Supplemental Nutrition Assistance Program Education Research Articles

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

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

Integrating Human-Centered Design Methods Into a Health Promotion Project: Supplemental Nutrition Assistance Program Education Case Study for Intervention Design.

Human-centered design, or design thinking, offers an extensive toolkit of methods and strategies for user-centered engagement that lends itself well to intervention development and implementation. These methods can be applied to the fields of public health and medicine to design interventions that may be more feasible and viable in real-world contexts than those developed with different methods. The design team aimed to develop approaches to building food skills among caregivers of children aged 0-5 years who are eligible for a federal food assistance program while they were in the grocery store. They applied 3 specific human-centered design methods-Extremes and Mainstreams, Journey Mapping, and Co-Creation Sessions-to collaboratively develop intervention approaches to enhance Supplemental Nutrition Assistance Program Education (SNAP-Ed) reach and impact across food retail settings. Extremes and Mainstreams is a specific kind of purposive sampling that selects individuals based on characteristics beyond demographics. Journey Mapping is a visual tool that asks individuals to identify key moments and decision points during an experience. Co-Creation Sessions are choreographed opportunities for individuals to explicitly contribute to the design of a solution alongside research or design team members. Ten caregivers with diverse lived experiences were selected to participate in remote design thinking workshops and create individual journey maps to depict their grocery store experiences. Common happy points and pain points were identified. Nine stakeholders, including caregivers, SNAP-Ed staff, and grocery store dieticians, cocreated 2 potential intervention approaches informed by caregivers' experiences and needs: a rewards program and a meal box option. These 3 human-centered design methods led to a meaningful co-design process where proposed interventions aligned with caregivers' wants and needs. This case study provides other public health practitioners with specific examples of how to use these methods in program development and stakeholder engagement as well as lessons learned when adapting these methods to remote settings.

“A Growing Relationship”: Cultivating Organizational Readiness to Influence Implementation of Policy, Systems, and Environmental (PSE) Change Programming in SNAP-Ed Funded School-Community Partnerships

ObjectiveProvide a nuanced understanding of how Supplemental Nutrition Assistance Program-Education (SNAP-Ed) implementers decide what programming a school is ready to implement and the organizational factors that facilitate the initial implementation of programming in schools. DesignCase studies conducted at schools during 2018–19. SettingNineteen School District of Philadelphia schools receiving nutrition programming funded by SNAP-Ed. ParticipantsInterviews were conducted with 119 school staff and SNAP-Ed implementers. A total of 138 hours of observations of SNAP-Ed programming were completed. Phenomenon of InterestHow do SNAP-Ed implementers decide what PSE programming a school is ready to implement? What organizational factors can be developed to facilitate the initial implementation of PSE programming in schools? AnalysisInterview transcripts and observation notes were coded deductively and inductively on the basis of theories of organizational readiness for programming implementation. ResultsSupplemental Nutrition Assistance Program-Education implementers focused on schools’ existing capacity when determining readiness for programming. Conclusions and ImplicationsFindings suggest that if SNAP-Ed implementers only focus on a school's existing capacity when assessing its readiness for programming, the school might not receive the programming it needs. Findings suggest SNAP-Ed implementers could develop a school's readiness for programming by concentrating efforts on cultivating relationships, program-specific capacity, and motivation at schools. Findings have equity implications for partnerships in underresourced schools that may have limited existing capacity and consequentially could be denied vital programming.

African American Perceptions of Service Provided by Supplemental Nutrition Assistance Program-Education: A Qualitative Exploration

ObjectiveTo assess African Americans’ satisfaction with Supplemental Nutrition Assistance Program-Education (SNAP-Ed) in Louisiana. MethodsAfrican American facilitators conducted 5 focus group discussions with 25 African American SNAP-Ed participants according to issues identified by African American SNAP-Ed implementers in Louisiana. Focus group discussion transcripts were coded independently using inductive and in vivo coding by 2 members of the research team. ResultsParticipants viewed lessons as race-neutral and thought they should include more information about African American history and culture. Participants also noted a lack of engagement with the African American community and stressed the need for the program to employ African American staff. However, participants thought the information was important for African Americans in the context of medical issues faced by their community. Conclusions and ImplicationsFindings indicate that SNAP-Ed in Louisiana be modified to address African American food history and culture, additional African American staff and better engagement with the African American community.

