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

Barriers and Facilitators to Online Grocery Shopping Among Supplemental Nutrition Assistance Program (SNAP) Participants: A Mixed Method Study

This mixed methods study explored online grocery shopping perceptions by surveying individuals who do and do not receive SNAP benefits (n = 129) and by conducting interviews with SNAP recipients (n = 26) who have grocery shopped online. T-tests assessed survey findings, codebook thematic analysis was used to identify qualitative themes, and results were interpreted collectively. Survey results found no differences in perceptions of online grocery shopping between SNAP and non-SNAP recipients (p-values = 0.2-1.0) and that 97% of SNAP recipients felt comfortable using SNAP online. Five qualitative themes were identified and provided context to the survey results. The study findings can inform policy actions within SNAP.

Experiences participating in federal nutrition assistance programs during the early months of the COVID-19 pandemic: an investigation in Vermont

BACKGROUND

Federal nutrition assistance programs serve as safety nets for many American households, and participation has been linked to increased food security and, in some instances, improved diet quality and mental health outcomes. The COVID-19 pandemic brought new and increased economic, social, and psychological challenges, necessitating inquiry into how nutrition assistance programs are functioning and associated with public health outcomes.

METHODS

Using data from a representative statewide survey administered in Vermont (n = 600) between July and September 2020, we examined participant experiences with major federal nutrition assistance programs: the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and school meal programs. We explored quantitative and qualitative responses regarding perceptions of program utility, and used nearest neighbors matching analyses in combination with bivariate statistical tests to assess associations between program participation and food insecurity, perceived stress, and fruit and vegetable intake as indicators of dietary quality.

RESULTS

One in four respondents (27.3%) used at least one federal nutrition assistance program. As compared to non-participants, we found higher rates of food insecurity among program participants (57.5% vs. 18.1%; p < 0.001), an association that persisted even when we compared similar households using matching techniques (p ≤ 0.001). From matched analyses, we found that, compared to low-income non-participants, low-income program participants were less likely to meet fruit intake recommendations (p = 0.048) and that low-income SNAP and WIC participants were less likely to meet vegetable intake recommendations (p = 0.035). We also found lower rates of perceived stress among low-income school meal participant households compared to low-income non-participants (p = 0.039). Despite these mixed outcomes, participants broadly valued federal nutrition assistance programs, characterizing them as helpful or easy to use.

CONCLUSIONS

We found that federal nutrition assistance programs as a group were not sufficient to address food insecurity and stress or increase fruit and vegetable intake in the state of Vermont during the early months of the COVID-19 pandemic. Nonetheless, participants perceived benefits from participation in these programs. Optimizing the utility of nutrition assistance programs depends on critical examination of their functioning under conditions of great stress.

"I Don't Want an App to Do the Work for Me": A Qualitative Study on the Perception of Online Grocery Shopping From Small Food Retailers

BACKGROUND

Small food retailers often stock energy-dense convenience foods, and they are ubiquitous in low-income urban settings. With the rise in e-commerce, little is known about the acceptability of online grocery shopping from small food retailers.

OBJECTIVE

To explore perceptions of the role of small food retailers (bodegas) in food access and the acceptability of online grocery shopping from bodegas among customers and owners in a diverse New York City urban neighborhood with low incomes.

DESIGN

In-depth interviews were conducted with bodega owners and adult customers between May and July 2022.

PARTICIPANTS/SETTING

Bodega owners who either had (n = 4) or had not (n = 2) implemented a locally designed online grocery system. Customers (n = 25) were recruited through purposive sampling and were eligible if they purchased at bodegas (>once per month), had low income (household income ≤130% of the federal poverty level or Supplemental Nutrition Assistance Program [SNAP] participants), and owned smartphones.

ANALYSES PERFORMED

All interviews were transcribed and analyzed in MAXQDA (Verbi Software, Berlin, Germany), using grounded theory.

RESULTS

To owners and customers, bodegas were seen as good neighbors providing culturally appropriate foods and an informal financial safety net. Their perceptions concerning food cost and availability of healthy foods in bodegas diverged. Although most perceived online grocery from bodegas as a positive community resource, they also believed it was not suited to their own community because of the bodega's proximity to customers' homes and the low digital literacy of some community members. Customers reported social norms of pride in not using online grocery shopping. Owners and customers believed the service would more likely be used if government benefits such as SNAP allowed payment for online orders. Both suggested improved outreach to increase program awareness and uptake.

CONCLUSIONS

Online grocery shopping from small food retailers may be acceptable in urban communities with low income and was perceived as a community resource. However, important barriers need to be addressed, such as social norms related to pride in not using online grocery services, digital literacy, program awareness, and allowing SNAP payment for online orders from bodegas.

'Healthier options tend to get lost in the noise of online' - Australian shoppers' experiences with online grocery platforms

OBJECTIVE

We aimed to understand what influences parents' purchasing behaviours when shopping for groceries online and potential ways to improve the healthiness of online grocery platforms.

DESIGN

We conducted semi-structured interviews, guided by the Marketing Mix framework. Reflexive thematic analysis was used to analyse data.

SETTING

Online interviews were conducted with primary grocery shoppers.

PARTICIPANTS

Parents (n 14) or caregivers (n 2) using online grocery platforms at least every 2 weeks.

RESULTS

Most participants perceived purchasing healthy food when shopping for groceries online to be more challenging compared to in physical stores. They expressed concerns about the prominence of online marketing for unhealthy food. Participants from lower socio-economic backgrounds often depended on online supermarket catalogues to find price promotions, but healthy options at discounted prices were limited. Across socio-economic groups, fresh items like meat and fruit were preferred to be purchased instore due to concerns about online food quality.Participants believed online grocery platforms should make healthy foods more affordable and supported regulations on supermarket retailers to promote healthy options and limit unhealthy food promotion online.

CONCLUSIONS

Participants had varied experiences with online grocery shopping, with both positive and negative aspects. Efforts to improve population diets need to include mechanisms to create health-enabling online grocery retail platforms. Government interventions to restrict marketing of unhealthy foods and promote marketing of healthy options on these platforms warrant investigation.

