Evaluating the Implementation and De-Implementation of Pandemic Era SNAP Expansion Policies on Diet and Health: A Mixed Methods Project

评估大流行时代 SNAP 饮食和健康扩展政策的实施和取消实施：混合方法项目

• 批准号: 10832272
• 负责人: Cindy Leung
• 金额: $ 229.92万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-22 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10832272
• 关键词: Administrator; Adopted; Adult; Advisory Committees; Affect; American; COVID-19 impact; COVID-19 pandemic; Client; Coping Skills; Cross-Sectional Studies; Data; Data Set; Data Sources; Databases; Deimplementation; Diet; Economics; Eligibility Determination; Ethnic Origin; Evaluation; Expenditure; Focus Groups; Food; Food Policy; Future; Goals; Health; Household; Hunger; Individual; Information Dissemination; Interview; Knowledge; Learning; Life Cycle Stages; Low income; Measures; Mediating; Mental Health; Methods; National Health and Nutrition Examination Survey; Outcome; Participant; Pathway interactions; Persons; Physiologic pulse; Play; Policies; Policy Maker; Poverty; Race; Recording of previous events; Research; Research Design; Research Methodology; Role; Running; Security; Surveys; United States; United States Department of Agriculture; Work; cost; data integration; design; diverse data; experience; expiration; flexibility; food insecurity; food security; health equity; health equity promotion; implementation evaluation; improved; innovation; insight; lens; marginalized population; novel; nutrition; pandemic disease; panel study of income dynamics; physical conditioning; population health; post-pandemic; poverty alleviation; pre-pandemic; programs; public database; public health emergency; response; waiver; Administrator; Adopted; Adult; Advisory Committees; Affect; American; COVID-19 impact; COVID-19 pandemic; Client; Coping Skills; Cross-Sectional Studies; Data; Data Set; Data Sources; Databases; Deimplementation; Diet; Economics; Eligibility Determination; Ethnic Origin; Evaluation; Expenditure; Focus Groups; Food; Food Policy; Future; Goals; Health; Household; Hunger; Individual; Information Dissemination; Interview; Knowledge; Learning; Life Cycle Stages; Low income; Measures; Mediating; Mental Health; Methods; National Health and Nutrition Examination Survey; Outcome; Participant; Pathway interactions; Persons; Physiologic pulse; Play; Policies; Policy Maker; Poverty; Race; Recording of previous events; Research; Research Design; Research Methodology; Role; Running; Security; Surveys; United States; United States Department of Agriculture; Work; cost; data integration; design; diverse data; experience; expiration; flexibility; food insecurity; food security; health equity; health equity promotion; implementation evaluation; improved; innovation; insight; lens; marginalized population; novel; nutrition; pandemic disease; panel study of income dynamics; physical conditioning; population health; post-pandemic; poverty alleviation; pre-pandemic; programs; public database; public health emergency; response; waiver

PROJECT SUMMARY The USDA Supplemental Nutrition Assistance Program (SNAP) has played a critical role in mitigating national food insecurity during the pandemic. Since March 2020, many federal and state-level policies have been enacted to expand SNAP eligibility, enhance SNAP benefits, and reduce the administrative burden of applying for and maintaining SNAP benefits. By March 2023, most flexibilities and pandemic-era SNAP benefit boosts were discontinued, resulting in a “hunger cliff” with considerable implications for poverty, food insecurity, and health equity. There are significant knowledge gaps about the implementation and subsequent de- implementation of pandemic-era SNAP policy changes and their effects on the health of low-income Americans. The overall objective of this application is to evaluate the effects of implementation and de- implementation of pandemic-era SNAP expansion policies on adult health outcomes using a mixed methods approach that builds on the project team’s robust existing work. The central hypothesis is that the onset of SNAP expansion policies led to better physical and mental health outcomes, mediated by higher food expenditures, lower food insecurity, and higher diet quality; the sunset of these policies adversely affected health through these same pathways. In Aim 1, the project team will create a novel comprehensive database to document states’ implementation and de-implementation of SNAP expansion policies from 2020 to 2023 through surveys and focus groups with state SNAP administrators. In Aim 2, the project team will conduct a national survey and in-depth interviews with SNAP participants to understand how the expiration of SNAP expansion policies impacted program utilization, food insecurity, and health. Finally, in Aim 3, robust methods for causal inference will be applied to three nationally representative datasets to examine national and state- level SNAP expansion policies on adult health and intermediate outcomes. This project will employ a sequential mixed methods study design to integrate data across all aims and add context and richness to the interpretation of the results. To promote inclusivity and support the dissemination of results to key audiences, the project team will regularly engage with a Policy Advisory Committee, including experts in federal and state/local SNAP policy, poverty alleviation, and nutrition security, and a Client Advisory Committee, comprised of individuals with lived experience using SNAP benefits. This comprehensive and rigorous evaluation will provide important evidence about the effects of the onset and sunset of SNAP expansion policies on the health of low-income Americans. Results from this project will be of direct relevance to policymakers and other stakeholders to inform planning for future public health emergencies and long-term food policy.

项目摘要 美国农业部补充营养援助计划（SNAP）在减轻国家 大流行期间的粮食不安全。自2020年3月以来，许多联邦和州级政策已经 颁布以扩大快照资格，提高快照福利并减少申请的管理燃烧 为了维持快照益处。到2023年3月，大多数灵活性和大流行时代的快照益处靴 被停产，导致“饥饿悬崖”，对贫困，粮食不安全和 健康平等。关于实施以及随后的发展存在很大的知识差距 实施流行时代的快照政策变化及其对低收入健康的影响 美国人。该应用的总体目的是评估实施和降低的影响 使用混合方法实施有关成人健康结果的大流行时代的SNAP扩展政策 基于项目团队强大的现有工作的方法。中心假设是 快速扩张政策导致了更好的身心健康结果，由更高的食物介导 支出，较低的粮食不安全和较高的饮食质量；这些政策的日落受到不利影响 通过这些相同的途径进行健康。在AIM 1中，项目团队将创建一个新颖的综合数据库 文件状态从2020年到2023年对SNAP扩展政策的实施和实施 通过调查和焦点小组与国家快照管理员。在AIM 2中，项目团队将进行 全国调查和对SNAP参与者的深入访谈，以了解快照的到期 扩展政策影响了计划利用，粮食不安全和健康。最后，在AIM 3中，强大的方法 因为因果推断将适用于三个国家代表性数据集，以检查国家和州 - 对成人健康和中级结果的级别扩展政策。该项目将采用 顺序混合方法研究设计，以整合所有目标的数据，并为 结果的解释。为了促进包容性并支持将结果传播给关键受众， 项目团队将定期与政策咨询委员会互动，包括联邦专家和 州/地方快照政策，缓解贫困和营养安全以及客户咨询委员会完成了 具有现场经验的个人，使用快照好处。这种全面而严格的评估将 提供有关快速扩张政策对健康的影响和日落的影响的重要证据 低收入美国人。该项目的结果将与政策制定者和其他 利益相关者为未来的公共卫生紧急情况和长期食品政策提供信息。