Systematic review of fruit and vegetable voucher interventions for pregnant women and families with young children

OBJECTIVE: This systematic review aimed to explore the impact of food voucher schemes during pregnancy and early life on fruit and vegetable (F&V) consumption and explore experiences of schemes. 

DESIGN: Six electronic databases and grey literature sources were searched. Interventional, observational, qualitative and mixed methods studies published from January 2000 to April 2024 in English were included. 

SETTING: Food voucher interventions targeting F&V intake. 

PARTICIPANTS: Low-income pregnant women and families with young children (aged under 5 years). 

RESULTS: 7,344 peer reviewed records, and 103 grey literature documents were screened. Sixteen peer reviewed studies (across eighteen reports) and eight grey literature documents met the inclusion criteria. All studies took place in the UK or the USA. There was a lack of consistency across primary quantitative outcomes. Overall, F&V voucher schemes did appear to increase fruit and/or vegetable consumption, but confidence in this finding was low. Qualitative data was more consistent. F&V vouchers were used in three main ways; as a financial benefit to subsidise food already being purchased, to increase the quantity or variety of F&V purchased, or as a safety net, to be used to ensure that the family had something to eat. 

CONCLUSIONS: F&V vouchers may increase F&V intake and are positively received by recipients. This review also highlights some of the difficulties that researchers face in evaluating the impact of public health measures to improve population health. It is clear that more high quality research is required to better understand the impacts of F&V vouchers on individual outcomes.