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Policymakers have suggested and implemented work requirements for safety-net programs such as the Supplemental Nutrition Assistance Program (SNAP). If these work requirements impact program participation, they may lead to greater food insecurity. This paper investigates the effects of implementing the work requirement for the SNAP on emergency food assistance usage. Data were used from a cohort of food pantries in Alabama, Florida, and Mississippi, which imposed the SNAP work requirement in 2016. Event study models were run in 2022, leveraging geographic variation in exposure to the work requirement to measure changes in the number of households served by the food pantries. The 2016 introduction of the SNAP work requirement increased the number of households served by food pantries. The impact is concentrated among urban food pantries. On average, an urban agency exposed to the work requirement served 34% more households in the 8 months after the work requirement than an agency with no exposure. Individuals who lose SNAP eligibility owing to the work requirement remain in need of assistance and seek other sources of food. SNAP work requirements thus increase the burden on emergency food assistance programs. Work requirements for other programs may also lead to increased emergency food assistance use. [ABSTRACT FROM AUTHOR]

Introduction: Church-based interventions have been shown to improve the dietary health of underserved populations, yet few studies have examined sustainability of health behavior change over time. This paper examines dietary outcomes over a 24-month period (baseline and 6, 18, and 24 months) for fruit and vegetable and fat consumption behaviors of African-American participants in the Health for Hearts United church-based intervention in North Florida.Study Design: This quasi-experimental, longitudinal trial was conducted from 2009 to 2012. Data were analyzed in 2018.Setting/participants: Six churches in a 2-county area (3 treatment, 3 comparison) were selected for the study using community-based participatory research approaches. Participants were African-American adults (aged ≥45 years; n=211 at baseline) randomly selected from the churches, stratified by age and sex.Intervention: Health for Hearts United intervention was developed by the 3 treatment churches. The 18-month intervention was implemented in 3 6-month phases, framed around 3 conceptual components, which included 4 types of programs and 4 key messages.Main Outcome Measures: Fruit and vegetable consumption was assessed using a single item (fruit and vegetable intake) and the National Cancer Institute Fruit and Vegetable Screener. Fat consumption was determined using a single item (fat intake) and the National Cancer Institute Fat Screener. Background characteristics included age, sex, educational level, and marital status.Results: Significant time effects only were found for daily fruit and vegetable intake (p<0.001), fat intake (p<0.001), and the Fat Screener (p<0.001) with dietary improvements in both treatment and comparison groups across the intervention phases. Fruit and Vegetable Screener results showed that time (p<0.001) and the interaction between time and treatment (p<0.01) were significant, with increases in fruit and vegetable consumption over time for both the treatment and comparison groups and with the increase differing between groups. Post hoc analysis revealed that the treatment group had greater increases in fruit and vegetable consumption than the comparison group between Phases 1 and 3 (p=0.03).Conclusions: Dietary behaviors of mid-life and older African Americans can be improved and sustained over 24 months using a church-based heart health intervention, with similar improvements noted for both comparison and treatment participants.Trial Registration: This study is registered at www.clinicaltrials.govNCT03339050. [ABSTRACT FROM AUTHOR]