First Analysis of Nationwide Trends in the Use of the SNAP-Ed Evaluation Framework

ObjectiveTo understand Supplemental Nutrition Assistance Program-Education (SNAP-Ed) Implementing Agencies’(SIAs) use of the SNAP-Ed Evaluation Framework (Framework), which is a tool that includes 51 indicators that SNAP-Ed programs can use to measure the success of their programs in the first 5 years after its release. MethodsA repeated cross-sectional study design was utilized to administer electronic surveys to between 124 and 154 SIAs who received SNAP-Ed funding in fiscal years 2017, 2019, and 2021. Analyses included descriptive statistics and tests of proportions. ResultsMost SIAs indicated that they used the Framework to inform both data collection instruments and program planning decisions and the rates remained relatively constant over the 3 time points (> 80%). The most common specific use of the Framework across all 3 time points was to define, count, or measure the work accomplished, but this statistically decreased from 2017 (76%) to 2021 (57%) (z-score = 3.31; P < 0.001). Conclusions and ImplicationsThe results of this analysis confirmed that 5 years after its introduction, uptake and use of the Framework was high and that, as a whole, SIAs focused on priority indicators set by the US Department of Agriculture, with no notable increases in addressing and measuring longer-term, multisector, and population-wide outcomes. The systematic study of the Framework's usability over time has a broader application to other national health promotion initiatives with shared frameworks.

Pantry clients and Supplemental Nutrition Assistance Program-Education practitioners' perspectives on factors influencing healthy eating policy, system and environmental interventions in food pantries.

The Supplemental Nutrition Assistance Program-Education identified food pantries as a targeted setting for policy, system, and environmental (PSE) interventions to promote healthy eating among households who rely on pantries to supplement their food needs. The present study sought to identify factors influencing capacity and readiness to implement healthy eating PSE interventions in food pantries. Qualitative interviews were conducted via zoom with twenty-six community residents with experience receiving SNAP benefits and twelve SNAP-Ed staff in rural and urban counties in Ohio to identify themes and indicators related to community/organisational capacity and readiness to implement healthy eating PSE interventions in food pantries. Themes and related indicators generated based on inductive and deductive coding of interview transcripts were prioritised and weighted by eleven community nutrition experts during a virtual consensus conference. Five themes emerged; expert-derived weights (scaled low, 0 to high, 1) reflect the perceived importance of each to implementation of healthy eating PSE interventions in food pantries: food pantry capacity and logistics [0⋅252], networks and relationships [0⋅228], community nutrition practitioner capacity [0⋅212], food pantry user characteristics [0⋅156], and stigma and stereotypes [0⋅1⋅52]. Overall, seventeen indicators were identified reflecting these themes. Successful and sustained PSE interventions at food pantries will require a tailored approach that considers food pantries' capacity, needs and opportunities within the community, and capacity of community nutrition practitioners. The themes and indicators identified provide guidance for responsive PSE approaches in food pantries that meet communities where they are.

