Performing Department
(N/A)
Non Technical Summary
Programs pairing nutrition incentives with SNAP benefits are showing promise as an effective strategy to increase access and purchasing of fruits and vegetables (FV) in low-income households. While South Carolina (SC) hosts several FV incentive programs, most are redeemable only at farmer's markets or from food hubs. The goal of thisproject is to increase healthy food access, food and nutrition security, and consumption of fruits and vegetables for limited-income households by expanding FV incentives to conventional grocery stores. Clemson University will partner with Piggly Wiggly, a medium sized grocery store chain prevalent in rural SC communities along the I-95 corridor, to implement a pilot FV nutrition incentive program. The year-long program will take place in the town of Lamar in Darlington County SC and will aim to develop and evaluate two fruit and vegetable FV incentive strategies. The first strategy will implement a 16-week, dietitian curated FV box incentive along with nutrition education including healthy recipes, a grocery store tour, and opportunities to attend monthly food demonstrations. The second strategy will aim to develop and pilot a self-select FV incentive that allowshoppers to choose their FVs and will utilize a fully electronic issuance and redemption mechanism at the point of sale. For both strategies, participants are eligible to redeem the FV incentive by spending $30 on any SNAP-eligible food using their SNAP-EBT to receive a dollar-for-dollar match up to a $60 cap per month for purchasing fruits and vegetables. The project team, in collaboration with supporting state agencies, local coalitions, and other stakeholders, will develop a plan for scaling both strategies based on lessons learned and partner capacity. A major benefit of grocery store-based FV incentive programs is increased flexibility for shoppers in accessing a wide variety of fruits and vegetables year-round while shopping for food and other household items.
Animal Health Component
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Research Effort Categories
Basic
50%
Applied
0%
Developmental
50%
Goals / Objectives
The primarygoal of the project is to increase food access, food and nutritionsecurity, and consumption of fruits and vegetables for low- income households in rural communites in South Carolina (SC). In partnership with Piggly Wiggly located in Lamar, SC, and local stakeholders,the projectteam will:1)Implement a curated fruit and vegetable box incentive andnutrition educationpilot for SNAP benefit recipients,and 2) Developanautomateddigitalissuance and redemption strategy for implementing self-select fruit and vegetable incentives with the aim to test this method in a small pilot. Automating and streamlining the redemption transaction at thepoint of sale will provide the basis for scaling fruit and vegetable incentive programsacross the state.
Project Methods
Objective 1: Develop an issuance and redemption workplan for a curated fruit and vegetable(FV) box incentive for SNAP benefit recipients. The project team will develop a workplan forissuing FV boxes using the "any SNAP eligible food for fruits and vegetables" model with a dollar-for-dollar match up to a $60/month cap (based on USDA estimated cost per day to consume daily recommended FV)10. Box contents will be curated by the project team registereddietitian using a variety of FVs according to the USDA defined subgroups and assembled at the grocery store by partner staff members. Boxes (costing $30 each) will be distributed bi-monthly for 16 weeks along with complementary culturally tailored recipes, nutrition, health, and food preparation/safety information. To redeem the produce box, participants must purchase at least $30 of any SNAP eligible products on the scheduled days for incentive issuance. Participants will be required to show a study team member a copy of their receipt(s) which the participants will keep themselves - the study team or check-out clerks will not keep a copy of receipts at any point- along with their key chain participant ID (as proof that they are participants in the study) and a photo ID. In the event that an individual loses their receipt, they will be encouraged to log into their SNAP benefits app/online platform to search their expenditures in place of a receipt. During the study onboarding appointment, participants will also be encouraged to take a picture of their receipts at the time of each purchase so that in the event they lose their receipt, they can show the photo to a study team member at pick up to redeem their incentive (study team members will not keep the photos or ever be sent the photos - they will simply look at them to ensure the $30 was spent).Objective 2: Implement procured produce box and nutrition education pilot for 50 SNAPrecipients. The project team will develop workplans for implementing and tracking participants the through the 16-week intervention which will include: 1) a total of 8 FV produce boxes ($30 value each) issued on a bi-monthly schedule and including tailored recipes, nutrition information,food preparation/storage and safe handling information, 2) a monthly food demonstration (optional) on a day/time of pick-up, and 3) a grocery store tour focused on label reading and