The potential influence of the digital food retail environment on health: A systematic scoping review of the literature

INTRODUCTION

The digital food retail environment (defined in this study as a digital platform, app or website where food can be purchased by individuals for personal consumption) is an emerging component of the wider food system. We aimed to systematically search and review the literature to understand the potential influence of the digital food retail environment on population diets and health.

METHODS

Four databases (across health, business, and marketing) and grey literature were searched using terms relating to "food and beverages," "digital," and "purchasing." Identified studies were included if they examined any aspect of the digital food retail environment where outcomes were examined with a health-related focus and were published before September 2023. All study designs were included (quantitative, qualitative, observational, and experimental). Reviews and conference abstracts were excluded.

RESULTS

We identified 21,382 studies, of which 57 articles were eligible for inclusion. Of the 57 included studies, 30 studies examined online grocery retail, 22 examined online food delivery platforms, and five examined meal kit subscription services. Of the 30 studies examining online grocery retail, six studies reported that customers believed they purchased fewer unhealthy food and beverages when shopping online, compared with shopping in-store. Nevertheless, customers also reported that their ability to choose healthy foods and beverages was reduced when shopping online due to difficulty in product comparison. Studies that examined online food delivery platforms primarily found that they promoted unhealthy foods and beverages more often than healthy options, through extensive use of marketing practices such as price discounts and images, and that unhealthy food offerings on these platforms dominate. Meal kit subscription services offered mostly healthy meals, with studies suggesting that these types of services may help individuals alleviate some of their "mental load" and stress related to cooking meals for their families.

CONCLUSIONS

The literature describing the digital food retail environment was found to be diverse, with different aspects having potential to impact health in different ways. Some evidence suggests that online grocery retail and meal kit subscription services may have positive population dietary impacts, whereas online food delivery platforms appear likely to promote unhealthy food purchasing. However, the current evidence base is fragmented, with many knowledge gaps. Further research is required to understand the influence of the digital food retail environment on population diets and how these environments can be designed to support healthy food choices.

A Formative Evaluation of an Online Meal Kit and Grocery Platform for Supplemental Nutrition Assistance Program Recipients

OBJECTIVE

To assess the barriers and facilitators to online food purchasing through a meal kit and grocery shopping website titled NY SNAP Express among Supplemental Nutrition Assistance Program (SNAP) beneficiaries.

METHODS

A purposive sample of SNAP-eligible adults residing in New York State participated in interviews guided by the Capabilities, Opportunities, Motivations, and Behaviors Model.

RESULTS

Barriers to online food purchasing among participants (n = 32) include physiological and health conditions, the weight of food, technology, language, the price of foods, transportation challenges, the stigma associated with SNAP, and concerns regarding the quantity and quality of meal kits. Facilitators include health and nutrition improvements, knowledge and skills, saving money, culturally relevant meals, increased efficiency in food purchases and preparation, and customization.

CONCLUSIONS AND IMPLICATIONS

Online platforms such as NY SNAP Express have the potential to increase nutritious food access and resources among SNAP recipients; however, improvements are necessary to meet the needs of its audience.

A Mixed-Methods Study of Perceived Implementation Challenges for WIC Online Ordering and Transactions

BACKGROUND

Federal food assistance programs are working towards online grocery shopping. Online ordering in Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is emerging following successful implementation in Supplemental Nutrition Assistance Program (SNAP).

OBJECTIVE

To identify anticipated challenges, potential solutions, and expected costs of WIC online ordering.

DESIGN

Cross-sectional, mixed-methods, web-based, survey research.

SUBJECTS AND SETTING

Data were collected from December 2020 to January 2021. Purposeful and snowball sampling included WIC stakeholders involved in developing processes and systems required for WIC online ordering. Respondents represented diverse geographic areas, levels of intraorganizational authority, and WIC benefit card types.

STATISTICAL ANALYSES PERFORMED

The research team used a rapid analysis and lean coding approach to identify emergent themes from open-ended survey responses. Descriptive statistics were used to describe the distribution of responses across themes and stakeholder types.

RESULTS

Respondents (n = 145) described 812 anticipated challenges within 20 themes grouped into five topic areas: rules and regulations; shopping experience; security, confidentiality, fraud, and WIC State agency processes; training, assistance, and education; and equitable access and buy-in. Addressing anticipated regulatory issues were among the few concrete potential solutions described. The two most frequent costs reported were increased staff time and start-up and ongoing technology costs.

CONCLUSIONS

This study identified several, critical anticipated challenges and considerations that will help prepare WIC state agencies for opportunities to expand online ordering to WIC participants.

Online Grocery Shopping and the Supplemental Nutrition Assistance Program (SNAP) Electronic Benefit Transfer Card (EBT): Perceptions of Head Start Caregivers

The objective of this study was to explore perceptions of online grocery shopping and the online United States Department of Agriculture's (USDA) Supplemental Nutrition Assistance Program (SNAP) Electronic Benefit Transfer card (EBT) program among Head Start caregivers. Three focus groups were conducted between December 2019 and January 2020. Most participants hadn't tried online grocery shopping. Concerns included others choosing perishables, receiving wrong items, and inappropriate substitutes. Perceived benefits included saving time, preventing impulse buys, and eating healthier. Results have broad applicability in the current COVID-19 pandemic where online grocery shopping and the online SNAP EBT program have rapidly expanded across the United States.

An Analysis of SNAP Online Purchasing Behavior in California: A Review of the First 7 Months of Program Implementation and Lessons Learned

PURPOSE

The Supplemental Nutrition Assistance Program (SNAP) Online Purchasing Pilot (OPP) allows for the online purchase of groceries using SNAP benefits. First implemented in California in late April 2020, little is known about program usage. This study assessed initial implementation of SNAP Online in California using SNAP OPP transaction data from April - October 2020. Insights can identify usage differences by demographics, store availability, and rurality to help inform future pilot programs and nutrition initiatives.

DESIGN

Using generalized estimating equations, we modeled county-level associations between transactions and county-level demographics, rurality, and retailer availability.

SETTING

Transaction data from California's Department of Social Services (CDSS) was linked with publicly-available, county-level demographics.

SUBJECTS

Anonymized county-level data on SNAP Online transactions and CalFresh households.

MEASURES

The primary outcome was successful SNAP Online food transactions per county.

ANALYSIS

Generalized estimating equation models with clustering by county was used.

