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

Abstract

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.

Online Pilot Grocery Intervention among Rural and Urban Residents Aimed to Improve Purchasing Habits

“…Our results are positioned within a limited but growing research field of online grocery shopping interventions [ 5 , 6 , 9 , 10 , 12 , 28 , 34 ]. To date, a few interventions have revealed how online shopping has helped to increase the purchase of high fiber foods [ 9 ] and decrease the purchase of less healthy food items that are high in saturated fats [ 12 ].…”

“…However, as mentioned previously, most of these studies tend to be simulation models, conducted pre-COVID-19 and the SNAP online pilot, and have less generalizability to actual customers’ shopping behaviors. Thus, our study built upon the previous research [ 5 , 10 , 15 , 28 , 34 ] to establish the content of the intervention to help improve future policy and public health practice applications aimed at assisting customers with online shopping. Although the data for all of the food purchases made during this study were not collected, these findings are encouraging when examining innovative strategies to improve food access, nutritional intake, and ultimately the health status of rural and SNAP populations, who generally have disproportional high rates of diet-related chronic diseases, in part due to nutritional inadequacy.…”

“…The growth predictions of online grocery shopping [ 2 , 36 ], in addition to the already existing online shopping options, has shed light on how the food environment as a whole is growing and evolving. Customers have even more ways to acquire food and, thus, research needs to keep pace with how customers are interacting with their food environment, and to make access to this type of shopping more equitable across geographic and socioeconomic differences [ 4 , 7 , 34 ]. There needs to be a concerted effort to understand and intervene within this food venue space in order to help consumers make healthful choices.…”

“…This pilot study provides suggestive findings related to how online shopping may improve food shopping habits, however, results need to be confirmed with a larger, more rigorous study. This study helps to inform future research and policy to improve accessibility to food outlets that accept SNAP, and to better understand online grocery shopping practices among rural and urban residents [ 28 , 34 ]. As the growth and utilization of online grocery shopping persists, a unique opportunity is presented for several industries to partner in an effort to improve dietary outcomes among customers.…”

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

“…These actions could help reduce SNAP participants’ risks of obesity and diet‐related NCDs. However, the digital divide and the predatory marketing practices of some online grocery retailers are key barriers that could instead exacerbate the consumption of unhealthy food and beverage products 17,18 …”