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Background The Supplemental Nutrition Assistance Program (SNAP), formerly known as food stamps, serves as the primary method of governmental-funded defense against food insecurity in the USA through the provision of food-purchasing assistance to eligible low-income people and families. However, participation in SNAP has been associated with dietary disparities and increased risk of chronic disease associated with overweight and obesity. Low-income individuals are more vulnerable to diet-related chronic disease, as they often have limited resources, are unable to afford healthier foods, such as fruits and vegetables, experience a lack of geographic access to healthy foods, and find themselves without time to prepare healthy meals. As a result, financially marginalized populations are less likely to adhere to Federal Dietary Guidelines for Americans. Objective The purpose of this study was twofold: first, to gain insight into factors influencing food choices and grocery shopping behaviors of women with children, on a limited budget, who utilize or are eligible for SNAP; second, to develop and implement interventions based on these insights to enable participants to better adhere to the Federal Dietary Guidelines for Americans. Methods We conducted independent formative interviews with 19 women in Spring 2018 to develop a social marketing campaign to promote a behavior change associated with healthy grocery shopping practices. These participants were interviewed using a loosely guided interview that gauged barriers, benefits, motivators, competition, and influencers of using a food budget. Of these participants, we identified those who were actively practicing the selected behavior of budgeting for and purchasing healthy foods, like fruits and vegetables. To empower women within this community by drawing from the experiences and knowledge of other women from this same community, participants were selected to participate in a more thorough interview process, followed by a journey mapping exercise. Data collected from the interviews and journey mapping exercise were analyzed for barriers and facilitators to developing and maintaining the adoption and use of a healthy food budget. In response, the research team conducted a search for interventions that aligned with the outlined barriers noted from the interviews and developed a social marketing campaign. This social marketing campaign was then delivered in a series of sessions where pre- and post-surveys were administered to assess grocery shopping behaviors and budgeting practices. Results Specific topics yielded from the journey mapping exercise included tips and tricks mothers used to successfully budget for and purchase healthy foods. Additionally, mothers who participated in the social marketing intervention reported grocery shopping at least one to two times a week. When asked about their habits related to purchasing fruits and vegetables through pre- and post-surveys, 60% of the participants reported intentionally purchasing fruits and vegetables every time they went grocery shopping. Seventy nine percent (79%) of women reported creating a budget allocated for groceries before shopping, while 42% reported sticking to this budget. Implications The study identified three domains of determinants that influence budgeting and shopping for healthy groceries that can inform future formative research and development of interventions among women with children who utilize or are eligible for SNAP.

Objective: The purpose of this study is to identify health resources associated with propensity to vote at the local-level among low-wage workers in two United States. cities. Literature confirms individuals of lower income have a lower propensity of turning out to vote, yet few studies have focused on low-income populations to identify the variation in factors associated with voting within this group. Furthermore, few studies have investigated health and voter turnout at the local-level. In this study, we examine factors related to political participation at the local-level within a low-wage sample, examine mental, physical, behavioral, and social health and their association with voter turnout, and assess if these relationships differ by city.Methods: We use cross-sectional survey data from a sample of 974 low-wage workers in Minneapolis, MN and Raleigh, NC. We computed descriptive statistics and employed a logistic regression to predict their likelihood of local voter turnout, with the key independent variables being health resources, such as self-rated health, body mass index (BMI), mental disability, smoking status, and health insurance status. We employed a logistic regression fully interacted with a city indicator variable to assess if these associations differed by city.Results: In both cities, less than 50 percent of respondents reported voting in the last election for mayor or city council. About three-quarters of the sample reported food or housing insecurity and the majority of respondents reported utilizing some government assistance, such as supplemental nutrition programs. BMI greater than 30 was significantly associated with lower likelihood of voter turnout compared to those of lower BMI status (marginal effect = −0.10, p = 0.026). Never smoking or quitting was significantly associated with higher likelihood of voter turnout compared to those who reported being a current smoker (marginal effect = 0.10, p = 0.002). Those with health insurance were significantly more likely to report voting compared to those without any insurance (marginal effect = 0.10, p = 0.022). These results did not significantly differ by city.Conclusions: Our research suggests low-wage workers face significant health burdens which may impact their propensity to vote at the local-level, and these associations do not significantly vary by city despite demographic and political differences between two jurisdictions.