RESULTS

During the first 7 months, median SNAP Online transactions per county per month was 665; 2.7% of total SNAP redemptions were from SNAP Online. Counties with more female-led, disabled, Latino, or Asian CalFresh households had fewer Amazon transactions. Each additional Walmart per county corresponded to 260.7 more Walmart transactions (P < .001). Each percent increase in county zip codes covered by Amazon Fresh corresponded to 45.4 fewer Walmart transactions (P < .05) and 37.3 more Amazon transactions (P < .001).

CONCLUSION

Number of stores per county was associated with greater online grocery transactions, whereas rurality was not. County-level SNAP demographics correlated with transactions at particular retailers.

Evaluation of WIC Online Ordering during the COVID-19 Pandemic: Evidence from an Oklahoma Grocery Store Chain

The COVID-19 pandemic is worsening the disparities in food access in the United States. As consumers have been increasingly using grocery online ordering services to limit their exposure to the COVID-19 virus, participants of federal nutrition assistance programs lack the online benefit redemption option. With the support of the US Department of Agriculture (USDA), retailers are pilot-testing online food benefit ordering in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). By combining the Oklahoma WIC administrative data, the online ordering data from a grocery store chain in Oklahoma, and the COVID-19 data in Oklahoma, this study examines how WIC participants responded to the online food benefit ordering option and how their adoption of online ordering was associated with the COVID-19 incidence. Results show that from July to December 2020, 15,171 WIC households redeemed WIC benefits at an Oklahoma chain store, but only 819 of them adopted online ordering. They together completed 102,227 online orders, which accounted for 2.7% of the store visits and 2.6% of the monetary value of WIC redemptions at these stores. There was no significant relationship between WIC online ordering adoption and COVID-19 incidence in Oklahoma.

A Systematic Review of Marketing Practices Used in Online Grocery Shopping: Implications for WIC Online Ordering

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) plans to allow participants to redeem their food package benefits online, i.e., online ordering. As grocery shopping online has become more common, companies have developed strategies to market food products to customers using online (or mobile) grocery shopping platforms. There is a significant knowledge gap in how these strategies may influence WIC participants who choose to shop for WIC foods online. This review examines the relevant literature to (1) identify food marketing strategies used in online grocery shopping platforms, (2) understand how these strategies influence consumer behavior and consumer diet, and (3) consider the implications for WIC participants. A total of 1862 references were identified from a systematic database search, of which 83 were included for full-text screening and 18 were included for data extraction and evidence synthesis. The included studies provide policymakers and other stakeholders involved in developing WIC online order processes with valuable information about the factors that shape healthy food choices in the online food retail environment. Findings indicate that some marketing interventions, such as nutrition labeling and food swaps, may encourage healthier food choices in the online environment and could potentially be tailored to reinforce WIC messaging about a healthy diet.

Prevalence and demographic correlates of online grocery shopping: results from a nationally representative survey during the COVID-19 pandemic

OBJECTIVE

To estimate the prevalence of online grocery shopping in a nationally representative sample and describe demographic correlates with online grocery shopping.

DESIGN

The Nielsen COVID-19 Shopper Behavior Survey was administered to a subset of Nielsen National Consumer Panel participants in July 2020. We used survey weighted-multivariable logistic regression to examine demographic correlates of having ever online grocery shopped.

SETTING

Online survey.

PARTICIPANTS

18 598 Nielsen National Consumer Panel participants in the USA.

RESULTS

Thirty-nine percent of respondents had purchased groceries online, and among prior purchasers, 89 % indicated that they would continue to online grocery shop in the next month. Canned/packaged foods were the most shopped for grocery category online, followed by beverages, fresh foods and lastly frozen foods. In adjusted analyses, younger respondents (39 years or less) were more likely (47 %) to have ever shopped for groceries online than older age groups (40-54 years, 55-64 years and 65+ years) (29 %, 22 % and 23 %, respectively, all P < 0·001). Those with greater than a college degree were more likely to have ever grocery shopped online (45 %) than respondents with some college education (39 %) and with a high school education or less (32 %) (both P < 0·001). Having children, having a higher income and experiencing food insecurity, particularly among higher income food-insecure households, were also associated with a higher probability of prior online grocery shopping.

CONCLUSIONS

The COVID-19 pandemic accelerated the transition to online grocery shopping. Future research should explore the nutrition implications of online grocery shopping.

Age-Specific Differences in Online Grocery Shopping Behaviors and Attitudes among Adults with Low Income in the United States in 2021

Background: Online grocery shopping has surged in popularity, but we know little about online grocery shopping behaviors and attitudes of adults with low income, including differences by age. Methods: From October to November 2021, we used a survey research firm to recruit a convenience sample of adults who have ever received Supplemental Nutrition Assistance Program (SNAP) benefits (n = 3526). Participants completed an online survey designed to assess diet and online food shopping behaviors. Using logistic regression, we examined the relationship between participant characteristics, including age, and the likelihood of online grocery shopping, and separately examined variation in the reasons for online grocery shopping by age. Results: About 54% of the participants reported shopping online for groceries in the previous 12 months. Odds of online shopping were higher for those aged 18−33 years (OR = 1.95 (95% CI: 1.52, 2.52; p < 0.001)) and 34−44 years (OR = 1.50 (95% CI: 1.19, 1.90; p < 0.001)) than for those aged ≥65 years. Odds were also higher for those who were food insecure and those with income below USD 20,000, higher educational attainment, and higher fruit and vegetable intake. Low prices were the most popular reason for online grocery shopping (57%). Adults aged 18−33 years old had higher odds of reporting low prices as a motivating factor than older adults (OR = 2.34 (95% CI: 1.78, 3.08; p < 0.001)) and lower odds of reporting being discouraged by lack of social interaction (OR = 0.34 (95% CI: 0.25, 0.45; p < 0.001)). Conclusion: Strategies for making online grocery shopping more affordable for adults with lower income may be promising, especially online produce. For older adults, additional support may be needed to make online shopping a suitable replacement for in-store shopping, such as education on technology and combining it with opportunities for social support.

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.

