Food, health, and nutrient supplements: beliefs among food stamp-eligible women and implications for food stamp policy

Family Economics and Nutrition Review, Spring, 2002 by Vivica Kraak, David L. Pelletier, Jamie Dollahite

Methods

Study Sites and Sampling

The purpose of this research was to clarify the perspectives about nutrient supplement use rather than to obtain population-level estimates of the distribution of particular beliefs. Qualitative methods were used by two researchers trained in qualitative research techniques (Miles & Hubberman, 1994) to elucidate attitudes and beliefs of food stamp-eligible women concerning food, health, and nutrient supplements. Member checks and peer debriefing (2) were techniques used by both researchers to enhance the reliability and credibility of the data (Kraak, Pelletier, & Dollahite, 2000).

Three study sites were selected to provide ethnic and regional variation among food stamp-eligible individuals who were nutrient supplement users or nonusers. A purposeful sample was obtained at each study site and was based on ethnicity (African American, White, Latina, and Asian), eligibility for food stamps (current recipient and/or former recipient), and use of supplements (user or nonuser). Each case was reviewed and classified according to the usual supplement-use habits. For instance, women were categorized as users if they occasionally used supplements whenever the supplements were needed or when they remembered to take them. By contrast, women were categorized as nonusers if they took a prenatal multivitamin/ mineral only during pregnancy, as advised by their physician, but did not use supplements preceding or following their pregnancy. The interviews were conducted in urban locations including New York; San Francisco, San Jose, and Oakland, California; and Fort Smith, Arkansas.

With the assistance of the Cooperative Extension staff in each site, we recruited 72 individuals--6 from each ethnic group in each location. Efforts were made to recruit participants who were food stamp-eligible adult women, at least 18 years old, who had received or were receiving food stamps, and were not pregnant or breastfeeding. The final sample consisted of 24 individuals in New York (NY), 25 in California (CA), and 23 in Arkansas (AR). Participants in NY were drawn from the Expanded Food and Nutrition Education Program (EFNEP). Those in CA and AR were drawn either from the EFNEP and Food Stamp Nutrition Education Program (FSNEP) or contacted with the assistance of organizations serving the population that met the sampling criteria.

The age range for the 72 participants was 19 to 75 years. Thirty-eight of the final sample used supplements, 34 did not; 37 were food stamp recipients, 34 were not; and 1 respondent was unclear about her use of supplements. The final sample consisted of 19 Whites, 16 African Americans, 20 Latinas, and 17 Asian Americans. Most interviews were conducted in English among bilingual interviewees; in interviews with three Asian participants, a bilingual interpreter was used.

Eligibility for EFNEP in the participating States required a family income less than or equal to 185 percent of the poverty level; whereas, eligibility for FSNEP was less than or equal to 130 percent of the poverty level. Specific questions about income were not asked, but participants were asked to identify all of the food assistance programs they knew they were eligible for and had participated in. Some EFNEP participants may have been ineligible to receive food stamp benefits. Current or former food stamp recipients made up 38 percent of the sample in NY, 52 percent in CA, and 65 percent in AR.