A snapshot of nutrition incentive adaptation during COVID-19: Consensus-building with practitioners

Exacerbated food insecurity has been among the many challenges presented by the emergence of the novel coronavirus 2019 in the United States. In the wake of the pandemic, expanded focus has turned to the capacities of established federal nutrition assistance programs and emergent nutrition access models to address these challenges. Supplemental Nutrition Assistance Program-based incentive pro­grams, or nutrition incentive programs, are an emergent model designed to provide financial incentives (additional funds) to limited-resource, Supplemental Nutrition Assistance Program (SNAP)-enrolled shoppers to improve the afforda­bility of fresh fruits and vegetables at farm-direct and other retail outlets. While policymakers, researchers, and other stakeholders have advanced efforts to evaluate the overall impact and efficacy of nutrition incentive programs, much remains to be understood about how these programs operate under pandemic conditions and how effective they have been at mitigating the associated increase in food hardship for limited-resource families. To examine the salient factors influencing nutrition incentive program operations during the pandemic, we applied a three-round, online Delphi process with an expert panel (N=15) of nutrition incentive practitioners between May and October 2021, analyzing the data using thematic analysis and descriptive statistics. The panelists reached consen­sus on several barriers, opportunities, and innova­tive adaptations in incentive programming opera­tions, both in the early stages of the pandemic outbreak and that may persist long-term. The find­ings—which include barriers such as “staff burnout and/or turnover,” opportunities such as “increased collaboration and networking between stakehold­ers,” and innovative adaptions such as “targeted expansion of SNAP/EBT eligibility”—have impli­cations for the operational and adaptive capacities of SNAP-based incentive program practitioners over the next several years. We provide recommen­dations for both researchers and nutrition incentive practitioners with an emphasis on further explor­ing and operationalizing the long-term barrier, oppor­tunity, and innovative adaptation findings to aid the continued development of nutrition incen­tive pro­gram resilience in preparation for future pandemic events or comparable food system shocks.