Source: TUFTS UNIVERSITY submitted to
FROM SCARCITY TO PROSPERITY: NUTRITION AND FOOD SPENDING GOALS AND CONSTRAINTS FOR LOW-INCOME AMERICANS
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
ACTIVE
Funding Source
AFRI COMPETITIVE GRANT
Reporting Frequency
Annual
Accession No.
1025556
Grant No.
2021-67023-34479
Cumulative Award Amt.
$499,936.00
Proposal No.
2020-06187
Multistate No.
(N/A)
Project Start Date
Apr 15, 2021
Project End Date
Apr 14, 2025
Grant Year
2021
Program Code
[A1641]- Agriculture Economics and Rural Communities: Markets and Trade
Project Director
Wilde, P.
Recipient Organization
TUFTS UNIVERSITY
200 WESTBORO ROAD
N. GRAFTON,MA 01536
Performing Department
(N/A)
Non Technical Summary
Suboptimal diet is a leading risk factor for chronic disease in the United States. Due to nutrition disparities, the double burden of suboptimal nutrition and obesity is elevated in low-income populations. The COVID-19 pandemic has shed light on the vulnerability caused by a high burden of diet-related chronic disease in the population overall, and it has also further exposed disparities across socio-economic groups related to these conditions. According to evidence from the National Health and Nutrition Examination Survey (NHANES), household food insecurity is inversely associated with diet quality for U.S. adults with low income. As noted in a recent report commemorating the 50th anniversary of the landmark 1969 White House Conference on Nutrition, "The burden of chronic illness reduces quality-of-life and life expectancy for millions of Americans, and results in healthcare costs that are placing unprecedented strain on the budgets of federal, state and local governments, businesses, and families."Through this study, we will answer three critical questions that are central to understanding drivers of unhealthy eating for Americans with low income:What are the food aspirations of consumers with low income, and are they similar to or different from those of consumers with higher income?,What nutrition perspectives, motivations, or theories do consumers with low income use when making food decisions?, andWhat economic and non-economic constraints prevent consumers from achieving their food aspirations?These research questions address USDA's Strategic Goal 7 (Provide All Americans Access to a Safe, Nutritious, and Secure Food Supply) and directly respond to NIFA's priority area question, "What are the causes and consequences of food insecurity?" In designing this study, we follow the recommendation of the Council of Food, Agriculture, and Resource Economics (CFARE) for new research on "understanding consumer preferences to enhance well-being," recognizing the role of the consumer's state of hunger and an array of "drivers of unhealthy eating."The proposed project will inquire into three pillars of the food support systems for consumers with low incomes. For each of these applied program areas, the project will answer questions that will improve the health and wellbeing of participating consumers and provide insights into consumer behavior:Supplemental Nutrition Assistance Program (SNAP). SNAP is USDA's largest program, the nation's largest anti-hunger program, and a key component of the social safety net more broadly. Our study will address the question: How well do the suggested Thrifty Food Plan (TFP) diets correspond to ones to which consumers aspire?Nutrition education. The federal government supports nutrition education through the Expanded Food and Nutrition Education Program (EFNEP), the SNAP nutrition education program (SNAP-Ed), school-based nutrition education programming, and other efforts. Our study will address the question: What nutrition perspectives, motivations, or theories do consumers with low income use when making food decisions?The emergency food system. Charitable food assistance programs, including food banks and food pantries, distribute free food and non-alcoholic beverages to people in need. Our study will address the question: How do the tradeoffs between cost and desired food qualities influence decisions for both clients and managers of emergency food programs?During the current COVID-19 crisis, this intersection of food security and nutrition policy is especially important. In response to the resulting economic dislocation, the 2020 Coronavirus Aid, Recovery, and Economic Stimulus (CARES) Act provided supplementary funding for SNAP and $243 million for food distribution through TEFAP, in addition to other new commodity distribution support, and proposals for further SNAP benefit increases are under consideration at this time.For each of the three program areas, it is essential to understand the goals and constraints of low-income food consumers. The TFP, for example, does not dictate diets based on the preferences of nutrition educators, and it would be quite unsound to do so. Instead, the TFP jointly considers the diets that consumers seek to achieve, the nutrition standards that must be met to achieve a more nutritious diet, and the cost constraints that consumers face. Similarly, in research on nutrition education for low-income Americans, there is an emphasis not just on nutrition facts, but also on motivators and barriers, which affect the level of engagement with healthy eating. And for years, the charitable emergency food system has wrestled with developing methods for distributing food that promote nutrition while recognizing that clients may place great importance on autonomy and acknowledging the risk that overly restrictive food distribution policies could induce stigma.This proposed study uses a mixed-methods approach, combining quantitative analysis of nationally representative survey data (using NHANES food intake data linked by food code with a new USDA food price data source, called Purchase to Plate Price Data) and qualitative data from interviews with emergency food system clients and staff (recruited through geographically diverse partner agencies in Alabama, Maine, Massachusetts, and North Carolina) to understand client goals and constraints relevant to achieving both food security and healthy food intake. We apply a sequential explanatory design, using qualitative research methods to understand and interpret the quantitative analysis, offering greater insight in combination than could be achieved with either approach alone.
Animal Health Component
50%
Research Effort Categories
Basic
50%
Applied
50%
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
7046010301020%
6076010301020%
7046010101015%
7026010101015%
7036010101015%
7046099301015%
Knowledge Area
703 - Nutrition Education and Behavior; 702 - Requirements and Function of Nutrients and Other Food Components; 607 - Consumer Economics; 704 - Nutrition and Hunger in the Population;

