A Consideration of the Evaluation of Demonstration Projects to End Childhood Hunger (EDECH)

The Development, Implementation, and Evaluation of Innovative Strategies to Reduce Food Insecurity among Children in the United States

The Need for Investment in Rigorous Interventions to Improve Child Food Security

Obesity and Hunger Threaten the Foundations of Child Health

Food Insecurity on College and University Campuses: A Context and Rationale for Solutions

Measuring the Effects of a Demonstration to Reduce Childhood Food Insecurity: A Randomized Controlled Trial of the Nevada Healthy, Hunger Free Kids Project

A Randomized Controlled Trial Measuring Effects of Extra Supplemental Nutrition Assistance Program (SNAP) Benefits on Child Food Security in Low-Income Families in Rural Kentucky

Comparing Food Security Before and During the COVID-19 Pandemic: Considerations When Choosing Measures

Access to health care and food in children with food allergy

The Need to Incorporate Diversity, Equity, and Inclusion: Reflections from a National Initiative Measuring Fruit and Vegetable Intake

USDA’s Food, Nutrition and Consumer Services Helps Bring Regional and Local Foods to Consumers

The Supplemental Nutrition Assistance Program (SNAP) (formerly the Food Stamp Program) is the Nation’s largest nutritional assistance program and the cornerstone of Federal Government efforts to alleviate hunger in the United States and its territories. SNAP benefits are funded by the United States Department of Agriculture’s Food and Nutrition Service (FNS). They are issued by individual States and redeemable at any authorized FNS SNAP retailer, which includes an increasing number of farmers markets. SNAP benefits are accessed via an Electronic Benefit Transfer (EBT) card that is processed using electronic funds transfer technology. EBT cards look and operate like bank-issued debit cards. SNAP benefits are accessed by swiping the EBT card on a point-of-sale (POS) terminal at an FNS retailer location and entering a personal identification number (PIN). FNS SNAP retailers can either use EBT-only machines, which look like standard commercial POS terminals and are provided for free by FNS, or supply their own terminals. EBT-only machines require electricity and a phone line connection, and accepts only EBT cards. Many FNS SNAP retailers choose to pay for commercial POS terminals that accept EBT, debit, and credit cards on the same machine. Electrical hookups and phone line connections are not available at many farmers market sites, preventing the use of the free EBT-only machines. Even when market managers and vendors are willing and able to invest in wireless POS terminals, the technology can be difficult to manage and promote at farmers markets. Operating an EBT machine requires an FNS license. FNS allows markets to obtain a single FNS license for all eligible vendors at the market. SNAP benefits are redeemed using one centrally located POS terminal; transactions are processed throughout the farmers markets using scrip (paper certificates, tokens, or receipts). SNAP customers redeem their benefits by swiping their EBT cards at the POS terminal in exchange for scrip, which they can use to buy eligible food products. This process is similar to one sometimes used for accepting credit and debit cards at farmers markets. While it is possible for individual vendors to have their own FNS license and POS terminal, scrip projects are the most common way for farmers markets to accept SNAP benefits. This handbook is a how-to guide for accepting SNAP benefits at farmers markets. Topics include why to accept SNAP benefits, how to install EBT systems at farmers markets, how to use scrip projects to accept SNAP benefits at farmers markets, how to become an FNS snap retailer, what equipment is required to accept SNAP benefits at farmers markets, and how to make SNAP EBT succeed at farmers markets.

