Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 South 2nd Street, Suite 300, Minneapolis, MN, 55454, USA.
University of Minnesota Medical School, Minneapolis, MN, USA.
Int J Behav Nutr Phys Act. 2021 Dec 4;18(1):157. doi: 10.1186/s12966-021-01223-7.
The Supplemental Nutrition Assistance Program (SNAP) is the largest anti-hunger program in the United States. Two proposed interventions to encourage healthier food expenditures among SNAP participants have generated significant debate: financial incentives for fruits and vegetables, and restrictions on foods high in added sugar. To date, however, no study has assessed the impact of these interventions on the benefit cycle, a pattern of rapid depletion of SNAP benefits that has been linked to worsening nutrition and health outcomes over the benefit month.
Low-income households not currently enrolled in SNAP (n = 249) received benefits every 4 weeks for 12 weeks on a study-specific benefit card. Households were randomized to one of four study arms: 1) incentive (30% incentive for fruits and vegetables purchased with study benefits), 2) restriction (not allowed to buy sugar-sweetened beverages, sweet baked goods, or candy using study benefits), 3) incentive plus restriction, or 4) control (no incentive or restriction). Weekly household food expenditures were evaluated using generalized estimating equations.
Compared to the control group, financial incentives increased fruit and vegetable purchases, but only in the first 2 weeks after benefit disbursement. Restrictions decreased expenditures on foods high in added sugar throughout the benefit month, but the magnitude of the impact decreased as the month progressed. Notably, restrictions mitigated cyclical expenditures.
Policies to improve nutrition outcomes among SNAP participants should consider including targeted interventions in the second half of the month to address the benefit cycle and attendant nutrition outcomes.
ClinicalTrial.gov, NCT02643576 . Retrospectively registered December 22, 2014.
补充营养援助计划（SNAP）是美国最大的反饥饿计划。有两项旨在鼓励 SNAP 参与者更健康地消费食品的提议干预措施引起了广泛争议：对水果和蔬菜的经济激励，以及对高添加糖食品的限制。然而，迄今为止，尚无研究评估这些干预措施对受益周期的影响，受益周期是 SNAP 福利迅速耗尽的一种模式，这种模式与受益月份内营养和健康状况恶化有关。
未参加 SNAP 的低收入家庭（n=249）在 12 周的时间内，每 4 周获得一次特定于研究的福利卡福利。家庭被随机分配到四个研究组之一：1）激励组（用研究福利购买水果和蔬菜可获得 30%的激励）；2）限制组（不得使用研究福利购买加糖饮料、甜烘焙食品或糖果）；3）激励加限制组；或 4）对照组（无激励或限制）。每周家庭食品支出使用广义估计方程进行评估。
与对照组相比，经济激励增加了水果和蔬菜的购买量，但仅在福利发放后的前 2 周。限制措施减少了整个受益月份高添加糖食品的支出，但随着月份的推进，影响的幅度减小。值得注意的是，限制措施减轻了周期性支出。
为改善 SNAP 参与者的营养结果而制定的政策应考虑在本月的后半段纳入有针对性的干预措施，以解决受益周期和随之而来的营养结果问题。
ClinicalTrials.gov，NCT02643576。于 2014 年 12 月 22 日回顾性注册。
