Pilot Randomized Trial of 2 Food Purchasing Interventions in Individuals With Hypertension in New Orleans: An American Heart Association Food Is Medicine Initiative

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.