Participation In Food Assistance Programs Research Articles

Impacts of COVID-19 on Food Access: An Examination of People’s Food Shopping Methods Change

The COVID-19 pandemic has exacerbated the food insecurity issue across the nation, especially for vulnerable population groups. As an important way to access food, online grocery shopping has gained substantial popularity during COVID-19. However, it is not clear how COVID-19 impacted both the in-store and online grocery shopping simultaneously and how the impacts varied among different population groups. To gain a comprehensive understanding of the impacts of COVID-19 on food access, we conducted two rounds of online survey during the initial and middle stages of COVID-19 in Maricopa County, Arizona, United States. In addition to the factors that have been examined in the literature, we examined how travel behavior, food environment, and lifestyle change affected both in-store and online shopping during COVID-19 when compared with before COVID-19. Analysis results suggest that the methods people used for grocery shopping varied with different stages of COVID-19 and among different population groups. Changes of people’s daily life and travel behavior during COVID-19 are found to be associated with people’s grocery shopping method selection. While people with better food environment were more likely to keep in-store grocery shopping, as the pandemic progressed, food environment became less important as a factor influencing the adoption of online grocery shopping. Food assistance program participants had a higher demand for the online grocery shopping service. However, the barriers associated with redeeming their benefits online prohibited them from becoming new online grocery shoppers during COVID-19. The study provides important insights into planning of food provision and formulating effective intervention strategies during future shocks.

Student Opposition to University Pouring Rights Contracts

IntroductionThe majority of large public universities have exclusive pouring rights contracts (PRCs) with beverage companies that produce and market sugar-sweetened beverages (SSBs). PRCs contain provisions that conflict with recommendations from major public health organizations that institutions reduce SSB availability, marketing, and consumption. This study assessed the following among students at 3 public universities: student perception of PRCs–the extent to which they favored or opposed PRCs, the association between student socioeconomic characteristics and perception of PRCs, student estimates of PRC revenue, and the association between student PRC revenue estimates and perception of PRCs. To contextualize results, actual PRC revenue as a percent of total revenues was estimated. MethodsA cross-sectional exploratory study was conducted among a convenience sample of 1,311 undergraduate SSB-consuming students recruited from 3 large and diverse public universities in Northern California. On an online questionnaire, undergraduate students indicated the extent to which they favored or opposed PRCs on a 10-point scale (oppose=1-5, favor=6-10) and provided a numeric estimate of the percentage of total university revenue they thought their university's PRC generated. Regression models were used to analyze differences in perception of PRCs by student socioeconomic status and estimates of university revenues generated by PRCs. Additionally, PRCs and financial reports were obtained from the 3 universities to estimate actual PRC revenue as a percent of total revenues. Survey data were collected between August and November 2018 and analyzed August 2022. ResultsA large majority of students (81%) opposed PRCs, and opposition did not significantly differ by student socioeconomic status, including by levels of food security, need-based financial aid, participation in federal food assistance or healthcare programs, parental education, or parental income (all p-values > 0.14). The median student estimates for PRC revenue as a percentage of total university revenue was 10%. In contrast, the estimated actual annual revenue generated from the PRCs ranged from 0.01-0.04% at these schools. Revenue estimates were not significantly associated with participants’ opposition or favoring of PRCs (p = 0.65). ConclusionsA large majority of students opposed PRCs, and this opposition was similar regardless of student socioeconomic status or student estimates of PRC revenues. Students markedly overestimated (by >100-1000-fold) the percentage of university revenue that came from PRCs. University administration should consider student views on PRCs when deciding whether to exit or continue with PRCs.

