Designing a Food Benefit Program to Optimize Diet Quality for Obesity Prevention

描述（由申请人提供）：该项目的目标是评估禁止使用补充营养援助计划（SNAP）福利购买高可自由支配卡路里的食品是否可以改善计划参与者购买和消费的食品的营养质量，特别是如果提供购买更有营养食品的奖励。将进行一项实验性试验，在320个目前未参加SNAP的低收入家庭中实施模拟版的SNAP计划。将在一个月的时间内收集基线测量数据，其中包括三次24小时饮食召回；收集家庭食品收据；家庭粮食安全调查表；身高和体重测量（来自最负责购买食品的成年家庭成员）。在基线测量完成后，家庭将被随机分配到四种情况之一：不受限制的食物福利（对照）；限制食品福利；奖励性食品福利；或者限制加激励食品福利。所有四种情况下的参与者都将获得一张现金卡，该卡将在三个月内每月增加资金。每月存入该卡的金额将是SNAP为家庭规模和收入水平相似的参与者提供的平均福利金额。所有参加者将被指示只使用现金卡购买食物。他们将被告知不应使用现金卡购买某些食品（例如酒精、膳食补充剂和其他目前不符合SNAP福利购买资格的食品）。那些被随机分配到限制食品福利组的人还被告知，他们不能用现金卡购买含糖饮料、甜烘焙食品或糖果。他们可以用自己的钱购买这些物品，但不能用现金卡。那些被随机分配到奖励食品福利组的人将被告知，他们使用现金卡购买的所有水果和蔬菜将获得30%的折扣。随机分配到限制加奖励食品福利组的受试者将收到限制加奖励食品福利组的说明（不得用现金卡购买含糖饮料、甜烘焙食品、糖果；用现金卡购买水果和蔬菜可享受7折优惠）。在三个月的实验期间，所有条件下的参与者都将被要求保存并提交所有食品购买的收据（包括使用和不使用项目现金卡的购买）。在实验的第三个月（最后一个月）将重复基线测量。将进行分析，以确定饮食摄入量、家庭食品购买、家庭食品不安全以及随访时的体重在实验组之间是否存在差异。这项研究的结果将为公共政策决策提供急需的数据。

DESCRIPTION (provided by applicant): The goal of this project is to evaluate whether prohibiting the use of Supplemental Nutrition Assistance Program (SNAP) benefits to purchase foods high in discretionary calories may improve the nutritional quality of foods purchased and consumed by program participants, particularly if paired with offering an incentive for the purchase of more nutritious foods. An experimental trial will be conducted whereby a mock version of the SNAP program will be implemented in 320 low income households not currently participating in SNAP. Over a one month period baseline measures will be collected, which will include three 24-hour dietary recalls; household food receipt collection; household food security questionnaire; and height and weight measures (from the adult household member most responsible for food shopping). After baseline measures have been completed households will be randomized to one of four conditions: unrestricted food benefit (control); restricted food benefit; incentive food benefit; or restricted plus incentive food benefit. Participants in all fou conditions will be given a cash card that will have funds added monthly for a three month period. The dollar amount placed on the card monthly will be the average amount of benefit provided by SNAP to participants in a household with a similar size and income level. All participants will be instructed to use the cash card for food purchases only. They will be told they should not use the cash card to purchase certain food items (e.g. alcohol, dietary supplements, and other food items currently non-eligible for purchase with SNAP benefits). Those randomized to the restricted food benefit condition will also be told they cannot use the cash card to buy sugar sweetened beverages, sweet baked goods, or candies. They may purchase these items using their own money, but not the cash card. Those randomized to the incentive food benefit condition will be told they will receive a 30% discount on all fruits and vegetables purchased using their cash card. Those randomized to the restricted plus incentive food benefit condition will receive the instructions provided to the restricted and incentive food benefit conditions (shouldn't buy sugar sweetened beverages, sweet baked goods, or candies with cash card; 30% discount received for fruits and vegetables purchased with the card). Participants in all conditions will be asked to save and submit receipts for all food purchases (both purchases made with and without the program cash card) for the three month experimental period. During the third (final) month of the experiment baseline measures will be repeated. Analyses will be conducted to determine whether dietary intake, household food purchases, household food insecurity, and body weight at follow-up differed between experimental groups. Results from this study will provide much needed data to inform public policy decision making.