ArticleMaternal & child nutrition2019
A realist qualitative study to explore how low-income pregnant women use Healthy Start food vouchers.
Article in Maternal & child nutrition, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Experiences of Food Insecurity During Pregnancy in High-Income Countries: A Meta-Synthesis of Qualitative Studies.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026Pooled it
- Systematic review of fruit and vegetable voucher interventions for pregnant women and families with young children.Public health nutrition · 2025Pooled it
- Food insecurity in children and young people in Scotland.The Proceedings of the Nutrition Society · 2024Review
- Barriers and facilitators to healthy eating in disadvantaged adults living in the UK: a scoping review.BMC public health · 2024Article
- Food Insecurity Is Associated with Diet Quality in Pregnancy: A Cross-Sectional Study.Nutrients · 2024Article
- The Use of Vignettes to Improve the Validity of Qualitative Interviews for Realist Evaluation.Qualitative health research · 2024Article
- Is the healthy start scheme associated with increased food expenditure in low-income families with young children in the United Kingdom?BMC public health · 2021Article
- Healthy eating strategies for socioeconomically disadvantaged populations: a meta-ethnography.International journal of qualitative studies on health and well-being · 2021Review
- Using realist approaches in nutrition and dietetics research.Nutrition & dietetics : the journal of the Dietitians Association of Australia · 2021Review
- A realist qualitative study to explore how low-income pregnant women use Healthy Start food vouchers.Maternal & child nutrition · 2019Article
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5 authors.
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Abstract
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.
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