2023-09-28 14:46:10 +00:00
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abstract: 'Background: Good nutrition is important during pregnancy, breastfeeding
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and early life to optimise the health of women and children. It is
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difficult for low-income families to prioritise spending on healthy
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food. Healthy Start is a targeted United Kingdom (UK) food subsidy
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programme that gives vouchers for fruit, vegetables, milk, and vitamins
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to low-income families. This paper reports an evaluation of Healthy
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Start from the perspectives of women and health practitioners.
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Methods: The multi-method study conducted in England in 2011/2012
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included focus group discussions with 49 health practitioners, an online
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consultation with 620 health and social care practitioners, service
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managers, commissioners, and user and advocacy groups, and qualitative
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participatory workshops with 85 low-income women. Additional focus group
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discussions and telephone interviews included the views of 25 women who
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did not speak English and three women from Traveller communities.
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Results: Women reported that Healthy Start vouchers increased the
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quantity and range of fruit and vegetables they used and improved the
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quality of family diets, and established good habits for the future.
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Barriers to registration included complex eligibility criteria,
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inappropriate targeting of information about the programme by health
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practitioners and a general low level of awareness among families.
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Access to the programme was particularly challenging for women who did
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not speak English, had low literacy levels, were in low paid work or had
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fluctuating incomes. The potential impact was undermined by the rising
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price of food relative to voucher value. Access to registered retailers
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was problematic in rural areas, and there was low registration among
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smaller shops and market stalls, especially those serving culturally
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diverse communities.
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Conclusions: Our evaluation of the Healthy Start programme in England
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suggests that a food subsidy programme can provide an important
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nutritional safety net and potentially improve nutrition for pregnant
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women and young children living on low incomes. Factors that could
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compromise this impact include erosion of voucher value relative to the
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rising cost of food, lack of access to registered retailers and barriers
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to registering for the programme. Addressing these issues could inform
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the design and implementation of food subsidy programmes in high income
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countries.'
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affiliation: 'McFadden, A (Corresponding Author), Univ Dundee, Coll Med Dent \& Nursing,
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11 Arlie Pl, Dundee DD1 4HJ, Scotland.
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McFadden, Alison, Univ Dundee, Coll Med Dent \& Nursing, Dundee DD1 4HJ, Scotland.
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Green, Josephine M.; McCormick, Felicia, Univ York, Dept Hlth Sci, York YO10 5DD,
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N Yorkshire, England.
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Williams, Victoria, Food Matters, Brighthelm Ctr, Brighton BN1 1YD, E Sussex, England.
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Fox-Rushby, Julia, Brunel Univ, Hlth Econ Res Grp, Uxbridge UB8 3PH, Middx, England.
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Renfrew, Mary J., Univ Dundee, Coll Med Dent \& Nursing, Dundee DD1 4HJ, Scotland.'
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article-number: '148'
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author: McFadden, Alison and Green, Josephine M. and Williams, Victoria and McLeish,
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Jenny and McCormick, Felicia and Fox-Rushby, Julia and Renfrew, Mary J.
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author-email: a.m.mcfadden@dundee.ac.uk
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author_list:
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- family: McFadden
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given: Alison
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- family: Green
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given: Josephine M.
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- family: Williams
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given: Victoria
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- family: McLeish
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given: Jenny
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- family: McCormick
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given: Felicia
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- family: Fox-Rushby
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given: Julia
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- family: Renfrew
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given: Mary J.
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da: '2023-09-28'
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doi: 10.1186/1471-2458-14-148
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files: []
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issn: 1471-2458
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journal: BMC PUBLIC HEALTH
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keywords: 'Food subsidy programme; Food vouchers; Healthy Start; Low-income
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families; Maternal and young child nutrition; Fruit and vegetable
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intake; Nutritional inequalities'
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keywords-plus: 'PUBLIC-HEALTH; VEGETABLE CONSUMPTION; INSECURITY; PREGNANCY; FRUIT;
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WOMEN'
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language: English
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month: FEB 11
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number-of-cited-references: '46'
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orcid-numbers: '杜, 美晨/0000-0002-1562-1155
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Renfrew, Mary/0000-0003-2905-403X
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McFadden, Alison/0000-0002-5164-2025
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Fox-Rushby, Julia/0000-0003-0748-0871
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McLeish, Jenny/0000-0002-9289-857X'
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papis_id: 31376593a88c91e4c6d2d600e8cd41d5
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ref: Mcfadden2014canfood
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researcherid-numbers: 'Renfrew, Mary J/A-2440-2010
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杜, 美晨/S-4063-2016
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'
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times-cited: '46'
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title: 'Can food vouchers improve nutrition and reduce health inequalities in low-income
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mothers and young children: a multi-method evaluation of the experiences of beneficiaries
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and practitioners of the Healthy Start programme in England'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000331306100001
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usage-count-last-180-days: '1'
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usage-count-since-2013: '82'
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volume: '14'
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web-of-science-categories: Public, Environmental \& Occupational Health
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year: '2014'
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