may be successful strategies to promote purchase of healthful foods, particularly for men and younger adults.
authors: University of Kentucky College of Nursing, Lexington, Kentucky , USA. fdbowe2@uky.edu.
authors: Frances
authors: F
authors: Hardin-Fanning
authors: University of Kentucky College of Nursing, Lexington, Kentucky , USA. y.gokun@uky.edu.
authors: Yevgeniya
authors: Y
authors: Gokun
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002755:Choice Behavior; D002908:Chronic Disease; D004032:Diet; D005260:Female; D005518:Food Preferences; D005523:Food Supply; D005638:Fruit; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007629:Kentucky; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012424:Rural Population; D012737:Sex Factors; D012959:Socioeconomic Factors; D014675:Vegetables; D055815:Young Adult