{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T05:58:28Z","timestamp":1794031108743,"version":"4.8.0"},"reference-count":39,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T00:00:00Z","timestamp":1714608000000},"content-version":"unspecified","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000867","name":"Robert Wood Johnson Foundation","doi-asserted-by":"publisher","award":["80524"],"award-info":[{"award-number":["80524"]}],"id":[{"id":"10.13039\/100000867","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005825","name":"National Institute of Food and Agriculture","doi-asserted-by":"publisher","award":["2019-70030-30415\/project accession no. 1020863"],"award-info":[{"award-number":["2019-70030-30415\/project accession no. 1020863"]}],"id":[{"id":"10.13039\/100005825","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,4,22]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      US Department of Agriculture (USDA) Gus Schumacher Nutrition Incentive Programme (GusNIP) produce prescription programme (PPR) \u2018prescriptions\u2019 provide eligible participants with low income, risk for diet-related chronic disease and food insecurity a healthcare issued incentive to purchase lower to no cost fruits and vegetables (FVs). However, GusNIP requirements specify that PPR prescriptions can only be redeemed for\n                      <jats:italic>fresh<\/jats:italic>\n                      (not frozen, canned or dried) FVs. This requirement may prevent participants from fully engaging in or benefiting from GusNIP PPR, given communities with lower healthy food access may have reduced fresh FV accessibility.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will use the nationally representative 2012\u20132013 National Household Food Acquisition and Purchase Survey (FoodAPS) and complementary FoodAPS Geography Component data in a secondary data analysis to examine how household GusNIP PPR eligibility relates to the quantity and variety of fresh, frozen, canned and dried FV purchases and to what extent individual, household and food environment factors shape the relationship. FoodAPS data include household food purchasing and acquisition information across a 7\u2009day period from 14\u2009317 individuals among 4826 households and was collected between April 2012 and January 2013. The FoodAPS Geography Component provides information about the local community\/environment relative to FoodAPS households. This study will examine the correlation or association of selected variables between different quantities and varieties of fresh, frozen, canned and dried FVs, as well as correlations among multilevel predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>We are following data integrity standards as outlined by agreements with the USDA Economic Research Service. All results of analyses will undergo a thorough disclosure review to ensure no identifiable data are shared. Results will be disseminated to research, practice and policy communities using an Open Access peer-reviewed manuscript(s), scientific and practice presentations, and a public facing report and infographic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-085322","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T13:06:39Z","timestamp":1714655199000},"page":"e085322","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["How does eligibility for GusNIP produce prescriptions relate to fruit and vegetable purchases and what factors shape the relationship? A protocol for a secondary analysis of nationally representative data in the USA"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3301-7258","authenticated-orcid":false,"given":"Bailey","family":"Houghtaling","sequence":"first","affiliation":[{"name":"Gretchen Swanson Center for Nutrition, Omaha, Nebraska, USA"},{"name":"Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanhua","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Biostatistics & Epidemiology, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio, USA"},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Yaroch","sequence":"additional","affiliation":[{"name":"Gretchen