An Analysis of Equity in Service Provided by the SNAP-Ed Program: A Comparison of Dietary Outcomes among African American and White Participants in Louisiana

Structural racism has contributed to increased poverty, food insecurity, and obesity rates among African Americans relative to Whites. Nutrition education programs should therefore consider how well they serve this population. The objective of this investigation was to assess whether African American and White Supplemental Nutrition Assistance Program Education (SNAP-Ed) participants in Louisiana had comparable dietary behavior outcomes by conducting secondary data analysis of previous program evaluations from 2017-2018 and 2018-2019 among African American and White SNAP-Ed participants (n = 434). Variables measured included pre- to post-intervention changes in dietary behaviors (e.g., self-reported consumption frequency of fruit, vegetables, whole grains, low-fat dairy, sugar-sweetened beverages, and juice). Statistical analyses included t-tests stratified by race and Pearson’s chi-square test for categories of change in dietary behaviors. In categorical analyses, Whites had increased consumption, and African Americans had decreased consumption of whole grain pasta following SNAP-Ed participation. Among those who did not change consumption patterns following SNAP-Ed participation, African Americans were more likely to consume fruit juice and juice-flavored sugary drinks at a rate above median consumption compared to White participants. Future research should identify how program participation is followed by different dietary behavior outcomes in different races and explore how SNAP-Ed could specifically address barriers to equity.

Development of EFNEP and SNAP-Ed Core Competencies in the Land-Grant University System

This report describes the development and revision of core competencies for the Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education program leaders, supervisors, and paraprofessional educators across the land-grant university system. The developing curriculum methodologies were used to engage panels of exemplary employees and an advisory panel of program leaders. A crosswalk examined key documents, and a gap analysis explored the competencies of similar professions. The resulting job duties and tasks reflect cultural, environmental, and educational trends. The core competencies are critical for writing job descriptions, guiding hiring, evaluating performance, and providing initial and ongoing training for the Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education.

State Implementation of SNAP Waivers and Flexibilities During the COVID-19 Pandemic: Perspectives From State Agency Leaders

ObjectiveTo describe state agencies’ implementation of the Supplemental Nutrition Assistance Program (SNAP) during the first year of the coronavirus disease of 2019 (COVID-19) pandemic, barriers and facilitators to SNAP implementation, and recommendations to improve SNAP implementation. DesignQualitative methodology guided by Bullock's determinants of policy implementation framework using 7 semistructured, virtual focus groups in April 2021. SettingTwenty-six states representing all 7 US Department of Agriculture Food and Nutrition Service regions. ParticipantsFour focus groups with state-level SNAP administrators and 3 focus groups with state-level SNAP supportive services (Supplemental Nutrition Assistance Program-Education, Employment & Training, and Outreach) supervisors (n = 62). Phenomenon of InterestSupplemental Nutrition Assistance Program implementation during the COVID-19 pandemic. AnalysisThematic analysis using a phronetic iterative approach. ResultsSix primary themes emerged: the policy response, technology needs, collaboration, participant communication, funding realities, and equity. Implementation challenges included the design of waivers in the early pandemic response, inadequate federal guidance and funding, outdated technology, and prepandemic regulations limiting state authority. Modernized technology systems, availability of virtual programming, partnerships, and enhanced benefits facilitated SNAP implementation. Conclusions and ImplicationsSupplemental Nutrition Assistance Program administrators adapted their programs to deliver services virtually during the COVID-19 pandemic. These experiences highlighted the importance of certain policy determinants, such as modernized technology and streamlined application processes, to improve outcomes for SNAP participants and staff.

Qualitative Evaluation of CalFresh Healthy Living (SNAP-Ed) Implementation Across Eight Universities

To identify key findings of a process evaluation focused on a novel application of the Supplemental Nutrition Assistance Program-Education (SNAP-Ed): CalFresh Healthy Living (CFHL) on College Campuses.

