Pilot Randomized Trial of 2 Food Purchasing Interventions in Individuals With Hypertension in New Orleans: An American Heart Association Food Is Medicine Initiative
Key result
A $100 monthly online grocery voucher yielded no significant difference in self-reported fruit and vegetable consumption compared to an in-store voucher in individuals with uncontrolled hypertension.
Why the study?
Voucher incentives have been shown to improve healthy food purchasing, but the comparative effects of online versus in-store voucher interventions on food purchasing and health outcomes in hypertensive individuals were unclear.
Does an online versus in-store food voucher intervention improve self-reported fruit and vegetable consumption in individuals with uncontrolled hypertension?
Key Points
- To compare the effects of an online versus an in-store grocery voucher intervention on food purchasing, diet quality, and cardiometabolic health outcomes in individuals with uncontrolled hypertension.
- Randomized pilot trial (N=98; NCT06214806) evaluating adults with uncontrolled hypertension randomly assigned to receive a $100 monthly voucher for either an online grocery platform or a local brick-and-mortar grocery store over 5 months.
- Both study arms received concurrent educational materials alongside monthly food purchasing vouchers.
- Assessed primary endpoint of change in self-reported fruit and vegetable consumption along with secondary endpoints (voucher utilization, education engagement, blood pressure, body mass index, and weight) using generalized estimating equations for repeated measures.
- Self-reported fruit and vegetable consumption did not differ between the online and in-store voucher arms, though overall consumption increased by 20% (interquartile range, −17% to 93%) across both arms.
- Voucher redemption was significantly higher in the in-store arm (>90%) than in the online platform arm (<64%), alongside greater engagement with educational materials in the in-store group.
- No statistically significant changes were observed in blood pressure, body weight, or body mass index over the 5-month follow-up period.
Study Design
Type
RCT (n=98)
Randomization
Randomized
Structured PICO
Does an online versus in-store food voucher intervention improve self-reported fruit and vegetable consumption in individuals with uncontrolled hypertension?
P
Population
98 individuals (mean age 57 years, 65% women) with uncontrolled hypertension, randomized to receive online versus in-store grocery vouchers and evaluated over 5 months.
I
Intervention
$100 monthly food voucher to an online grocery platform, plus educational materials, over 5 months
C
Comparator
$100 monthly food voucher to an in-store local grocery, plus educational materials, over 5 months
O
Outcome
Change in self-reported fruit and vegetable consumption over 5 monthspatient reported
Limitations
- Small population size
- Technological barriers
- Small sample size
- Need to address technological barriers
- Lack of long-term health impact assessment
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“We know that healthy food is an important way to promote heart health and prevent heart attacks and strokes, but for too many communities, it's easier said than done. This research team wants to partner with participants to develop a better understanding of how best to support people to make healthier food choices.”
“We plan to use what we learn in this pilot study to help us to plan future clinical outcome assessments that offer comprehensive approaches to chronic disease management. It's crucial for doctors like me to think more broadly beyond what medications I prescribe in my office. Studies like these provide the evidence base to think about patients' real-world circumstances.”
“These and other food is medicine research efforts supported by the Association's Health Care by Food™ initiative hold the promise to improve health outcomes for millions of patients living with or at risk for cardiovascular disease and other serious chronic health conditions.”
Implication
A $100 monthly food voucher increased self-reported fruit and vegetable consumption by 20% over 5 months in patients with uncontrolled hypertension, with higher utilization and engagement observed for in-store versus online vouchers.
Abstract
Background Consuming fruits and vegetables daily is linked to improved health in individuals with hypertension. Voucher incentives have been shown to improve healthy food purchasing. The objective of this study was to compare the effects of an online versus in‐store voucher intervention on food purchasing and health outcomes in hypertensive individuals. Methods In this randomized pilot trial, 98 participants with uncontrolled hypertension received a $100 monthly food voucher to either an online grocery platform or an in‐store local grocery. Both groups received educational materials. The primary outcome was change in self‐reported fruit and vegetable consumption. Secondary outcomes were voucher use, engagement with educational materials, and changes in blood pressure, weight, and body mass index. Generalized estimating equations for repeated measures were used to assess changes in food‐group consumption over 5 months. Results The mean age of participants was 57 years, and 65% were women. No difference was detected between arms for self‐reported fruit and vegetable consumption. There was an overall 20% ( interquartile range, −17% to 93%) increase in fruit and vegetable consumption within both arms. Voucher use was significantly higher in the in‐store arm (>90%) than the online arm (<64%). Engagement with educational materials was greater in the in‐store arm. No significant changes in weight, body mass index , or blood pressure were observed. Conclusions No difference was detected between in‐store and online vouchers for fruit and vegetable consumption. Higher engagement and voucher use were observed in the in‐store arm than the online arm. Future interventions should be conducted in larger populations and address technological barriers to enhance program effectiveness and assess long‐term health impacts. Registration URL: https://clinicaltrials.gov/ ; Unique identifier: NCT06214806.
Discussion
No takes yet. Share an insight, caveat, or question.
Cite This Study
Tannu et al. (2026) conducted an RCT in Uncontrolled hypertension (n=98). Online grocery food voucher vs. In-store local grocery food voucher was evaluated on Change in self-reported fruit and vegetable consumption. A $100 monthly online grocery voucher yielded no significant difference in self-reported fruit and vegetable consumption compared to an in-store voucher in individuals with uncontrolled hypertension.