Swanson Center for Nutrition, Omaha, Nebraska, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Milburn Atkinson","sequence":"additional","affiliation":[{"name":"Gretchen Swanson Center for Nutrition, Omaha, Nebraska, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Byker Shanks","sequence":"additional","affiliation":[{"name":"Gretchen Swanson Center for Nutrition, Omaha, Nebraska, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,5,2]]},"reference":[{"key":"2025121510033533000_14.5.e085322.1","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1001\/jama.2021.1915","article-title":"Prioritizing nutrition security in the US","volume":"325","author":"Mozaffarian","year":"2021","journal-title":"JAMA"},{"key":"2025121510033533000_14.5.e085322.2","unstructured":"United States Department of Agriculture, Food and Nutrition Service . USDA actions on nutrition security. 2022 Available: https:\/\/www.usda.gov\/sites\/default\/files\/documents\/usda-actions-nutrition-security.pdf"},{"key":"2025121510033533000_14.5.e085322.3","unstructured":"The White House . Biden-Harris administration national strategy on hunger, nutrition, and health. The White House; 2022. Available: https:\/\/www.whitehouse.gov\/wp-content\/uploads\/2022\/09\/White-House-National-Strategy-on-Hunger-Nutrition-and-Health-FINAL.pdf"},{"key":"2025121510033533000_14.5.e085322.4","unstructured":"United States Department of Agriculture and United States Department of Health and Human Services . Dietary Guidelines for Americans 2020-2025. 9th edn. Washington (DC): USDA and USDHHS, Available: https:\/\/www.dietaryguidelines.gov\/"},{"key":"2025121510033533000_14.5.e085322.5","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.jfca.2017.06.012","article-title":"Differences in fruit and vegetable intake of U.S. adults by sociodemographic characteristics evaluated by two methods","volume":"64","author":"Hoy","year":"2017","journal-title":"J Food Compos Anal"},{"key":"2025121510033533000_14.5.e085322.6","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2014.302113"},{"key":"2025121510033533000_14.5.e085322.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.nutres.2014.08.016"},{"key":"2025121510033533000_14.5.e085322.8","doi-asserted-by":"crossref","unstructured":"Singleton CR , Winkler M , Houghtaling B , et al . Understanding the intersection of race\/ethnicity, socioeconomic status, and geographic location: a scoping review of US consumer food purchasing. Int J Environ Res Public Health 2020;17. doi:10.3390\/ijerph17207677","DOI":"10.3390\/ijerph17207677"},{"key":"2025121510033533000_14.5.e085322.9","doi-asserted-by":"crossref","unstructured":"Singleton CR , Wright LA , McDonald M , et al . Structural racism and geographic access to food retailers in the United States: a Scoping review. Health Place 2023;83. doi:10.1016\/j.healthplace.2023.103089","DOI":"10.1016\/j.healthplace.2023.103089"},{"key":"2025121510033533000_14.5.e085322.10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.0158"},{"key":"2025121510033533000_14.5.e085322.11","doi-asserted-by":"crossref","first-page":"2238","DOI":"10.1038\/s41591-022-02027-3","article-title":"A food is medicine approach to achieve nutrition security and improve health","volume":"28","author":"Mozaffarian","year":"2022","journal-title":"Nat Med"},{"key":"2025121510033533000_14.5.e085322.12","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1161\/CIR.0000000000001182","article-title":"Food is medicine: a Presidential advisory from the American heart Association","volume":"148","author":"Volpp","year":"2023","journal-title":"Circulation"},{"key":"2025121510033533000_14.5.e085322.13","unstructured":"United States Department of Agriculture, National Institute of Food and Agriculture . The GUS Schumacher nutrition incentive program - produce prescription program. 2023 Available: https:\/\/www.nifa.usda.gov\/grants\/funding-opportunities\/gus-schumacher-nutrition-incentive-program-produce-prescription"},{"key":"2025121510033533000_14.5.e085322.14","unstructured":"United States Department of Agriculture, National Institute of Food and Agriculture . Gus Schumacher nutrition incentive program (Gusnip). 