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Purchasing, consumption, and health data from 3,073 Supplemental Nutrition Assistance Program Shoppers (SNAP) at 77 U.S. farmers’ markets (FMs) are reported. Descriptive and bivariate analyses indi...

At the time this study was conducted, Dr. Oberle was a Pediatric Endocrinology Fellow at Children’s Hospital of Philadelphia and was supported by a National Institutes of Health institutional training grant (T32DK063688). This research was supported by the National Institutes of Health’s National Center for Advancing Translational Sciences, grant UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health’s National Center for Advancing Translational Sciences. This manuscript has not been published elsewhere and has not been submitted simultaneously for publication elsewhere. The authors have no conflicts of interests to disclose.

Supplemental Nutrition Assistance Program (SNAP) participation has been associated with obesity in women. The objective of this pilot study was to describe the caloric intake and dietary qu...

Food insecurity is a substantial and persistent problem in the United States. This paper explores key challenges experienced by households relying on the Supplemental Nutrition Assistance Program (SNAP) and food pantries. It also identifies strategies used by these households to cope with these challenges. Qualitative and limited quantitative data collected in two states from households using both SNAP and charitable food pantries were used for the analysis. The findings of this study provide a comprehensive picture of the broad range of challenges associated with relying on public and nonprofit nutrition assistance, particularly the prevalence of adverse health and disability affecting households. Approximately 60% of households identified health conditions, with diabetes and cardiovascular disease being the most commonly cited. Households also experienced challenges with employment, living arrangements and household composition, and transportation, among others. This study also provides insight into strategies employed by households to surmount these obstacles. Illuminating the range of personal and family hardships and the coping strategies of vulnerable populations can inform discussion of potential changes in the design and delivery of public and nonprofit food assistance programs to help alleviate stressors in vulnerable households.

Research exploring the attitudes and opinions of food pantry clients on the Supplemental Nutrition Assistance Program (SNAP) program is limited. The purpose of this study was to explore differences...

The Supplemental Nutrition Assistance Program (SNAP) increases the food purchasing power of its clients by distribution of monthly benefits. The goal of this study was to determine if food expenditure patterns of SNAP households meet the Thrifty Food Plan (TFP) recommendations. Results indicated that greater TFP-adjusted total grocery expenditure was significantly associated with greater spending on low fat dairy, vegetables, whole grains and fruits relative to the recommendations. Future research could focus on psychosocial factors associated with inadequate grocery spending among SNAP households.

Objective: To examine differences in Supplemental Nutrition Assistance Program (SNAP) participation among persons who experience employment changes, controlling for disability and individua...

Policy interventions have been identified as a potential avenue to improve dietary quality among Supplemental Nutrition Assistance Program (SNAP) participants. However, limited research has explore...

The Partnerships to Improve Community Health Project focused on making improvements to farmers’ markets, including adding welcome signs and accepting Supplemental Nutrition Assistance Program/Elect...

The objective of this study was to investigate the association of household food security status and Supplemental Nutrition Assistance Program (SNAP) participation with parental feeding style and c...

The New York City Department of Health and Mental Hygiene piloted a farm-to-preschool program for low-income Supplemental Nutrition Assistance Program (SNAP)-eligible children and their families at...

There is a lack of consensus on how we should measure and identify food deserts. Recently, some scholars have called for studies that incorporate the lived experiences of food desert residents themselves into the discussion. We interviewed 42 black and Latino low-income female caregivers of young children living in an urban area classified as a food desert about how they shop for food. The women we spoke with talked about their motivations for choosing stores, as well as their experiences dealing with poor food access and an unequal distribution of food stores. We found that women cited price as the strongest motivator for choosing a store but found that a lack of transportation and Supplemental Nutrition Assistance Program (SNAP) participation also had significant effects on shopping behaviors. This study underscores the importance of qualitative, participatory approaches to food environment research.

Using the 2013 Current Population Survey, this article examines predictors of Supplemental Nutrition Assistance Program (SNAP) participation using an adapted version of Andersen’s behavioral model of service use. All variables were found to be significant. We created a risk index, an index counting the number of predictive characteristics an individual possessed, to calculate predicted probabilities of SNAP participation. For each additional risk factor an individual possessed, the predicted probability increased on average by 0.09. Those possessing 10 or more risk factors had the highest predicted probability (74%) of SNAP participation. This research confirms known predictors of SNAP participation. The risk index demonstrates that it is possible to predict SNAP participation not by which factors an individual possesses but how many.

With the recent cuts to the Supplemental Nutrition Assistance Program (SNAP), more information is needed to assess the impact these policies have on vulnerable children. As such, this study assesses the potential moderating effect of SNAP participation on the association between material deprivation and educational outcomes among children living in poverty (n = 10 971, and n = 14 928). SNAP participation was found to moderate the association between material deprivation and grade retention, indicating that SNAP may be contributing to grade retention among children living in poverty, which can have positive lifelong consequences.

