title: A qualitative study of diverse experts' views about barriers and strategies to improve the diets and health of Supplemental Nutrition Assistance Program (SNAP) beneficiaries.
abstract: The Supplemental Nutrition Assistance Program (SNAP), the largest federal food assistance program, currently serves 44.7 million Americans with a budget of $75 billion in 2011. This study engaged leading experts for in-depth, semi-structured interviews to explore their opinions concerning the existing challenges and barriers to eating nutritiously in SNAP. Experts also proposed strategies for improving nutritional status among SNAP recipients. Twenty-seven individuals were interviewed from advocacy, government, industry, and research organizations. Interviews were recorded, transcribed, coded, and analyzed for thematic content. The high cost of nutrient-rich foods, inadequate SNAP benefits, limited access to purchasing healthy foods, and environmental factors associated with poverty were identified as barriers that influence nutrition among low-income households in the United States. Six themes emerged among respondents from diverse sectors about how to address these challenges, including providing SNAP participants with incentives to purchase nutrient-rich food consistent with the 2010 Dietary Guidelines for Americans, restricting the purchase of nutrient-poor foods and beverages with program benefits, modifying the frequency of SNAP benefit distribution, enhancing nutrition education, improving the SNAP retailer environment, and increasing state and federal level coordination and consistency of program implementation. Given the recent dramatic increase in SNAP enrollment, policymakers must address existing barriers as well as consider new strategies to improve nutrition policies in SNAP so that the program can continue to address food insecurity needs as well as provide a healthful diet for SNAP beneficiaries.
authors.affiliation: Department of Nutrition at Harvard School of Public Health, Boston, MA, USA.
authors.forename: Cindy W
authors.initials: CW
authors.lastname: Leung
authors.forename: Elena E
authors.initials: EE
authors.lastname: Hoffnagle
authors.forename: Ana C
authors.initials: AC
authors.lastname: Lindsay
authors.forename: Hayley E
authors.initials: HE
authors.lastname: Lofink
authors.forename: Vanessa A
authors.initials: VA
authors.lastname: Hoffman
authors.forename: Sophie
authors.initials: S
authors.lastname: Turrell
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Blumenthal
mesh_terms: D002755:Choice Behavior; D004032:Diet / Q000191:economics / Q000592:standards*; D004777:Environment; D063105:Food Assistance; D005523:Food Supply / Q000191:economics / Q000592:standards; D015438:Health Behavior; D006266:Health Education; D006293:Health Promotion / Q000458:organization & administration*; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D009042:Motivation; D018673:Nutrition Policy; D052756:Nutritional Sciences / Q000193:education*; D009752:Nutritional Status; D011203:Poverty; D011786:Quality Control; D014481:United States