Crespo-Bellido Mayra, Headrick Gabby, López Miguel Ángel, Holcomb Jennifer, Khan Ariana, Sapkota Shanti, Hollis-Hansen Kelseanna
Center for Nutrition and Health Impact, Omaha, NE, United States.
Department of Exercise and Nutrition Sciences, Milken Institute of Public Health, George Washington University, Washington, DC, United States.
Adv Nutr. 2025 Feb;16(2):100361. doi: 10.1016/j.advnut.2024.100361. Epub 2024 Dec 20.
In response to the coronavirus disease 2019 (COVID-19) public health emergency (PHE), the federal government deployed policy flexibilities in food and nutrition assistance programs including the Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to meet the needs those experiencing economic hardship. Emergent literature evaluates the impact of these flexibilities on program outcomes. The objective of this study was to explore the impact of policy flexibilities deployed during the COVID-19 PHE on access, enrollment/retention, benefit utilization, and perceptions of SNAP and WIC. Keyword searches were performed in November 2023, February 2024, and August 2024. The search included peer-reviewed literature from 2020 to 2024, following Johanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, resulting in 37 eligible articles. Twelve studies evaluated policy flexibilities in SNAP only, 21 in WIC only, and 4 in both programs. Across these, 12 studies explored program access, 7 enrollment/retention, 13 benefit utilization, and 15 program perceptions. JBI critical appraisal tools were used to assess risk of bias. The reviewed articles show that although SNAP and WIC participants identified challenges to access, there were increases in enrollment/retention due to policy flexibilities enabling remote services and reducing administrative burden in both programs. Benefit increases led to greater purchase of preferred foods in SNAP and greater access to fruit and vegetables in WIC. Overall, participants were satisfied with the flexibilities and reported most were beneficial for their households. Some implementation challenges were identified by participants and staff. A few studies showed potential risks of bias, including selection bias and confounding bias. COVID-19-related policy flexibilities in SNAP and WIC demonstrated significant improvements in selected program outcomes; however, challenges communicating policy flexibilities to authorized vendors and participants created difficulties to benefiting from the flexibilities. Findings from the evaluations of these flexibilities can inform future program enhancements and long-term regulatory changes. This study was registered in PROSPERO (CRD42023493302).
为应对2019年冠状病毒病（COVID-19）公共卫生紧急事件（PHE），联邦政府在食品和营养援助计划中采取了政策灵活性措施，包括补充营养援助计划（SNAP）和妇女、婴儿和儿童特殊补充营养计划（WIC），以满足那些面临经济困难的人们的需求。新兴文献评估了这些灵活性措施对计划成果的影响。本研究的目的是探讨在COVID-19公共卫生紧急事件期间实施的政策灵活性措施对SNAP和WIC的获取、登记/留存、福利利用以及认知的影响。于2023年11月、2024年2月和2024年8月进行了关键词搜索。搜索范围包括2020年至2024年的同行评审文献，遵循乔安娜·布里格斯研究所（JBI）和系统评价与荟萃分析优先报告项目指南，共筛选出37篇符合条件的文章。12项研究仅评估了SNAP中的政策灵活性措施，21项仅评估了WIC中的措施，4项同时评估了这两个计划中的措施。其中，12项研究探讨了计划获取情况，7项研究探讨了登记/留存情况，13项研究探讨了福利利用情况，15项研究探讨了对计划的认知情况。使用JBI批判性评价工具评估偏倚风险。综述文章表明，尽管SNAP和WIC的参与者指出了获取方面的挑战，但由于政策灵活性措施使得两个计划都能够提供远程服务并减轻行政负担，登记/留存人数有所增加。福利增加导致SNAP中对首选食品的购买量增加，WIC中对水果和蔬菜的获取机会增加。总体而言，参与者对这些灵活性措施感到满意，并表示大多数措施对他们的家庭有益。参与者和工作人员指出了一些实施方面的挑战。一些研究显示存在潜在的偏倚风险，包括选择偏倚和混杂偏倚。SNAP和WIC中与COVID-19相关的政策灵活性措施在选定的计划成果方面显示出显著改善；然而，在向授权供应商和参与者传达政策灵活性措施方面存在挑战，这给从这些灵活性措施中受益带来了困难。对这些灵活性措施的评估结果可为未来的计划改进和长期监管变革提供参考。本研究已在国际前瞻性系统评价注册库（PROSPERO）注册（注册号：CRD42023493302）。
