EBT Payment for Online Grocery Orders: a Mixed-Methods Study to Understand Its Uptake among SNAP Recipients and the Barriers to and Motivators for Its Use.

OBJECTIVE: To examine Supplemental Nutrition Assistance Program (SNAP) recipients' use of the first online supermarket accepting Electronic Benefit Transfer (EBT) payment. METHODS: In this mixed-methods study, the authors collected EBT purchase data from an online grocer and attempted a randomized controlled trial in the South Bronx, New York City, followed by focus groups with SNAP beneficiaries aged ≥18 years. Participants were randomized to shop at their usual grocery store or an online supermarket for 3 months. Focus groups explored barriers and motivators to online EBT redemption. RESULTS: Few participants made online purchases, even when incentivized in the randomized controlled trial. Qualitative findings highlighted a lack of perceived control over the online food selection process as a key barrier to purchasing food online. Motivators included fast, free shipping and discounts. CONCLUSIONS AND IMPLICATIONS: Electronic Benefit Transfer for online grocery purchases has the potential to increase food access among SNAP beneficiaries, but challenges exist to this new food buying option. Understanding online food shopping barriers and motivators is critical to the success of policies targeting the online expansion of SNAP benefits.

Picking fruit from our backyard's trees: The meaning of nostalgia in shaping Latinas' eating practices in the United States.

Based on a focus group study conducted in New York City (NYC), this paper examines the traditional staples (i.e., nostalgic foods) that Latinas regularly consume in the U.S., along with their beliefs regarding the impact of such foods on weight gain and related body image. Our research findings highlight the "double-bind" of nostalgic foods, defined by Latinas' retention of highly caloric familiar items along with their progressive abandonment of fresh produce and fruits. Despite participants' efforts to eat healthy staples from their homelands, they mostly kept foods perceived as unhealthy (e.g., fatty meats, fried foods). This phenomenon was informed by the "same-food paradox," represented by Latinas' beliefs that the same traditional foods that would make them lose weight in their native countries would lead them to gain weight in the U.S. Our qualitative data show that participants' concerns about their weight gain in the U.S. is in tune with their general body dissatisfaction, as indicated by our quantitative results. Finally, our findings reveal the role of stress in promoting Latinas' deleterious daily habits, including their consumption of fat-saturated snacks. Overall, these results speak to the cultural and structural barriers to healthy eating that financially strapped study participants experienced in NYC. In order to design successful public health interventions targeting Latinas, the nostalgic aspects of food preferences should be considered in conjunction with the barriers that keep them from engaging with healthier lifestyles in the U.S.

In our country tortilla doesn't make us fat: cultural factors influencing lifestyle goal-setting for overweight and obese Urban, Latina patients.

Obesity disproportionately affects Latina adults, and goal-setting is a technique often used to promote lifestyle behavior change and weight loss. To explore the meanings and dimensions of goal-setting in immigrant Latinas, we conducted four focus groups arranged by language ability and country of origin in an urban, public, primary care clinic. We used a narrative analytic approach to identify the following themes: the immigrant experience, family dynamics, and health care. Support was a common sub-theme that threaded throughout, with participants relying on the immigrant community, family, and the health care system to support their goals. Participants derived satisfaction from setting and achieving goals and emphasized personal willpower as crucial for success. These findings should inform future research on how goal-setting can be used to foster lifestyle behavior change and illustrate the importance of exploring the needs of Latino sub-groups in order to improve lifestyle behaviors in diverse Latino populations.

Latina food patterns in the United States: a qualitative metasynthesis.

BACKGROUND: Obesity disproportionately affects Latinas living in the United States, and cultural food patterns contribute to this health concern. OBJECTIVE: The aim of this study was to synthesize the qualitative results of research regarding Latina food patterns in order to (a) identify common patterns across Latino culture and within Latino subcultures and (b) inform future research by determining gaps in the literature. METHODS: A systematic search of three databases produced 13 studies (15 manuscripts) that met the inclusion criteria for review. The Critical Appraisal Skills Program tool and the recommendations of Squires for evaluating translation methods in qualitative research were applied to appraise study quality. Authors coded through directed content analysis and an adaptation of the Joanna Briggs Institute Qualitative Assessment and Review Instrument coding template to extract themes. Coding focused on food patterns, obesity, population breakdown, immigration, acculturation, and barriers and facilitators to healthy eating. Other themes and categories emerged from this process to complement this approach. RESULTS: Major findings included the following: (a) Immigration driven changes in scheduling, food choice, socioeconomic status, and family dynamics shape the complex psychology behind healthy food choices for Latina women; (b) in Latina populations, barriers and facilitators to healthy lifestyle choices around food are complex; and (c) there is a clear need to differentiate Latino populations by country of origin in future qualitative studies on eating behavior. DISCUSSION: Healthcare providers need to recognize the complex influences behind eating behaviors among immigrant Latinas in order to design effective behavior change and goal-setting programs to support healthy lifestyles.