Subject Of Investigation
6010 - Individuals; 6099 - People and communities, general/other;

Field Of Science
1010 - Nutrition and metabolism; 3010 - Economics;
Goals / Objectives
The overarching theme of the proposed research is an assessment of the food aspirations, nutrition perspectives, and barriers of consumers, particularly of those with low incomes. We expect that the gap in diet quality from the ideal for consumers with low incomes is the result of binding constraints associated with costs, access, and behavioral context. The project rests upon three objectives.Objective 1. Food consumer goals and aspirations. To describe the food aspirations of consumers with low incomes. Through qualitative interviews and quantitative analysis, we will identify food patterns that low-income consumers consider desirable. The structure of the Thrifty Food Plan and many least-cost diets is that current consumption reflects desired consumption (Wilde and Llobrera, 2009). However, current consumption reflects cost constraints and other barriers, so the food consumption pattern of middle- or higher-income consumers may offer a better indication of the underlying food aspirations for consumers with low incomes.Objective 2. Nutrition perspectives and motivations. To identify the food categories that consumers with low-income know, seek to meet, and have difficulty meeting. Current Thrifty Food Plan practice sets nutrient and food category constraints to identify optimal diets (Carlson et al., 2007; Wilde and Llobrera, 2009). The proposed approach will identify which nutrients and MyPlate food categories low-income consumers know about, seek to satisfy, and have difficulty satisfying. Many of the nutrient and food group constraints in the Thrifty Food Plan framework are non-binding. Fruits and vegetables are notable food categories that are both binding constraints and frequently identified by low-income consumers as foods that they seek to acquire (Zhang, et al., 2018).Objective 3. Economic and non-economic constraints. To assess and relax the constraints that prevent consumers from achieving their food aspirations. The qualitative data will help us search for and identify the resource, time, and psychological constraints that prevent low-income consumers from achieving their goals for an affordable, healthy, desirable food bundle. We will evaluate the implications of multiple constraints. While previous research focused on the cost constraint as the dominant factor to poor diet quality, newer research suggests the importance of time. However, no research considers the combination of these and other constraints. We anticipate the combination of these, not solely the individual constraints, are what limit diet quality.
Project Methods
Mixed-Methods Approach The proposed approach combines qualitative data collection of food pantry clients with the nationally-representative data from NHANES and the Purchase to Plate Price Tool.(a) NHANES and Purchase to PlateThe National Health and Nutrition Examination Survey (NHANES) interviews and collects samples from approximately 5,000 individuals each year (10,000 in a 2-year NHANES wave). At the project start, we will use the 2011-2012 and 2013-2014 NHANES waves. We will update the analysis using the 2015-2016 and 2017-2018 NHANES waves if corresponding updated price data become available before January 2022 (in the second year of this 3-year study). The NHANES food intake data are linked by individual food code with the new Purchase to Plate Price Tool (PPPT). Critical variables for this analysis include: household demographics (including race, ethnicity, and household structure), household income, SNAP participation status, food intake by category and Healthy Eating Index scores, household food security status, including the overall categorical indicator and the response frequencies of the adult-referenced food security survey items, and self-reported dietary quality and barriers to acquiring healthy food.(b) Qualitative Interviews The qualitative methods have two components: 1) We will interview clients of food pantries to develop an in-depth understanding of respondent experiences, and 2) we will ground-truth and contextualize our findings with interviews of pantry staff. The primary source data are designed to illuminate several critical features of economic and non-economic constraints faced by low-income food consumers. These data will inform the NHANES analysis as well as filling in critical gaps about the distinctive experiences of consumers with low incomes and acute experience of food-related hardship.Our partners include four food banks, including two in the Southeast (Alabama and North Carolina) and two in the Northeast (Maine and Massachusetts). We (Folta and Wilson) will prepare for qualitative interviews in the first year and conduct them in the second and third years with food pantry clients and staff per sequential, explanatory mixed-methods design