The California Nutrition Incentive Program: Participants’ Perceptions and Associations with Produce Purchases, Consumption, and Food Security

Abstract

We examined the associations of a Supplemental Nutrition Assistance Program (SNAP) point-of-purchase financial incentive program at farmers’ markets with produce purchase, consumption, and food security outcomes. We conducted cross-sectional, interviewer-administered intercept surveys with 325 adult SNAP participants at six incentive programs, five comparison farmers’ markets, and nine comparison supermarkets in California in the summer of 2018. The program provided dollar-for-dollar point-of-purchase incentives with $10 or $20 maximum at participating farmers’ markets. We measured produce consumption by an NCI screener; food security by the USDA 6-item screener; and program satisfaction with open-ended questions asked of a subsample. The quantitative analysis involved multilevel linear and logistic regression, adjusted for covariates. Qualitative data were coded and analyzed thematically. Shoppers at farmers’ markets offering $20 incentives had significantly higher odds of purchasing most of their produce at farmers’ markets than shoppers at $10 incentive (3.1, CI: 1.1, 8.7) or comparison markets (8.1, CI 2.2, 29.7). Incentives were not associated with quantitatively measured produce consumption. Each additional incentive dollar was associated with reduced odds of food insecurity (0.987, CI 0.976, 0.999). Participants appreciated the program; supermarket shoppers lacked awareness. Point-of-purchase incentives are appreciated and underutilized. Further understanding of optimal program design for produce consumption and food security impact is needed.

Feasibility and Response to the San Diego County, California, Supplemental Nutrition Assistance Program (SNAP) Agency Sending Food and Nutrition Text Messages to All Participants: Quasi-Experimental Web-Based Survey Pilot Study

“…The follow-up survey included an additional 9 questions assessing respondent perceptions of the intervention. Two questions assessing self-reported intake were adapted from the University of California Food Behavior Checklist [ 34 ], and 2 questions about the perceived importance of seasonal and California-grown fruits and vegetables were adapted from the University of California [ 35 ] and the University of Nebraska [ 36 ]. All other questions were developed by the research team.…”

Fluidity in capability: Longitudinal assessments of suicide capability using ecological momentary assessments

“…Predictor variables used random intercept and fixed slopes as participants had different starting values 2 . While we acknowledge the potential of inflated Type I error that may occur with multiple comparisons, we did not include adjustments for multiple comparisons but instead described the tests conducted given the exploratory nature of analyses as per Gosliner et al., 2022; Gupta et al., 2022; Monteith et al., 2023; Perneger, 1998; Rothman, 1990.…”

Advancing Equity in the Farm Bill: Opportunities for the Gus Schumacher Nutrition Incentive Program (GusNIP)

“…Nutrition incentives (NIs) help people purchase and consume FVs by providing financial subsidies, rebates, or discounts for FVs, thus making them more affordable. A robust body of evidence shows that NIs increase purchase and consumption of FVs [38][39][40][41][42][43][44][45][46][47][48][49], improve food security [44,49,50], and provide economic benefits to impacted communities [44,51,52]. Microsimulation and econometric models suggest that NIs lead to improved health outcomes and are cost effective [53,54].…”