Food Security, Fruit and Vegetable Intake, and Chronic Conditions among Supplemental Nutrition Assistance Program Education Participants Attending Free Food and Produce Events

Non-traditional settings, such as schools, early childhood education programs, and healthcare clinics, can play a critical role in preventing obesity by providing free and nutritious food outside of food pantries to households that are experiencing low or very low food security, particularly during emergency situations. This evaluation study describes a low-income population that attended free food and produce distribution events during the COVID-19 pandemic. In 2021, a cross-sectional survey was administered to this group (n = 1498) to assess their food security status, fruit and vegetable (F+V) consumption, and prevalence of chronic disease condition(s). Program and event assessments were carried out using descriptive, bivariate, and multivariable logistic regression analyses. More than a quarter (26%) of the participants attended the free food events for the first time. Approximately 70% reported some level of low food security, 57% to 64% did not meet F+V intake recommendations, and 37% had a diet-related chronic disease condition. In the adjusted models, households with very low food security had lower odds of meeting F+V recommendations (aOR, 0.41, 95% CI, 0.28, 0.58 and aOR, 0.27, 95% CI, 0.19, 0.39, respectively) and higher odds of having a chronic condition (aOR, 3.49, 95% CI, 2.34, 5.20) than those with high or marginal food security. Given these experiences, future research should examine how safety net food assistance programs can incorporate alternative service/distribution models to improve the nutritional value of the foods they offer.

P141 Where Do We Go From Here? California Local Health Departments Navigate School-based SNAP-Ed During COVID-19

BackgroundCOVID-19 forced California Supplemental Nutrition Assistance Program Education (SNAP-Ed) to suddenly shift planned strategies to meet SNAP-eligible population needs. K-12 schools, important SNAP-Ed partners for reaching children and families, were profoundly affected. Most (77%) local health departments (LHDs) reported they were unable to accomplish previously planned activities at school sites in 2020.ObjectiveTo understand pandemic-related changes to school-based SNAP-Ed and identify areas of opportunity.Study Design, Settings, ParticipantsWe conducted secondary mixed-methods analyses of California LHDs’ school-based SNAP-Ed activity and needs assessment data from fiscal years 2020-2021.Measurable Outcome/AnalysisOutcomes include number and type of SNAP-Ed programs that were halted or newly implemented, number of participants reached, policies, systems, and environmental change strategies (PSEs) adopted, new methods of education delivery, and extent to which schools implemented nutrition and physical activity (Nut-PA) best practices. Qualitative analysis examined COVID-19-related barriers and facilitators to SNAP-Ed implementation.ResultsIn 2020, 270 PSE interventions were initiated in schools; 21% were discontinued and 12% were created in response to COVID. New opportunities included using school meal distributions to provide free groceries, home gardening kits, and brief face-to-face nutrition education. Many LHDs transitioned to virtual Nut-PA education, increasing SNAP-Ed participant reach. In Fall 2020, as schools adjusted to alternative learning models, school-level assessments of Nut-PA practices indicated the most common area of opportunity was nutrition education. Over 75% of schools reported that PSE strategies requiring on-site/in-person implementation, such as improving lunchroom facilities, were not feasible. Facilitators of SNAP-Ed implementation included community support and strong partnerships between schools, community-based organizations, and SNAP-Ed implementing agencies; barriers included regulations and staff turnover.ConclusionsSNAP-Ed programs nationwide can continue to serve SNAP-eligible children and families during crises like COVID-19 by partnering with schools and other community organizations. These partners identified the nutrition and physical activity needs of a community and the best practices to address them.FundingSupplemental Nutrition Assistance Program - Education

P091 Assessing Level of Interest in In-person and Virtual Nutrition Education Among SNAP-Ed Eligible Utahns

