4 pp. / The University of Arizona Cooperative Extension SNAP-Ed program contributes to the Arizona economy by bringing funds from outside the state and utilizing them to encourage healthy eating and active living for people in low-income households. Purchases made for conducting this work generate a ripple of economic activity in other Arizona industries. Economists call these the indirect and induced multiplier effects. This report summarizes the total economic contribution of SNAP-Ed spending, including multiplier effects, on the Arizona economy for the years 2011 and 2012.

Food pantry clients are at an increased risk of poor diet quality which can lead to a variety of chronic diseases. Identifying nutrition interventions that help improve the dietary intake of this vulnerable population is important to help improve health outcomes. Utah’s Supplemental Nutrition Assistance Program-Education (SNAP-Ed), also known as Food $ense, partners with many pantries throughout the state to improve healthy food access. This research was conducted to evaluate the effectiveness of a pantry intervention, Thumbs Up for Healthy Choices, to evaluate its impact on food pantry clients’ selection and use of identified healthy foods. In addition to program evaluation, data identifying interest in programs such as Thumbs Up, as well as common barriers that prevent pantry clients from making healthy choices was also collected and analyzed. This research was funded through a Utah State University (USU) Extension mini-grant for $8,500. The findings will be used to guide future SNAP-Ed initiatives that aim to make the healthy choice the easy choice in food pantries. The results will also be used to build the evidence base for the Thumbs Up for Healthy Choices program, which will allow other SNAP-Ed programs throughout the country to adopt and implement this effective program.

Nutrition education has become a topic of significant concern in today’s society. An area prominent in the interest of nutrition is the battle against food security. Programs like the Supplemental Nutrition Assistance Program – Education (SNAP-Ed) is helping to improve its participants’ food security by providing nutrition education. Kentucky SNAP-Ed participants were asked to complete a survey and a 24-hour food recall to evaluate their knowledge in the following areas: Healthy Eating Index (HEI) scores, food resource management and nutrition practices. Each participant completed an average of 7-12 nutrition education lessons throughout the year. To graduate from the program participants were required to complete the same survey and food recall, applying knowledge gained from the program. Responses from 2,868 participants were analyzed to assess the impact of the SNAP-Ed program. Results demonstrated an improvement of average post-mean responses in all three areas (p-value < 0.001). In conclusion, this research supports that those who participated in the 2012 – 2013 SNAP-Ed program graduated with an overall positive change in nutrition behavior, promoting enhanced food security in low-income families.

Food insecurity and diet quality are concerns in low-income populations, contributing to high rates of obesity. Food management skills may enable low-income populations to obtain a healthy food supply rather than relying on less expensive and less nutritious foods to fill their diets. The purpose of this study was to assess the relationship between food management practices and diet quality in SNAP-ED/EFNEP participants. This study examines the association between food management behaviors and dietary outcomes (Healthy Eating Index totals, total calories, carbohydrates, protein, fat, and fiber, and servings of fruits, vegetables, milk, and meats/beans) as measured by the Behavior Checklist and diet information collected by Extension Program assistants for 1,585 participants in Kentucky counties (n=57) during 2010-2011. The results of the cross-sectional analysis suggest that food management practices can help low-income SNAP-ED and EFNEP participants obtain more food for their families. However, diet quality was only improved for the variable ‘healthy foods,’ (participants who responded that they thought about healthy foods when deciding what to feed their families). It was concluded that an integrated approach of food management practices and nutrition education is needed to improve diet quality for low-income populations.

