Using Formative Research to Develop a Social Marketing Campaign to Understand Food Shopping Behaviors in Young Mothers

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.