2023 Available: https:\/\/www.nifa.usda.gov\/grants\/programs\/hunger-food-security-programs\/gus-schumacher-nutrition-incentive-program"},{"key":"2025121510033533000_14.5.e085322.15","doi-asserted-by":"crossref","unstructured":"Toossi S , Jones J . The food and nutrition assistance landscape: fiscal year 2022 annual report. 2023 Available: https:\/\/www.ers.usda.gov\/webdocs\/publications\/106763\/eib-255.pdf?v=8292.3","DOI":"10.32747\/2023.8054020.ers"},{"key":"2025121510033533000_14.5.e085322.16","unstructured":"The nutrition incentive program training, technical assistance, evaluation and information center. GUS Schumacher nutrition incentive program (Gusnip): year 3 impact findings. 2023. Available: https:\/\/nutritionincentivehub.org\/media\/2uwlf3ch\/gusnip-y3-impact-findings-report.pdf"},{"key":"2025121510033533000_14.5.e085322.17","unstructured":"United States Department of Agriculture, National Institute of Food and Agriculture . Request for applications: the GUS Schumacher nutrition incentive program produce prescription program. 2024 Available: https:\/\/www.nifa.usda.gov\/sites\/default\/files\/2024-02\/FY24-GusNIP-NI-RFA-P.pdf"},{"key":"2025121510033533000_14.5.e085322.18","doi-asserted-by":"crossref","unstructured":"Ahmed S , Byker Shanks C . Quality of vegetables based on total phenolic concentration is lower in more rural consumer food environments in a rural American state. Int J Environ Res Public Health 2017;14. doi:10.3390\/ijerph14080924","DOI":"10.3390\/ijerph14080924"},{"key":"2025121510033533000_14.5.e085322.19","doi-asserted-by":"publisher","DOI":"10.1002\/jsfa.2825"},{"key":"2025121510033533000_14.5.e085322.20","doi-asserted-by":"crossref","first-page":"2537","DOI":"10.1080\/00036840801964468","article-title":"The time cost of food at home: general and food stamp participant profiles","volume":"42","author":"Davis","year":"2010","journal-title":"Applied Economics"},{"key":"2025121510033533000_14.5.e085322.21","doi-asserted-by":"crossref","unstructured":"Byker Shanks C , Ahmed S , Smith T , et al . Availability, price, and quality of fruits and vegetables in 12 rural Montana counties, 2014. Prev Chronic Dis 2015;12. doi:10.5888\/pcd12.150158","DOI":"10.5888\/pcd12.150158"},{"key":"2025121510033533000_14.5.e085322.22","unstructured":"United States Department of Agriculture, Economic Research Service . Food access research Atlas. 2023 Available: https:\/\/www.ers.usda.gov\/data-products\/food-access-research-atlas\/"},{"key":"2025121510033533000_14.5.e085322.23","unstructured":"United States Department of Agriculture, Economic Research Service . National household food acquisition and purchase survey (Foodaps): user\u2019s guide to survey design, data collection, and overview of datasets. 2016. Available: https:\/\/www.ers.usda.gov\/media\/u4nl3g2g\/0_foodaps-user-guide-puf.pdf"},{"key":"2025121510033533000_14.5.e085322.24","unstructured":"Wilde P , Llobrera J . Foodaps retail environment study data: documentation. USDA agreement no.: 58-5000-1-0051. USDA, ERS and Tufts University; 2014. Available: https:\/\/www.ers.usda.gov\/media\/8611\/gccodebook.pdf [Accessed 7 Feb 2024]."},{"key":"2025121510033533000_14.5.e085322.25","unstructured":"Gundersen C , Baylis K , Fan L , et al . Construction of weekly store-level food basket costs: documentation. Urbana-Champaign (IL): USDA, ERS and University of Illinois; 2016 [cited 2024 January 24]. Available from; 2016. Available: https:\/\/www.ers.usda.gov\/media\/8612\/priceindexdata.pdf"},{"key":"2025121510033533000_14.5.e085322.26","unstructured":"United States Department of Agriculture, Economic Research Service . Geography component. 