Introduction: The Supplemental Nutrition Assistance Program (SNAP) is effective in significantly reducing food insecurity. However, fruit and vegetable consumption among SNAP participants is far below national dietary guidelines. The majority of SNAP benefits are spent at supermarkets and superstores, and interventions in these outlets have potential to reach many SNAP participants. This project highlights outcomes of a statewide fruit and vegetable coupon program (Complete Eats) for SNAP participants in Washington state.

Methods: From June 2017 through July 2018, Washington State Department of Health partnered with a large supermarket chain to offer Complete Eats in all of their 169 stores. SNAP participants who spent $10 of their benefits on fruits and vegetables at participating stores received a $5 coupon valid toward a future fruit and vegetable purchase. We calculated coupon redemption rate and changes in purchasing patterns as a result of the program.

Results: $6,613,605 worth of coupons were issued, and $1,234,430 worth of coupons were redeemed by SNAP participants (18.7% redemption rate). Among coupon redeemers, the average amount spent per household on fruits and vegetables increased by 15% compared to pre-program estimates. The number of shopping trips containing fruit and vegetable purchases increased by 9%. Overall, the program showed a 10% increase in average dollar amount spent on fruits and vegetables per shopping trip, resulting in an average of $14.22 spent during coupon redemption (184% higher than the $5 coupon).

Discussion: A statewide fruit and vegetable coupon program in supermarkets improves access to healthy foods for SNAP participants.

Introduction: As a social determinant of nutrition-related health, affordable housing may be integral to strategies promoting food access and food security among low-income households. How affordable housing supports these outcomes is understudied in mixed-income, urban contexts. Within Boston’s mixed-income Chinatown, we capitalized on recent affordable housing development to investigate health-related experiences of residents before and after their moves. Earlier baseline survey results indicated that in terms of food access in their previous neighborhoods, proportionally more respondents were close to their nearest food retailer compared to national estimates. In terms of food security in their previous neighborhoods, proportionally fewer respondents were food secure. We re-engaged a sample of residents to examine how living in Chinatown-based affordable housing has affected these experiences.

Methods: We conducted semi-structured interviews with nine residents recruited from a pool of 56 baseline survey respondents. Data collection and thematic analysis are ongoing.

Results: Regarding food access, preliminary results suggest living in Chinatown has provided interview respondents with more convenient access to food retailers. Some respondents, though, reflected on the need for a mainstream supermarket in Chinatown. Regarding food security, many respondents reported strategically budgeting to afford food. For some respondents, having subsidized rent has not eased pressure on their food budgets.

Discussion: This study contributes to emerging evidence on intersections between nutrition and housing needs. From the standpoint of food access and food security, affordable housing has both strengths and shortcomings that may influence its effectiveness at promoting nutrition-related well-being for low-income residents of mixed-income, urban neighborhoods.

Background Food insecure (FI) children have disproportionate risk for poor nutrition and obesity. Family meals can protect against such health disparities, yet little is known about associations between FI and family meals, and how parenting practices may be instrumental in facilitating structured, well-organized meals for FI families. This study tests associations between FI and mealtime structure, and whether this is mediated by parenting styles.

Methods Data were collected from low-income families (n=270) across two years when children were approximately 6.0- (Time 1-T1) and 8.6-years-old (Time 2-T2). Parents reported on FI (FI vs. not) and parenting style (lax/overreactive parenting). Mealtime structure measures (e.g., family-style meals, TV off) include 1) perceived: parent-endorsed 16-items, and 2) observed: independently coded mealtime videos. Path analyses tested cross-sectional and longitudinal associations between FI (T1) and mealtime structure (T1, T2), mediated by parenting laxness/overreactivity (T1).

Results On average, families lived at 98% of the poverty line; 36% percent were FI at T1 and 35% were FI at T2. FI operated through higher parenting laxness to associate with less structured meals at T1 and T2 for both perceived (T1: β = -.05, 95% CI = -0.10, -0.01; T2 β = -.06, 95% CI = -.11, -.02) and observed (T1: β = -.04, 95% CI = -.08, -.0; T2: β = -.04, 95% CI = -.08, -.01) mealtime structure measures.

Conclusions FI may operate through parenting laxness to reduce the likelihood of structured mealtimes in early and mid-childhood. Interventions should address FI-related barriers to promote mealtime quality.

Introduction:

The Food Access Pilot Project (FAPP) utilizes meal delivery subscription services to provide healthy, home delivered meals to low income people living with HIV who are experiencing food insecurity in four rural and semi-rural counties in California that lack high quality food support programs. Food insecurity in this population must be addressed, as studies have found significant associations between food insecurity and negative health outcomes among people living with HIV.

Approach:

With Ryan White Part B funding, The Health Trust launched this project in January 2017 to improve client health outcomes by increasing food security via weekly deliveries that provide 30% of the client’s daily calories. Unlike many food bank programs, FAPP is enhanced by a nutrition assessment and education component conducted by a Registered Dietitian.

Results:

As of February 2019, FAPP has served 188 clients across four counties. After at least 6 months of receiving food, a significant proportion of clients surveyed (50%, n=67) reported they no longer felt food insecure (p< .05). Clients still reporting food insecurity showed a decrease in severity, with significantly fewer clients reporting a high level of food insecurity after 6 months of deliveries (60% vs 27%, p<.05).

Discussion:

These promising results suggest that providing even just 30% of a client’s daily calories is an effective intervention to reduce perceived food insecurity. This project highlights the importance of creating partnerships between larger nonprofits with robust AIDS services programs and smaller AIDS service organizations in order to enhance nutritional support resources in rural counties.