Heterogeneity in grocery shopping patterns among low-income minority women in public housing

BACKGROUND

Public housing residents, who tend to be predominantly female and racial/ethnic minorities, are at a particularly high risk for chronic health conditions. Prior studies have suggested that a lack of access to healthy and affordable food may be an important barrier in public housing communities, but evidence is mixed on the association between the neighborhood food environment and dietary quality, suggesting the need to examine food access patterns in low-income, minority communities more deeply. The purpose of this study was to examine the variability in grocery shopping patterns, and the factors that predict them, among low-income minority women in public housing.

METHODS

Interviewer-administered surveys and body composition measurements were collected in the Watts Neighborhood Health Study, an ongoing longitudinal cohort study of low-income urban public housing residents located in South Los Angeles. Descriptive analyses were conducted to understand the variation in grocery shopping patterns among women. Logistic and ordered logistic regression models were estimated to examine the association between resident characteristics and grocery shopping patterns.

RESULTS

There was considerable variability in grocery shopping patterns, including the types of grocery stores accessed, distance travelled, frequency of shopping, and reasons behind grocery store choice. Grocery shopping patterns were associated with several participant characteristics, including race/ethnicity, working status, access to a car, income, and education. Hispanic participants were less likely to shop at a supermarket, travel further distances to shop, shop more frequently, and were more likely to prioritize price in their choice of primary grocery store than non-Hispanic Black women participants.

CONCLUSIONS

There was considerable variability in grocery shopping patterns, even within this low-income, minority community despite access to the same neighborhood food environment. Convenience and quality, in addition to price, were priorities for choice of primary grocery store, and differences by race/ethnicity suggest that initiatives to improve the neighborhood food environment should consider quality of food, cultural factors, and availability of foods desired by the surrounding community, in addition to price and proximity of grocery stores.

A click too far from fresh foods: A mixed methods comparison of online and in-store grocery behaviors among low-income households

A recent policy in the U.S. authorized monthly benefits from a nutrition assistance program - Supplemental Nutrition Assistance Program (SNAP) - to be used online to increase grocery access and promote healthy eating. This study examined online grocery attitudes and purchasing behaviors among low-income SNAP-eligible households with young children with and without online grocery experience. An explanatory sequential mixed methods design was used, including a survey informed by the theory of planned behavior (TPB) and focus groups conducted between November-March 2021. In the quantitative phase, 310 Maryland residents completed an online survey assessing TPB constructs (attitudes, social norms, perceived control), and food purchase frequency online and in-store. Subsequently, 42 participated in the qualitative phase. Differences in TPB constructs and food purchases were compared between families with and without online grocery experience. Online food selection and fees were a common obstacle to online grocery purchasing. Families who had purchased groceries online (57%) had more positive attitudes and perceived fewer barriers to online shopping than those who had not. Self-reported frequency of buying fresh produce (OR = 0.34, p < 0.001), meat and seafood (OR = 0.29, p < 0.001), and sweets (OR = 0.54, p = 0.005) were lower online than in-store. Families discussed mistrust of online hired shoppers and fewer impulse purchases online as reasons for less frequent purchases of produce and sweets, respectively. Successful scale-up of the U.S. policy must address barriers to healthier purchasing behaviors to effectively promote equitable food access, such as decreasing delivery fees and improving the online food selection.

A systematic scoping review of the literacy literature to develop a digital food and nutrition literacy model for low-income adults to make healthy choices in the online food retail ecosystem to reduce obesity risk

Adults with lower incomes are disproportionately affected by poverty, food insecurity, obesity, and diet-related non-communicable diseases (NCDs). In 2020-2021 amid the coronavirus disease 2019 (COVID-19) pandemic, the United States Department of Agriculture (USDA) expanded the Supplemental Nutrition Assistance Program (SNAP) Online Purchasing Pilot program to enable eligible participants to purchase groceries online in 47 states. This expansion underscores the need for SNAP adults to have digital literacy skills to make healthy dietary choices online. Currently, a digital literacy model does not exist to help guide USDA nutrition assistance policies and programs, such as SNAP. We conducted a systematic scoping review of the academic and gray literature to identify food, nutrition, health, media, financial, and digital literacy models. The search yielded 40 literacy models and frameworks that we analyzed to develop a Multi-dimensional Digital Food and Nutrition Literacy (MDFNL) model with five literacy levels (i.e., functional, interactive, communicative, critical, and translational) and a cross-cutting digital literacy component. Utilization of the MDFNL model within nutrition assistance policies and programs may improve cognitive, behavioral, food security, and health outcomes and support equity, well-being, digital inclusion, and healthy communities to reduce obesity and NCD risks.

Content Analysis of Online Grocery Retail Policies and Practices Affecting Healthy Food Access

OBJECTIVE

To describe policies and practices of online grocery retailers that may affect healthy food access, including retailers participating in the US Department of Agriculture's Supplemental Nutrition Assistance Program Online Purchasing Pilot.

DESIGN

Cross-sectional, quantitative content analysis of 21 online grocery retail websites from November 2019 to January 2020.

MAIN OUTCOME MEASURES

Data collected using a coding instrument capturing the presence of policies and practices related to (1) online purchasing and delivery access; (2) availability of features that allow price comparisons and provide nutrition information; and (3) data privacy.

ANALYSIS

Descriptive statistics for features, practices, and policies across online grocery retail websites.

RESULTS

Most retailers (95%) added fees to online orders. Among pilot retailers, 38% added ≥ 3 fees, and 50% required a minimum order > $15. Few retailers (29%) displayed Nutrition Facts Labels on all products, including 50% of pilot retailers. All retailers collected personal information from shoppers and automatically shared data with affiliated companies.

CONCLUSIONS AND IMPLICATIONS

High fees, limited access to nutrition information on retailer sites, and lack of data privacy are prevalent in online grocery retail settings, including among Online Purchasing Pilot retailers. Online retail practices may perpetuate disparities in healthy food access by discouraging use through fees and making nutritious food choices difficult.

Opportunities to address the failure of online food retailers to ensure access to required food labelling information in the USA

OBJECTIVE

The rapid growth in web-based grocery food purchasing has outpaced federal regulatory attention to the online provision of nutrition and allergen information historically required on food product labels. We sought to characterise the extent and variability that online retailers disclose required and regulated information and identify the legal authorities for the federal government to require online food retailers to disclose such information.

