补充营养援助计划激励措施的使用的促进因素和障碍：一项针对低收入患者的诊所干预措施的研究结果。
Facilitators and Barriers to Supplemental Nutrition Assistance Program Incentive Use: Findings From a Clinic Intervention for Low-Income Patients.
机构信息
Department of Family Medicine, University of Michigan, Ann Arbor, Michigan; Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan.
University of Michigan Medical School, Ann Arbor, Michigan.
出版信息
Am J Prev Med. 2019 Apr;56(4):571-579. doi: 10.1016/j.amepre.2018.11.010. Epub 2019 Feb 21.
INTRODUCTION
Healthy food incentives matching Supplemental Nutrition Assistance Program (SNAP) benefits spent on fruits and vegetables subsidize increased produce consumption among low-income individuals at risk for food insecurity and diet-related disease. Yet many eligible participants do not use these incentives, in part because of limited awareness. This study examined the acceptability and impact of a primary care-based informational intervention on facilitators and barriers to use of the statewide SNAP incentive program Double Up Food Bucks.
METHODS
Focus groups (n=5) were conducted April-June 2015 among a purposive sample (n=26) of SNAP-enrolled adults from a Michigan health clinic serving low-income patients. All had participated in a waiting room-based informational intervention about Double Up Food Bucks; none had used Double Up Food Bucks before the intervention. Groups were stratified by Double Up Food Bucks use/non-use during the 6-month intervention period. Results were analyzed in 2016-2017 through an iterative content analysis process.
RESULTS
Participants reported the waiting room intervention was acceptable and a key facilitator of first-time Double Up Food Bucks use. Motivators for Double Up Food Bucks use included (1) eating more healthfully, (2) stretching SNAP benefits, (3) higher-quality produce at markets, and (4) unique market environments. Remaining barriers included (1) lack of transportation, (2) limited market locations/hours, and (3) persistent confusion among a small number of participants regarding incentive use.
CONCLUSIONS
Low-income patients who received an informational intervention about Double Up Food Bucks reported numerous benefits from participation. Yet barriers remained for a subset of patients. Improving geographic accessibility and ease of SNAP incentive redemption may further improve dietary quality and food security among vulnerable populations.
简介
健康食品激励计划与补充营养援助计划（SNAP）相匹配，将 SNAP 用于水果和蔬菜的福利支出用于补贴低收入、面临食物不安全和饮食相关疾病风险的个人增加农产品消费。然而，许多符合条件的参与者并没有使用这些激励措施，部分原因是他们的意识有限。本研究考察了以初级保健为基础的信息干预措施对使用全州范围内 SNAP 激励计划“双倍食品券”的促进因素和障碍的接受程度和影响。
方法
2015 年 4 月至 6 月，对一家为低收入患者服务的密歇根健康诊所的 SNAP 注册成年人进行了 5 次焦点小组讨论（n=26），这是一项有目的的抽样调查。所有参与者都参加了一个关于“双倍食品券”的候诊室信息干预；在干预之前，没有人使用过“双倍食品券”。根据在 6 个月的干预期间使用/未使用“双倍食品券”的情况，对小组进行分层。结果于 2016-2017 年通过迭代内容分析过程进行分析。
结果
参与者报告称，候诊室干预措施是可以接受的，是首次使用“双倍食品券”的主要促进因素。使用“双倍食品券”的动机包括：（1）更健康地饮食；（2）扩充 SNAP 福利；（3）在市场上获得更高质量的农产品；（4）独特的市场环境。仍然存在的障碍包括：（1）缺乏交通工具；（2）市场位置/时间有限；（3）少数参与者对激励措施的使用持续感到困惑。
结论
接受过关于“双倍食品券”信息干预的低收入患者报告称，参与其中带来了许多好处。然而，对于一部分患者来说，障碍仍然存在。改善地理可达性和 SNAP 激励措施的兑现便利性，可能会进一步提高弱势群体的饮食质量和粮食安全。
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