to contextualize the quantitative findings.During Year 1, we will develop a protocol and semi-structured interview guides for the qualitative work. As described below, a memorandum with quantitative results, a deliverable in the last quarter of the first project year, will be used as an input for the interview guide. This memo will include descriptive statistics about mean food consumption amounts by income category, 2-4 model diets from the optimization analysis, and a section listing hypotheses about respondent goals and constraints for discussion in the qualitative analysis. Questions will be designed to gather input from food pantry patrons on the quantitative findings to provide a richer context for those findings. Our advisory board will provide input on the questions and will review the interview guide, per a qualitative best practice (Krueger, 1998).We will interview 32 food pantry participants, which is a sample large enough to provide a "range of voices" concerning age, racial and ethnic background, education, marital status, and employment status. The partnering food banks will help with recruitment of participants for the study, providing geographic diversity. The interviews will cover participant aspirations regarding desirable food consumption patterns, their understanding or perception of diet-health linkages, constraints that hinder their attainment of their desired food consumption pattern, and their opinion of 2-4 model diets that will be presented.For the interviews with pantry staff, we will develop a semi-structured interview guide informed by the findings of the qualitative and quantitative work from the first two years of the project. These interviews will ground-truth the findings and provide an expert opinion of the work. Pantry staff engages individuals who struggle with low incomes. Some of these staff have personal experience with food insecurity. For the pantry staff interviews, we will recruit 8 leaders from the food bank areas where we will recruit food pantry clients. Using a similar structure as was used for recruiting clients, we will ensure that staff represent the sizes and types of services that the pantries provide. The qualitative and quantitative teams along with the advisory board, will discuss findings by the end of Project Year 2.We will conduct the interviews remotely using Zoom videoconferencing software. We will pay participants $25 for the hour-long interviews.Analysis Methods (a) Analysis of NHANES and Purchase to Plate Price Data. Our quantitative analysis will include, first, an initial descriptive analysis of how food intake quantities by food category vary across income levels and SNAP participation; second, a series of analyses using the TFP optimization framework to explore the interaction of consumer goals and constraints; and, third, the construction of alternative model food bundles for further assessment in the qualitative components of the study.(1) Descriptive analysis of food consumption by income category. First, in the initial descriptive analysis, using the data from NHANES, Wilde and Fan will estimate the food consumption patterns of U.S. consumers at several income strata. We will characterize the healthfulness of food bundles for NHANES households with income equal to 1, 2, 3, and 4 times the federal poverty threshold. We will test whether food consumption patterns differ by race/ethnicity and education levels, conditional on having a comparatively high income.(2) Optimization analyses. Second, we will conduct a series of optimization analyses, using quadratic programming inspired by the Thrifty Food Plan. Beyond the use in SNAP policy, these optimization models offer insight into more fundamental cost and nutrition tradeoffs in food spending.(3) Alternate model food bundles. Third, based on the descriptive and optimization analyses, we will propose a set of alternate model food bundles for further study in the qualitative analysis. In parallel format, we will describe the official TFP and several alternative food bundles based on the several different assumptions about participant goals or constraints summarized earlier.(b) Analysis of Qualitative Interviews. Folta, with Wilson, will lead qualitative analysis. With the verbatim transcriptions of the Zoom interviews, we will analyze the data using content analysis. We will create codebooks, initially based on the interview guide, for both the food pantry client and staff interviews. We will pilot codebooks and revised to include any new themes that emerge. We will use NVivo software to assist with the analysis. Theming will occur by examining counts and coding densities and visualizing the data for patterns. We will examine data for contradictions and contrary evidence. Preliminary findings will be presented and discussed at team meetings to finalize themes, which will then be presented to the Advisory Committee to "ground truth" interpretations and finalize results.