The goal of the U.S. Department of Agriculture’s Supplemental Nutrition Assistance Program (SNAP) is to assist food insecure households by providing federally allocated funds to increase purchasing power and ultimately achieve a more nutritious diet; however, working poor households tend to be underserved by SNAP. This study identified factors associated with SNAP participation in a nationally representative sample of the working poor (adults with household incomes ≤ 130% of the poverty level who worked 27 or more weeks during the year). Data were from the 2012 American Community Survey. Multivariable logistic regression was used to examine independent factors associated with SNAP participation. Adjusting for all other factors and state of residence, those more likely to participate in SNAP included those who were women; younger; non-Hispanic black or Hispanic; separated/divorced; less educated; U.S. citizens; English-speaking; disabled; with no health insurance; on government health plan; moved w...

Supplemental Nutrition Assistance Program (SNAP) participation has been demonstrated to improve household food insecurity, yet not all those who are eligible for the program participate. This article describes findings from both peer-reviewed and grey literature pertaining to factors that influence SNAP participation. SNAP participation has demonstrated benefits for low-income individuals and families for improving dietary intake, reducing food insecurity, and ultimately providing one strategy to alleviate poverty. The findings are described with a social science and behavioral lens in order to glean public health implications and recommendations from a broad array of literature. Factors influencing SNAP participation across the social–ecological model are discussed. Macro- and microlevel recommendations are made and actions applicable in targeted outreach, program, and organizational strategies are recommended.

Food insecurity is a substantial stressor for many households. Though an association between food insecurity and depression has been well established, most studies have been cross-sectional. Although many receive benefits from the Supplemental Nutrition Assistance Program (SNAP), its role in reducing distress associated with food insecurity is unclear. Using data from 1,225 women who participated in the Fragile Families and Child Wellbeing Study, this study investigated 1) whether change in food security status predicts change in depression severity over a two-year period, 2) whether participating in SNAP predicts depression, and 3) whether the relationship between food insecurity and depression varies based on receipt of SNAP. Food insecurity was linked to probability of depression over time. Additionally, for those who became food insecure over the two-year period, losing SNAP benefits was associated with increased probability of depression, while gaining benefits was associated with reduced probability of depression. This suggests that the SNAP program offsets emotional hardship for those who have recently become food insecure. Further research is needed to evaluate the most efficient and efficacious means to reduce food insecurity and improve emotional wellbeing among vulnerable families.

Increasing the number of farmers’ markets and implementing Electronic Benefit Transfer (EBT) systems for the Supplemental Nutrition Assistance Program (SNAP) at more farmers’ markets have been suggested as strategies to overcome food access issues, but little is known about their availability in the rural South. This study examines differences in availability of farmers’ markets and SNAP/EBT at markets by county-level rural/urban classification, percentage poverty, percentage racial/ethnic minority, and percentage obese residents in North Carolina counties. Data were collected using a cross-sectional survey. Though results related to rurality and economic status are mixed, regression analyses indicate that the percentage of African American residents is inversely associated with the number of markets and number of markets that accept EBT. Results suggest that access to farmers’ markets varies in North Carolina, and additional research is needed to determine whether this impacts obesity.

The Supplemental Nutrition Assistance Program (SNAP) is the largest federal nutrition assistance program. Undocumented noncitizens are ineligible to receive SNAP benefits, but their children under age 18 or other qualified noncitizen family members may be eligible. Due to the recent economic recession as well as anti-immigrant legislation and sentiment in Arizona, it is possible that eligible low-income Hispanics are not participating in programs like SNAP that would alleviate hunger and food security. A self-administered survey on nutrition assistance program participation, demographics, food security, and acculturation was completed by a convenience sample of 352 women aged 18–65 years in metro Phoenix, Arizona. Fifty-one percent of participants were food secure. Significant differences in degree of food insecurity by acculturation status existed with 8% of Hispanic dominant women having “very low food security” in contrast to 19% of English dominant women (P = .003). Fifty percent received SNAP benefit...

The objective of this mixed methods study was to measure changes in the home food environment of Supplemental Nutrition Assistance Program (SNAP)-eligible Hispanic families participating in a series of nutrition education and resource management classes. This small pilot project conducted before and after inventories and ethnographic interviews with 5 families to measure success of the classes in improving the quality and quantity of foods at home. Families improved food security by making the following behavior changes to stretch their food dollars: planning menus, using leftovers, using shopping lists, and shopping less often. Participants used savings to purchase additional healthy food including whole wheat bread and fruit.

