Stakeholder perceptions of healthy food access and SNAP online grocery ordering during and after COVID-19

Abstract

The COVID-19 pandemic prompted local and national changes to food programs, including expansion of the Online Purchasing Pilot to increase access to online grocery ordering with Supplemental Nutrition Assistance Program (SNAP) benefits. Yet, health equity remains chal­lenged by limited food access and barriers to online ordering. As part of a needs assessment to inform the development of future individual and policy, systems, and environmental (PSE) change interven­tions, we aimed to (1) explore community stake­holders’ perceptions of food access and online grocery ordering with SNAP benefits during and after the end of the COVID-19 public health emer­gency and (2) synthesize equity-oriented recom­mendations to improve healthy food access. We conducted qualitative interviews with stakeholders from 15 organizations in a low-income, low food access Connecticut community during (n = 12) and after (n = 9) the public health emergency. Interview transcripts were thematically analyzed according to a health equity framework. Excerpts were com­pared across time points and developed into themes relating to food access and online ordering. Themes informed proposed solutions to improve equity in food and online ordering access. Though stakeholders described a community with many food resources, inadequate bus routes and cultural barriers limit food access. Stakeholders reported increasing food insecurity during and following the public health emergency. Inflation and the end to SNAP emergency allotments further increased need. Fees, internet and technology access, and digital literacy were perceived as barriers to online ordering adoption. Equity-oriented recommen­dations to improve healthy food access included (1) increasing availability of healthy options from various cultural dietary patterns, (2) recruiting Spanish- and K’iche’-speaking staff at food retailers and within the charitable food system, (3) strengthening local bus routes, and (4) forming community collaborations to provide digital, food, and nutrition literacy resources. Thus, while expansion of the Online Purchasing Pilot may address trans­portation barriers to food access, additional solu­tions are needed to improve overall food access. Community programs that support SNAP online ordering may be combined with policy, systems, and environmental changes to improve health equity.