Progress 04/15/23 to 04/14/24

Outputs
Target Audience:During Year 3, we reached the following audiences: 1. Researchers in food policy and applied economics: presentations described under "events" below for the Agricultural and Applied Economics Association (AAEA), the Society of Behavioral Medicine, Tufts University, Penn State University, and several journal outlets. 2. Practitioners in the operation of food banks and food pantries: representatives from four regional food banks in North Carolina, Massachusetts, Nevada, and Maine, through the meetings of our advisory committee. 3. Practitioners in government work related to the Thrifty Food Plan (TFP) and costs of healthy food through the NIFA investigators meeting in July 2023, meetings with staff of USDA's Center on Nutrition Policy and Promotion (CNPP) related to Groundtruthing the Cost of the TFP, and meetings between co-Investigator Linlin Fan and Department of Defense related to the cost of healthy food in military cafeterias. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?Throughout Year 3, there were many opportunities for training and professional development for two PhD students and one masters student. Training and professional development opportunities included growth in quantitative and qualitative skills and analysis. On the quantitative team, two PhD students, Yiwen Zhao (Penn State) and Angelica Valdes Valderrama (Tufts University), gained training and professional developed in quantitative research skills. Both individuals received support and assistance to continuously improve their use of statistical programming, including R and Stata, to run optimization models. Throughout the first quantitative manuscript submission process, Yiwen and Angelica have grown professionally in their ability to respond to reviewers' feedback and refine the manuscript for subsequent submissions. On the qualitative team, one masters student, Hayley Fryling (Tufts University), gained knowledge in various qualitative research skills. Hayley received training from the Qualitative Principal Investigator on conducting key-informant interviews, prior to conducting eight of the interviews with food pantry staff. Additionally, Hayley received training in theming the codes from the food pantry staff interviews using NVivo. Lastly, Hayley has grown professionally in developing a research manuscript, by conducting a literature review on the procurement process and nutritional needs of food pantries during operation and leading the writing of the second manuscript. How have the results been disseminated to communities of interest? The entire NIFA team met with our food bank partners and other advisory committee members on May 18th, 2023 and January 24th, 2024. Dr. Wilde presented at two workshops held at the Friedman School at Tufts University for advisory committee member Will Masters's Workshop on Modeled Diets, on September 7th, 2023 and April 30th, 2024. Dr. Wilde and Dr. Wilson presented, and Angelica Valdes Valderrama attended, a post-conference AAEA workshop in Publishing in Nutrition Journals for Applied Economists, in July 2023. Dr. Wilde presented key quantitative results at NIFA's Investigator Meeting, in July 2023, in Washington, DC. Dr. Wilde presented at two seminars at Harvard University and the Friedman School at Tufts, in Spring 2024. What do you plan to do during the next reporting period to accomplish the goals?For Year 4 deliverables, we are working on research manuscripts, deliverables for our food pantry partners with lessons from this project, and a data tool. There are two research manuscripts currently in review from both the quantitative team and the qualitative team: Zhao Y., Fan L., Wilson N., Valdes Valderrama A., Wilde, P. "Nutrition Objectives and Constraints for Low-income Americans". Food Policy. Folta S., Wilson N., Wensman J., Zoubek S., Fryling H. "Constrained resources, food choice, and sense of autonomy among consumers with low incomes: A qualitative study". Journal of Nutrition Education and Behavior. There are three other research manuscripts currently being drafted and written that contain main quantitative and qualitative results: Valdes Valderrama A, et al. "Implications of vegetarian and Mediterranean diets for the affordability of healthy food". Yiwen Zhao's second manuscript from our quantitative research on relaxing TFP constraints. The second manuscript from our qualitative research on the procurement process at food pantries to meet client needs, from the food pantry staff interviews. In collaboration with Andrea Carlson of USDA/ERS, who is a member of our advisory committee, and with the Department of Defense, co-Investigator Prof. Linlin Fan is leading a spinoff project using TFP-style models to analyze the daily cost of food in military cafeterias. The NIFA team is developing deliverables for our food pantry partners with lessons and recommendations from this project for healthy and affordable food distributions. This includes a potential partnership with Duke's World Food Policy Center to record and distribute a podcase. Additionally, the team plans to write issue briefs and summary results reports. The NIFA team has drafted an update Dr. Wilde's data tool of the Thrifty Food Plan Calculator, last updated in 2014. This will be published online in the next reporting period.

