The impact of financial incentives and restrictions on cyclical food expenditures among low-income households receiving nutrition assistance: a randomized controlled trial

Abstract Background 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 vegetab...

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Autores principales:	Sruthi Valluri, Susan M. Mason, Hikaru Hanawa Peterson, Simone A. French, Lisa J. Harnack
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Supplemental nutrition assistance program Benefit cycle Financial incentives Financial restrictions Cyclical food expenditures Nutritional diseases. Deficiency diseases RC620-627 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/f473549d07014c89bb74c2c8d578169f
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spelling	oai:doaj.org-article:f473549d07014c89bb74c2c8d578169f2021-12-05T12:26:21ZThe impact of financial incentives and restrictions on cyclical food expenditures among low-income households receiving nutrition assistance: a randomized controlled trial10.1186/s12966-021-01223-71479-5868https://doaj.org/article/f473549d07014c89bb74c2c8d578169f2021-12-01T00:00:00Zhttps://doi.org/10.1186/s12966-021-01223-7https://doaj.org/toc/1479-5868Abstract Background 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. Methods 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. Results 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. Conclusions 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. Trial registration ClinicalTrial.gov, NCT02643576 . Retrospectively registered December 22, 2014.Sruthi ValluriSusan M. MasonHikaru Hanawa PetersonSimone A. FrenchLisa J. HarnackBMCarticleSupplemental nutrition assistance programBenefit cycleFinancial incentivesFinancial restrictionsCyclical food expendituresNutritional diseases. Deficiency diseasesRC620-627Public aspects of medicineRA1-1270ENInternational Journal of Behavioral Nutrition and Physical Activity, Vol 18, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Supplemental nutrition assistance program Benefit cycle Financial incentives Financial restrictions Cyclical food expenditures Nutritional diseases. Deficiency diseases RC620-627 Public aspects of medicine RA1-1270
spellingShingle	Supplemental nutrition assistance program Benefit cycle Financial incentives Financial restrictions Cyclical food expenditures Nutritional diseases. Deficiency diseases RC620-627 Public aspects of medicine RA1-1270 Sruthi Valluri Susan M. Mason Hikaru Hanawa Peterson Simone A. French Lisa J. Harnack The impact of financial incentives and restrictions on cyclical food expenditures among low-income households receiving nutrition assistance: a randomized controlled trial
description	Abstract Background 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. Methods 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. Results 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. Conclusions 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. Trial registration ClinicalTrial.gov, NCT02643576 . Retrospectively registered December 22, 2014.
format	article
author	Sruthi Valluri Susan M. Mason Hikaru Hanawa Peterson Simone A. French Lisa J. Harnack
author_facet	Sruthi Valluri Susan M. Mason Hikaru Hanawa Peterson Simone A. French Lisa J. Harnack
author_sort	Sruthi Valluri
title	The impact of financial incentives and restrictions on cyclical food expenditures among low-income households receiving nutrition assistance: a randomized controlled trial
title_short	The impact of financial incentives and restrictions on cyclical food expenditures among low-income households receiving nutrition assistance: a randomized controlled trial
title_full	The impact of financial incentives and restrictions on cyclical food expenditures among low-income households receiving nutrition assistance: a randomized controlled trial
title_fullStr	The impact of financial incentives and restrictions on cyclical food expenditures among low-income households receiving nutrition assistance: a randomized controlled trial
title_full_unstemmed	The impact of financial incentives and restrictions on cyclical food expenditures among low-income households receiving nutrition assistance: a randomized controlled trial
title_sort	impact of financial incentives and restrictions on cyclical food expenditures among low-income households receiving nutrition assistance: a randomized controlled trial
publisher	BMC
publishDate	2021
url	https://doaj.org/article/f473549d07014c89bb74c2c8d578169f
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The impact of financial incentives and restrictions on cyclical food expenditures among low-income households receiving nutrition assistance: a randomized controlled trial

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