Association for Public Policy Analysis & Management

Many low-income families overconsume foods of low nutritional value and under-consume nutrient-dense foods such as fruits and vegetables. These dietary patterns play an important role in the disproportionate burden of diet-related morbidity and mortality among low-income adults. The Supplemental Nutrition Assistance Program (SNAP), administered by the U.S. Department of Agriculture (USDA), is intended to improve nutrition outcomes and reduce hunger among program participants. SNAP is the largest federal nutrition program, serving 42.2 million individuals in 2017.

Although limited, some research suggests that SNAP-based incentives are a promising strategy to promote fruit and vegetable consumption. Starting in the mid-2000s, several organizations implemented federally funded SNAP-based incentive programs (SBIPs) primarily at farmers markets and to a lesser extent at grocery stores, to increase purchasing power of low-income households and to improve fruit and vegetable consumption. SBIPs provide matching funds to purchase fruits and vegetables.

The USDA designed the Healthy Incentives Pilot (HIP) to examine the changes in fruit and vegetable purchase and consumption resulting from point-of-sale financial incentives provided to SNAP participants. Between November 2011 and December 2012, 7,500 randomly selected SNAP households in Hampden County, Massachusetts received 30 cents in incentives for every SNAP dollar they spent on fruits and vegetables. Results were positive—HIP participants consumed 0.26 more cups of fruits and vegetables per day than non-participants. The HIP evaluation findings, while encouraging, are limited in generalizability, as HIP was implemented in only county in Massachusetts.

Building on the success of HIP, Congress authorized the Food Insecurity Nutrition Incentive (FINI) Grant Program in the Agricultural Act of 2014 to support the expansion of nutrition incentive programs for fruits and vegetables. Between 2015 and 2018, USDA awarded $86.1 million in FINI grants to local, State, and national organizations across the country to implement SBIPs in several retail environments including grocery stores, farmers markets, mobile markets, and Community Supported Agriculture (CSAs). While the form and amount of incentives varied across grant programs and retailer types, most offered a double-dollar coupon or discount, whereby a SNAP participant earned an amount in incentives equal to the purchase price of the qualifying products.

This paper will present results from the national FINI evaluation. A baseline and a 6-month follow-up survey with SNAP participants served as the primary data sources for this examination. The analysis included 2,471 SNAP participants who responded to the surveys. The primary outcomes included FINI take-up, changes in fruit and vegetable monthly expenditures, and changes in daily fruit and vegetable consumption. Program outcomes were estimated by comparing SNAP households with access to FINI (the intervention group) to a matched comparison group with no access to FINI. This comparison identified the share of observed changes in outcomes that were attributable to FINI versus the changes that reflected general trends among a group of similar households that were not receiving FINI. Lessons learned from the FINI projects will inform policymakers of the impact of incentives on fruit and vegetable purchase and consumption as well as strategies for implementing successful incentive programs in different retailer settings.