Objective: Women, Infants, and Children (WIC) cash value vouchers (CVV) have been inconsistently redeemed in Arizona. The objective of this study was to explore perceived barriers to use of CVV as well as strategies participants use to overcome them.

Design: Eight focus groups were conducted to explore attitudes and behaviors related to CVV use.

Setting: Focus groups were conducted at 2 WIC clinics in metro-Phoenix, AZ.

Participants: Participants in WIC who were at least 18 years of age and primarily responsible for buying and preparing food for their households.

Phenomenon of interest: Perceived barriers to CVV use and strategies used to maximize their purchasing value.

Analysis: Transcripts were analyzed using a general inductive approach to identify emergent themes.

Results: Among 41 participants, multiple perceived barriers emerged, such as negative interactions in stores or confusion over WIC rules. Among experienced shoppers, WIC strategies also emerged to deal with barriers and maximize CVV value, including strategic choice of times and locations at which to shop and use of price-matching, rewards points, and other ways to increase purchasing power.

Conclusions and implications: Arizona WIC participants perceived barriers that limit easy redemption of CVV. Useful strategies were also identified that could be important to explore further to improve WIC CVV purchasing experiences.

In the face of the coronavirus (COVID-19) pandemic, food assistance programs adapted quickly and in unprecedented ways to meet the challenges of high unemployment, disruptions in the food supply, and school closures. Supported by US Department of Agriculture’s COVID-19 program-specific waivers, some programs relaxed their eligibility criteria, while others improvised on delivery modalities or temporarily increased benefits.1 To examine food assistance program participation and participant experiences during the first few months of the pandemic, we collected online survey data in July 2020 from a sample of over 1,500 U.S. households, representative of the US population. This brief summarizes participation in key food assistance programs, namely, the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Program for Women Infants and Children (WIC), School Food Programs, as well as emergency food assistance provided through Food Pantries. 

The epidemic of overweight and obesity and its multiple causes have captured the attention of researchers, program administrators, politicians, and the public alike. Recently, many stakeholder groups have started investigating the role that food and nutrition assistance programs play in the etiology of the problem and in identifying possible solutions. As a result, policy changes have been recommended and implemented for programs such as the National School Lunch Program (NSLP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to improve the nutritional quality of foods they offer to their participants. The Supplemental Nutrition Assistance Program (SNAP) is also attracting attention as a potential vehicle to reduce the burden of obesity among its users. Because of the tough economic and political climate in which all federal programs currently operate, the need for making nutrition assistance programs more efficient and effective in addressing health and nutrition related problems affecting the country has never been greater.

This document proposes a set of strategies to improve the effectiveness and efficiency of SNAP. These strategies are based on a review of research literature, recommendations from expert groups, and the experiences of other communities and states. We include information that pertains to potential stakeholder arguments for and against each strategy, as well as the political feasibility, financial impact, and logistical requirements for implementation. We drew candidate strategies from the range of options that have been tested through research and from policies that have been implemented around the country. The order of strategies in this document is based on overall strength of supportive research, as well as political and implementation feasibility. The four proposed strategies are improving access to healthy foods to provide better choices, incentivizing the purchase of healthy foods, restricting access to unhealthy foods, and maximizing education to more effectively reach a larger population of SNAP participants.

Beginning in March 2020, the COVID-19 pandemic triggered a sudden and severe economic downturn and led to disruptions in domestic and international food systems and supply chains. Over the first few months of the pandemic, in the United States, many stores had empty shelves, bars and restaurants closed, and children could no longer go to school. The unemployment rate increased from 3.5% in February 2020 to 14.8% in April 2020, leading to economic instability for many households. As a result, household food insecurity, defined as having limited or inconsistent access to nutritious and affordable food, increased rapidly.

