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Peer-reviewedCC BY 4.0Nutrition and Health

Does the British Columbia Farmers’ Market Nutrition Coupon Program improve the diet quality and food security of parents and children with lower incomes? Protocol for a dose-response, pragmatic randomized controlled trial

  • Dana Lee Olstad1
  • David JT Campbell1,2,3
  • Tolulope T Sajobi1
  • Heather O’Hara4
  • Peter Leblanc4
  • Gavin R McCormack1
  • Leticia Radin-Pereira1
  • Yun Yun Lee1
  • Michelle L Aktary1
  • Leia M Minaker5
  • Eldon Spackman1
5 affiliations
  1. 1Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
  2. 2Department of Medicine, Cumming School of Medicine, University of Calgary Foothills Medical Centre—North Tower, Calgary, AB, Canada
  3. 3Department of Cardiac Sciences, Cumming School of Medicine, Calgary, AB, Canada
  4. 4British Columbia Association of Farmers’ Markets, Vancouver, BC, Canada
  5. 5Future Cities Institute, School of Planning, University of Waterloo, Waterloo, ON, Canada
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Abstract

Background: The British Columbia Farmers’ Market Nutrition Coupon Program (FMNCP) provides lower-income households with coupons to purchase healthy foods at farmers’ markets.

Aim: This pragmatic randomized controlled trial (RCT) will examine the effectiveness and cost-effectiveness of two higher subsidies for healthy food, compared to the usual FMNCP healthy food subsidy, on the diet quality (primary outcome), food insecurity, and other health-related outcomes of 276 parent–child dyads with lower incomes.

Methods: In this single-blind, three-arm, parallel-group pragmatic RCT, 276 parent–child dyads in lower-income households will be randomized to receive the usual FMNCP healthy food subsidy ($27/week) or a subsidy that is two ($54/week) or three times ($81/week) higher. Participants will receive 16 weeks of coupons that can be redeemed for up to 20 weeks. Outcomes will be assessed in one parent (18–64 years) and child (6–17 years) from each household pre-, mid-, and post-intervention. Dietary intake will be collected via two 24-h dietary recalls at each time point to calculate diet quality using the Healthy Eating Food Index-2019. Food insecurity and other health-related outcomes will be assessed using validated self-reported instruments. Mixed effects regression will assess the effects of the interventions, relative to the usual subsidy, on outcomes in parents and children. A full incremental analysis will quantify the cost-effectiveness ratios of the healthy food subsidies.

Summary: This dose-response RCT will show how the diet quality, food insecurity, and other health-related outcomes of parents and children vary according to subsidy amount.

Trial registration: The trial is registered at www.clinicaltrials.gov (NCT06992947).

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Cite

BibTeXRIS
BibTeX
@article{olstad2026does,
  title = {{Does the British Columbia Farmers’ Market Nutrition Coupon Program improve the diet quality and food security of parents and children with lower incomes? Protocol for a dose-response, pragmatic randomized controlled trial}},
  author = {Dana Lee Olstad and David JT Campbell and Tolulope T Sajobi and Heather O’Hara and Peter Leblanc and Gavin R McCormack and Leticia Radin-Pereira and Yun Yun Lee and Michelle L Aktary and Leia M Minaker and Eldon Spackman},
  journal = {Nutrition and Health},
  year = {2026},
  month = sep,
  doi = {10.1177/02601060261473062},
  url = {https://doi.org/10.1177/02601060261473062},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Does the British Columbia Farmers’ Market Nutrition Coupon Program improve the diet quality and food security of parents and children with lower incomes? Protocol for a dose-response, pragmatic randomized controlled trial
AU  - Dana Lee Olstad
AU  - David JT Campbell
AU  - Tolulope T Sajobi
AU  - Heather O’Hara
AU  - Peter Leblanc
AU  - Gavin R McCormack
AU  - Leticia Radin-Pereira
AU  - Yun Yun Lee
AU  - Michelle L Aktary
AU  - Leia M Minaker
AU  - Eldon Spackman
PY  - 2026
DA  - 2026/09/12
JO  - Nutrition and Health
DO  - 10.1177/02601060261473062
UR  - https://doi.org/10.1177/02601060261473062
AB  - Background: The British Columbia Farmers’ Market Nutrition Coupon Program (FMNCP) provides lower-income households with coupons to purchase healthy foods at farmers’ markets.  Aim: This pragmatic randomized controlled trial (RCT) will examine the effectiveness and cost-effectiveness of two higher subsidies for healthy food, compared to the usual FMNCP healthy food subsidy, on the diet quality (primary outcome), food insecurity, and other health-related outcomes of 276 parent–child dyads with lower incomes.  Methods: In this single-blind, three-arm, parallel-group pragmatic RCT, 276 parent–child dyads in lower-income households will be randomized to receive the usual FMNCP healthy food subsidy ($27/week) or a subsidy that is two ($54/week) or three times ($81/week) higher. Participants will receive 16 weeks of coupons that can be redeemed for up to 20 weeks. Outcomes will be assessed in one parent (18–64 years) and child (6–17 years) from each household pre-, mid-, and post-intervention. Dietary intake will be collected via two 24-h dietary recalls at each time point to calculate diet quality using the Healthy Eating Food Index-2019. Food insecurity and other health-related outcomes will be assessed using validated self-reported instruments. Mixed effects regression will assess the effects of the interventions, relative to the usual subsidy, on outcomes in parents and children. A full incremental analysis will quantify the cost-effectiveness ratios of the healthy food subsidies.  Summary: This dose-response RCT will show how the diet quality, food insecurity, and other health-related outcomes of parents and children vary according to subsidy amount.  Trial registration: The trial is registered at www.clinicaltrials.gov (NCT06992947).
SN  - 0260-1060
SN  - 2047-945X
ER  -