Federal Food Program Participation and Beverage Intake Among Families With Low Household Income

ObjectiveExamine beverage intake among families with low income by household participation in federal food assistance programs. DesignCross-sectional study conducted in fall/winter 2020 via an online survey. ParticipantsMothers of young children insured by Medicaid at the time of the child's birth (N = 493). Variables MeasuredMothers reported household federal food assistance program participation, later categorized as Supplementation Nutrition Program for Women, Infants, and Children (WIC) only, Supplemental Nutrition Assistance Program-Education (SNAP) only, both WIC and SNAP, and neither. Mothers reported beverage intake for themselves and their children aged 1–4 years. AnalysisNegative binomial and ordinal logistic regression. ResultsAfter accounting for sociodemographic differences between groups, mothers from households participating in WIC and SNAP consumed sugar-sweetened beverages (incidence rate ratio, 1.63; 95% confidence interval [CI], 1.14–2.30; P = 0.007) and bottled water (odds ratio, 1.76; 95% CI, 1.05–2.96; P = 0.03) more frequently than mothers from households in neither program. Children from households participating in WIC and SNAP also consumed soda (incidence rate ratio, 6.07; 95% CI, 1.80–20.45; P = 0.004) more frequently than children in either program. Few differences in intake were observed for mothers or children participating in only WIC or SNAP vs both programs or neither program. Conclusion and ImplicationsHouseholds participating in both WIC and SNAP may benefit from additional policy and programmatic interventions to limit sugar-sweetened beverage intake and reduce spending on bottled water.

OR23-07-23 The Influence of Food Assistance Program Participation on the Quality of the Home Food Environment Is Modified by Household Food Security Levels

OR23-07-23 The Influence of Food Assistance Program Participation on the Quality of the Home Food Environment Is Modified by Household Food Security Levels

The Relationship Between Food Insecurity and Food Assistance Program Participation in Families of Preschool Children in the Rio Grande Valley

ABSTRACT The South Texas Early Prevention Study-PreK, a cluster randomized trial, explored the Bienestar Coordinated School Health Program’s influence on health variables in South Texas children. Factors associated with food insecurity (FI) were analyzed. Income-to-poverty ratio, income, and food assistance (FA) program participation were all associated with FI. Forty percent of families (257/643) reporting FI did not utilize FA. Of those families with FI, but who reported no FA participation, 31.8% were FA eligible. Families experiencing FI may underutilize FA programs, despite eligibility. Curtailing obstacles preventing FA program participation and matching those who are eligible with FA programs are crucial.

Economic Growth and Adult Obesity Rates in Rural America

Obesity has become an increasingly severe problem in the United States. From 2008 to 2018, the adult obesity rate rose from 33.8% to 42.4%, with rates that are notably higher in rural areas when compared to their urban counterparts. Meanwhile, rural regions have experienced relatively slower employment growth and higher poverty rates during the recovery from the Great Recession. Social scientists are interested in determinants of – and potential solutions to – this rise in obesity rates. The existing literature has focused on the relationship between obesity and social/economic factors, such as the number of fast-food restaurants, limited physical activity, and unemployment rates. However, one unexplored question is whether the level of economic growth experienced by a rural area plays a role in the obesity problem. This paper assesses the impact of economic growth (measured by county-level GDP per capita) on obesity rates (measured by the county-level percentage of adults with BMI higher than 30) in rural America. Nationwide, data is collected on a host of demographic and economic characteristics for all non-metropolitan counties from 2012 to 2016, resulting in a county-level panel data set (n=1,948, t=5). Control variables include age, race and ethnicity, unemployment rates, rates of physical inactivity, food assistance program participation, and an index measuring healthy food availability. Two different econometric approaches were applied: (1) a fixed-effects panel regression model and (2) a difference-in-difference model using propensity score matching (PSM). The results of both econometric models suggest there is no relationship between economic growth and future obesity rates. This suggests that programs focused on rural economic growth may not affect other quality-of-life metrics. The conclusion discusses these competing interests and how regional scientists can play a role in future research in this area.

The 2016 Presidential Election, the Public Charge Rule, and Food and Nutrition Assistance Among Immigrant Households.

Objectives. To investigate whether the 2016 US presidential election and the subsequent leak of a proposed change to the public charge rule reduced immigrant families' participation in food and nutrition assistance programs. Methods. We used nationally representative data on n = 57 808 households in the United States from the 2015-2018 Current Population Survey-Food Security Supplement. We implemented difference-in-difference-in-difference analyses to investigate whether the election and proposed rule change produced decreases in immigrant families' participation in food and nutrition assistance programs and whether such decreases varied according to state policy generosity toward immigrants. Results. Findings indicate significant and large decreases in Supplemental Nutrition Assistance Program, School Breakfast Program, and National School Lunch Program participation among immigrants in moderately generous states but no changes to receipt of food assistance from nongovernmental sources or to household food insecurity. Conclusions. Both anti-immigrant rhetoric and the perceived threat of policy enactment can be enough to produce chilling effects that have potentially serious implications for the health of immigrant households and thus the health of the nation. (Am J Public Health. 2022;112(12):1738-1746. https://doi.org/10.2105/AJPH.2022.307011).

