Barriers and Facilitators of Online Grocery Services: Perceptions from Rural and Urban Grocery Store Managers.

Online grocery shopping has expanded rapidly in the U.S., yet little is known about the retailer's perceptions of online grocery services, which can aid in the expansion of services. Furthermore, many barriers to online grocery utilization persist across geographic areas, especially among Supplemental Nutrition Assistance Program (SNAP)-authorized retailers. This study captured perceived barriers and facilitators of online grocery shopping for managers of SNAP-authorized retailers. Qualitative semi-structured interviews were conducted with managers (n = 23) of grocery stores/supermarkets in urban and rural areas across four different states: TN, KY, NC, and NY. Grocery store managers offering online ordering (n = 15) and managers from brick-and-mortar stores without online services (n = 8) participated in the interviews. Three primary themes emerged among managers offering online ordering: (1) order fulfillment challenges, (2) perceived customer barriers, and (3) perceived customer benefits. Among managers at brick-and-mortar locations without online services, four major themes emerged: (1) thoughts on implementing online shopping, (2) COVID-19 pandemic impacts, (3) competition with other stores, and (4) benefits of maintaining brick-and-mortar shopping. This study provides a deeper understanding of retailers' experience and perceptions of online grocery services among stores authorized to accept SNAP benefits. This perspective is necessary to inform policies and enhance the evolving virtual food marketplace for SNAP customers.

Disparities in dietary practices during the COVID-19 pandemic by food security status.

Little is known about the differences in dietary practices among food secure and food insecure populations during the early COVID-19 pandemic restrictions. The purpose of this study was to examine differences in dietary practices the early COVID-19 pandemic restrictions between adults reporting food security versus food insecurity. An online cross-sectional survey using validated measures was administered between April and September 2020 to explore both dietary patterns and practices and food security status among persons residing in five U.S. states from different regions of the country during the COVID-19 pandemic. Between-group differences (food secure versus food insecure) were examined for dietary practice outcomes using Pearson's Chi-Square test statistic, with Fisher's Exact test for cell counts less than five. There were 3,213 adult respondents. Food insecurity increased among the survey sample from 15.9% before the COVID-19 pandemic to 23.1% during the onset of the COVID-19 pandemic (p < 0.01). Compared to food secure respondents, those experiencing food insecurity reported more group gatherings for meals during the pandemic, decreased fruit and vegetable intake, and a need for more nutrition support resources than food secure respondents (p < 0.05). Food secure individuals reported increasing alcohol consumption, more frequent take-out or delivery ordering from fast food or restaurants, and more interest in supporting the local food system (p < 0.05). Results indicate a clear risk of disparities in dietary practices based on food security status during the early COVID-19 pandemic restrictions. Public health research, practice, and policy efforts should tailor specific efforts towards both food secure and food insecure groups.

Online Pilot Grocery Intervention among Rural and Urban Residents Aimed to Improve Purchasing Habits.

Online grocery shopping has the potential to improve access to food, particularly among low-income households located in urban food deserts and rural communities. The primary aim of this pilot intervention was to test whether a three-armed online grocery trial improved fruit and vegetable (F&V) purchases. Rural and urban adults across seven counties in Kentucky, Maryland, and North Carolina were recruited to participate in an 8-week intervention in fall 2021. A total of 184 adults were enrolled into the following groups: (1) brick-and-mortar "BM" (control participants only received reminders to submit weekly grocery shopping receipts); (2) online-only with no support "O" (participants received weekly reminders to grocery shop online and to submit itemized receipts); and (3) online shopping with intervention nudges "O+I" (participants received nudges three times per week to grocery shop online, meal ideas, recipes, Facebook group support, and weekly reminders to shop online and to submit itemized receipts). On average, reported food spending on F/V by the O+I participants was USD 6.84 more compared to the BM arm. Online shopping with behavioral nudges and nutrition information shows great promise for helping customers in diverse locations to navigate the increasing presence of online grocery shopping platforms and to improve F&V purchases.

Examining the relationship between physical activity and mental health during the COVID-19 pandemic across five U.S. States.

The objectives of this paper are to investigate: 1) how the COVID-19 pandemic influenced both physical activity practices and mental health status, and 2) to assess the relationship between the two. Our mixed-methods study draws on 4,026 online survey responses collected between April - September 2020 across five states (Louisiana, Montana, North Carolina, Oregon and West Virginia). Logistic regression models were run for two outcome variables (physical activity and mental health status (measured using the Kessler Psychological Distress scale)). Researchers controlled for race/ethnicity, household income/size, gender, urbanicity, education, employment, use of government assistance and presence of chronic health conditions. Qualitative analysis was applied to open-ended survey responses to contextualize quantitative findings. Household income was significant in predicting difficulty maintaining pre-pandemic physical activity levels; pre-pandemic physical activity levels were associated with increased psychological distress levels during COVID-19; and race/ethnicity, income status and urbanicity were significantly associated with deteriorating mental health status and physical activity levels during COVID-19. Data suggests that a bi-directional, cyclical relationship between physical activity and mental health exists. Policy implications should include physical activity promotion as a protective factor against declining mental health.

Examining Rural Food-Insecure Families' Perceptions of the Supplemental Nutrition Assistance Program: A Qualitative Study.

The Supplemental Nutrition Assistance Program (SNAP) is a critical program that helps reduce the risk of food insecurity, yet little is known about how SNAP addresses the needs of rural, food-insecure residents in the United States (U.S.). This study examines how rural, food-insecure residents perceive SNAP. Semi-structured interviews were conducted with 153 individuals living in six diverse rural regions of Arkansas, Montana, North Carolina, Oregon, Texas, and West Virginia. SNAP was described as a crucial stop-gap program, keeping families from experiencing persistent food insecurity, making food dollars stretch when the family budget is tight, and helping them purchase healthier foods. For many rural residents interviewed, SNAP was viewed in a largely positive light. In efforts to continue improving SNAP, particularly in light of its relevance during and post-coronavirus (COVID-19) pandemic, policymakers must be aware of rural families' perceptions of SNAP. Specific improvements may include increased transparency regarding funding formulas, budgeting and nutrition education for recipients, effective training to improve customer service, connections among social service agencies within a community, and increased availability of automation to streamline application processes.