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

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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.