During the first months of 2021, vaccinations began rolling out, more individuals returned to in-person work, children to schools, and restrictions were gradually phased out. Unemployment has decreased since the April 2020 peak to 5.4% in July 2021, but remains above pre-pandemic levels. This brief describes the prevalence of household food insecurity, job disruptions, and food-related behaviors as reported by a nationally representative sample of 1,643 U.S. adults, both in the year prior to the COVID-19 pandemic (March 2019 – March 2020) and during the first four months of 2021 (January – April 2021), a period representing approximately one year since the onset of the pandemic.

Background: The Nike + Fuelband is a commercially available, wrist-worn accelerometer used to track physical activity energy expenditure (PAEE) during exercise. However, validation studies assessing the accuracy of this device for estimating PAEE are lacking. Therefore, this study examined the validity and reliability of the Nike + Fuelband for estimating PAEE during physical activity in young adults. Secondarily, we compared PAEE estimation of the Nike + Fuelband with the previously validated SenseWear Armband (SWA).

Methods: Twenty-four participants (n = 24) completed two, 60-min semi-structured routines consisting of sedentary/light-intensity, moderate-intensity, and vigorous-intensity physical activity. Participants wore a Nike + Fuelband and SWA, while oxygen uptake was measured continuously with an Oxycon Mobile (OM) metabolic measurement system (criterion).

Results: The Nike + Fuelband (ICC = 0.77) and SWA (ICC = 0.61) both demonstrated moderate to good validity. PAEE estimates provided by the Nike + Fuelband (246 ± 67 kcal) and SWA (238 ± 57 kcal) were not statistically different than OM (243 ± 67 kcal). Both devices also displayed similar mean absolute percent errors for PAEE estimates (Nike + Fuelband = 16 ± 13 %; SWA = 18 ± 18 %). Test-retest reliability for PAEE indicated good stability for Nike + Fuelband (ICC = 0.96) and SWA (ICC = 0.90).

Conclusion: The Nike + Fuelband provided valid and reliable estimates of PAEE, that are similar to the previously validated SWA, during a routine that included approximately equal amounts of sedentary/light-, moderate- and vigorous-intensity physical activity.

Background: Emerging interventions that rely on and harness variability in behavior to adapt to individual performance over time may outperform interventions that prescribe static goals (e.g., 10,000 steps/day). The purpose of this factorial trial was to compare adaptive vs. static goal setting and immediate vs. delayed, non-contingent financial rewards for increasing free-living physical activity (PA).

Methods: A 4-month 2 × 2 factorial randomized controlled trial tested main effects for goal setting (adaptive vs. static goals) and rewards (immediate vs. delayed) and interactions between factors to increase steps/day as measured by a Fitbit Zip. Moderate-to-vigorous PA (MVPA) minutes/day was examined as a secondary outcome.

Results: Participants (N = 96) were mainly female (77%), aged 41 ± 9.5 years, and all were insufficiently active and overweight/obese (mean BMI = 34.1 ± 6.2). Participants across all groups increased by 2389 steps/day on average from baseline to intervention phase (p < .001). Participants receiving static goals showed a stronger increase in steps per day from baseline phase to intervention phase (2630 steps/day) than those receiving adaptive goals (2149 steps/day; difference = 482 steps/day, p = .095). Participants receiving immediate rewards showed stronger improvement (2762 step/day increase) from baseline to intervention phase than those receiving delayed rewards (2016 steps/day increase; difference = 746 steps/day, p = .009). However, the adaptive goals group showed a slower decrease in steps/day from the beginning of the intervention phase to the end of the intervention phase (i.e. less than half the rate) compared to the static goals group (−7.7 steps vs. -18.3 steps each day; difference = 10.7 steps/day, p < .001) resulting in better improvements for the adaptive goals group by study end. Rate of change over the intervention phase did not differ between reward groups. Significant goal phase x goal setting x reward interactions were observed.

Conclusions: Adaptive goals outperformed static goals (i.e., 10,000 steps) over a 4-month period. Small immediate rewards outperformed larger, delayed rewards. Adaptive goals with either immediate or delayed rewards should be preferred for promoting PA.