Read the attached summary of an experiment that was used as part of an evaluation of the US Department of Agriculture's Healthy Incentives Pilot program (HIP). Based on the reading, discuss the following:

QSDA _- United Slates Department of Agriculture Food and Nutrition Serv'i ce, Ofce of Policy Support September 2 01 at EVALUATION OF THE HEALTHY INCENTIVES PILOT (HIP) FINAL REPORT SUMMARY The Food, Conservation, and Energy Act of 2008 authorized and mded pilot projects to determine if nancial incentives provided at the point of sale to Supplemental Nutrition Assistance Program (SNAP) participants would increase their consumption of fruits, vegetables, and other healthil foods. The US. Department of Agricultureis Food and Nutrition Service used this authority and funding to implement the Healthy Incentives Pilot (HIP). Under HIP, SNAP participants received an incentive of 30 cents for every SNAP dollar spent on targeted fruits and vegetables (TFVs) at participating retailers. TFVs included fresh, canned, frozen, and dried fruits and vegetables without added sugars, fats, oils, or salt, but excluded white potatoes and 100% fruit juice. The incentive was immediately credited back to the participants\" electronic benet transfer (EBT) card to be spent on any SNAP-eligible foods and beverages. Implemented by the Massachusetts Department of Transitional Assistance in Hampden County, HIP operated between November 2011 and December 2012. The county includes urban, rural, and suburban populations with a total of approximately 55,000 SNAP households. Hampden County has the lowest median household income in the State. This nal report addresses HIP's ve research objectives: 1) Assess the causal impact of HIP on fruit and vegetable consumption, and other key measures of dietary intake, by SNAP participants; 2) Identify and assess factors that inuence how HIP impacts participants; 3) Describe the processes involved in implementing and operating HIP; 4) Assess the impact of HIP on stakeholders; and 5) Quantify, to the extent possible, the Federal, State, and local administrative and benet costs of the pilot. Methods HIP was evaluated using a rigorous research design with random assignment to treatment and control groups. Of the SNAP households in Hampden County, 7,500 were randomly assigned to the HIP group and the remaining households to the non-HIP group (control group). This experimental study design provides the strongest evidence of causal impact. Comprehensive data collection supported analyses of HIP impacts on participants, retailers, and other stakeholders. Data collected included: 0 24-hour dietary recall interviews of a random subsarnple of HIP and non-HIP participants 0 Focus groups with HIP participants 0 EBT transaction data that provided detailed information on households\" SNAP EBT purchases 0 Retailer surveys and interviews with key stakeholders that provided information to document the process of implementing and operating HIP, examine its effect on stakeholders, and estimate the costs of the pilot and of nationwide expansion of HIP HIP participants (respondents aged 16 and older) consumed almost a quarter of a cup (26 percent) more targeted fruits and vegetables per day than did nonparticipants. 0 HIP participants reported higher consumption of dark green vegetables, redforange vegetables, and other vegetables (e.g., celery, cucumbers, mushrooms, green Page 2 beans, etc.), and fruits other than citrus, melons and berries (e.g., apples, pears, bananas, grapes, etc.) than non-HIP participants. 0 PHP participants increased their consumption of vegetables more than their consumption of fruit. 0 Increased fruit and vegetable consumption drove an increased score on the 2010 Healthy Eating Index (62 versus 57 out of 100). HIP households spent more SNAP benets on targeted fruits and vegetables than non-HIP households in participating supermarkets and superstores $12.05 versus $10.86 on average each month an increase of $1.19 or 11 percent. 0 PHP households earned average incentives of $3.65 each month. 0 Average monthly purchases of targeted fruits and vegetables were relatively stable across the pilot period. HIP households reported higher total spending on fruits and vegetables than non- HIP households. 0 HIP survey respondents reported spending $78.17 each month on all fruits and vegetables, $6.15 more than non-HIP households. This includes spending with EBT and other forms of payment in both participating and nonparticipating retailers. o Two-thirds of HIP households said they bought larger amounts and a greater variety of fruits and vegetables because of HIP. o Three-quarters of HIP households felt that fruits and vegetables had become more affordable due to HIP. HIP participants were more likely to have fruits and vegetables available at home during the pilot. HIP impacts on consumption were greater for those with greater baseline preferences and/or higher baseline spending on targeted fruits and vegetables. Awareness and understanding of HIP increased over time. Nine to eleven months into the pilot, approximately 24 percent of the households in the study reported that they had not heard about HIP, as compared to 38 percent unaware of HIP 5 months earlier. Late in the pilot, approximately 25 percent of respondents also reported that HP was difcult to understand. Most retailers did not nd HIP difcult to operate. 0 Over 90 percent of participating retailers reported no change in check-out time, and only 1 5 percent indicated that HIP purchases were hard to process. I More than half of participating grocery stores received more shipments from a supplier, increased the frequency of restocking the display oor, or increased shelf space for fruits and vegetables. 0 Participating retailers without integrated electronic cash registers were more likely to report negative effects on store operations. Total costs for implementing HIP, including the $263,043 in incentives earned by HIP participants, were $4.4 million. The largest share of costs (55 percent) were incurred for system design, development, and testing for EBT and retailer systems changes. The estimated total cost for implementing HIP nationwide is approximately $90 million over 5 years, including costs for modifying EBT and retailer systems and State agency costs. Estimates for annual incentive costs range from $825 million to $4.5 billion, depending on assumptions about retailer participation and fruit and vegetable spending. For More Information Bartlett, Susan, Jacob Klerman, Parke Wilde, Lauren Olsho, Christopher Logan, Michelle Blocklin, Marianne Beauregard, and Ayesha Enver. Evaluation offhe Healthy Incentives Pilot (HIP) F inal Report. Prepared by Abt Associates for the U.S. Department of Agriculture, Food and Nutrition Service, September 2014. Available online at http ://www.fns.usda. gov/ops/research-and- analysis. USDA is an equal opportunity provider and employer