Abstract

ObjectivesOnline grocery shopping has grown in popularity among low-income households. Yet, few studies have explored how this service can equitably promote healthy food access and reduce food insecurity and nutritional inequities. Thus, this study explores community-identified recommendations for enhancing online grocery shopping to promote equitable food access. MethodsPrimary food purchasers of Supplemental Nutrition Assistance Program (SNAP) eligible, low-income households with children under 8 years old were recruited via Facebook to participate in audio-recorded focus groups and interviews as part of a larger mixed-methods study (Nov 2020 – March 2021). Participants were asked about their experiences with online grocery shopping, SNAP, and specific recommendations on how both programs could be improved to reduce inequities in food access. Recordings were transcribed and analyzed using an equity-oriented obesity prevention framework centered on 1) increasing healthy options, 2) reducing deterrents, 3) improving social and economic resources, and 4) building community capacity. ResultsA total of 44 primary food purchasers participated in in-depth interviews (n = 5) or one of 11 focus groups of 3–5 people (n = 39). Overall, 31 distinct recommendations emerged, which were grouped into 7 categories. Recommendations targeted four distinct stakeholder groups: grocery delivery service providers (D), grocery stores (G), health educators (H), and policy makers (P). To increase healthy options, participants emphasized improving access to services/foods and flexible methods of receiving groceries (D, G, P); to reduce deterrents through greater control of item selection and enhanced shopper interactions (D, G, P), to improve social and economic resources through more payment options and expanding SNAP eligibility and services (H, P), and to build on community capacity through meal planning support (G, H, P). ConclusionsFindings provide specific, actionable, community-informed trajectories for stakeholders to tailor online grocery shopping services to promote equitable food access for SNAP-eligible, low-income shoppers. Funding SourcesRobert Wood Johnson Foundation Healthy Eating Research (Grant # 77,246).

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