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. 2020 Sep 2;17(17):6390. doi: 10.3390/ijerph17176390

Table 3.

Themes, sub-themes, operational definitions, illustrative quotes, and code frequency, N = 153.

Theme Sub-Theme Operational Definition Illustrative Quote Code Frequency
(1) Adequacy of Monthly SNAP Benefits Participant describes the adequacy of the funding amount for monthly SNAP benefit allotments. Certain people they just don’t give enough benefits to, you know? Mine actually could be a little more, but I’m grateful for what I get. But, to me, it could be a little basic for one, or two persons it could be more than what they do. But like I said, I’m grateful for what I got because I could be getting nothing. And then I really would be struggling.” (Female, Arkansas, PID-AR03) 136
(1a) Stretching food dollars Participant describes various strategies employed during the month to help cover their monthly food costs, including using coupons, bulk shopping, and budgeting. What amount I get, I just make it last, you know. I just try to make sure that it’s not like, ‘Oh, we got food money. Let’s just go blow it,’ you know.” (Female, West Virginia, PID-WV07) 46
(1b) Confusion regarding monthly SNAP benefit allotments Participant discusses confusion around how the monthly SNAP benefit allotment is calculated. I could see that maybe they need to revamp the program for the elderly, that they would get a little bit more in food stamps ‘cause I know elderly people that only get, you know, 15, 16 dollars a month but they really don’t have the money to buy food ‘cause they’re having to buy other things, medications and things.” (Female, West Virginia, PID-WV07).” 52
(1c) Fluctuations in SNAP benefits Participant describes fluctuations in monthly SNAP benefits due to certain situations, including wage and/or income changes or changes to members in the household. “It’s only me because me and my wife separated. And I can pretty much deal with myself, you know, a little. But things can get tight because I was receiving food stamps at one time and then they cut it all the way back to $15 a month. But I still—I get that, but that $15 don’t go far.” (Male, North Carolina, PID-NC05) 38
(2) Benefits of the SNAP Program Participant describes the benefits of participating in the SNAP program. It’s a great program. It helps a lot and I’m so thrilled to be able to be part of one of them while I’m struggling.” (Female, West Virginia, PID-WV13) 105
(2a) Provision of food to household communities Participant discusses the need for SNAP among families in their rural communities. There’s a lot of babies, a lot of families out there…and I rather for someone else to have it that really needs it, than me having it, because I don’t need it as much anymore.” (Male, North Carolina, PID-NC05) 23
(2b) Program features that rural families’ value Participant discusses features of the SNAP program that rural families’ value, such as consistency in when benefits are distributed. Like I said, the government’s already helping you out with the benefits. I mean, what more can you really ask? It helps towards low-income housing families. Their adamant. They’re direct. And like I said, you can receive your benefits on time. If they say they’re going to be here that day, that’s what they mean.” (Female, North Carolina, PID-NC04) 63
(2c) SNAP and diet quality Participant describe how changes in SNAP benefits impact their family’s diet quality. He likes to have milk every day and then once the food stamps are gone it’s hard. I mean milk is something that if he’s wanting it every day, it’s not something that just lasts.” (Female, West Virginia, PID-WV02) 19
(3) Barriers to Effective Program Use Participant describes barriers to accessing the SNAP program. When my husband got sick, we had a heck of a time trying to get ‘em [SNAP] because they were still looking at his income from months prior. And he hadn’t worked. Of course, he had money in savings, where we had been saving, but that was for the bills comin’ in. But they really didn’t care about that. All they seen was dollar signs and we could afford food, but we had to make sure the kids had roof over their head and water, electric, and heat.” (Female, West Virginia, PID-WV23) 47
(3a) SNAP customer service Participant describes poor customer service when dealing with employees that process and re-certify SNAP applications. They will find any little reason to kind of disqualify you.” (Female, Arkansas, PID-AR26) 14
(3b) SNAP application process Participant describes frustrations with the SNAP application process including the length of time it takes to complete the application, complex questions, submitting the application, and/or lengthy application approval times. If you do all the paperwork and everything when they tell you, like the dateline that they give you, it’s easy. But, if you miss that date where—it’s like really hard. You have to be like calling them and calling.” (Female, Texas, PID-TX19) 33