Brick-and-mortar food retail implementation of a nutrition incentive program using Electronic Benefit Transfer integration in Southern California

Background Nutrition incentive programs (NIPs) that integrate fruit and vegetable (FV) incentives into Supplemental Nutrition Assistance Program (SNAP) Electronic Benefit Transfer (EBT) systems have strong potential for scaling in the United States, yet little is known about implementation from brick-and-mortar food retailers’ perspectives. Purpose To examine brick-and-mortar food retailers’ perceptions and experiences with an NIP using SNAP EBT integration for FV incentives at the point of sale. Methods Guided by the Inner Context of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, an implementation science evaluation was conducted among 79 independent chain grocers implementing the NIP in Southern California. Leadership and staff were invited to complete an online survey (89% response rate) using validated tools (e.g. Implementation Leadership Scale), expert-developed items, and open-ended questions. The analysis included descriptive statistics and inferential tests that assessed response differences between leadership and staff. Results Of 538 respondents, most were female (76%) and Latino/a (94%). Perceptions and experiences with the NIP were favorable across EPIS Inner Context constructs, with some differences noted. Leadership support for implementation was rated highly overall, though staff scored items on supportive and knowledgeable leadership lower compared to leadership. While highly satisfied with NIP implementation overall, open-ended responses highlighted opportunities to optimize implementation across stores. Conclusions Nutrition incentive programs integrating FV incentives into SNAP EBT systems appear well-suited to the brick-and-mortar food retail context. Findings can inform the design and testing of implementation strategies to support sustainment and scaling for population-level impact locally and nationally.