<h3>Background</h3> In response to SARS-CoV-2, Utah's Supplemental Nutrition Assistance Program-Education (SNAP-Ed) pivoted from in-person to virtual nutrition education classes. Virtual nutrition programs have been found to be effective among certain demographics. Additionally, virtual classes may be a preferred mode of SNAP-Ed nutrition education delivery. <h3>Objective</h3> The objective of this needs assessment was to compare the level of interest in in-person and virtual nutrition classes, as well as several online platforms among SNAP-Ed eligible Utahns. <h3>Study Design, Settings, Participants</h3> An electronic survey was sent to eligible Utahns through a listserv of current SNAP recipients, a SNAP-Ed e-newsletter, and links posted on SNAP-Ed social media platforms. Survey respondents were asked to report demographics, preferred frequency and duration of classes, and electronic device use and access barriers. Respondents also ranked six preferred modes of delivery including in-person, Facebook Live, YouTube, Zoom, Canvas, and other. <h3>Measurable Outcomes/Analysis</h3> Descriptive statistics were collected and analyzed. Responses to questions about class duration and frequency, virtual platforms, and electronic device use were compared among age groups, ethnicities, gender, and rurality. Respondents ranked six modes of delivery on a scale of 1-6 (1 = most preferred; 6 = least preferred) and mean scores were calculated. <h3>Results</h3> Two-hundred sixty-nine individuals completed the survey. In-person classes were ranked as the most popular mode of delivery (mean = 2.57) followed by Facebook Live (2.77), YouTube (2.84), Zoom (2.97), Canvas (3.89), other (5.73). In-person classes were ranked highest among most subgroups, however virtual classes were most popular among respondents aged 18-24 & older than 35. Respondents most selected weekly (49%), 45-minute classes (33%) as the preferred frequency and duration. Seventy percent reported no barriers to internet access. <h3>Conclusions</h3> The results of this assessment suggest that virtual education may be a valuable tool to reach certain subgroups of SNAP-Ed eligible Utahns. However, given the expressed preference of in-person classes, virtual education should be used as a supplemental approach to traditional group classes. <h3>Funding</h3> Supplemental Nutrition Assistance Program - Education

P109 Factors Associated with Perceived Feasibility of Offering an Online Nutrition Education Program for Low-Income Adults

<h3>Background</h3> Research examining the implementation of online nutrition education programs for low-income populations is lacking. Understanding perceived feasibility and related contextual factors from the perspective of program facilitators is needed to determine best implementation practices. <h3>Objective</h3> To understand the perspectives of Cooperative Extension Services (CES) employees regarding perceived feasibility of implementing the University of Georgia Supplemental Nutrition Assistance Program-Education (UGA SNAP-Ed) online nutrition education program, Food eTalk, in their professional settings to the communities they serve. <h3>Study Design, Setting, Participants</h3> In-depth, individual interviews were conducted with 15 UGA CES employees (100% female, 13.3% African American, 53.3% from urban counties) interested in offering Food eTalk to their low-income clientele. The Consolidated Framework for Implementation Research (CFIR), an implementation science meta-theory for evaluating interventions, informed the development of semi-structured interview guides. Topics included nutrition education, community collaboration, and the feasibility of implementing Food eTalk through UGA CES. <h3>Measurable Outcome/Analysis</h3> Multi-coder data analysis included deductive coding of predefined CFIR constructs and the use of inductive methods to capture emerging themes. <h3>Results</h3> At the time of the interviews, most participants were offering online nutrition education programs due to the COVID-19 pandemic. Contextual factors such as organizational structure and culture, and the types of nutrition education programs UGA CES personnel currently offered to their clients played a role in perceptions of program feasibility. Adequate personnel and time to offer Food eTalk influenced perceptions of program feasibility, as well. Challenges associated with offering Food eTalk included skepticism about the effectiveness of online programs, managing multiple job responsibilities, client SNAP-Ed eligibility for Food eTalk, and concerns about client internet access. <h3>Conclusions</h3> While most UGA CES employees found implementing an online nutrition education program to be a feasible programming opportunity, organizational culture, structure, and target audience influenced educator perceptions of feasibility. The findings from this study will inform and guide statewide Food eTalk implementation efforts in UGA CES. <h3>Funding</h3> Supplemental Nutrition Assistance Program - Education

P037 Current Food Resource Management Skills Predict Interest in SNAP-Ed Education During COVID-19

