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

该项目的目的是评估禁止使用补充营养援助计划（SNAP）福利购买高热量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，特别是如果与提供购买更有营养食品的激励措施相结合。将进行一项实验性试验，在320个目前没有参加SNAP的低收入家庭中实施SNAP方案的模拟版本。将在一个月内收集基线测量数据，其中包括三次24小时饮食召回;家庭食品收据收集;家庭食品安全问卷调查;以及身高和体重测量（来自最负责食品购物的成年家庭成员）。在完成基线措施后，家庭将被随机分配到以下四种情况之一：无限制的食物福利（对照）;限制性食物福利;奖励性食物福利;或限制性加奖励性食物福利。在所有四个条件的参与者将得到一个现金卡，将有资金增加每月为三个月的时间。每月存入卡上的美元金额将是SNAP向具有类似规模和收入水平的家庭参与者提供的平均福利金额。所有参与者将被指示只使用现金卡购买食品。他们将被告知他们不应该使用现金卡购买某些食品（例如酒精，膳食补充剂和目前不符合SNAP福利购买资格的其他食品）。那些被随机分配到限制食品福利条件的人也将被告知他们不能使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。那些随机分配到奖励食品福利条件的人将被告知，他们将获得使用现金卡购买的所有水果和蔬菜的30%折扣。那些随机分配到限制加奖励食品福利条件的人将收到提供给限制和奖励食品福利条件的说明（不应该用现金卡购买含糖饮料，甜烘焙食品或糖果;用卡购买水果和蔬菜可享受30%的折扣）。所有条件下的参与者将被要求保存并提交三个月实验期内所有食品购买的收据（使用和不使用计划现金卡购买）。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，以确定实验组之间的饮食摄入量、家庭食品购买量、家庭食品不安全性和随访时的体重是否存在差异。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.