Background Food insecurity (FI) is an adverse social determinant of health (SDoH) prevalent among pediatric cancer patients and associated with poorer health outcomes in general pediatrics. Receipt of federal SNAP benefits reduces FI in general pediatrics, and is thus a marker of appropriate resource support to mitigate adverse SDoH. Dana-Farber Cancer Institute (DFCI) Acute Lymphoblastic Leukemia (ALL) Consortium Trial 16-001 is the first pediatric oncology clinical trial to prospectively collect parent-reported SDoH, including income, SNAP receipt, and FI. We investigated whether income-eligible pediatric ALL families were successfully receiving SNAP benefits, and whether SNAP receipt was associated with FI. Methods Secondary analysis of children aged 1-17 years with de novo ALL enrolled on the DFCI 16-001-embedded SDoH cohort study at 6 US centers from 2017-2022. We utilized parent-reported SDoH data at diagnosis (T0) and 6-mos (T1) into therapy to identify families as (1) SNAP-eligible, proxied as household income <130% Federal Poverty Level based on federal guidelines; and (2) food insecure, based on validated 2-item screen. McNemar’s test compared SNAP receipt at T0 vs T1 among those eligible at both timepoints. Associations between SNAP eligibility, SNAP receipt, and FI were evaluated with chi-square tests. Results At T0, among 262 evaluable families, 21% reported FI. A total of 20% (n=53) were SNAP-eligible, of whom 60% (n=32) reported FI and 53% (n=28) were receiving SNAP. Among 28 SNAP-recipient families, 61% reported FI. Similarly, at T1, among 223 evaluable families, 25% reported FI. A total of 28% (n=62) were SNAP-eligible, of whom 58% (n=36) reported FI and 58% (n=36) were receiving SNAP. Among 36 SNAP-recipient families, 56% reported FI. A significantly higher proportion of the 33 families SNAP-eligible at both T0 and T1 were receiving SNAP at T1 (70%) compared to T0 (52%) (p=0.034). Among eligible families, SNAP receipt was not associated with lower odds of FI at T0 (OR 1.03, p=0.96) or T1 (OR 0.83, p=0.73). Discussion FI, a well-defined adverse SDoH associated with inferior health outcomes, is highly prevalent among a trial-enrolled pediatric ALL population. Despite care delivery at highly resourced centers with dedicated staff to address social needs, a substantial proportion of likely eligible families (as proxied by income) were not receiving SNAP benefits 6-mos into therapy. Further, receipt of SNAP was inadequate to ameliorate FI in this cohort, with ~60% of SNAP recipients reporting concurrent FI both at T0 and T1. Ensuring successful connection of eligible families to existing benefits is an essential first step. However, high rates of FI among SNAP recipients indicate that resource navigation, though necessary, is not sufficient to address FI for this population. These data provide immediate targets for health equity interventions—including systematic benefits navigation, direct resource provision, and policy-based approaches for benefits augmentation—to address adverse SDoH and improve cancer outcomes. Citation Format: Rahela Aziz-Bose, Yael Flamand, Puja J. Umaretiya, Lenka Ilcisin, Ariana Valenzuela, Peter D. Cole, Lisa M. Gennarini, Justine M. Kahn, Kara M. Kelly, Bruno Michon, Thai-Hoa Tran, Jennifer J. G. Welch, Lewis B. Silverman, Kira Bona. Food insecurity and receipt of Supplemental Nutrition Assistance Program (SNAP) benefits among income-eligible US pediatric acute lymphoblastic leukemia patients enrolled on a multi-center clinical trial [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B096.

Associations between Food Insecurity, Supplemental Nutrition Assistance Program (SNAP) Benefits, and Body Mass Index among Adult Females

The LSU AgCenter Healthy Communities Initiative: Community-Participatory Policy, Systems, and Environmental Change

The Supplemental Nutrition Assistance Program (SNAP) (formerly the Food Stamp Program) is the Nation’s largest nutritional assistance program and the cornerstone of Federal Government efforts to alleviate hunger in the United States and its territories. SNAP benefits are funded by the United States Department of Agriculture’s Food and Nutrition Service (FNS). They are issued by individual States and redeemable at any authorized FNS SNAP retailer, which includes an increasing number of farmers markets. SNAP benefits are accessed via an Electronic Benefit Transfer (EBT) card that is processed using electronic funds transfer technology. EBT cards look and operate like bank-issued debit cards. SNAP benefits are accessed by swiping the EBT card on a point-of-sale (POS) terminal at an FNS retailer location and entering a personal identification number (PIN). FNS SNAP retailers can either use EBT-only machines, which look like standard commercial POS terminals and are provided for free by FNS, or supply their own terminals. EBT-only machines require electricity and a phone line connection, and accepts only EBT cards. Many FNS SNAP retailers choose to pay for commercial POS terminals that accept EBT, debit, and credit cards on the same machine. Electrical hookups and phone line connections are not available at many farmers market sites, preventing the use of the free EBT-only machines. Even when market managers and vendors are willing and able to invest in wireless POS terminals, the technology can be difficult to manage and promote at farmers markets. Operating an EBT machine requires an FNS license. FNS allows markets to obtain a single FNS license for all eligible vendors at the market. SNAP benefits are redeemed using one centrally located POS terminal; transactions are processed throughout the farmers markets using scrip (paper certificates, tokens, or receipts). SNAP customers redeem their benefits by swiping their EBT cards at the POS terminal in exchange for scrip, which they can use to buy eligible food products. This process is similar to one sometimes used for accepting credit and debit cards at farmers markets. While it is possible for individual vendors to have their own FNS license and POS terminal, scrip projects are the most common way for farmers markets to accept SNAP benefits. This handbook is a how-to guide for accepting SNAP benefits at farmers markets. Topics include why to accept SNAP benefits, how to install EBT systems at farmers markets, how to use scrip projects to accept SNAP benefits at farmers markets, how to become an FNS snap retailer, what equipment is required to accept SNAP benefits at farmers markets, and how to make SNAP EBT succeed at farmers markets.