Nutrition Assistance Program Participation Research Articles

Eat Smart, Live Strong Intervention Increases Fruit and Vegetable Consumption Among Low-Income Older Adults

This study evaluated the impact of a four-session interactive nutrition education program—Eat Smart, Live Strong (ESLS)—on the consumption of fruit and vegetables by low-income older adults. A pre–post quasi-experimental design study was conducted with a longitudinal sample of 614 low-income Supplemental Nutrition Assistance Program (SNAP) participants and those eligible for SNAP, aged 60 to 80 years, in 17 intervention and 16 comparison senior centers in Michigan. The study compared participants’ self-reports of their consumption of fruit and vegetables using a modified version of the University of California Cooperative Extension Food Behavior Checklist. ESLS increased participants’ average daily consumption of fruit by 0.2 cups (P < 0.05) and vegetables by 0.31 cups (P < 0.01). ESLS, a four-session, cognitive-behavioral nutrition education program is an effective curriculum for helping low-income older adults eat more fruit and vegetables.

Farmers’ market shopping and dietary behaviours among Supplemental Nutrition Assistance Program participants

Farmers’ market shopping and dietary behaviours among Supplemental Nutrition Assistance Program participants

Food Insecurity and Food Access in U.S. Metropolitan Areas

AbstractHousehold food insecurity in the United States has reached its highest levels to date. As public and private initiatives have emerged to help improve diets by fostering access to food, the availability of more food stores may result in lower levels of food insecurity. In this article, we assess the relationship between adult food insecurity and food store density in metropolitan areas of the United States. We find that while small grocery/convenience stores show a mitigating effect on adult food insecurity across different samples of households, the effects of large supermarkets/grocery stores and supercenters vary. We also find that Supplemental Nutrition Assistance Program participation and food access can have a simultaneously beneficial effect in reducing adult food insecurity. Implications for policies aiming to improve food security by fostering access to food stores are discussed.

The Short‐Run Impact of the Healthy Incentives Pilot Program on Fruit and Vegetable Intake

In response to low consumption levels of fruits and vegetables by Supplemental Nutrition Assistance Program (SNAP) participants, the USDA Food and Nutrition Service created the Healthy Incentives Pilot (HIP) to test the efficacy of providing a 30% incentive for purchases of targeted fruits and vegetables (TFVs). Four to six months after implementation, mean daily TFV intake for adult HIP participants was 0.22 cup‐equivalents higher (24% higher) than for control‐group SNAP participants. These impact estimates with a random‐assignment research design generally agree with previously published nonexperimental elasticity estimates, which imply that a pure price reduction of 30% would increase fruit and vegetable consumption by about 20%.

Caloric beverage intake among adult supplemental nutrition assistance program participants.

We compared sugar-sweetened beverage (SSB), alcohol, and other caloric beverage (juice and milk) consumption of Supplemental Nutrition Assistance Program (SNAP) participants with that of low-income nonparticipants. We used 1 day of dietary intake data from the 2005-2008 National Health and Nutrition Examination Survey for 4594 adults aged 20 years and older with household income at or below 250% of the federal poverty line. We used bivariate and multivariate methods to compare the probability of consuming and the amount of calories consumed for each beverage type across 3 groups: current SNAP participants, former participants, and nonparticipants. We used instrumental variable methods to control for unobservable differences in participant groups. After controlling for observable characteristics, SNAP participants were no more likely to consume SSBs than were nonparticipants. Instrumental variable estimates showed that current participants consumed fewer calories from SSBs than did similar nonparticipants. We found no differences in alcoholic beverage consumption, which cannot be purchased with SNAP benefits. SNAP participants are not unique in their consumption of SSBs or alcoholic beverages. Purchase restrictions may have little effect on SSB consumption.

Supplemental Nutrition Assistance Program Participation Among Child Welfare–Involved Families

Using a national probability sample of families involved in child welfare, we estimated food stamp participation rates based on child placement following maltreatment investigation. Of the 69% of households that retained their child after investigation and were eligible for food stamps, 73% participated in the Supplemental Nutrition Assistance Program; of the 51% of kinship foster homes that were eligible, 58% participated; and of the 22% of traditional foster homes that were eligible, 26% participated. Participation rates for households involved in child welfare were lower than for households in the general population; traditional foster homes participated at the lowest rates. Outreach to child welfare–involved families and child welfare agencies are needed to increase enrollment.