strategies for shopping for affordable nutritious foods based on grocery store layout and produce availability/seasonality. With support from the SC SNAP agency and local coalitions, the team will promote and recruit 50 participants into the program. Criteria to participate will be proof of receiving SNAP benefits via EBT card, the ability to pick up produce boxes according to the schedule, taking a pre and post-surveys, and attending the in-person onboarding appointment with grocery store tour. Participants will be enrolled and consented by phone and administered a baseline NTAE Core Metrics survey with additional project specific questions. The survey will be provided via Qualtrics platform (NTAE account) and issued by email invitation or in personbased on participant preference. Five cohorts of 10 people will attend a project onboarding appointment where participants will receive: 1) a participant ID card, 2) a project welcome and resource packet explaining project instructions including what to expect as a participant, boxpick-up schedule, food demonstration schedule, project contact information, and generalnutrition and food information, 3) a $15 gift card for those that participated in the survey, and 4) grocery store tour (described above). After the intervention, participants will be issued a followup NTAE Core Metrics survey (post) and a $15 gift card. Approximately 10 participants and 8-10 Piggly Wiggly staff members will be invited to participate in separate focus groups to evaluate perceptions such as produce box assembly and the issuance/redemption process, and FV box/nutrition education satisfaction and utilization (participants only).Objective 3: Develop issuance and redemption workplan for a self-select FV incentive forSNAP benefit recipients. The project team will review current models and strategies (ref forreview) to inform development of the plan and consult with technical experts including theNational Grocers Association Foundation Technical Assistance Center (NGAF TA Center), andrepresentatives from the North Carolina based SuperSNAP program11. The resulting workplanwill utilize a fully digital issuance/redemption strategy that fits with the Piggly Wiggly capacityand cost. If a viable plan is developed within the grant period, the project team will conduct asmall pilot (up to 10 people) for 1-2 month period, working closely with the NGAF TA centerand USDA program team.Objective 4: Evaluate, Report, and Disseminate project outcomes and process measures.The project team will evaluate the project using self-assessment process measures, NTAE coremetric survey (with added project specific questions), and focus group interviews with 10program participants and 8 Piggly Wiggly staff members. All findings will be reviewed inregular Project Team and Advisory Committee meetings and reported monthly to the NTAE andannually to USDA. Additionally, the Advisory Committee will discuss feasibility and strategiesfor scaling to a standard sized project, strategies for sustainability and assist with projectdissemination. Anticipated participants include Piggly Wiggly representatives, CU, communitystakeholders (e.g. local coalitions, county/city representatives, a program recipient, SC DSSSNAP agency, SC-DHEC) and incentive experts such as a representative from the NCSuperSNAP and from the NGAF -TA Center.EvaluationProject evaluation will include a self-assessment of process measures over the course of theproject and summative evaluation of project outcomes after the project ends. The projectAdvisory Committee will assist the Project team to evaluate the project which will assess thedegree to which the project procedures, intervention processes and timelines are being met. TheProject team and Advisory members will review data summaries to identify strengths andweaknesses of the project to make appropriate improvements, and ultimately evaluate thesuccess of the project. Feedback from this group will be included in a final project report.Process and summative assessment measures are summarized as follows:Process Self -AssessmentPromotion metrics:# posters/fliers distributed, # social media and othermedia platform announcementsParticipant enrollment and completion metrics: # enrolled, # drop out and reasons for drop out, #completed, completion rateFood demonstration participation metrics:# of food demonstrations attended; reasons for not attending; participants' perceptions of food demonstration and recipe use will be collected by survey.FV box redemption metrics: # boxes curated, # boxes redeemed, # days boxes distributed, the reasons for not redeeming boxSurvey data collection & compliance metrics (preand post): # surveys completed/rate of survey completion,validity criteria will be set to ensure the quality of survey dataSummative Outcome AssessmentFood and nutrition security, FVconsumption, nutrition and food literacy,SNAP utilization, perceived health........................Survey questions including NTAE core metricsPerceptions of incentiveissuance/redemption processes............................Focus GroupsAnalysesDescriptive statistics of the population, two-sided paired T-test and Chi-squared tests will beapplied to compare outcomes from pre- and post-intervention. Alpha will be set at 0.05 and95% confidence interval will be calculated.