BackgroundCOVID-19 and related restrictions presented numerous challenges to individuals, communities, and nutrition education programs.ObjectiveTo better understand how nutrition education programs, like SNAP-Ed, might target eligible clients during COVID-19 by assessing interest in nutrition education by baseline behaviors.Study Design, Settings, and ParticipantsLow-income adults, ages 18+, in Virginia. A cross-sectional online survey using Qualtrics panels was conducted March-April 2020.Measurable Outcome/AnalysisSurvey questions included socio-demographic information, questions about food resource management practices (i.e., menu planning, using grocery shopping list, cooking at home), physical activity levels, and access to nutritious foods within their community, based on current adult SNAP-Ed evaluation instruments used in Virginia. Descriptive statistics were computed for all survey questions. Chi-square statistics (set a priori at α=0.05) were employed to examine associations between interest in programs and current practices.ResultsThere were a total of 1,408 survey respondents from across Virginia. Results showed that interest in education programs were significantly associated with: SNAP participation within the past 12 months; using a grocery shopping list; cooking the main meal at home; meal planning; and regular physical activity.ConclusionsThe findings characterize individuals with interest in potential SNAP-Ed programs and can be used to help inform and tailor program recruitment and marketing. Additional research is warranted to examine modality and dosage of interested individuals, in addition to recruitment and retention rates of individuals referred to existing SNAP-Ed programs from a survey of this nature.FundingUSDA Virginia Cooperative Extension Supplemental Nutrition Assistance Program-Education, Virginia Department of Social Services-Supplemental Nutrition Assistance Program (SNAP)

Lessons Learned Recruiting Comparison Elementary Schools for Impact Evaluation of SNAP-Ed Interventions

To determine the effectiveness of Supplemental Nutrition Assistance Program- Education (SNAP-Ed) nutrition and physical activity programming in elementary schools, it is necessary to recruit socioeconomically similar comparison schools not receiving SNAP-Ed programming. We developed a flexible recruitment strategy to tailor our approach to each individual school district and site. Here we discuss the lessons learned during the 10-month recruitment period, including early outreach, emphasizing participation benefits, leveraging and building relationships, and visiting sites.

Factors Influencing Capacity and Readiness to Implement Healthy Eating Interventions in Food Pantries Through SNAP-Ed Programming

ObjectivesFood pantries provide free food to households, including those receiving Supplemental Nutrition Assistance Program (SNAP), thereby buffering food insecurity in communities. The SNAP-Ed program identified food pantries as a targeted setting for policy, system, and environmental (PSE) changes to promote healthy eating. This study sought to identify factors influencing capacity and readiness to implement healthy eating PSE interventions in food pantries. MethodsWe conducted qualitative interviews with 26 residents and 12 SNAP-Ed staff from rural and urban counties in Ohio to identify themes and indicators related to community readiness and organizational and practitioner capacity to implement healthy eating PSEs in food pantries. Themes and related indicators were generated based on inductive and deductive coding of interview transcripts. Eleven food pantry and nutrition experts prioritized and weighted themes and indicators during a virtual consensus conference. ResultsFive themes emerged, and expert-derived weights (scaled low, 0 to high, 1) reflect the perceived importance of each to implementation of healthy eating PSE interventions in food pantries; (1) food pantry capacity and logistics [0.253], (2) networks & relationships [0.228], (3) community nutrition practitioner capacity [0.212], (4) food pantry user characteristics [0.156], and (5) stigma and stereotypes [0.1.52]. Overall, 17 indicators were identified across these themes. ConclusionsFood pantries are unique settings for implementing healthy eating PSE interventions, thus successful and sustained PSE change will require a tailored approach that considers food pantries capacity, needs and opportunities within the community, and capacity of community nutrition practitioners, including SNAP-Ed. The themes and indicators identified through this study will be incorporated into an online assessment tool to support tailored approaches that meet communities where they are. Funding SourcesFinancial support for this work was provided by the U.S. Department of Agriculture, Food and Nutrition Service, Supplemental Nutrition Assistance Program – Education (SNAP-Ed).

