Evaluating the Implementation and De-Implementation of Pandemic Era SNAP Expansion Policies on Diet and Health: A Mixed Methods Project

评估大流行时代 SNAP 饮食和健康扩展政策的实施和取消实施：混合方法项目

• 批准号: 10832272
• 负责人: Cindy Leung
• 金额: $ 229.92万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-22 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10832272
• 关键词: Administrator; Adopted; Adult; Advisory Committees; Affect; American; COVID-19 impact; COVID-19 pandemic; Client; Coping Skills; Cross-Sectional Studies; Data; Data Set; Data Sources; Databases; Deimplementation; Diet; Economics; Eligibility Determination; Ethnic Origin; Evaluation; Expenditure; Focus Groups; Food; Food Policy; Future; Goals; Health; Household; Hunger; Individual; Information Dissemination; Interview; Knowledge; Learning; Life Cycle Stages; Low income; Measures; Mediating; Mental Health; Methods; National Health and Nutrition Examination Survey; Outcome; Participant; Pathway interactions; Persons; Physiologic pulse; Play; Policies; Policy Maker; Poverty; Race; Recording of previous events; Research; Research Design; Research Methodology; Role; Running; Security; Surveys; United States; United States Department of Agriculture; Work; cost; data integration; design; diverse data; experience; expiration; flexibility; food insecurity; food security; health equity; health equity promotion; implementation evaluation; improved; innovation; insight; lens; marginalized population; novel; nutrition; pandemic disease; panel study of income dynamics; physical conditioning; population health; post-pandemic; poverty alleviation; pre-pandemic; programs; public database; public health emergency; response; waiver

PROJECT SUMMARY The USDA Supplemental Nutrition Assistance Program (SNAP) has played a critical role in mitigating national food insecurity during the pandemic. Since March 2020, many federal and state-level policies have been enacted to expand SNAP eligibility, enhance SNAP benefits, and reduce the administrative burden of applying for and maintaining SNAP benefits. By March 2023, most flexibilities and pandemic-era SNAP benefit boosts were discontinued, resulting in a “hunger cliff” with considerable implications for poverty, food insecurity, and health equity. There are significant knowledge gaps about the implementation and subsequent de- implementation of pandemic-era SNAP policy changes and their effects on the health of low-income Americans. The overall objective of this application is to evaluate the effects of implementation and de- implementation of pandemic-era SNAP expansion policies on adult health outcomes using a mixed methods approach that builds on the project team’s robust existing work. The central hypothesis is that the onset of SNAP expansion policies led to better physical and mental health outcomes, mediated by higher food expenditures, lower food insecurity, and higher diet quality; the sunset of these policies adversely affected health through these same pathways. In Aim 1, the project team will create a novel comprehensive database to document states’ implementation and de-implementation of SNAP expansion policies from 2020 to 2023 through surveys and focus groups with state SNAP administrators. In Aim 2, the project team will conduct a national survey and in-depth interviews with SNAP participants to understand how the expiration of SNAP expansion policies impacted program utilization, food insecurity, and health. Finally, in Aim 3, robust methods for causal inference will be applied to three nationally representative datasets to examine national and state- level SNAP expansion policies on adult health and intermediate outcomes. This project will employ a sequential mixed methods study design to integrate data across all aims and add context and richness to the interpretation of the results. To promote inclusivity and support the dissemination of results to key audiences, the project team will regularly engage with a Policy Advisory Committee, including experts in federal and state/local SNAP policy, poverty alleviation, and nutrition security, and a Client Advisory Committee, comprised of individuals with lived experience using SNAP benefits. This comprehensive and rigorous evaluation will provide important evidence about the effects of the onset and sunset of SNAP expansion policies on the health of low-income Americans. Results from this project will be of direct relevance to policymakers and other stakeholders to inform planning for future public health emergencies and long-term food policy.

项目总结 美国农业部补充营养援助计划(SNAP)在缓解全国 大流行期间的粮食不安全。自2020年3月以来，许多联邦和州一级的政策 颁布以扩大SNAP资格，提高SNAP福利，并减轻申请的行政负担 用于和维护SNAP福利。到2023年3月，最灵活和大流行时代的SNAP收益将得到提升 停产，造成“饥饿悬崖”，对贫穷、粮食无保障和 健康公平。在实施和随后的销毁方面存在显著的知识差距 大流行时期SNAP政策变化的实施及其对低收入者健康的影响 美国人。本应用程序的总体目标是评估实施和取消 使用混合方法实施大流行时期SNAP扩展政策对成人健康结果的影响 建立在项目团队强大的现有工作基础上的方法。中心假说是 Snap扩张政策在食品价格上涨的推动下，带来了更好的身心健康结果 支出减少，粮食不安全程度降低，饮食质量提高；这些政策的落幕对其产生了不利影响 健康通过这些相同的途径。在目标1中，项目组将创建一个新的综合数据库，以 记录各国从2020年到2023年实施和取消实施SNAP扩展政策的情况 通过调查和州SNAP管理员的焦点小组。在目标2中，项目团队将进行 全国调查和对SNAP参与者的深入采访，以了解SNAP的到期情况 扩张政策影响了项目利用率、粮食不安全和健康。最后，在目标3中，健壮的方法 对于因果推理，将应用于三个具有全国代表性的数据集，以检查国家和州- 关于成人健康和中期结果的SNAP扩展政策。该项目将雇用一名 顺序混合方法研究设计，以集成所有目标的数据，并为 对结果的解释。为促进包容性，支持向主要受众传播成果， 项目小组将定期与政策咨询委员会接触，包括联邦和 州/地方SNAP政策、扶贫和营养安全，以及客户咨询委员会，包括 具有使用SNAP福利的生活经验的个人。这项全面而严格的评估将 为SNAP扩展政策的开始和日落对健康的影响提供重要证据 低收入的美国人。该项目的结果将与政策制定者和其他 利益攸关方为未来突发公共卫生事件和长期粮食政策的规划提供信息。