Facilitators and Barriers to Supplemental Nutrition Assistance Program Incentive Use: Findings From a Clinic Intervention for Low-Income Patients

Publication date: Available online 21 February 2019

Source: American Journal of Preventive Medicine

Author(s): Alicia J. Cohen, Kelsie E. Oatmen, Michele Heisler, Oran B. Hesterman, Ellen C. Murphy, Suzanna M. Zick, Caroline R. Richardson

Introduction

Healthy food incentives matching Supplemental Nutrition Assistance Program (SNAP) benefits spent on fruits and vegetables subsidize increased produce consumption among low-income individuals at risk for food insecurity and diet-related disease. Yet many eligible participants do not use these incentives, in part because of limited awareness. This study examined the acceptability and impact of a primary care–based informational intervention on facilitators and barriers to use of the statewide SNAP incentive program Double Up Food Bucks.

Methods

Focus groups (n=5) were conducted April–June 2015 among a purposive sample (n=26) of SNAP-enrolled adults from a Michigan health clinic serving low-income patients. All had participated in a waiting room-based informational intervention about Double Up Food Bucks; none had used Double Up Food Bucks before the intervention. Groups were stratified by Double Up Food Bucks use/non-use during the 6-month intervention period. Results were analyzed in 2016–2017 through an iterative content analysis process.

Results

Participants reported the waiting room intervention was acceptable and a key facilitator of first-time Double Up Food Bucks use. Motivators for Double Up Food Bucks use included (1) eating more healthfully, (2) stretching SNAP benefits, (3) higher-quality produce at markets, and (4) unique market environments. Remaining barriers included (1) lack of transportation, (2) limited market locations/hours, and (3) persistent confusion among a small number of participants regarding incentive use.

Conclusions

Low-income patients who received an informational intervention about Double Up Food Bucks reported numerous benefits from participation. Yet barriers remained for a subset of patients. Improving geographic accessibility and ease of SNAP incentive redemption may further improve dietary quality and food security among vulnerable populations.

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