Southern California Nutrition Incentive Program

Study Overview
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Brief Summary
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The specific aims of this proposal are to implement SCNIP in 6 Northgate Gonzalez Markets across San Diego, Orange and LA counties (2 in each county), and determine which level of financial incentive rebate (specifically, $10/month, $20/month, or $40/month) optimally increases the purchase and consumption of SNAP eligible fruits and vegetables.

Detailed Description
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The University of California San Diego (UCSD) Center for Community Health, in collaboration with Northgate Gonzalez Markets and its regional partners, will implement a Food Insecurity Nutrition Incentive program in Los Angeles, Orange and San Diego Counties - the Southern California Nutrition Incentive Program (SCNIP). This program will develop, implement and evaluate a multi-tiered model that will enable low-income, SNAP-eligible consumers to make healthier food choices and purchase more fruits and vegetables. This model will include: tier 1) an innovative fruit and vegetable financial incentive rebate program that utilizes the consumer's Northgate Gonzalez Market customer loyalty card, electronic benefit transfer (EBT) card, and electronic wallet (e-wallet); tier 2) fruit and vegetable promotions that include discount pricing; and tier 3) SNAP-Ed programming (e.g., in-store cooking classes, tours, and healthy food self-labeling system) to educate and support the purchasing behaviors of SNAP-eligible families. Through the use of the customer loyalty card, EBT card, and e-wallet, the rebate program will be able to track the purchase of SCNIP eligible fruits and vegetables and provide a rebate at the point-of-sale that can be used to purchase additional fruits and vegetables, thus increasing the purchasing power of SNAP-eligible families for healthy food options. Earned and dispensed rebate dollars will be stored on the e-wallet enabling the tracking of purchasing behaviors and dollars spent on healthy fruits and vegetables in this program. With this data, we will be able to determine what level of financial incentive rebate ($10/month, $20/month, or $40/month) (tier 1) optimally increased SNAP families' per capita spending on fruits and vegetables in conjunction with the fruit and vegetable promotions (tier 2) and nutrition education activities (tier 3).

Official Title
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Southern California Nutrition Incentive Program

Conditions
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Food Insecurity

Intervention / Treatment
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* Other: Financial Incentive: High
* Other: Financial Incentive: Middle
* Other: Financial Incentive: Low


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Northgate Gonzalez Market customer who currently receives SNAP benefits and has a valid EBT card 18 years of age or older Speaks and reads in English or Spanish Shops at the selected Northgate Gonzalez Market regularly, at least two times per month Exclusion Criteria: Does not receive SNAP benefits Unable to complete surveys in English or Spanish Another immediate family member living in the same household is already recruited into the study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: $40/month<br>Financial incentives: Participants will be randomized to receive $40/month in incentive dollars for the purchase of SNAP eligible fruits and vegetables. Purchasing behaviors will be tracked. | Other: Financial Incentive: High<br>* dlParticipants in this group will receive an additional $40/month to use towards the purchase of SNAP eligible fruits and vegetables. They will be able to access these dollars through an electronic wallet (e-wallet) that is tied to their customer loyalty card. They will also have access to the fruit and vegetable promotions that include discount pricing and SNAP-Ed programming (e.g., in-store cooking classes, tours, and healthy food self-labeling system) to educate and support the purchasing behaviors of SNAP-eligible families.<br>* Other names: Mas Fresco;|
| Active Comparator: $20/month<br>Financial Incentives: Participants will be randomized to receive $20/month in incentive dollars for the purchase of SNAP eligible fruits and vegetables. Purchasing behaviors will be tracked. | Other: Financial Incentive: Middle<br>* Participants in this group will receive an additional $20/month to use towards the purchase of SNAP eligible fruits and vegetables. They will be able to access these dollars through an electronic wallet (e-wallet) that is tied to their customer loyalty card. They will also have access to the fruit and vegetable promotions that include discount pricing and SNAP-Ed programming (e.g., in-store cooking classes, tours, and healthy food self-labeling system) to educate and support the purchasing behaviors of SNAP-eligible families.<br>* Other names: Mas Fresco;|
| Active Comparator: $10/month<br>Financial Incentives: Participants will be randomized to receive $10/month in incentive dollars for the purchase of SNAP eligible fruits and vegetables. Purchasing behaviors will be tracked. | Other: Financial Incentive: Low<br>* Participants in this group will receive an additional $10/month to use towards the purchase of SNAP eligible fruits and vegetables. They will be able to access these dollars through an electronic wallet (e-wallet) that is tied to their customer loyalty card. They will also have access to the fruit and vegetable promotions that include discount pricing and SNAP-Ed programming (e.g., in-store cooking classes, tours, and healthy food self-labeling system) to educate and support the purchasing behaviors of SNAP-eligible families.<br>* Other names: Mas Fresco;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dollars spent on Fruits and Vegetables | Total amount of incentive dollars spent on Fruits and Vegetables per month | 1 year | 
| Quantity of Fruits and Vegetables | total quantity of fruits and vegetables purchased per month with incentive dollars | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dietary intake | Change in self-reported fruit and vegetable consumption during the intervention | 1 year | 
| Six-item short form of the Food Security Survey Module | Change in food insecurity score at the end of the intervention period | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Supplemental Nutrition Assistance Program, Food insecurity, fruit and vegetable, healthy diet