Supplemental Nutrition Assistance Program Participation and Child Food Security

This article investigates the association between Supplemental Nutrition Assistance Program (SNAP) participation and child food security by using data from the largest national survey of the food security of SNAP participants to date. The analysis used a survey of nearly 3000 households with children and a quasi-experimental research design that consisted of 2 sets of comparisons. Using a cross-sectional sample, we compared information collected from SNAP households within days of program entry with information collected from a contemporaneous sample of SNAP households that had participated for ∼6 months. Next, by using a longitudinal sample, we compared baseline information collected from new-entrant SNAP households with information from those same households 6 months later. Multivariate logistic regression analysis was used to estimate associations between SNAP and child food security. SNAP participation was associated with an approximately one-third decrease in the odds of children being food insecure in both samples. In the cross-sectional analysis only, SNAP was also associated with a decrease in the odds of children experiencing severe food insecurity (designated very low food security). Findings were qualitatively robust to different empirical specifications. After controlling for other possible confounders, we found children in households that had participated in SNAP for 6 months experienced improvements in food security. On the basis of these findings, we conclude SNAP serves a vital role in improving the health and well-being of low-income children by increasing food security. Future research is needed to determine whether specific groups of children experience differential improvements in food security.

Supplemental Nutrition Assistance Program Participation and Child Food Security

This article estimates the effect of the Supplemental Nutrition Assistance Program (SNAP) on children’s food security using data from the largest national survey of food security of SNAP participants to date. The study found children in households that had participated in SNAP for 6 months experienced improvements in food security. On the basis of these findings, we conclude SNAP serves a vital role in improving the health and well-being of low-income children by increasing food security.

Supplemental Nutrition Assistance Program participation did not help low income Hispanic women in Texas meet the dietary guidelines

ObjectiveLow-income Hispanic women are at greater risk for dietary deficiencies and obesity. We assessed the association between Supplemental Nutrition Assistance Program participation and dietary intake among 661 Hispanic women aged 26–44years living in Texas. MethodsCross-sectional data was collected using standard methods. Analysis of variance and logistic regression examined the influence of Supplemental Nutrition Assistance Program on diet after adjusting for household characteristics, body mass index, and food security status. ResultsMost women did not meet recommended dietary guidelines. Supplemental Nutrition Assistance Program participants consumed higher amounts of total sugars, sweets–desserts, and sugar-sweetened beverages than Supplemental Nutrition Assistance Program nonparticipants. High sodium intakes and low dairy consumption were observed in both groups. Only 27% of low-income eligible women received Supplemental Nutrition Assistance Program benefits. DiscussionLow-income Hispanic women participating in Supplemental Nutrition Assistance Program reported less healthful dietary patterns than nonparticipants. This may contribute to the increased obesity prevalence and related comorbidities observed in this population. ConclusionSupplemental Nutrition Assistance Program should play an important role in enhancing the overall dietary quality of low-income households. Policy initiatives such as limiting the purchase of sugar-sweetened beverages and education to enable women to reduce consumption of high sodium processed foods deserve consideration as means to improve the dietary quality of Supplemental Nutrition Assistance Program participants. Effective measures are needed to increase Supplemental Nutrition Assistance Program participation rates among Hispanics.

Factors Within Multiple Socio-Ecological Model Levels of Influence Affecting Older SNAP Participants' Ability to Grocery Shop and Prepare Food

The study identified and determined if factors within multiple levels of the socio-ecological model were effective in explaining older adult Supplemental Nutrition Assistance Program (SNAP) participants' ability to grocery shop and prepare food. Data were collected from 370 SNAP participants, 65 years and above, via a telephone survey. Factors within multiple levels of influence were significant in explaining both ability to grocery shop and prepare food, including physical and emotional wellbeing; self-reliance; finances; housing; family and friend interactions; social support; and food access. To effectively influence older SNAP participants, integrated SNAP education programs addressing multiple levels of influence are recommended.

