EFFECTS OF A PRODUCE PRESCRIPTION PROGRAM ON NUTRITIONAL OUTCOMES AND FOOD PURCHASES IN NORTH CAROLINA

The goal of this project is to assess if participation in a $40/month produce prescription program for the federal Supplemental Nutrition Assistance Program (SNAP) participants with diet sensitive health conditions (SuperSNAP) is associated with changes in food purchase composition and nutritional outcomes compared to matched SNAP beneficiaries. We also assessed if the onset of the COVID-19 pandemic contributed to any other shifts. This study used retail transaction data (October 2019-April 2022) linked with nutrition label data to assess changes in purchase composition across key food categories and nutrient profile changes. We applied a linear mixed effects model with overlap weights to perform a difference-in-difference analysis of purchases by SuperSNAP program enrollees (treatment) compared to SNAP participants who were not in SuperSNAP (control).The analytical sample included 1,447 SuperSNAP shoppers and 41,003 control shoppers. SuperSNAP participation was associated with a 6.7% (95% CI (5.9, 7.6), p <0.000) increase in share of calories from fruits, vegetables, nuts, and legumes without additives. Compared to control shoppers, share of total calories purchased by SuperSNAP shoppers decreased by 1.7% (95% CI (-2.2, -1.1), p <0.000) from sugar sweetened beverages and 2.1% (95% CI (-2.8, -1.5), p