Impacts
What was accomplished under these goals? Objective 1: Food consumer goals and aspirations In the quantitative analysis, our first manuscript, currently in the second round of review with Food Policy, addresses consumer goals and aspirations by investigating alternative objective functions in TFP-style models. Specifically, in addition to the objective function used in USDA's 2021 TFP Update, we investigated an alternate objective function in which low-income consumers seek to minimize the distance between their diet and a more aspirational diet typical of higher-income consumers. In the qualitative analysis, our team drafted and submitted to the Journal of Nutrition Education and Behavior the first manuscript derived from the food pantry client interviews. The manuscript primarily focused on food choice and constraints, exploring their implications for individual autonomy. Additionally, it included major and minor findings and quotes about the food aspirations and goal eating patterns of consumers with low incomes. For the interviews with food pantry staff, our interview guide included questions about their engagement with food pantry clients to understand their food preference and needs and how that influences their food procurement. These responses were coded and added to the theming report. Objective 2: Nutrition perspectives and motivations In the quantitative analysis, we investigated a sequence of nutrition constraint sets within TFP-style models: (1) cost and food energy only, (2) cost, food energy, and nutrient constraints, (3) cost, food energy, nutrient, and Healthy U.S.-Style Dietary Pattern constraints, and (4) all constraints including practicality constraints. In the qualitative analysis, our theming report from the food pantry client interviews included major and minor findings and quotes about the food groups that consumers with low-incomes aim to purchase and their challenges and constraints to meet these aspirations. These perspectives were further explored in the first manuscript describing the role and significance of food in the lives of individuals with low incomes, highlighting how this could impact their autonomy based on their access to and control over foods essential for managing health issues and feeding their families. For our interviews with food pantry clients, our guide included questions about the types of foods they are unable to procure and potential client needs they struggle to meet due to procurement limitations or challenges with current demand. These responses were coded and added to the theming report. Objective 3: Economic and non-economic constraints In the quantitative analysis, we estimated TFP-style models with alternate daily per-person cost constraints from $0 to $10 in addition to the official TFP cost constraint. In the qualitative analysis, the first manuscript presents major findings regarding the constraints and barriers encountered by consumers with low incomes in achieving a healthy diet or one aligned with their desired dietary goals. After the food pantry staff interviews, we finished the coding and theming of the major and minor findings and quotes about constraints food pantries face while procuring food, such as availability, affordability and logistics and the trade-offs during operation to meet client demand and client preferences. These responses were added to the theming report.

Publications

  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Zhao, Y. Making Healthy Food More Affordable. Agricultural and Applied Economics Association Annual Meeting, Washington DC, July 2023.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Folta S., Wilson N., Wensman J., Zoubek S., Fryling H. Food and Sense of Autonomy Among People with Low Incomes: A Qualitative Study. Society of Behavioral Medicine Annual Meeting, Philadelphia PA, March 2024.


