Feasibility and Response to the San Diego County, California, Supplemental Nutrition Assistance Program (SNAP) Agency Sending Food and Nutrition Text Messages to All Participants: Quasi-Experimental Web-Based Survey Pilot Study

• Published in: Journal of medical Internet research 2023-04, Vol.25 (1), p.e41021-e41021
• Main Authors: Gosliner, Wendi, Felix, Celeste, Strochlic, Ron, Wright, Shana, Yates-Berg, Allison, Thompson, Hannah R, Tang, Hao, Melendrez, Blanca
• Format: Article
• Language: English
• Subjects: Behavioral sciences; Bilingualism; California; Cost control; Diet; Dietary guidelines; Exercise; Feasibility; Feasibility Studies; Focus groups; Food Assistance; Food consumption; Food stamps; Fruit; Fruits; Health behavior; Health care; Healthy food; Households; Humans; Internet; Intervention; Measures; Mobile phones; Money; Nutrition education; Nutrition research; Obesity; Original Paper; Pilot Projects; Polls & surveys; Purchasing; Quasi-experimental methods; Role models; Self-efficacy; Surveys and Questionnaires; Text Messaging; Vegetables; Weight control
• ISSN: 1438-8871; 1439-4456; 1438-8871
• DOI: 10.2196/41021

The Supplemental Nutrition Assistance Program (SNAP) provides over 40 million Americans with money for food without typically providing participants with food or nutrition information. Educational SMS text messages can reach large numbers of people, and studies suggest SNAP participants appreciate nutrition education and have access to mobile phones. Using a pre-post intervention design, we assessed the feasibility of, and program satisfaction and outcomes resulting from, the San Diego County, California SNAP agency sending monthly food and nutrition education SMS text messages to all SNAP participants to increase fruit and vegetable purchasing and consumption. We developed and sent 5 behavioral science-informed SMS text messages with links to a project website in English and Spanish with information about selecting, storing, and preparing seasonal fruits and vegetables. The San Diego County SNAP agency sent monthly texts to ~170,000 SNAP households from October 2020 to February 2021. SNAP participants completed web-based surveys in response to a text invitation from the SNAP agency in September 2020 (baseline, n=12,036) and April 2021 (follow-up, n=4927). Descriptive frequencies were generated, and adjusted multiple linear mixed models were run on a matched data set of participants that completed both baseline and follow-up surveys (n=875) assessing pre- or postattitudes, behaviors, knowledge, and self-efficacy. We used adjusted logistic regression models to assess differences between the matched (n=875) and nonmatched (n=4052) participants related to experiences with the intervention (questions asked only at follow-up). After the intervention, matched participants reported significant increase in knowing where to get information about selecting, storing, and preparing fruits and vegetables (3.76 vs 4.02 on a 5-point Likert scale with 5=strongly agree, P