Research Article
Qualitative Evaluation of Drivers of Eating Decisions among SNAP Participants in Mississippi

https://doi.org/10.1016/j.jneb.2020.04.006Get rights and content

Abstract

Objective

To explore food-related decision patterns among Supplemental Nutrition Assistance Program (SNAP) recipients in Mississippi.

Design

A qualitative design was used to conduct focus groups (n = 18) based on the Health Belief Model with low-income female caregivers of children aged under 13 years.

Setting

Mississippi.

Participants

Cluster sampling was used to recruit participants (n = 126) from the 4 regional divisions of Mississippi State University Extension.

Phenomenon of Interest

Drivers of eating decisions among SNAP participants.

Analysis

Focus groups were recorded, transcribed, and coded by 2 independent coders using thematic analysis.

Results

Drivers of food selection often overlapped with barriers to healthy eating. Participants used many strategies to manage costs and viewed healthy foods as out of reach and quick to perish. Cost, taste preferences, habits, and family factors were primary drivers of food selection and preparation; each of these presented barriers to healthier eating. Health was most often shared as a driver of food selection once disease was established. Participants reported a variety of strategies used in striving for healthier eating.

Conclusions and Implications

Focusing on ways to manage the costs of healthy foods, honor taste preferences, and work within habits/families may enhance efforts to support healthy eating among SNAP participants.

Section snippets

INTRODUCTION

Disparities in diet quality and health status among Mississippians underline the importance of effective public health strategies for reducing disease risk, with a particular focus on underserved and minority audiences. According to the Centers for Disease Control and Prevention, only 8.7% of adults met the daily fruit recommendation, and 6.2% met the daily vegetable recommendation in the state of Mississippi in 2015, compared with 12.2% and 9.3% in the US, respectively.1 In addition, 37.3% of

Study Design

Eighteen focus groups (FGs) were conducted in 12 locations across Mississippi in 2016 as a part of formative evaluation efforts to guide SNAP-Education (SNAP-Ed) programming. Focus groups were chosen to allow participants to interact with one another about food choice patterns and healthy eating ideas and strategies to improve understanding of commonalities among SNAP participants in Mississippi that could be used in developing relevant programming. Focus groups, as opposed to individual

RESULTS

Table 1 depicts that the majority of participants (n = 126) were African American women aged 26–45 years with 2 or 3 children; most participants (n = 112) were receiving SNAP benefits at the time of the survey. The sections that follow describe themes associated with each study objective: drivers of food decisions, barriers to healthy eating, strategies for healthy eating, and perceptions of healthy eating. Responses related to some of the themes illustrated positive and negative cases. For

DISCUSSION

Themes described in this study align with other research, indicating the balancing of multiple (often competing) priorities when making food-related decisions, with cost, taste preferences, habits, and family influences as primary factors. As shown in other research,10 SNAP participants in the current study readily identified food patterns that promote health, such as eating fruits and vegetables and cutting sugar and salt and were familiar with strategies for improving healthy eating, such as

IMPLICATIONS FOR RESEARCH AND PRACTICE

Health advocates cite significant potential to impact malnutrition and obesity with the $75 billion/year investment in SNAP.36 Efforts to improve healthy food availability (via incentives,33 policies and programs to bring fresh food into food deserts,37,38 increased access to farmers’ markets,39 etc.) and to improve nutrition behaviors40, 41, 42 among low-income audiences have shown progress. Making healthy eating more achievable, desirable, and perceived as normal within social groups may help

ACKNOWLEDGMENTS

This study was funded by the US Department of Agriculture SNAP and Mississippi State University Extension. The authors would also like to thank the participants for sharing their experiences with the research team and the Southern Research Group for assistance with data collection.

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    Conflict of Interest Disclosure: The authors have not stated any conflicts of interest.

    Dr Gray was affiliated with Mississippi State University Extension Service at the time this study was completed.

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