Browsing by Subject "Fruits and vegetables"

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    Cyclical Food Purchasing Behavior Among Low-Income Households Receiving Nutrition Assistance
    (2021-05) Valluri, Sruthi
    The Supplemental Nutrition Assistance Program (SNAP) is the largest anti-hunger program in the United States. SNAP benefits are rapidly depleted immediately after disbursement. This phenomenon, known as the “benefit cycle,” is associated with adverse dietary, nutrition, and health outcomes. Despite significant interest in policy interventions to address the benefit cycle, longitudinal research evaluating cyclical food purchasing and the underlying mechanisms driving such behavior is limited. The primary aim of this dissertation is to evaluate trends in food expenditures after households receive nutrition assistance, and examine the benefit cycle using behavioral and traditional economic frameworks. This dissertation uses data from a prospective trial of low-income households receiving nutrition assistance. The first paper describes patterns in food purchasing before and after households receive benefits. After benefit distribution, cyclical expenditures were observed for all food categories. Although cyclical spending behavior was observed broadly across different households, lower food security and income was associated with more severe expenditure cycles. The second paper evaluates the association between food expenditures and shopper impulsivity, which has been cited as a potential driver of the benefit cycle and is a target of SNAP educational interventions. Total food expenditures were cyclical for all households, but patterned by impulsivity. Shopper impulsivity was associated with expenditures on foods high in added sugar, but not fruits and vegetables. Findings suggest that shopper impulsivity likely exacerbates behavioral mechanisms underlying the benefit cycle, but is not the primary driver. The benefit cycle has also been attributed to time-inconsistent preferences, which suggests that households demonstrate a preference for immediate benefit consumption. The third paper evaluates how households discount utility across time, and whether observed time preferences explain cyclical food expenditures. Contrary to theoretical predictions, time-inconsistent preferences did not fully account for the benefit cycle. However, households with greater resources mitigated the benefit cycle and prioritized healthy foods when doing so. The final manuscript evaluates the impact of benefits over the course of the benefit cycle. Standard economic theory states that extramarginal households who receive more benefits than their typical food budgets respond sharply to increases in benefits. Given the relatively small portion of SNAP households who are extramarginal, the high marginal propensity to spend (MPS) out of benefits observed among SNAP households is incongruous with predictions. The fourth manuscript estimates the MPS out of benefits and cash across the benefit month by household extramarginality. Compared to other households, extramarginal households had a higher MPS out of benefits throughout the benefit month, but a lower MPS out of cash in the final two weeks. Extramarginal households also demonstrated a cyclical pattern in the MPS out of benefits. Results suggest that the benefit cycle can help explain the outsized MPS out of benefits reported in the literature, and a subset of extramarginal households may be driving more severe fluctuations in spending patterns. Understanding patterns in cyclical food purchasing and the mechanisms driving such behavior is critical for evaluating interventions to address the benefit cycle. Results from this dissertation suggest that interventions targeting households that are resource-constrained or extramarginal may help mitigate severe fluctuations in spending. Findings also suggest that policy proposals to help attenuate the benefit cycle—such as educational interventions for impulsive shoppers or more frequent benefit distribution to help households smooth consumption—should be directly evaluated to ensure their effectiveness.
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    A novel dietary improvement strategy: examining the potential impact of community supported agriculture membership
    (2014-11) Vasquez, Angela Marie
    Objectives: Chronic diseases have grown exponentially in recent years and have become a major burden on our society by increasing rates of premature death and disability, decreasing productivity, and increasing health care costs. Employer-based health promotion programs are increasingly common as a tool to improve employee health and to curb costs related to chronic diseases. This study evaluated the effectiveness of a novel, employer-based health promotion intervention to improve the dietary intake and health status of employees using Community Supported Agriculture (CSA). The key objectives were to evaluate the overall experience of CSA participants, to determine whether participants reported a change in their household food environment and meal patterns, and to investigate the association of CSA participation with dietary intake and health outcomes. Methods: A convenience sample of employees from three employers was recruited using multiple communication methods with a total of 324 employees completing all study requirements. Data was collected using baseline and follow-up CSA surveys and the HealthPartners annual health assessment taken prior to and following completion of the study. Descriptive statistics were used to examine participant demographic characteristics and variables related to the CSA experience. To evaluate whether prior CSA experience and share utilization were predictive of participants' future CSA plans, logistic regression was used. Changes in the household food environment and meal patterns were assessed using paired sample t-tests and the Wilcoxon signed-rank test. Linear regression methods were used to investigate associations of CSA participation with dietary intake and health outcomes. Results: The majority of study participants were female, White, college educated, and lived in households with children and two adults. Common reasons CSA participants reported for joining CSA included fresh food, a dislike of grocery stores, and the educational and family experience of being part of CSA. Participants were generally satisfied with their overall CSA experience, and the majority reported that they planned to renew their CSA membership in the following year or that they were unsure of their plans. Additionally, those participants with a history of prior CSA experience and higher share utilization rates were more likely to report that they planned to renew their membership in the following year. CSA participation was also found to be associated with an increase in the presence of vegetables in the household, the frequency of offering fruits and vegetables at snacks or meals, and the frequency of household meals. Additionally, CSA participation was associated with a decrease in the frequency of eating at all types of restaurants and fast food restaurants specifically. Participants reported that the amount and variety of produce consumed increased as a result of CSA participation, although inferential analyses of the change in daily produce servings and weekly produce variety from baseline to follow-up did not support this finding. CSA share type, weekly utilization, and prior CSA participation were not predictive of daily produce servings. In addition, there was not a significant association between CSA participation and health status or BMI. Conclusions: The overall experience of employer-based CSA members was similar to that of CSA members in previous studies, although some discrepancies in employees' motivations for joining and differences in individual satisfaction variables were identified. For example, study participants were more likely to be satisfied with logistics such as the CSA pick-up site and distribution time of day than participants in previous studies. The results of this study also demonstrated that CSA participation is associated with improvements in the household food environment such as an increase in the number of vegetables present, frequency with which produce is served at snacks and meals, frequency of household meals, and frequency of restaurant eating. The findings regarding the association between CSA participation and dietary intake and health were less definitive. Participants indicated that they felt the amount and variety of produce consumed increased as a result of CSA participation in response to the self-report questions on the follow-up CSA survey, but objective measures did not show a change in daily produce servings, weekly produce variety, health status, or BMI from baseline to follow-up when compared to matched controls.