DESIGN

We performed a limited scan of ten products across nine national online retailers and conducted legal research using LexisNexis to analyse federal regulatory agencies' authorities.

SETTING

USA.

PARTICIPANTS

N/A.

RESULTS

The scan of products revealed that required information (Nutrition Facts Panels, ingredient lists, common food allergens and per cent juice for fruit drinks) was present, conspicuous and legible for an average of only 36·5 % of the products surveyed, ranging from 11·4 % for potential allergens to 54·2 % for ingredients lists. More commonly, voluntary nutrition-related claims were prominently and conspicuously displayed (63·5 % across retailers and products). Our legal examination found that the Food and Drug Administration, Federal Trade Commission and United States Department of Agriculture have existing regulatory authority over labelling, online sales and advertising, and Supplemental Nutrition Assistance Programme retailers that can be utilised to address deficiencies in the provision of required information in the online food retail environment.

CONCLUSIONS

Information regularly provided to consumers in conventional settings is not being uniformly provided online. Congress or the federal agencies can require online food retailers disclose required nutrition and allergen information to support health, nutrition, equity and informed consumer decision-making.

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.

Increasing Healthy Food Access for Low-Income Communities: Protocol of the Healthy Community Stores Case Study Project

Improving healthy food access in low-income communities continues to be a public health challenge. One strategy for improving healthy food access has been to introduce community food stores, with the mission of increasing healthy food access; however, no study has explored the experiences of different initiatives and models in opening and sustaining healthy food stores. This study used a case study approach to understand the experiences of healthy food stores in low-income communities. The purpose of this paper is to describe the methodology used and protocol followed. A case study approach was used to describe seven healthy food stores across urban settings in the U.S. Each site individually coded their cases, and meetings were held to discuss emerging and cross-cutting themes. A cross-case analysis approach was used to produce a series of papers detailing the results of each theme. Most case studies were on for-profit, full-service grocery stores, with store sizes ranging from 900 to 65,000 square feet. Healthy Food Availability scores across sites ranged from 11.6 (low) to 26.5 (high). The papers resulting from this study will detail the key findings of the case studies and will focus on the challenges, strategies, and experiences of retail food stores attempting to improve healthy food access for disadvantaged communities. The work presented in this special issue will help to advance research in the area of community food stores, and the recommendations can be used by aspiring, new, and current community food store owners.

OUP accepted manuscript

Context

Online grocery services are an emerging component of the food system with the potential to address disparities in access to healthy food.

Objective

We assessed the barriers and facilitators of equitable access to healthy foods in the online grocery environment, and the psychosocial, purchasing, and dietary behaviors related to its use among low-income, diverse populations.

Data Sources

Four electronic databases were searched to identify relevant literature; 16 studies were identified.

Results

Barriers to equitable access to healthy food included cost and limited availability of online grocery services in food deserts and rural areas. The expansion of online grocery services and the ability to use nutrition assistance benefits online were equity-promoting factors. Perceived low control over food selection was a psychosocial factor that discouraged online grocery use, whereas convenience and lower perceived stress were facilitators. Findings were mixed regarding healthfulness of foods purchased online. Although few studies assessed diet, healthy food consumption was associated with online grocery use.

Conclusion

Researchers should assess the impact of online grocery shopping on low-income families’ food purchases and diet.

Systematic Review Registration

PROSPERO registration no. CRD: 42021240277

"Now I Feel a Little Bit More Secure": The Impact of SNAP Enrollment on Older Adult SSI Recipients

In June 2019, California expanded Supplemental Nutrition Assistance Program (SNAP) eligibility to Supplemental Security Income (SSI) beneficiaries for the first time. This research assesses the experience and impact of new SNAP enrollment among older adult SSI recipients, a population characterized by social and economic precarity. We conducted semi-structured, in-depth interviews with 20 SNAP participants to explore their experiences with new SNAP benefits. Following initial coding, member-check groups allowed for participants to provide feedback on preliminary data analysis. Findings demonstrate that SNAP enrollment improved participants' access to nutritious foods of their choice, contributed to overall budgets, eased mental distress resulting from poverty, and reduced labor spent accessing food. For some participants, SNAP benefit amounts were too low to make any noticeable impact. For many participants, SNAP receipt was associated with stigma, which some considered to be a social "cost" of poverty. Increased benefit may be derived from pairing SNAP with other public benefits. Together, the impacts of and barriers to effective use of SNAP benefits gleaned from this study deepen our understanding of individual- and neighborhood-level factors driving health inequities among low-income, disabled people experiencing food insecurity and SNAP recipients.

A systematic review of supermarket automated electronic sales data for population dietary surveillance

Context

Most dietary assessment methods are limited by self-report biases, how long they take for participants to complete, and cost of time for dietitians to extract content. Electronically recorded, supermarket-obtained transactions are an objective measure of food purchases, with reduced bias and improved timeliness and scale.

Objective

The use, breadth, context, and utility of electronic purchase records for dietary research is assessed and discussed in this systematic review.

Data sources

Four electronic databases (MEDLINE, EMBASE, PsycINFO, Global Health) were searched. Included studies used electronically recorded supermarket transactions to investigate the diet of healthy, free-living adults.

Data extraction

Searches identified 3422 articles, of which 145 full texts were retrieved and 72 met inclusion criteria. Study quality was assessed using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

Data analysis

Purchase records were used in observational studies, policy evaluations, and experimental designs. Nutrition outcomes included dietary patterns, nutrients, and food category sales. Transactions were linked to nutrient data from retailers, commercial data sources, and national food composition databases.

Conclusion

Electronic sales data have the potential to transform dietary assessment and worldwide understanding of dietary behavior. Validation studies are warranted to understand limits to agreement and extrapolation to individual-level diets.

Systematic Review Registration

PROSPERO registration no. CRD42018103470

Digital Food Retail: Public Health Opportunities

For over two decades, digital food retail services have been emerging alongside advances in mobile technology and improved access to wi-fi. Digitalization has driven changes within the food environment, complicating an already complex system that influences food-related behaviors and eating practices. Digital food retail services support an infrastructure that enhances commercial food systems by extending access to and availability of highly processed foods, further escalating poor dietary intakes. However, digital food retail services are heterogeneous–food delivery apps, online groceries, and meal kits–and can be feasibly adapted to nutrition interventions and personalized to individual needs. Although sparse, new evidence indicates great potential for digital food retail services to address food insecurity in urban areas and to support healthy eating by making it easier to select, plan, and prepare meals. Digital food retail services are a product of the digital transformation that reflect consumers’ constant need for convenience, which must be addressed in future research and interventions. This paper will discuss public health opportunities that are emerging from the global uptake of digital food retail services, with a focus on online groceries, food delivery apps, and meal kits.