Progress 04/15/22 to 04/14/23

Outputs
Target Audience:During Year 2, we reached the following audiences: 1. Researchers in food policy and applied economics: presentations described under "events" below for the Northeastern Agricultural and Resource Economics Association (NAREA), the Agricultural and Applied Economics Association (AAEA), the Korean Nutritional Society, Tufts University, and Penn State University. 2. Practitioners in the operation of food banks and food pantries: representatives from four regional food banks in North Carolina, Massachusetts, Nevada, and Maine, through the meetings of our advisory committee. 3. Practitioners in government work related to the Thrifty Food Plan (TFP) and costs of healthy food through a webinar primarily for Congressional staff and NGOs through a webinar of the Council on Food, Agricultural, and Resource Economics (C-FARE). Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?Throughout Year 2, there were many opportunities for training and professional development for a few project members and graduate students. Training opportunities included growth in qualitative skills and analysis. Two graduate students, Jada Wensman (Tufts University) and Hayley Fryling (Tufts University), and a research team member, Sarah Zoubek (Duke University), gained knowledge in various qualitative research skills. Jada received training in coding the informant interviews from the food pantry clients using NVivo. Hayley received training in theming the food pantry client's codes using NVivo and in conducting a literature review on the current operations and food and nutrition content of food pantries. Sarah received training in REDCap for managing food pantry client interviews. How have the results been disseminated to communities of interest?During Year 2 of this project, we disseminated results to several communities of interest through conference presentations, a meeting with food bank and food pantry personnel on our external advisory committee, a video on the cost of healthy food, and media outreach. The conference presentations included two keynote presentations and three other presentations: Wilde, P. "How Much Does a Healthy Diet Cost?: Consumer Aspirations and Constraints in a Rapidly Changing Food Environment" (keynote speaker). Northeastern Agricultural and Resource Economics Association (NAREA) annual meeting, Mystic CT, Jun 2022. Wilde, P. "That's Good to Know: The Policy Setting for Food Acquisition Research and Methods." USDA International Food Acquisition Research and Methods (iFARM). University of Maryland, College Park, MD, Oct 2022. Wilde, P. "Global Food and Nutrition Policy Trends." Korean Nutrition Society Annual Meeting. Oct 2022. Wilde, P. "U.S. Food Policy and Federal Nutrition Assistance Programs." Guest lecture for a food law and policy course by Prof. Jennifer Pomeranz, New York University, Jul 2022. Wilson, N. "The Prevalence of Food Insecurity Across the US," a webinar discussion of how public policy can help tackle food and nutrition insecurity. Council on Food, Agriculture, and Resource Economics (CFARE) (October 28, 2022). We met with the food bank and food pantry personnel on our Advisory Committee on November 3, 2022 and have a next meeting planned for May 2023 (at the start of Year 3). This meeting was partly to plan for qualitative interviews with a sample of food pantry personnel (which will be used in Year 3 of this project) and partly to seek expert stakeholder input on dissemination of results that can be useful for emergency food system stakeholders as they seek to deliver food that meets the needs of clients, is healthy, and cost-efficient for the non-profit entities. The Friedman School of Nutrition Science and Policy at Tufts presented a short video "micro-course" titled, "How Much Does a Healthy Diet Cost?," based on the quantitative research from this project. The media outreach included: Dr. Wilde spoke to Larry Edelman Boston Globe about food price inflation at advisory committee member Will Masters' suggestion (September 14th, 2022). Dr. Wilde spoke to a second Boston Globe reporter about food price inflation (September 22nd, 2022). Dr. Wilde spoke to Samantha Field, NPR Marketplace, about health and affordability of nutritious food delivered through federal nutrition assistance programs as part of the program's coverage of the White House Conference (September 2022). What do you plan to do during the next reporting period to accomplish the goals?For stakeholder input, we will meet with our Advisory Committee once near the start of Year 3, in May 2023, once in the middle of Year 3, in September 2023, and once later after the main project deliverables have been drafted, in February, 2024. For Year 3 outputs, we are working on conference presentations, research manuscripts, and a report with lessons from this project for emergency food system partners. The research manuscripts contain our main quantitative, qualitative, and mixed methods results: Zhao, Y., L. Fan, N. Wilson, A. Valdes Valderrama, and P. Wilde. "Nutrition Objectives and Constraints for Low-income Americans." Planned for submission to Food Policy in May, 2023. The first manuscript from our qualitative research is planned for submission to Journal of Nutrition Education and Behavior in June, 2023. Valdes Valderrama, A., et al. "Implications of vegetarian and Mediterranean diets for the affordability of healthy food." Planned for submission to Public Health Nutrition in October, 2023. Conference presentations: Dr. Wilde will present key results as part of the NIFA investigator meeting in July, 2023, in Washington, DC. Various members from the quantitative team (Dr. Wilde, Yiwen, Dr. Fan) will give presentations at the Agricultural and Applied Economics Association (AAEA) Conference in July 2023. Dr. Folta and Dr. Wilson will submit an abstract to present at the Society of Behavioral Medicine (SBM) Conference in March 2024. Dr. Wilde will present on a panel at the Jean Mayer USDA Human Nutrition Research Center on Aging in July 2023 about nutrition for older adults. Other plans: We will complete qualitative interviews with 8-10 food pantry staff in North Carolina, Massachusetts, Nevada and Maine. Dissemination: We will plan Year 3 dissemination activities regarding the major results from both the qualitative and quantitative team including Thrifty Food Plan analysis and food banks and food pantry recommendations for healthy and affordable food distributions. Dr. Wilde has an invitation with the USDA about the Thrifty Food Plan in September 2023. Potential food policy discussions with Duke Partnerships in the Duke DC Office in early Fall of 2023.