Low consumption of fruits and vegetables due to various barriers among food insecure populations presents a significant health risk across all ages. Nutrition education is available to low-income populations, but due to the complexity and variety of influences that determine dietary behavior, increasing nutrition knowledge as a singular approach does not successfully result in behavior change. This may be supported by low Supplemental Nutrition Assistance Program (SNAP) redemption rates at farmers markets. There is a lack of data using the Theory of Planned Behavior to assess intentions to purchase fruits and vegetables by SNAP-Ed participants at farmers markets in Southern Illinois. There is also a lack of research on the interest in using social media for nutrition education on fruit and vegetable consumption in low-income populations throughout Southern Illinois. A cross-sectional survey was used to understand SNAP-Ed participants’ intentions to purchase fruits and vegetables at farmers markets, as well as their interest in receiving and using online nutrition education through various social media applications. A survey instrument was distributed to low-income participants of various SNAP-Ed nutrition classes hosted by the University of Illinois-Extension throughout the 16 southernmost counties of Illinois. The survey analyzed constructs of the Theory of Planned Behavior and relationships with intentions using regression analysis. Additionally, questions regarding social media usage were used to determine what technologies and social media applications are most commonly used among the sample, and any interest in receiving nutrition education through such applications. A total sample of n=189 SNAP-Ed participants completed the survey. The study found that attitude regarding fresh fruits and vegetables at farmers markets was the strongest predictor of intent to purchase fruits and vegetables for SNAP-Ed participants who receive SNAP benefits. Second, online nutrition education focused on fruit and vegetable purchases at farmers markets may be more generalizable regarding certain socio-demographic factors for SNAP-Ed participants who receive SNAP benefits. Third, results from the study demonstrate that 76.9% of respondents had Internet access, which is higher than current national rates for Internet accessibility in rural areas. Therefore, it is important to consider an increased Internet accessibility beyond at-home broadband coverage, which may include public libraries, work, school, or on a Smartphone. The most important socio-demographic characteristic to consider regarding social media use was age in the context of generations (Millennials, Working Adults, Seniors). Overall, SNAP-Ed participants were most likely to exhibit interest in nutrition education from text messages, email, or on Facebook. SNAP-Ed participants would like to receive online nutrition education via email (30.1%), Facebook (24.7%), and text messaging (21.0%). Online nutrition education in the form of email, Facebook, and text messaging would be the most successful in terms of recruitment and interaction for SNAP-Ed participants. Therefore, using social media to deliver nutrition education may be an effective supplement to reinforce the current classroom curriculum used in SNAP-Ed programming. Findings from this study support the use of online nutrition education through social media applications as an avenue to increase fruit and vegetable purchases at farmers markets in the Southern Illinois Mississippi Delta Region.

abstract: In the delivery of a public service, meeting the needs of its users through cocreation has generated considerable research. Service users are encouraged to engage with public services through dialogue, sustained interaction, and equal partnership, wherein the role of the user changes from passive to active. As the relationship between service provider and service user evolves, researchers have sought to explain how resources, time, accessibility, and bandwidth may affect such relationships, specifically concerning the economically disadvantaged. While many researchers have focused on the logistical barriers that inhibit cocreation among the economically disadvantaged presented by such factors as cost and transportation, limited research has examined the relationship between the service provider and economically disadvantaged service user. Combining previous research, this study examines what economically disadvantaged service users actually do when they cocreate value with a public service by conducting 12 in-depth interviews with participants of SNAP-Ed, nutrition education for persons eligible for government assistance. The study's findings suggest that cocreation exists through relational characteristics of collaboration, isolation, acceptance, connection, and guidance that help in the development and maintenance of relationships, and that a relationship between service provider and user could be further typified by equality. This finding suggests that equality is an independent construct not necessary in the process of cocreation--a departure from previous research--but rather a way to approach the service provider/user relationship. This study is intended as a step toward examining cocreation through the development of organization-public relationships. / Dissertation/Thesis / Doctoral Dissertation Journalism and Mass Communication 2014

abstract: Fruit and vegetable consumption among school children falls short of current recommendations. The development of Public-Private Partnerships (PPP), which combine the resources of government entities with the resources of private entities, such as businesses or not-for-profit agencies, has been suggested as an effective approach to address a number of public health concerns, including inadequate fruit and vegetable consumption. The United States Department of Agriculture's (USDA) Fresh Fruit and Vegetable Program (FFVP) provides fruits and vegetables as snacks at least twice per week in low-income elementary schools. In addition to increasing fruit and vegetable consumption behaviors at school, children participating in the FFVP have been found to make more requests for fruits and vegetables in grocery stores and at home, suggesting the impact of the program extends beyond school settings. The purpose of this multicase study was to describe key stakeholders' perceptions about creating PPPs between schools and nearby retailers to cross-promote fruits and vegetables in low-income communities, using the FFVP. Semi-structured interviews were conducted with participants from three cases groups: grocery store/produce managers (n=10), district FFVP personnel (n=5) and school FFVP personnel (n=12). Data were analyzed using a directed content analysis approach using constructs from the Health Belief Model, including benefits, barriers, strategies, and motivation. While findings varied by case group, key benefits of creating a PPP included the potential to increase store sales, to enhance public relations with the community, and to extend the impact of the FFVP to settings outside of schools. Barriers included offering expensive produce through the FFVP, time/labor-associated costs, and needing approval from authorities and supervisors. Strategies for developing a PPP included using seasonal produce and having clear instructions for teachers and staff. Stakeholders reported being motivated to create a PPP by the potential to improve health outcomes in children and by wanting to help the community. Both objective and subjective measures were suggested to measure the success of such a partnership. Finally, the educational component of the USDA's Supplemental Nutrition Assistance Program (SNAP-Ed) has the potential to serve as a catalyst for organizing a PPP between FFVP-participating schools and nearby grocery stores. / Dissertation/Thesis / Doctoral Dissertation Nutrition 2017