Federal Food Assistance Program Participation during the COVID-19 Pandemic: Participant Perspectives and Reasons for Discontinuing.

This study aims to describe reasons for discontinuing participation and experiences participating in the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) during the COVID-19 pandemic. We analyzed data from a cross-sectional online survey distributed to a national sample, restricted to (1) households that discontinued participating in SNAP (n = 146) or WIC (n = 149) during the pandemic and (2) households that participated in SNAP (n = 501) or WIC (n = 141) during spring 2021-approximately one year into the pandemic. We conducted thematic analyses of open-ended survey questions and descriptive statistics for Likert-scale items. Themes raised by respondents who discontinued participating in SNAP or WIC included difficulty recertifying and virus exposure concerns. Former WIC participants reported the program was not worth the effort and former SNAP participants reported failing to requalify. Respondents participating in WIC or SNAP during the pandemic mentioned transportation barriers and insufficient benefit value. WIC participants had trouble redeeming benefits in stores and SNAP participants desired improved online grocery purchasing experiences. These results suggest that enhancements to WIC and SNAP, such as expanded online purchasing options, program flexibilities, and benefit increases, can improve program participation to ensure access to critical nutrition supports, especially during emergencies.

Socioeconomic Inequalities Impact the Ability of Pregnant Women and Women of Childbearing Age to Consume Nutrients Needed for Neurodevelopment: An Analysis of NHANES 2007-2018.

Adequate consumption of nutrients that support infant neurodevelopment is critical among pregnant women and women of childbearing age. Understanding the potential effects of socioeconomic inequalities on nutrient gaps in these life stages is thus important for informing strategies to mitigate negative health consequences. Usual intake (foods and dietary supplements) of neurodevelopment-related nutrients was determined from 24 h recalls among women of childbearing age and pregnant women (20–44 years) using data from 2007–2018 NHANES. Usual intake was compared across household food security, poverty-to-income ratio (PIR), and household participation in federal food and nutrition assistance programs. Intake of EPA + DHA was universally low with >95% of all women (pregnant and non-pregnant) below the DGA recommendation from foods alone. Women in households that participated in the Supplemental Nutrition Assistance Program had a significantly lower intake of multiple nutrients relative to those who did not participate. For example, 50% had intakes below the estimated average requirement (EAR) for vitamin A (versus 32%), 42% were below the EAR for calcium (versus 33%) and 65% were below the EAR for magnesium (versus 42%). Similar gradients were observed by PIR and household food security, and among pregnant women whereby gaps were more evident in those experiencing socioeconomic inequalities. The use of dietary supplements attenuated shortfalls for most nutrients. These findings highlight a critical need to support the nutritional requirements for women of childbearing age and pregnant women.

Dynamics of macroeconomic factor effects on food assistance program participation in the United States.

Using polynomial distributed lag (PDL) models, the impacts of macroeconomic factors relating to economic, financial, and sociological stress and designed to be short-run predictors of U.S. economic performance are identified and assessed concerning participation in key food assistance programs (SNAP, WIC, and NSLP). The econometric analysis covers the period October 1999 to September 2020. The impact of COVID-19 on participation in these programs also is quantified. Based on the parameter estimates obtained from the econometric PDL models, ex-ante forecasts of participation in the SNAP, WIC, and NSLP subsequently are made and evaluated over the period October 2020 to August 2021. The empirical results show that different sets of macroeconomic drivers affect participation levels across the respective food assistance programs. No macroeconomic factor is common across SNAP, WIC, and NSLP participation. Changes in macroeconomic conditions which influence SNAP, WIC and NSLP participation are not just contemporaneous but also affect participation levels anywhere from 1 month to 12 months later. Importantly, this research allows not only the determination of the macroeconomic factors which affect program participation but also allows the determination of the ability of the respective models to forecast program participation. As such, the Food and Nutrition Service will be in better position to assess program needs as well as to forecast program participation levels to minimize errors in the budgetary process.