Food insecurity in the United States is associated with poverty and ethnicity. Rates of food insecurity among groups who may not qualify for government assistance programs such as Supplemental Nutrition Assistance Program (SNAP) are lacking. Hispanic adults taking English as a second language (ESL) day and evening classes in an affluent area of Northern California were surveyed in Spanish to determine the prevalence of food insecurity and respondents’ knowledge and use of food assistance programs. Of 107 respondents (57% male), 58.9% had a steady job. Yet, 68% were food insecure. Many (79%) respondents purchased inexpensive staple foods when money was limited. Gender, household size, time of day attending classes, and employment status had no effect on food security status. Eighteen percent (n = 13) of food insecure respondents accessed food assistance programs but the reminder (82%, n = 60) reported lack of access, primarily due to lack of program awareness. This study suggests that food insecurity is wi...

This study examined Supplemental Nutrition Assistance Program (SNAP) outreach efforts among representatives of community organizations, as well as local and statewide needs for increasing SNAP participation. We conducted qualitative interviews with 34 SNAP outreach workers across 27 states; participants reported working at food banks, social services agencies, antihunger nonprofits, legal aid agencies, faith-based nonprofits, and health clinics. Four major needs emerged as themes for community-level organizations: increased personnel, increased funding, improved application process, and increased community awareness. For broader, statewide needs, 3 themes emerged: increased staffing of state caseworkers, decreased stigma and negative perceptions, and improved application processing capacity and infrastructure. The findings of this qualitative study suggest that community organizations and state SNAP-administering offices should work together more closely to share best practices, improve SNAP application-r...

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.

The environments in which people make food decisions can affect their diet quality and health. This study evaluates how access to food stores authorized to access benefits of the Supplemental Nutrition Assistance Program (SNAP) is related to food security, body weight, and food consumption outcomes among SNAP-participating adolescents. The analysis is based on 2007 data on eighth-grade students in the Early Childhood Longitudinal Study, Kindergarten Class of 1998–1999 (ECLS-K) and US Department of Agriculture administrative data on all SNAP-authorized food stores in 40 states (n = 151 155). Access is assessed based on the proximity to and density of SNAP retailers within a buffer of the participants' residences. There is substantial variation across states in the availability of SNAP-authorized food stores. Access to such retailers plays a different role in affecting nutrition outcomes of SNAP-participating adolescents depending on their residence in urban, suburban, or rural areas.

We conducted a cross-sectional, ecological study of the Supplemental Nutrition Assistance Program (SNAP) food environment in a large US Southeastern urban county, examining types of stores that accept SNAP, foods sold, and store locations. Negative binomial regression examined associations between the concentration of SNAP-approved full-service and limited-service stores and premature death to due heart disease and diabetes. Most SNAP-approved stores in low-income communities offered limited food choice; less than 1% sold fresh fruits and vegetables. In adjusted analysis, each additional limited-service SNAP store was associated with 23% more premature deaths due to heart disease.

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 particip...

The purpose of this study was to empirically test the antecedents of behavioral intention in vegetable consumption behavior among Supplemental Nutrition Assistance Program (SNAP) recipients based on the theory of planned behavior and to find a strategy to boost vegetable consumption. Two hundred and eighty-seven participants were recruited and interviewed by telephone, and 176 completed the survey questionnaire. In contrast to the conventional theory of planned behavior, the results of this study showed that attitude, subjective norms, and perceived behavioral control did not predict intention to eat more vegetables, but attitude, intention, and perceived behavioral control predicted the behavior of consuming vegetables. The findings of this study suggest that intervention by vegetable recipe cards had a significant influence on SNAP recipients' desires to eat more vegetables.

Three household observations and semistructured interviews (n = 14) were conducted with Bhutanese refugee mothers to understand food shopping and dietary practices in this group of the refugee populations. Participants were recruited through a resettlement agency and snowballing techniques. Observation results indicated that steaming and stir-frying were common cooking methods and spices such as green chilies, turmeric, and fenugreek seeds were used commonly in seasoning. All the interview participants received Supplemental Nutrition Assistance Program (SNAP) benefits and went to multiple stores for food shopping. Semistructured interview results indicated that Bhutanese women continued preparing traditional meals of rice, vegetables, lentil, or meat curry and fresh pickle.

Households that have recently left the Supplemental Nutrition Assistance Program (SNAP) are more likely to be food insecure than those who remained on the program. We analyze data from the Current Population Survey Food Security Supplement to find reasons for this seeming anomaly. Analysis of a 2-year panel sample of households interviewed in 2 successive years found different conditions in 2 distinct groups. One third of households that left SNAP in one year returned in the following year and were more likely to have had very low food security in both years. Households that left SNAP in 1 year and remained off through the following year were also more likely than current recipients to have had very low food security in the first year, but by the end of the following year, the prevalence of very low food security was lower than among those still on the program. Logistic regression analysis indicates that, for households with very low food security, leaving SNAP was strongly associated with higher income a...