title: Reach of Supplemental Nutrition Assistance Program-Education (SNAP-Ed) interventions and nutrition and physical activity-related outcomes, California, 2011-2012.
abstract: BACKGROUND
  This study combined information on the interventions of the US Department of Agriculture's Supplemental Nutrition Assistance Program-Education with 5,927 interview responses from the California Health Interview Survey to investigate associations between levels of intervention reach in low-income census tracts in California and self-reported physical activity and consumption of fruits and vegetables, fast food, and sugar-sweetened beverages.
  
  
  METHODS
  We determined 4 levels of intervention reach (low reach, moderate reach, high reach, and no intervention) across 1,273 program-eligible census tracts from data on actual and eligible number of intervention participants. The locations of California Health Interview Survey respondents were geocoded and linked with program data. Regression analyses included measures for sex, age, race/ethnicity, and education.
  
  
  RESULTS
  Adults and children from high-reach census tracts reported eating more fruits and vegetables than adults and children from no-intervention census tracts. Adults from census tracts with low, moderate, or high levels of reach reported eating fast food less often than adults from no-intervention census tracts. Teenagers from low-reach census tracts reported more physical activity than teenagers in no-intervention census tracts.
  
  
  CONCLUSIONS
  The greatest concentration of Supplemental Nutrition Assistance Program-Education interventions was associated with adults and children eating more fruits and vegetables and adults eating fast food less frequently. These findings demonstrate the potential impact of such interventions as implemented by numerous organizations with diverse populations; these interventions can play an important role in addressing the obesity epidemic in the United States. Limitations of this study include the absence of measures of exposure to the intervention at the individual level and low statistical power for the teenager sample.
authors.affiliation: Chief, Research and Evaluation Section, Nutrition Education and Obesity Prevention Branch, California Department of Public Health, 1616 Capitol Ave, PO Box 997377, MS 7204, Sacramento, CA 95899-7377. Email: fred.molitor@cdph.ca.gov.
authors.forename: Fred
authors.initials: F
authors.lastname: Molitor
authors.affiliation: the Nutrition Education and Obesity Prevention Branch, California Department of Public Health, Sacramento, California.
authors.forename: Sharon
authors.initials: S
authors.lastname: Sugerman
authors.affiliation: UCLA Center for Health Policy Research, Los Angeles, California.
authors.forename: Hongjian
authors.initials: H
authors.lastname: Yu
authors.affiliation: the Nutrition Education and Obesity Prevention Branch, California Department of Public Health, Sacramento, California.
authors.forename: Michael
authors.initials: M
authors.lastname: Biehl
authors.affiliation: UCLA Center for Health Policy Research, Los Angeles, California.
authors.forename: May
authors.initials: M
authors.lastname: Aydin
authors.affiliation: UCLA Center for Health Policy Research, Los Angeles, California.
authors.forename: Melanie
authors.initials: M
authors.lastname: Levy
authors.affiliation: UCLA Center for Health Policy Research, Los Angeles, California.
authors.forename: Ninez A
authors.initials: NA
authors.lastname: Ponce
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002140:California; D019352:Censuses; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data; D057140:Fast Foods; D005247:Feeding Behavior; D005260:Female; D063105:Food Assistance; D005638:Fruit; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000592:standards*; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D052756:Nutritional Sciences / Q000193:education*; D017063:Outcome Assessment, Health Care; D015203:Reproducibility of Results; D012923:Social Class; D011795:Surveys and Questionnaires; D014675:Vegetables; D055815:Young Adult