Comparison of Fruit and Vegetable Prices between Farmers' Markets and Supermarkets: Implications for Fruit and Vegetable Incentive Programs for Food Assistance Program Participants.

This cross-sectional study was part of a larger evaluation of a fruit and vegetable (FV) incentive program for Supplemental Nutrition Assistance Program (SNAP) participants in California. We examined the price differences in FV to explore whether these could help explain a previously observed lack of effect of the incentive program on FV consumption. Differences by type (organic/no-spray or conventional), among a convenience sample of farmers’ markets (n = 11) and nearby supermarkets (n = 7), were assessed using Wilcoxon rank-sum tests adjusting for clustering by market. We calculated the cost of market baskets comprising recommended FV servings for a household using median prices to consider the implications of FV price differences for SNAP shoppers who use financial incentives for FV. We found that farmers’ markets primarily offered organic FV while supermarkets primarily offered conventionally grown FV. Farmers’ market prices tended to be lower than supermarkets for organic FV but higher for conventional FV. Compared to supermarkets, the market basket composed only of organic FV cost USD 16.34 less at farmers’ markets, whereas a basket comprised of a mix of conventionally and organically grown FV cost USD 3.68 more. These differences warrant further exploration; FV price and type should be considered in studies aimed at understanding the impact of SNAP financial incentive programs.

Patterns of Food Assistance Program Participation, Food Insecurity, and Pantry Use among U.S. Households with Children during the COVID-19 Pandemic.

This study aims to describe differences in participation in the Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women and Children (WIC), and school meal programs by household characteristics prior to and during the pandemic, and to examine the association of program participation with food security status and food pantry use. We analyze secondary data (n = 470) from an online survey collected in July/August 2020 using weighted multiple logistic regression models. Participation in SNAP declined among households with children in the first four months of the pandemic, while participation in WIC increased slightly, and participation in school meals remained unchanged. There were significant differences in SNAP, WIC, and school meal programs use by race/ethnicity, income, and urbanicity before and during the pandemic. Food insecurity prevalence was higher among SNAP participants at both periods but the gap between participants and non-participants was smaller during the pandemic. Pantry use and food insecurity rates were consistently higher among federal nutrition assistance program participants, possibly suggesting unmet food needs. These results highlight the need for increased program benefits and improved access to food, particularly during periods of hardship.

Comparison of Emergency Preparedness Practices between Food Assistance Program Participants and Non-Participants in the United States.

Background: Previous research has suggested many households are meeting the Federal Emergency Management Agency’s 3-day emergency food and water storage recommendations. The impact of limited economic household resources on emergency preparedness practices related to food and water is uncertain. The purpose of this study was to compare emergency preparedness practices in households participating in United States’ food assistance programs with households not participating in these programs. Methods: A convenience sample of adults (n = 572) completed an online Qualtrics survey. Descriptive statistics, chi-square statistics, and independent t-tests were used to measure differences between households participating in food assistance programs vs. non-participating households. Results: Most households participating in food assistance programs felt prepared to provide household members with food and water during an emergency, which did not significantly differ from non-participating households. Households using food assistance programs had less accessible cash but had similar foods on-hand for an emergency compared to non-participating households. However, they more frequently reported having baby formula/food and less frequently reported having vitamin/mineral supplements compared to non-participating households. Conclusions: Food assistance programs may be effective in providing enough food and water to help low-income families be prepared for an emergency.

SNAP participation among low-income US households stays stagnant while food insecurity escalates in the months following the COVID-19 pandemic

The COVID-19 pandemic led to increased food-insecurity rates, particularly among low-income households. Participation in the Supplemental Nutrition Assistance Program (SNAP) was expected to rise in response. We surveyed 931 US residents from households with annual incomes below $50,000 to collect information on food security and food assistance program participation in the year prior to the pandemic and in the first four months of the pandemic, along with household and individual-level demographics. Food insecurity increased from 31% prior to the pandemic to 39% in the first four months of the pandemic, while self-reported SNAP participation stagnated. Even more alarmingly, among low-income households that were also food-insecure, 47% reported participating in SNAP prior to the pandemic but only 39% did so in the first four months following the pandemic’s onset. In particular, Black households, households with children, and those in the lowest income category experienced the largest declines in SNAP participation. Food assistance programs designed to alleviate hunger should facilitate participation among the most vulnerable, especially when these groups are faced with multiple challenges, like during the COVID-19 pandemic.