Personal Weight Status Classification and Health Literacy Among Supplemental Nutrition Assistance Program (SNAP) Participants

The purpose of this study was to examine the conceptual gap between self-perceived weight and body mass index (BMI), and to assess the knowledge gap between perceived importance of following dietary guidelines and health literacy levels. Adults (n = 131) eligible for the Supplemental Nutrition Assistance Program (SNAP) were interviewed at eleven SNAP regional offices in Maryland. Based on BMI calculated from self-reported height and weight, 65.6% of participants were overweight or obese while 40.5% perceived that they were overweight or obese. In sub-group analysis categorized by BMI, only 20.0% in the overweight and 20.0% in the obese group correctly perceived themselves as being overweight or obese. Following dietary guidelines was perceived as important by a majority of participants, but only 43.5% had adequate health literacy. Conceptual and knowledge gaps between self-perception and objective health status existed in the low-income SNAP-eligible sample. Future studies need to address these gaps because misperceived weight status and insufficient health literacy are critical barriers to inducing behavioral change.

Few Changes in Food Security and Dietary Intake From Short-term Participation in the Supplemental Nutrition Assistance Program Among Low-income Massachusetts Adults

To examine whether short-term participation in the Supplemental Nutrition Assistance Program (SNAP) affects food security and dietary quality among low-income adults recruited from a Massachusetts-wide emergency food hotline. A 3-month, longitudinal study was conducted among 107 adults recruited at the time of SNAP application assistance. Outcomes included household food security (10-item US Department of Agriculture Food Security Survey Module), dietary intake (eg, grains, fruit) and diet quality (modified Alternate Healthy Eating Index). Data were analyzed using paired t tests and multivariable linear regression. Supplemental Nutrition Assistance Program participation was not associated with improved household food security over 3 months (P = .25). Compared with non-participants, SNAP participants increased refined grain intake by 1.1 serving/d (P = .02), from baseline to follow-up. No associations were observed with other foods, nutrients, or dietary quality. Policies that simultaneously improve household food security and dietary quality should be implemented to support the health of low-income Americans participating in this crucial program.

Recent trends in spending patterns of Supplemental Nutrition Assistance Program participants and other low-income Americans

Recent trends in spending patterns of Supplemental Nutrition Assistance Program participants and other low-income Americans

Do Asians Demonstate Optimal Compliance In CDC Recommended Pediatric Vaccine Schedule?

To estimate the impacts of a new supermarket in a low-income desert, on residents' economic status and health.We surveyed a randomly selected cohort in two low-income Pittsburgh neighborhoods before and about 1 year following the opening of a supermarket. We used difference-in-difference approach to test changes across the two neighborhoods in residents' food security, United States Department of Agriculture Supplemental Nutrition Assistance Program and Special Supplemental Nutrition Program for Women Infant and Children participation, employment, income, and self-reported health/chronic disease diagnoses.We observed declines in food insecurity (−11.8%, P < .01), Supplemental Nutrition Assistance Program participation (−12.2%, P < .01), and fewer new diagnoses of high cholesterol (−9.6%, P = .01) and arthritis (−7.4%, P = .02) in the neighborhood with the new supermarket relative to residents of the comparison neighborhood. We also found suggestive evidence that residents' incomes increased more ($1550, P = .09) and prevalence of diabetes increased less in the neighborhood with the supermarket than in the comparison neighborhood (−3.6%, P = .10).Locating a new supermarket in a low-income neighborhood may improve residents' economic well-being and health. Policymakers should consider broad impacts of neighborhood investment that could translate into improved health for residents of underserved neighborhoods.

