Online Program

A Systematic Review of Dietary Interventions for Low-Income Populations

Sunday, November 1, 2015

Heather Traino, PhD, MPH, Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA
Maria Thomson, PhD, Department of Social and Behavioral Health, Virginia Commonwealth University, Richmond, VA
Katelyn Schifano, BA, CHES, NCI, National Outreach Network, Virginia Commonwealth University Massey Cancer Center, Richmond, VA
Maghboeba Mosavel, PhD, Department of Social and Behavioral Health, Virginia Commonwealth University, Richmond, VA
Joann T. Richardson, PhD, Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA
Introduction: Recent enacted reductions to the Supplemental Nutrition Assistance Program (SNAP) benefits will eliminate access to food stamps for nearly 1 million Americans. Given this policy change and the well-documented effects of diet on health outcomes, continued efforts are needed to ensure historically disadvantaged populations are included in and benefit from interventions developed to encourage adherence to nutritionally adequate diets. We reviewed the extant literature to characterize the quantity and quality of studies evaluating dietary modification interventions for low-income populations.

 Methods: Searches of online databases, reference lists and past reviews were conducted. Articles reporting the results of trials designed specifically for low-income populations, enrolling adults, and using a concurrent-control design were included in the review. Two trained coders independently extracted data from each report; the CALO-RE taxonomy was used to identify the specific behavior change components employed.

 Results: Forty-seven articles from 1976 to 2013 were included; six described research conducted outside the US. Steps taken to tailor the intervention to a low-income population included formative research, pretesting, and reading level adjustments; the tailoring process was unclear in 14 reports (29.8%). Most reports operationalized ‘low-income’ by geography or receipt of public assistance; only eleven reports (23.4%) used a financial metric. The most commonly used approaches to behavior change were through instruction (70.0%), provision of normative information (42.6%), and behavioral modeling (31.9%). 

 Discussion: A more refined definition of ‘low-income’ and population-specific tailoring is needed to address dietary modification among underserved populations.  Interventions incorporating hands-on learning, social support, and relapse prevention are recommended.

Learning Areas:

Chronic disease management and prevention
Public health or related research
Social and behavioral sciences

Learning Objectives:
Evaluate the scope, strengths and weaknesses of published dietary interventions for low-income populations. Describe the multiple definitions used to define “low-income” in dietary interventions. Identify approaches to behavior change employed in dietary intervention studies.

Keyword(s): Nutrition, Underserved Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the PI or Co-I on multiple federally-funded grants focusing on eliminating health disparities and improving health outcomes for historically disadvantaged populations
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.