Comparing shopper characteristics by online grocery ordering use among households in low-income communities in Maine

OBJECTIVE

Online grocery shopping could improve access to healthy food, but it may not be equally accessible to all populations - especially those at higher risk for food insecurity. The current study aimed to compare the socio-demographic characteristics of families who ordered groceries online v. those who only shopped in-store.

DESIGN

We analysed enrollment survey and 44 weeks of individually linked grocery transaction data. We used univariate χ2 and t-tests and logistic regression to assess differences in socio-demographic characteristics between households that only shopped in-store and those that shopped online with curbside pickup (online only or online and in-store).

SETTING

Two Maine supermarkets.

PARTICIPANTS

863 parents or caregivers of children under 18 years old enrolled in two fruit and vegetable incentive trials.

RESULTS

Participants had a total of 32 757 transactions. In univariate assessments, online shoppers had higher incomes (P < 0 0001), were less likely to participate in Special Supplemental Nutrition Program for Women, Infants, and Children or Supplemental Nutrition Assistance Program (SNAP; P < 0 0001) and were more likely to be female (P = 0·04). Most online shoppers were 30-39 years old, and few were 50 years or older (P = 0·003). After controlling for age, gender, race/ethnicity, number of children, number of adults, income and SNAP participation, female primary shoppers (OR = 2·75, P = 0·003), number of children (OR = 1·27, P = 0·04) and income (OR = 3·91 for 186-300 % federal poverty line (FPL) and OR = 6·92 for >300 % FPL, P < 0·0001) were significantly associated with likelihood of shopping online.

CONCLUSIONS

In the current study of Maine families, low-income shoppers were significantly less likely to utilise online grocery ordering with curbside pickup. Future studies could focus on elucidating barriers and developing strategies to improve access.

Acceptability and Willingness to Pay for a Meal Kit Program for African American Families with Low Income: A Pilot Study

Food insecurity is a persistent issue among individuals with low income and is associated with various nutrition- and health-related consequences. Creative approaches to increasing food access should be investigated as possible solutions. Meal kits, which are boxes or bags of fresh and shelf-stable ingredients for one or more meals, along with a step-by-step recipe showing how to cook each meal at home, may serve as a creative solution. Meal kits have historically been marketed to higher-income demographics. The purpose of this pilot study was to investigate the utilization, acceptability, and willingness to pay for a healthy meal kit program among African American main food preparers with children and low income (n = 36). Participants received a healthy meal kit with three recipes and ingredients, a cooking incentive, and a nutrition handout weekly for six weeks. Data were collected on participants’ use, acceptability, and willingness to pay for the meal kits and analyzed using descriptive statistics. The intervention was highly utilized, and participants reported high acceptability ratings for most recipes. After the intervention, participants were willing to pay $88.61 ± 47.47 for a meal kit with three meals, each with four portions, which was higher than indicated at baseline and similar to the cost to produce the kits. Meal kits may offer a creative solution to improving food access if affordable for families with low income.

Applying a Multi-Dimensional Digital Food and Nutrition Literacy Model to Inform Research and Policies to Enable Adults in the U.S. Supplemental Nutrition Assistance Program to Make Healthy Purchases in the Online Food Retail Ecosystem

The United States (U.S.) Department of Agriculture (USDA)-administered Supplemental Nutrition Assistance Program (SNAP) made substantial changes in response to the coronavirus disease 2019 (COVID-19) pandemic. These changes highlight the need to identify the digital literacy skills and capacities of SNAP adults to purchase healthy groceries online. We conducted a scoping review of four electronic databases, Google and Google Scholar to identify studies that measured food and nutrition literacy outcomes for U.S. adults. We applied a multi-dimensional digital food and nutrition literacy (MDFNL) model to assess six literacy levels and components. Of 18 studies published from 2006-2021, all measured functional and interactive literacy but no study measured communicative, critical, translational, or digital literacy. Six studies examined SNAP or SNAP-Education outcomes. Adults with higher food or nutrition literacy scores had better cognitive, behavioral, food security and health outcomes. We suggest how these findings may inform research, policies, and actions to strengthen the multi-dimensional literacy skills of SNAP participants and SNAP-eligible adults to support healthy purchases in the online food retail ecosystem.

Feasibility and Acceptability of a "Click & Collect" WIC Online Ordering Pilot

BACKGROUND

Barriers to shopping for foods in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) have been reported. Online ordering options may improve the WIC shopping experience but are understudied.

OBJECTIVE

The objective of this study was to test feasibility and acceptability of a "Click & Collect" model for WIC online ordering from the perspective of WIC participants.

DESIGN

A Click & Collect online ordering model was adapted to the WIC program and implemented at 1 grocery store. In the Click & Collect model, WIC participants placed an online order ("click"), then completed payment and pickup at the store ("collect").

PARTICIPANTS/SETTING

Twenty-five WIC participants in East Tennessee were included.

MAIN OUTCOME MEASURES

Feasibility was assessed by examining online order summaries and store receipts to determine whether WIC transactions were completed successfully. Acceptability was assessed by qualitative semi-structured interviews conducted with WIC participants after participating in the pilot.

ANALYSES PERFORMED

Descriptive statistics were used to analyze sociodemographic and purchase data in SPSS software, version 27. Qualitative interviews were transcribed and analyzed for themes using directed content analysis in NVivo, version 12.0.

RESULTS

All WIC participants in the study placed an online order, and 96% picked up the order, indicating a high degree of feasibility. In follow-up qualitative interviews, WIC participants reported interest in the Click & Collect model, and provided suggestions to improve practicality across the following 4 primary themes: website experience, curbside pickup, online shopping fee, and shopping preferences.

CONCLUSIONS

The pilot was successfully implemented at 1 store. Click & Collect online ordering was feasible and acceptable to WIC participants, although additional work is needed to make it practical. Online shopping options for the WIC program should be further explored to expand access to nutritious WIC foods in families with low income.