P71 Barriers to Attendance in a Father-focused Adolescent Obesity Prevention Program: Padres Preparados, Jóvenes Saludables

<h3>Background</h3> Latino family-centered, community-based intervention studies to prevent childhood obesity have primarily involved mothers; therefore, little information about father participation is available. A Latino father-focused program to prevent adolescent obesity was conducted with low participation from some fathers. <h3>Objective</h3> The study aim was to determine factors associated with fathers' attendance in an adolescent obesity prevention program. <h3>Study Design, Settings, Participants</h3> Data were from 147 fathers participating in the Padres Preparados, Jóvenes Saludables program, a randomized controlled trial to prevent Latino adolescent (10-14 years) obesity. Eight weekly (2-hour) sessions were conducted in the Minneapolis/St. Paul metropolitan area (2017-2020). Participants were randomly assigned to intervention or waitlist control groups after baseline data collection. <h3>Measurable Outcome/Analysis</h3> The program facilitator recorded father presence or absence at each session. Attendance data were used in cluster analysis to identify attendance patterns. Predictor variables were measured at baseline with surveys and via anthropometric measures, including demographics, socioeconomic status, adolescent weight status, adolescent weight concerns, food-related activities with adolescents, family meal frequency, food assistance program participation, family stress, number of children, neighborhood safety, assigned group, site, and session season. Multinomial logistic regression analyses were used to examine associations between attendance patterns and predictor variables after assessing appropriateness for inclusion in regression models. <h3>Results</h3> Three attendance patterns were identified for all fathers: consistently high attendance (52%), declining attendance (18%), and non-attendance (30%). Compared to fathers with a consistently high attendance pattern, fathers with a non-attendance pattern were more likely to be assigned to the waitlisted control group (OR: 7.9 [95% CI: 2.6-23.9]; <i>P</i> < 0.01) and have lower household income (OR: 2.8 [95% CI: 1.0-7.8]; <i>P</i> = 0.04). No predictors were associated with declining attendance compared to consistently high attendance. <h3>Conclusion</h3> Maintaining contact with control families during waiting periods and providing online sessions to increase flexibility for low-income families could address Latino father non-attendance.

The Spatial Context of Food Assistance: Examining Local Food Assistance Environment in the Context of SNAP

ABSTRACT We develop the concept of the local food assistance environment to examine how spatial access to different local food assistance resources might shape food assistance program participation. Using unique survey data capturing Supplemental Nutrition Assistance Program (SNAP) participation in metropolitan Detroit, we explore how spatial access to local food assistance resources (e.g., SNAP offices, food retailers, charitable food assistance programs) may be associated with SNAP receipt. Descriptive analyses find that closer proximity to food assistance resources and retailers who accept food assistance benefits is positively associated with self-reported SNAP receipt.

Impact of Participation in Food Assistance Programs Among NHANES Dialysis Patients from 2001-2016

Impact of Participation in Food Assistance Programs Among NHANES Dialysis Patients from 2001-2016

Supplemental Nutrition Assistance Program-Education Improves Food Security Independent of Food Assistance and Program Characteristics.

The purpose of this project was to determine whether consistent food assistance program participation or changes in participation over time mediated or moderated the effect of federal nutrition education through the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) on food security and determine the associations of SNAP-Ed program delivery characteristics with change in food security. This secondary analysis used data from a randomized controlled trial from September 2013 through April 2015. SNAP-Ed-eligible participants (n = 328; ≥18 years) in households with children were recruited from 39 counties in Indiana, USA. The dependent variable was one year change in household food security score measured using the United States Household Food Security Survey Module. Assessment of mediation used Barron-Kenny analysis and moderation used interactions of food assistance program use and changes over time with treatment group in general linear regression modeling. Program delivery characteristics were investigated using mixed linear regression modeling. Results showed that neither consistent participation nor changes in food assistance program participation over time mediated nor moderated the effect of SNAP-Ed on food security and neither were SNAP-Ed program delivery characteristics associated with change in food security over the one year study period. SNAP-Ed directly improved food security among SNAP-Ed-eligible Indiana households with children regardless of food assistance program participation and changes over time or varying program delivery characteristics.