Association Between the Retail Food Environment, Neighborhood Deprivation, and County-Level Dietary Outcomes Among Supplemental Nutrition Assistance Program–Education (SNAP-Ed) Recipients in Kentucky, 2010–2011

The term obesity paradox was coined to describe potential associations between Supplemental Nutrition Assistance Program (SNAP) participation, food insecurity, and obesity. The study aimed to examine associations between (1) the retail food environment and macronutrients and (2) neighborhood deprivation and macronutrients. During 2010–2011, 57 Kentucky counties participated in the Supplemental Nutrition Assistance Program for Education (SNAP-Ed; n = 1585 total individuals aggregated at the county level) through the University of Kentucky Cooperative Extension. Dietary data were used to create county-level aggregate mean intake on calories, fat, protein, and carbohydrates. The retail food environment was determined by collecting food venue data from InfoUSA 2011, local health departments, and the Kentucky Department of Agriculture. There was a higher mean aggregate consumption of calories (206.23; 95% confidence interval [CI]: 173.93, 418.25) and fat grams (6.50; 95% CI: 3.04, 10.81) among SNAP-Ed participants in counties with 3 or more gas stations with food marts compared to SNAP-Ed participants in counties with less than 3 gas stations with food marts. County-level availability of certain food venues was associated with county-level aggregate dietary intake among SNAP-Ed participants.

Low Utilization of SNAP and TANF by EFNEP and WIC Participants

To find if the full benefit of nutrition assistance programs are being utilized by eligible women already participating in EFNEP or WIC. Prior research with this population suggested that EFNEP and WIC participants are not pursuing other nutrition assistance programs that they could qualify for. Program outreach is imperative to reduce health disparities among limited-income populations. In 2011, 444 women aged 18 to 65 at EFNEP (41%), WIC (43%), and an unemployment center (16%) completed a self-administered survey on nutrition assistance program participation, demographics, USDA food security module, and the Bidimensional Acculturation Scale (BAS). Data was analyzed using descriptive statists and comparisons were made using Chi Square as appropriate. Seventy-two percent self-identified as Hispanic, 53% were non-US born, but only 38% were Hispanic dominant, with 23% bicultural by the BAS. Nearly half of all participants were food secure (51%). Significant differences in degree of food insecurity were seen by acculturation status with 8% of Hispanic dominant women having “very low food security” in contrast to 19% of English dominant women (p=0.003). Forty-seven percent received SNAP benefits, but more US born (54%) than non-US born (41%; p=0.004) used the program. Only 12% of all women used TANF with significantly more English dominant and US born women receiving funds (p=0.004). These findings suggest underutilization of SNAP and TANF by EFNEP and WIC participants. Greater efforts are needed to increase awareness of these resources across programs in addition to further analysis identifying barriers and motivators to participation.

Characteristics and Barriers Associated with Participation in the Supplemental Nutrition Assistance Program (SNAP) Participants by Persons Living with HIV

ObjectiveSNAP serves 50 million Americans. For HIV‐infected people in poverty, SNAP participation provides nutritional support for the management of HIV disease. The objective of this study was to characterize barriers for participation in SNAP in this population.MethodsAfter consenting 175 participants, questionnaires on sociodemographics and lifestyle were collected. SPSS was used for analyses.ResultsParticipants were 66% male, 74% African‐American and 70% received SNAP. Antiretroviral use (OR=15.2, 95%CI:4.3–52.7,p&lt;0.001), income&lt;$1000/month (OR=5.28,95%CI:1.6–17.0,p=0.006) and US‐born (OR=16.50,95%CI:3.6–75.5, p&lt;0.001) were associated with SNAP participation; 27% of nonparticipants cited denial of application as the main reason for not participating in SNAP. Recent incarceration (17.4%) and being unaware of eligibility or living or living in a shelter (15.4%) were barriers to participation.ConclusionSNAP participation is high in this HIV‐infected cohort; however, recent incarceration and living in a shelter are barriers that are distinct to this population. Outreach programs targeting low income HIV‐infected persons should consider these barriers and develop strategies to overcome them.

Neighbourhood and consumer food environment is associated with dietary intake among Supplemental Nutrition Assistance Program (SNAP) participants in Fayette County, Kentucky.