Validity of a Market Basket Assessment Tool for Use in Supplemental Nutrition Assistance Program Education Healthy Retail Initiatives

ObjectiveTo assess the validity of the Market Basket Analysis Tool (MBAT) for food environment quality within various retail environments compared to the Nutrition Environment Measures Survey in Stores (NEMS-S). MethodsIn-store assessments using the MBAT and the NEMS-S on the same day in a given store were conducted in grocery stores, corner stores, pharmacies, and dollar stores in a metropolis, and urban and rural counties across 4 states: Louisiana, Mississippi, North Carolina, and Virginia. Descriptive statistics, correlations, and ANOVAs were used to assess store location, store type differences, and MBAT and NEMS-S scores. ResultsMarket Basket Analysis Tool and NEMS-S data were collected from 114 stores. Market Basket Analysis Tool and NEMS-S total and all individual component scores were significantly correlated (r = 0.84, P ≤ 0.0001; r range, 0.51–0.88; P ≤ 0.0001). Conclusions and ImplicationsThe MBAT offers a methodology to measure the food retail environment focusing on the availability of healthful food items with a reduced training time and streamlined data collection compared with the NEMS-S. Future work can assess the completion time of the MBAT compared with the NEMS-S and the ability of the MBAT to detect changes in food environment quality post healthy food retail interventions.

Nutrition Environment at Food Pantries Improves After Fresh Produce Donation Program

ObjectiveTo evaluate the influence of the Growing Together Illinois fresh produce donation program and understand factors that affect produce distribution at participating food pantries. MethodsIn this intervention at 17 Illinois food pantries, Master Gardeners supported food donation gardens, and Supplemental Nutrition Assistance Program Education provided educational and environmental interventions to increase selection and use of fresh produce. This mixed-methods pre-post study assessed pantry characteristics and program impact via Nutrition Environment Food Pantry Assessment Tool evaluations, interview feedback from pantry staff, and structured pantry observations. ResultsPantries experienced significant increases from preintervention to postintervention in providing various types of produce, marketing and nudging healthful products, providing additional resources, and total Nutrition Environment Food Pantry Assessment Tool scores. Participants had positive feedback about the program and educational interventions and reported the weekly timing of donations mitigated potential storage and spoilage issues. Conclusions and ImplicationsFuture research could focus on approaches to increase fresh produce in food pantries while supporting clients via nutrition and cooking education.

HomeStyles-2 for SNAP-Ed families with children in middle childhood: Cluster randomized trial protocol

BackgroundChildhood obesity prevention efforts are needed in the United States, especially for families with low income. The purpose of this study is to determine whether HomeStyles-2, a nutrition education and childhood obesity prevention program for families with children in middle childhood (ages 6 to 11 years), motivates parents to re-shape their home environments and weight-related lifestyle practices to be more supportive of meeting national nutrition and physical activity recommendations and weight status of their children more so than those in the control condition. MethodsA research-practice partnership with Florida's Supplemental Nutrition Assistance Program-Education (SNAP-Ed) program was formed to conduct a cluster randomized trial to evaluate the HomeStyles-2 intervention. SNAP-Ed-eligible individuals who are parents/caregivers of children aged 6–11 living in the study catchment area will be invited to enroll in the study and participate in a six-lesson series using the HomeStyles-2 program or an attention control program. The primary outcome measures related to parent weight-related behaviors will be assessed on the individual level. Linear mixed models with a hierarchical design will be used to assess outcomes of interest. DiscussionThis study has the potential to demonstrate the effectiveness of a new curriculum implemented in a federal nutrition education program. Because of the COVID-19 pandemic, adjustments were made to the intervention design to allow for virtual delivery of the intervention through SNAP-Ed. This unanticipated change will offer much-needed research on the effectiveness of virtual nutrition education, which may help to expand SNAP-Ed's reach across the country.Trial registration: NCT05019339.