A realist qualitative study to explore how low‐income pregnant women use Healthy Start food vouchers

Bibliographic Data

ID15536403
AuthorsHeather Ohly (0000-0002-2493-5834, University of Lancashire, corresponding author), Nicola Crossland (0000-0003-1063-8123, University of Lancashire), Fiona Dykes (0000-0002-2728-7967, University of Lancashire), Nicola M Lowe (0000-0002-6934-2768, University of Lancashire), Victoria Hall Morán (0000-0003-3165-4448, University of Lancashire)
Year2018
Volume15
Issue1
Pagese12632-e12632
Publication date2018-06-29
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueMaternal and Child Nutrition (JOURNAL)
Journal identifiersISSN: 1740-8695 • E-ISSN: 1740-8709
PublisherWiley (PUBLISHER • GB)
DOI10.1111/mcn.12632
PMID29956890
OpenAlexW2791705970
LanguageEN
Citations received6
References cited9

Healthy Start is the UK government's food voucher programme for low-income pregnant women and young children. It was introduced in 2006, but the impact of the programme on nutritional outcomes remains understudied. This study sought to explore potential outcomes of the Healthy Start programme (including intended and unintended outcomes) and develop explanations for how and why these outcomes might occur. A realist review preceded this study, in which programme theories were developed and tested using existing evidence. This qualitative study aimed to further refine and consolidate the programme theories from the realist review while remaining open to new and emerging theories (or hypotheses) about how low-income pregnant women use Healthy Start vouchers. Semistructured interviews were conducted with 11 low-income women from North West England, who received Healthy Start vouchers during pregnancy. A realist logic of analysis was applied to generate clear and transparent linkages between outcomes and explanations. The findings suggested that some women used the vouchers to improve their diets during pregnancy (intended outcome), whereas some women were diverted towards alternative or unintended outcomes. Women's circumstances, values, beliefs, and motivations influenced how they perceived and responded to the vouchers. This paper presents four evidence-based programme theories to explain four contrasting (and potentially overlapping) outcomes: dietary improvements (theory refined from review), shared benefits (new theory), financial assistance (theory refined from review), and stockpiling formula (new theory). It considers how the Healthy Start programme could be improved, to increase the possibilities for low-income women to experience the intended outcome of dietary improvements

Demographic economics · Developmental psychology · Economics · Environmental health · Family planning · Government (linguistics · Low income · Outcome (game theory · Political science · Population · Public economics · Qualitative research · Sociology · Unintended consequences · Unintended pregnancy · Voucher · Food Security and Health in Diverse Populations · Gender, Labor, and Family Dynamics · Homelessness and Social Issues · Medicine · Psychology · Gerontology

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