Impacts
What was accomplished under these goals? During Year 2, both the quantitative and qualitative teams worked towards each of the objectives listed above to assess low-income Americans' food aspirations, nutrition perspectives, and economic and non-economic constraints. Objective 1: Food consumer goals and aspirations In the quantitative analysis, our first manuscript investigated three different objective functions, reflecting three perspectives low-income consumers might have about what food bundles are desirable (they might want a food bundle similar to their own typical food consumption pattern on grounds of familiarity, or instead a more aspirational food bundle similar to the typical consumption pattern of middle- or high-income consumers). In the qualitative analysis, our team completed 34 qualitative interviews with food pantry clients that included questions about their goal eating patterns and prepared food aspirations. After the interviews, we finished the coding and theming of these goals and aspirations and completed an initial theming report that synthesized the major and minor findings and quotes discussed by food pantry clients. Objective 2: Nutrition perspectives and motivations In the quantitative analysis, we continued to use the linked NHANES and price data to begin analysis on relaxed constraint models, focusing on motivations of low-income Americans including sodium intake and the cost of fruits and vegetables. These models were added to the manuscript for the first quantitative paper. In the qualitative analysis, our completed food pantry client interviews included questions about low-income Americans' nutrition perspectives that influence their food choices. These perspectives included the role of food in their lives, the foods they avoid, their health concerns and their perspectives on specific food groups like sodium, whole grains, fruit and vegetables, animal proteins and dairy. These responses were coded and added to the initial theming report. Objective 3: Economic and non-economic constraints In the quantitative analysis, for economic constraints, we studied varying cost targets in incremental steps to determine the minimum cost needed to achieve a feasible food bundle that satisfies all constraints. For non-economic constraints, we included both nutrient constraints (such as getting enough calcium) and broad food category constraints (such as getting enough fruits or meats). In the qualitative analysis, we completed the food pantry client interviews about their major constraints for eating well, their barriers for eating prepared foods and their desired improvements to SNAP and other food assistance policies to alleviate program constraints and limitations. These constraints and barriers were coded and added to the initial theming report. Also, our team finalized our food pantry staff questionnaire that includes constraints food pantries face while procuring food and the trade-offs during operation. Lastly, we finished a nutrition education report.