The Supplemental Nutrition Assistance Program (SNAP) is the largest domestic hunger safety net program in the United States. It has been shown that SNAP increases households' purchasing power. However, only a quarter of Americans follow recommended healthy eating patterns. Hence, there is a question whether the additional income from SNAP transfers to healthier eating. This paper addresses three questions. First, what factors explain SNAP participation of low-income individuals in addition to basic income eligibility requirements? Second, does SNAP participation increase fruit and vegetable consumption? Third, what effect does the Supplemental Nutrition Assistance Program Education (SNAP-Ed) in Arizona have on fruit and vegetable consumption for low-income households? The data used in this study were drawn from two waves of the Arizona Behavioral Risk Factor Surveillance System survey. The study found people in Arizona ate fruits, on average 1.4 times per day and vegetables 1.6 times per day. Marital and household arrangement status significantly affected both SNAP participation and fruit and vegetable consumption, but effects for men and women differed. Distance from services assisting with SNAP enrollment appeared to have no negative effect on eligible respondent enrollment. People living in counties with more SNAP-Ed contractors per person below 125% of the poverty line consumed more fruits and vegetables, but the effect was only marginally significant. Future research should consider more geographically specific measures of SNAP-Ed reach.

In 2016, 12.3% of households in the United States (U.S), or 15.6 million people, were food insecure during some part of the year. Food insecurity is more prevalent among households with children, and has been shown to have adverse effects on child development, aggressive behavior, psycho-social development, and academic performance. Nutrition assistance and education programs play critical roles in alleviating food insecurity. The Virginia 365 Project (VA365) was a United States Department of Agriculture (USDA)-funded multi-level school- and home-based approach aimed at reducing food insecurity in low-income areas of Virginia through meal programs and nutrition education for parents through the Expanded Food and Nutrition Education Program (EFNEP) and the Supplemental Nutrition Assistance Program Education Program (SNAP-Ed). Impacts of coordinated nutrition assistance programs for children have generally focused on food security or nutrition outcomes, not broader impacts on academic achievement, attendance, and aggressive behavior. This study examined the feasibility of using school-level surveillance data, collected in state longitudinal data systems, to detect changes in academic and behavioral outcomes, using the VA365 program as a case study. Relevant data indicators were identified and compared from the Virginia Longitudinal Data System and from the longitudinal data systems from other Mid-Atlantic region (MARO) SNAP-Ed states (n=9) to determine generalizability to other states for broader program impacts. Results provide a greater understanding of the potential for accessing existing school-level data to document the public value of school-based nutrition programs beyond improved food security and dietary intake to include academic achievement, discipline and attendance outcomes. / Master of Science / In 2016, 15.6 million Americans were food insecure, or struggled to get safe and consistent access to food, during some part of the year. Food insecurity is more common in households with children. It can have negative outcomes on a child’s development, behavior, psycho-social development, and grades. The Virginia 365 Project (VA365) was a federally funded approach to reducing food insecurity in children located in low-income areas of Virginia through a combination of free school meals, food backpack programs, and nutrition education. The goal of this study was to determine the feasibility of using data already collected by schools to assess impacts of this anti-hunger program on student behavior, attendance, and academic achievement. All schools collect data as part of the Virginia Longitudinal Data System. We analyzed data that were collected as part of this system as well as other states around Virginia to determine how and if they could be used to describe the benefits of the program. The results of this study may help researchers understand the potential of this approach to investigating the broader impacts of nutrition programs beyond nutrition and food insecurity outcomes.

Doctor of Education / Department of Educational Leadership / Royce Ann Collins / Nutrition educators traditionally rely on quantitative research to design interventions for Supplemental Nutrition Assistance Program (SNAP) audiences, such a low-income African American mothers. Such studies indicated the dietary behaviors of this population related to increased risk for chronic disease. Few studies explored the factors that potentially influenced the perceived self-efficacy and affected the dietary habits of SNAP learners. This study addressed the gap between quantitative research findings about the dietary habits of low-income African American mothers and their perceptions of factors influencing those behaviors. A qualitative bounded multi-site case study design was used to explore factors theoretically linked to social cognitive theory (SCT) that affected the dietary habits of low-income African American mothers. The theoretical framework rested on the interaction between SCT and critical race theory (CRT). The research sample included fifteen women, five from each of three public housing sites. The research design included semi-structured interviews supported by multiple data sources. A pilot study took place. Constant comparison was the technique used to analyze the semi-structured interviews and code the findings. The emergent themes aligned with the theoretical framework to answer the research questions. Triangulation helped to ensure the study’s quality. The findings supported the SCT premise that behavioral, personal, and environmental factors interacted reciprocally to influence dietary habits. The findings supported the CRT tenets that race, history, narratives, and interest convergence mattered and influenced dietary habits. The results had implications for adult educators designing effective nutrition programs for diverse learners.