The aim of the study was to determine the association between dietary outcomes and the neighbourhood food environment (street network distance from home to stores) and consumer food environment (Nutrition Environment Measurement Survey-Stores (NEMS-S) audit). The neighbourhood food environment was captured by creating 0?5-mile and 1-mile network distance (street distance) around each participant’s home and the nearest food venue (convenience store, grocery store, supermarket, farmers’ market and produce stand). The consumer food environment was captured by conducting NEMS-S in all grocery stores/supermarkets within 0?5 and 1 mile of participants’ homes. Fayette County, KY, USA. Supplemental Nutrition Assessment Program (SNAP) participants, n 147. SNAP participants who lived within 0?5 mile of at least one farmers’ market/produce stand had higher odds of consuming one serving or more of vegetables (OR56?92; 95% CI 4?09, 11?69), five servings or more of grains (OR51?76; 95% CI 1?01, 3?05) and one serving or more of milk (OR53?79; 95% CI 2?14, 6?71) on a daily basis. SNAP participants who lived within 0?5 mile of stores receiving a high score on the NEMS-S audit reported higher odds of consuming at least one serving of vegetables daily (OR53?07; 95% CI 1?78, 5?31). Taken together, both the neighbourhood food environment and the consumer food environment are associated with a healthy dietary intake among SNAP participants.

Time to eat? The relationship between food security and food-related time use.

In the present analysis, we seek to establish a relationship between time spent on food-related activities and food security status as well as between time spent on these activities and Supplemental Nutrition Assistance Program (SNAP, formerly called the Food Stamp Program) participation and benefit level. After matching similar households using Coarsened Exact Matching, we estimate the relationship between food-related time, food insecurity and SNAP participation and benefit level using a comprehensive data set that combines two subsets of the Current Population Survey from years 2004-2010: the Food Security Supplement and the American Time Use Survey. City, suburban and rural areas of the USA. Non-institutionalized US population over the age of 15 years. Total sample size is 10 247 households. In single households, food insecurity and SNAP participation are associated with 20% more time in meal preparation and 13% less time eating. Similarly, in married households, SNAP participation and benefit level are associated with 32% less time in meal preparation while food insecurity is associated with 17% less time eating and 14% less time in grocery shopping. A significant relationship exists between time spent on food-related activities and food insecurity and SNAP. This implies that federal and state government may need to consider the time constraints many low-income households face when reforming food assistance programmes.

Convenience stores are the key food environment influence on nutrients available from household food supplies in Texas Border Colonias

BackgroundFew studies have focused on the relationship between the retail food environment and household food supplies. This study examines spatial access to retail food stores, food shopping habits, and nutrients available in household food supplies among 50 Mexican-origin families residing in Texas border colonias.MethodsThe design was cross-sectional; data were collected in the home March to June 2010 by promotora-researchers. Ground-truthed methods enumerated traditional (supercenters, supermarkets, grocery stores), convenience (convenience stores and food marts), and non-traditional (dollar stores, discount stores) retail food stores. Spatial access was computed using the network distance from each participant’s residence to each food store. Data included survey data and two household food inventories (HFI) of the presence and amount of food items in the home. The Spanish language interviewer-administered survey included demographics, transportation access, food purchasing, food and nutrition assistance program participation, and the 18-item Core Food Security Module. Nutrition Data Systems for Research (NDS-R) was used to calculate HFI nutrients. Adult equivalent adjustment constants (AE), based on age and gender calorie needs, were calculated based on the age- and gender composition of each household and used to adjust HFI nutrients for household composition. Data were analyzed using bivariate analysis and linear regression models to determine the association of independent variables with the availability of each AE-adjusted nutrient.ResultsRegression models showed that households in which the child independently purchased food from a convenience store at least once a week had foods and beverages with increased amounts of total energy, total fat, and saturated fat. A greater distance to the nearest convenience store was associated with reduced amounts of total energy, vitamin D, total sugar, added sugar, total fat, and saturated fat. Participation in the National School Lunch Program (NSLP) was associated with lower household levels of total energy, calcium, vitamin C, sodium, vitamin D, and saturated fat. Spatial access and utilization of supermarkets and dollar stores were not associated with nutrient availability.ConclusionsAlthough household members frequently purchased food items from supermarkets or dollar stores, it was spatial access to and frequent utilization of convenience food stores that influenced the amount of nutrients present in Texas border colonia households. These findings also suggest that households which participate in NSLP have reduced AE-adjusted nutrients available in the home. The next step will target changes within convenience stores to improve in-store marketing of foods and beverages to children and adults.