(P11-006-25) Assessing the Supplemental Nutrition Assistance Program (SNAP): A Systematic Review Protocol

Objectives: The 2022 National Strategy on Hunger, Nutrition, and Health proposed expanding eligibility for the Supplemental Nutrition Assistance Program (SNAP) to additional underserved populations. To inform policy decisions about SNAP expansion, we will conduct a systematic review to assess relationships between SNAP participation and household food insecurity, diet intake and quality, and health outcomes. We present the protocol for that review.

Methods: The protocol was developed in collaboration with experts in nutrition, public health, and economics. We registered the protocol a priori in PROSPERO and information specialists developed the search strategy, including Agricola, Business Source, CAB Abstracts, CINAHL, EconLit, ERIC, and MEDLINE, to include articles published in English after 1980. Eligible studies include those conducted among the US population under 200% of the poverty line who participate in SNAP and have a comparison group. Eligible outcomes are household food insecurity or insufficiency, food intake and diet quality, anthropometrics, cardiovascular disease, and type 2 diabetes. Two independent reviewers will dual screen articles at title and abstract and then at full-text level. For each outcome, data will be organized by study design and then by SNAP intervention type and comparator. Random-effects meta-analyses will be performed on continuous outcomes using standardized mean differences and on categorical outcomes using the risk difference model, along with narrative synthesis. Risk of bias will be assessed using study design-specific tools. Sub-group analyses will include population characteristics (age, baseline health conditions, race or ethnicity, and socioeconomic factors) and different comparison groups. Sensitivity analyses will be conducted by omitting studies at high or very high risk of bias and studies that do not address selection bias. Certainty of evidence will be assessed using GRADE.

Results: N/A

Conclusions: This systematic review will provide evidence that can be used to support policy decisions about expanding SNAP’s eligibility, which could have an impact on food security, dietary quality, and health outcomes for underserved populations in the US.

Funding Sources: Texas A&M Agriculture, Food and Nutrition Evidence Center