WIC Participants' Perspectives About Online Ordering and Technology in the WIC Program

OBJECTIVE

The objective of this study was to assess the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants' perceptions about ordering WIC groceries online.

METHODS

Qualitative semistructured interviews were conducted with 24 WIC participants in East Tennessee from May to October 2019. Interviews were transcribed verbatim and analyzed using a grounded theory approach.

RESULTS

Participants were interested in online ordering and spoke favorably about delivery and pickup options. Participants were willing to pay $2-5 to order online, though they were more willing to pay for a home or curbside delivery than an in-store pickup. Participants suggested additional ways to integrate technology into WIC food retail operations, such as providing benefit balances via text message and developing a mobile phone application for Tennessee WIC.

CONCLUSIONS AND IMPLICATIONS

Findings can inform pilot tests for WIC online ordering.

Comparing Online and In-Store Grocery Purchases

OBJECTIVE

To describe the grocery shopping patterns of people who shopped both online and in-store and evaluate whether shoppers purchased fewer unhealthy, impulse-sensitive items online.

DESIGN

Secondary analysis of 44 weeks of grocery transaction data collected for fruit and vegetable incentive trials in 2 Maine supermarkets.

PARTICIPANTS

A total of 137 primary household shoppers who shopped at least once in-store and online (curbside pickup) for 5,573 total transactions MAIN OUTCOME MEASURES AND ANALYSIS: Paired t tests and descriptive analyses compared online and in-store transactions with respect to frequency, total spending, number of items purchased, and spending on 10 food groups and 34 subgroups. Mixed-effects regression models estimated differences in online vs in-store spending on 5 unhealthy, impulse-sensitive subgroups.

RESULTS

When shopping online, participants spent 44% more per transaction ($113.58 vs $78.88, P < 0.001) and purchased more items (38.3 vs 26.6 items/transaction, P < 0.001). Compared with in-store, shopping online was associated with reduced spending per transaction on candy (-$0.65, P < 0.001), cold or frozen desserts (-$0.52, P < 0.001), and grain-based desserts (-$1.29, P < 0.001).

CONCLUSIONS AND IMPLICATIONS

Online shopping was associated with lower spending on certain unhealthy, impulse-sensitive foods. Grocery-based healthy eating initiatives might leverage online ordering platforms to increase their reach and effectiveness.

Designing online grocery stores to support healthy eating for weight loss

OBJECTIVES

The current study aimed to identify features to include in online grocery stores to support healthful food purchasing by those striving to lose weight.

DESIGN

A Value Proposition Design approach was used to gain shopper insights, devise potential online grocery store features and obtain feedback on these features.

SETTING

Telephone interviews were conducted to gain insight into shoppers' needs and perceptions. Results were used by the research team to identify potential online grocery shopping features that may support healthful purchase decisions, and interviews were conducted with a different sample of shoppers to gather feedback on features.

PARTICIPANTS

Insight (n 25) and feedback (n 25) interviews were conducted with convenience samples of adults trying to lose weight.

RESULTS

Participants were primarily female, white, college educated and with obesity or overweight. Online grocery features devised by the research team based on findings from the insight interviews included (1) shopping cart nutrition rating tool; (2) healthy meal planning tool; (3) interactive healthy eating inspiration aisle and (4) healthy shopping preference settings option. Findings from the feedback interviews indicated that the healthy meal planning tool, healthy shopping preference settings option and shopping cart nutrition rating tool features were positively rated by most participants.

CONCLUSIONS

There are multiple features grocers should consider including in their online stores to attract and support customers striving to eat healthy for weight loss.

Grocery Delivery of Healthy Foods to Pregnant Young Women With Low Incomes: Feasibility and Acceptability Mixed Methods Study

BACKGROUND

Poor maternal diets increase the risk of excess gestational weight gain which can contribute to serious intergenerational morbidity for both the mother and infant. Pregnant young women with low incomes have disproportionately high rates of inadequate fruit and vegetable consumption as well as excess weight gains during pregnancy.

OBJECTIVE

Our aim was to describe the feasibility and acceptability of Special Delivery, a longitudinal nutrition intervention that delivers healthy foods to pregnant youth (aged 14-24 years) with low incomes.

METHODS

The Special Delivery pilot study, conducted in Michigan, enrolled pregnant young women with low incomes. Study participants were sent twice-monthly grocery deliveries consisting of US $35 worth of healthy foods, primarily fruits and vegetables. Between grocery deliveries, participants received daily SMS text message prompts to confirm receipt of delivery and document diet and weight. Program feasibility was assessed by the number of grocery orders placed, delivered, and confirmed by participants. Qualitative interviews and SMS text message data were used to determine acceptability by assessing participants' perspectives on grocery delivery, participants' perspectives on dietary impact of the program, and foods consumed by participants.

RESULTS

A total of 27 participants were enrolled in the pilot study. The mean age was 20.3 years (SD 2.0), and 59.3% (16/27) were African American or Black. During the pilot, 263 deliveries were sent with 98.5% (259/263) successful deliveries and 89.4% (235/263) deliveries confirmed by participants. Participants reported that grocery delivery was convenient; that delivered foods were high quality; and that the program improved their diet, increased access to healthy foods, and promoted healthy habits during pregnancy.

CONCLUSIONS

A grocery delivery-based weight gain and nutrition intervention is both feasible and acceptable among low-income pregnant youth. Grocery deliveries were successfully completed and participants were willing and able to receive grocery deliveries, eat the healthy foods that were delivered, and communicate via SMS text message with study coordinators. The Special Delivery program warrants further evaluation for efficacy in promoting healthy weight gain for low-income youth during pregnancy.

