Predictors of Supplemental Nutrition Assistance Program Use at Farmers' Markets With Monetary Incentive Programming.

ABSTRACT

PURPOSE: Healthy food incentive program implementation targeting people receiving Supplemental Nutrition Assistance Program (SNAP) benefits is supported by the federal Food Insecurity Nutrition Incentive (FINI) grant program. This study examined factors contributing to increased SNAP use at farmers' markets with an FINI-funded incentive program. DESIGN: Implementation evaluation. SETTING: Sixteen states and District of Columbia. PARTICIPANTS: Two hundred eighty-two FINI-funded farmers' markets open in 2016. MEASURES: Weekly SNAP sales and transactions per 1000 SNAP households in the Zip Code Tabulation Areas around markets. ANALYSIS: Two-level hierarchical regression modeling. RESULTS: Most farmers' markets (53%) had less than 100 SNAP transactions in 2016. Weekly SNAP sales and transactions per 1000 SNAP households were 69.9% and 47.7% higher, respectively, if more than 1 incentive was available versus 1. Not having paid market staff resulted in declines in these sales (-34.3%) and transactions (-38.1%) compared to markets with paid staff. There was a 6.2% and 5.1% increase in SNAP sales and transactions for each additional produce vendor. Weekly SNAP sales and transactions were about 2 to 3 times higher in rural areas compared to metropolitan. Clustering of markets within states explained 10% of the variation in weekly SNAP sales and transactions. CONCLUSION: Four implementation factors were identified that may facilitate the reach of SNAP-based monetary incentive programs at farmers' markets to maximize reach and impact among SNAP shoppers.