(OR23-07-23) The Influence of Food Assistance Program Participation on the Quality of the Home Food Environment Is Modified by Household Food Security Levels

Objectives: Given that food assistance (FA) programs aim towards improving food and nutrition security, their association to the quality of the home food environment (HFE) is critically important to understand. This study examines the impact of FA program participation on HFE quality and explores how food security moderates this association.

Methods: Data from the Denver Food Access Survey, distributed in City and County of Denver, Colorado during March, 2021, was examined. Food security was calculated using the USDA ERS U.S. Household Food Security Scale (0-18). Participation in FA programs was measured by aggregating total enrollment in 16 programs. HFE quality was assessed by the Home-IDEA3 (HI3) food inventory (131 items), which computes quality by way of a HFE adequacy score (e.g., fruits and vegetables; 0-45) and a HFE moderation score (e.g., convenience foods and sugar-sweetened beverages; 0-25). A higher score in either is associated with a higher quality HFE. Multiple linear regressions tested associations between FA program participation, HFE quality, and covariates - food security, education, income, and ethnicity. Analyses were performed using R (v 4.1.3, 2022); α < 0.05.

Results: The survey was completed by 702 respondents who identified as White (73%) or Black (16%), with 25% as Hispanic; 56% were low-income ( < 185%). The mean food security score was 7.5 ± 5.1 (out of 18), and 41% were enrolled in 3+ FA programs. Mean HFE adequacy and moderation scores were 20.4 ± 6.8 (out of 45) and 12.6 ± 2.4 (out of 25), respectively. FA program participation was positively associated with HFE adequacy scores (β= 2.28, p< 0.001), and negatively associated with HFE moderation scores (β= -0.20, p=0.049). A statistically significant moderation effect for food security on the association between level of FA program participation and HFE adequacy scores (β= -0.20, p< 0.001) was found.

Conclusions: Participation in FA programs is associated with meaningfully higher HFE adequacy scores, whereas its association with HFE moderation scores is statistically significant, but not large enough to be meaningful. These findings have implications on the evaluation of FA programs and efforts to ensure nutrition security in addition to food security.

Funding Sources: Foundation for Food and Agriculture Research (FFAR); NICHD 2T32HD087137-06