Associations between Governmental Policies to Improve the Nutritional Quality of Supermarket Purchases and Individual, Retailer, and Community Health Outcomes: An Integrative Review

Supermarkets are natural and important settings for implementing environmental interventions to improve healthy eating, and governmental policies could help improve the nutritional quality of purchases in this setting. This review aimed to: (1) identify governmental policies in the United States (U.S.), including regulatory and legislative actions of federal, tribal, state, and local governments, designed to promote healthy choices in supermarkets; and (2) synthesize evidence of these policies' effects on retailers, consumers, and community health. We searched five policy databases and developed a list of seven policy actions that meet our inclusion criteria: calorie labeling of prepared foods in supermarkets; increasing U.S. Department of Agriculture (USDA) Supplemental Nutrition Assistance Program (SNAP) benefits; financial incentives for the purchase of fruit and vegetables; sweetened beverage taxes; revisions to the USDA Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package; financial assistance for supermarkets to open in underserved areas; and allowing online purchases with SNAP. We searched PubMed, Econlit, PsycINFO, Web of Science, and Business Source Ultimate to identify peer-reviewed, academic, English-language literature published at any time until January 2020; 147 studies were included in the review. Sweetened beverage taxes, revisions to the WIC food package, and financial incentives for fruits and vegetables were associated with improvements in dietary behaviors (food purchases and/or consumption). Providing financial incentives to supermarkets to open in underserved areas and increases in SNAP benefits were not associated with changes in food purchasing or diet quality but may improve food security. More research is needed to understand the effects of calorie labeling in supermarkets and online SNAP purchasing.

How Online Grocery Stores Support Consumer Nutrition Information Needs

OBJECTIVE

To evaluate the availability of nutrition-related information and features on leading online grocery store Web sites.

METHODS

Twelve US grocery Web sites were assessed to determine (1) if Nutrition Facts panel or ingredient statements were available for 26 food items; and (2) if options to filter or sort search results by nutrition-related food attributes were available.

RESULTS

Nutrition Facts panel and ingredient statement information were available for most foods for which this information is required on product packaging (85% of foods). Most stores offered the ability to filter food search results by a nutrition-related food attribute. The ability to sort search results by a nutrition attribute was not an option at any of the stores.

CONCLUSIONS AND IMPLICATIONS

Online grocery stores include a variety of nutrition-related features. However, the Nutrition Facts panel and ingredient statement information are not universally available for foods for which this information is required on product packaging.

Online Grocery Shopping by NYC Public Housing Residents Using Supplemental Nutrition Assistance Program (SNAP) Benefits: A Service Ecosystems Perspective

This paper examines adoption of online grocery shopping, and potential cost and time savings compared to brick and mortar food retailers, by New York City public housing residents using Supplemental Nutrition Assistance Program (SNAP) benefits. A mixed methods action research project involving the co-creation of an online shopping club, the Farragut Food Club (FFC), recruited 300 members who registered to shop online using SNAP, and received waivers on delivery minimums and provided technical assistance and centralized food delivery. We conducted a survey (n = 206) and focus groups to understand shopping practices; FFC members collected receipts of groceries over two weeks before and after the pilot to measure foods purchased, stores patronized, and prices. We interviewed FFC members to elicit experiences with the pilot, and estimated cost differences between products purchased in brick and mortar stores and equivalent products online, and transportation time and cost differences. Online shopping represented a small (2.4%) percentage of grocery spending. Unit prices for products purchased on Amazon ($0.28) were significantly higher than for equivalent products purchased in brick and mortar stores ($0.23) (p < 0.001.) Compatibility with existing routines, low relative advantage, and cost of online products limited the adoption of online shopping among SNAP users.

Perceived Advantages and Disadvantages of Online Grocery Shopping among Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Participants in Eastern North Carolina

This study's purpose was to qualitatively examine perceived advantages and disadvantages of online grocery shopping among participants (n = 7) in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Initial in-depth, qualitative interviews were conducted, after which participants completed an episode of online grocery shopping, picked up the online order at the store, and completed an in-store shopping episode and a follow-up in-depth interview. Interviews were audio-recorded, transcribed verbatim, and analyzed deductively. Participants stated that in-store impulse purchases occurred at the check-out and cookie aisles and included chips and candy, but sometimes healthier foods such as fruit. Advantages of online grocery shopping included ease, convenience, and saving time. Disadvantages included inadequate substitutions, the online shopping fee, lack of control over selection of perishable goods, and inability to find good deals online versus in the store. Further research is needed to determine how to encourage healthy grocery purchases online.

Online Grocery Shopping Knowledge, Attitudes, and Behaviors Among SNAP Participants

OBJECTIVE

To inform policy proposals to allow online grocery shopping with Supplemental Nutrition Assistance Program (SNAP) benefits by examining relevant behaviors, knowledge, and attitudes of SNAP recipients.

METHODS

This qualitative study used a purposive recruitment strategy to conduct 4 1-hour focus groups in Las Cruces, NM. Participants were SNAP recipients who do the grocery shopping for their families. Focus groups were video and audio recorded, transcribed, and coded.

RESULTS

Few participants had shopped for groceries online, and participants were generally uninterested in grocery shopping online. Identified barriers were cost, quality control for perishable foods in particular, and distrust of the overall process. Participants expressed interest in suggested services aimed at increasing the benefits of shopping online.

CONCLUSIONS AND IMPLICATIONS

SNAP recipients in this study have not adopted online grocery shopping for various reasons. Additional research could inform policy by investigating which participants would benefit from using SNAP benefits online and strategies for facilitating use.

Online grocery shopping: promise and pitfalls for healthier food and beverage purchases

Objectives

(i) To determine the current state of online grocery shopping, including individuals’ motivations for shopping for groceries online and types of foods purchased; and (ii) to identify the potential promise and pitfalls that online grocery shopping may offer in relation to food and beverage purchases.

Design

PubMed, ABI/INFORM and Google Scholar were searched to identify published research.

Setting

To be included, studies must have been published between 2007 and 2017 in English, based in the USA or Europe (including the UK), and focused on: (i) motivations for online grocery shopping; (ii) the cognitive/psychosocial domain; and (iii) the community or neighbourhood food environment domain.

Subjects

Our search yielded twenty-four relevant papers.

Results

Findings indicate that online grocery shopping can be a double-edged sword. While it has the potential to increase healthy choices via reduced unhealthy impulse purchases, nutrition labelling strategies, and as a method to overcome food access limitations among individuals with limited access to a brick-and-mortar store, it also has the potential to increase unhealthy choices due to reasons such as consumers’ hesitance to purchase fresh produce online.

Conclusions

Additional research is needed to determine the most effective ways to positively engage customers to use online grocery shopping to make healthier choices.