Publications


    Progress 04/15/21 to 04/14/22

    Outputs
    Target Audience:During Year 1, we reached the following audiences: 1. Researchers in food policy and applied economics: presentations described under "events" below for the Agricultural and Applied Economics Association (AAEA), Indiana University, Tufts University, and USDA's Ag Outlook forum. 2. Practitioners in the operation of food banks and food pantries: representatives from four regional food banks in North Carolina, Massachusetts, Nevada, and Maine, through the meeting of our advisory committee in August 2021. 3. Practitioners in government work related to the Thrifty Food Plan (TFP) and costs of healthy food. Tufts University Friedman School of Nutrition Science and Policy invited USDA/CNPP staff involved with the TFP, Tusa-Rebecca Pannucci and Claire Brown, to give our main Wed seminar in spring 2022. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?We had several opportunities for training and professional development. We provided training to five graduate students: Angelica Valdez-Valderama (Tufts University), Elena Martinez (Tufts University), Jada Wensman (Tufts University), Katie Schroeder (Tufts University) and Yiwen Zhao (Penn State University). And one undergraduate student: Aiden Gildea (Duke University). Valdez-Valderama, Martinez, and Zhao each are working on quantitative analysis. Wensman and Schroeder received training in the conduct of qualitative interviews and is assisting with interviews and coding, in addition to conducting a literature review on the use of food cost analysis in design of curricula for nutrition education. How have the results been disseminated to communities of interest?During Year 1, for dissemination, as noted above, we reached the following audiences: 1. Researchers in food policy and applied economics: presentations described under "events" for the Agricultural and Applied Economics Association (AAEA), Indiana University, Tufts University, and USDA's Ag Outlook forum. 2. Practitioners in the operation of food banks and food pantries: representatives from four regional food banks in North Carolina, Massachusetts, Nevada, and Maine, through the meeting of our advisory committee in August 2021. 3. Practitioners in government work related to the Thrifty Food Plan (TFP) and costs of healthy food. For example, Tufts University Friedman School of Nutrition Science and Policy invited USDA/CNPP staff involved with the TFP, Tusa-Rebecca Pannucci and Claire Brown, to give our main Wednesday seminar in spring 2022. PI Parke Wilde has been serving on an external advisory group for USDA/CNPP on the TFP process, and met with researchers from the Government Accountability Office (GAO) about TFP modeling. What do you plan to do during the next reporting period to accomplish the goals?During Year 2, we plan the following activities: (1) Advisory committee meeting in late spring 2022. (2) PI Parke Wilde will give a keynote talk on costs of health food, including some early results from this project, at the annual meeting of the Northeastern Agricultural and Resource Economics Association (NAREA), June 2022, in Mystic, CT. (3) We anticipate two journal article submissions in Year 2: Zhao et al., "Objectives and constraints for low-income Americans' healthy diets"; and Wilde et al., "Factors that increase the cost of healthy food in the U.S. food supply." We are working on three more journal articles in Year 2, for submission that may take place late in Year 2 or in Year 3: by Valdes-Valderrama et al., Folta et al., and Martinez et al. (4) We will complete the qualitative interviews with food pantry clients and staff in North Carolina, Massachusetts, Nevada, and Maine. (5) In Year 2, we will begin planning for dissemination activities in Year 3, focused in three areas: Thrifty Food Plan analysis, design of healthy and affordable distribution systems for food banks and food pantries, and design of nutrition education curricula informed by research on consumer aspirations and constraints.

    Impacts
    What was accomplished under these goals? We have accomplishments under the three objectives. Objective 1. Food consumer goals and aspirations. (a) In the quantitative analysis, we used NHANES data to estimate mean food intake for our 122 food categories, separately by age/sex demographic group (most importantly, the 4 age/sex groups in the reference family for the Thrifty Food Plan) and by income and program participation strata (SNAP participants, low-income non-participants, and higher-income non-participants). Using this analysis file, at the end of Year 1, we began estimating models with alternate assumptions about consumer goals and aspirations (for example, assuming low-income consumers either aspire to typical consumption for low-income or higher-income consumers). (b) In the qualitative analysis, our interview guide includes questions about consumer goals and aspirations. Objective 2. Nutrition perspectives and motivations. (a) In the quantitative analysis, we used our linked NHANES and price data to estimate optimization models with alternate assumptions about nutrient and MyPlate food group constraints. We began with just cost and food energy constraints, and systematically added additional constraint groups step by step, noting the implications for feasibility and difficulty of achieving a model solution. (b) In the qualitative analysis, our interview guide includes questions about nutrition perspectives that influence consumer food choices. Objective 3. Economic and non-economic constraints. (a) In the quantitative analysis, we investigated alternate cost constraints, step by step, from the lowest cost that permits a feasible model solution all the way up to costs higher than the Thrifty Food Plan cost target. (b) In the qualitative analysis, our interview guide includes questions about client perspectives on the costs of healthy food. In addition, for use in intuitive communication of our study results, we generated graphics for a series of example food recipes, using a presentation method derived from Cooking Matters nutrition education materials. These graphics, currently in the form of PowerPoint slides, facilitate discussion of economic (food budget) and non-economic constraints (such as time and cooking ability).

    Publications