2022 Available: https:\/\/www.ers.usda.gov\/data-products\/foodaps-national-household-food-acquisition-and-purchase-survey\/geography-component\/"},{"key":"2025121510033533000_14.5.e085322.27","unstructured":"United States Department of Agriculture, Economic Research Service . Documentation. USDA, ERS; 2022. Available: https:\/\/www.ers.usda.gov\/data-products\/foodaps-national-household-food-acquisition-and-purchase-survey\/documentation\/"},{"key":"2025121510033533000_14.5.e085322.28","unstructured":"Sweitzer M , Brown D , Karns SA , et al . Food-at-home expenditures: comparing commercial household scanner data from IRI and government survey data. Technical bulletin no.: TB-1946. n.d. Available: https:\/\/www.ers.usda.gov\/webdocs\/publications\/85252\/tb-1946.pdf?v=6261.5"},{"key":"2025121510033533000_14.5.e085322.29","unstructured":"Ver Ploeg M , Scharadin B , Miller L , et al . Utilizing the USDA\u2019s National household food acquisition and purchase survey to calculate a household-level food environment measure. Technical bulletin; 1964. Available: https:\/\/www.ers.usda.gov\/webdocs\/publications\/108710\/tb-1964.pdf?v=6170.9"},{"key":"2025121510033533000_14.5.e085322.30","unstructured":"KFF . Medicaid and CHIP income eligibility limits for pregnant women, 2003-2023. 2023. Available: https:\/\/www.kff.org\/affordable-care-act\/state-indicator\/medicaid-and-chip-income-eligibility-limits-for-pregnant-women-as-a-percent-of-the-federal-poverty-level\/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D"},{"key":"2025121510033533000_14.5.e085322.31","unstructured":"KFF . Medicaid income eligibility limits for parents. 2002. Available: https:\/\/www.kff.org\/medicaid\/state-indicator\/medicaid-income-eligibility-limits-for-parents\/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D"},{"key":"2025121510033533000_14.5.e085322.32","unstructured":"Center for Health Care Strategies . A brief history of publicly financed health care in the United States. n.d. Available: https:\/\/www.chcs.org\/media\/Medicaid-Timeline-Fact-Sheet_01.14.20v2.pdf"},{"key":"2025121510033533000_14.5.e085322.33","unstructured":"KFF . Medicaid income eligibility for other non-disabled adults. 2011. Available: https:\/\/www.kff.org\/medicaid\/state-indicator\/medicaid-income-eligibility-limits-for-other-non-disabled-adults\/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D"},{"key":"2025121510033533000_14.5.e085322.34","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1802313"},{"key":"2025121510033533000_14.5.e085322.35","doi-asserted-by":"crossref","first-page":"1633","DOI":"10.1016\/j.jand.2020.05.016","article-title":"Fruit and vegetable purchasing patterns and supplemental nutrition assistance program participation: findings from a nationally representative survey","volume":"120","author":"Tseng","year":"2020","journal-title":"J Acad Nutr Diet"},{"key":"2025121510033533000_14.5.e085322.36","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1001\/jama.2021.13304","article-title":"Updated guidance on the reporting of race and ethnicity in medical and science journals","volume":"326","author":"Flanagin","year":"2021","journal-title":"JAMA"},{"key":"2025121510033533000_14.5.e085322.37","doi-asserted-by":"crossref","unstructured":"Heeringa SG , West B , Heeringa SG , et al . Applied Survey Data Analysis. 2nd edn. Taylor & Francis Group, LLC, 2017. Available: https:\/\/doi.org\/10.1201\/9781315153278","DOI":"10.1201\/9781315153278"},{"key":"2025121510033533000_14.5.e085322.38","doi-asserted-by":"crossref","unstructured":"Byker Shanks C , Houghtaling B , Shanks J , et al . Disparities in dietary practices during the COVID-19 pandemic by food security status. Prev Med Rep 2022;28. doi:10.1016\/j.pmedr.2022.101830","DOI":"10.1016\/j.pmedr.2022.101830"},{"key":"2025121510033533000_14.5.e085322.39","unstructured":"United States Department of Agriculture, Economic Research Service . Summary findings: food price outlook. 2024 Available: https:\/\/www.ers.usda.gov\/data-products\/food-price-outlook\/summary-findings\/"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-085322","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T18:03:47Z","timestamp":1765821827000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-085322"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":39,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5,2]]},"published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1136\/bmjopen-2024-085322"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-085322","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5]]}}}