P25 Expansion of Fruit And Vegetable Incentives Impacts People with SNAP at NYC Farmers Markets

<h3>Background</h3> Adequate fruit and vegetable consumption is associated with reduced risk of cardiovascular disease but few New York City (NYC) adults report consuming recommended amounts. Both fruit and vegetable consumption have been reported as lower among adults with low income vs high income. Increased availability of financial incentives for farmers' market purchases could reduce barriers to affordable produce, thereby potentially increasing consumption. Research is limited on the factors influencing fruit and vegetable consumption among food assistance program participants, especially for large, urban populations. <h3>Objectives</h3> This study aimed to offer a preliminary evaluation of the Health Bucks year-round expansion to assess possible short-term effects on fruit and vegetable purchasing and consumption. <h3>Study Design, Setting, Participants</h3> Two cross-sectional surveys of NYC farmers market shoppers were conducted, immediately before (June 2016) and 1 year after (June 2017) implementation of year-round expansion of the Health Bucks incentive program. Eligible respondents were individuals aged 18+ enrolled in the Supplemental Nutrition Assistance Program (SNAP) and able to complete an interviewer-administered survey in English or Spanish. A convenience sample of respondents was surveyed each year (n = 425 and n = 453). <h3>Measured Outcome/Analysis</h3> The survey separately assessed total daily fruit and vegetable consumption among people with SNAP, measured through validated dietary screening questions. Adjusted multivariable logistic regression models, including fixed effects for year, market location and demographics, were conducted. Significance was determined at <i>P</i> < .05. <h3>Results</h3> Mean daily intake (servings) of fruit remained constant between years (0.7 vs 0.7, <i>P</i> = .708); mean vegetable intake increased (2.3 vs 2.6, <i>P</i> = .004). <h3>Conclusions</h3> Expansion of Health Bucks from 5 to 12 months was associated with increased vegetable consumption among people with SNAP at NYC farmers markets. Future program priorities may include additional promotion to increase awareness among people with SNAP and expansion to supermarkets, which may be more opportune venues for utilizing incentives.

Trends in types of protein in US adolescents and children: Results from the National Health and Nutrition Examination Survey 1999-2010.

BackgroundIt is unclear if the intakes of different types of protein have changed over time.ObjectiveWe delineated trends in types of protein (beef, pork, lamb or goat, chicken, turkey, fish, dairy, eggs, legumes, and nuts and seeds) in US children (2-<12 years) and adolescents (12–19 years) from 1999 to 2010.MethodsWe used 6 repeated cross-sectional surveys (National Health and Nutrition Examination Survey 1999–2010, n≥1,665 for children; n≥1,156 for adolescents) to test for linear trends in the intake of types of protein (grams per kilogram of body weight) among children and adolescents, and according to sociodemographic groups and participation in food assistance programs.ResultsAmong children, pork intake (0.76 to 0.51 g/kg) decreased, but chicken (0.98 to 1.28 g/kg), all poultry (1.18 to 1.55 g/kg), egg (0.63 to 0.69 g/kg), and legume (0.35 to 0.54 g/kg) intake increased (all P<0.05). Among adolescents, beef intake decreased (0.92 to 0.67 g/kg) whereas chicken (0.59 to 0.74 g/kg) and all poultry (0.72 to 0.86 g/kg) intake increased from 1999 to 2010 (all P<0.01). Participants of the Women, Infants, and Children (WIC) increased the intake of chicken and dairy (all P<0.05) over time whereas no significant trend was observed for income-eligible non-participants. Fish intake did not change in any age group, and recommended types of protein (poultry, fish, nuts and seeds) declined among children of lower socioeconomic status.ConclusionsIntake of recommended types of protein increased among children, adolescents and WIC participants. However, subgroup analyses suggest socioeconomic disparities.