Elizabeth Adams always planned to be a pediatrician. She loved working with kids and envisioned a medical career supporting families and children.
Then, as an undergraduate student, Adams started learning more about behavioral medicine and prevention. It changed her perspective. And while she kept the same goal — supporting children and families — she decided to approach it from a research angle.
“I got really intrigued by ‘food is medicine, exercise is medicine,’ these big initiatives to promote lifestyle changes and healthy behaviors to prevent future disease risk or future diseases,” she says. “The prevention and behavior angle really intrigued me as opposed to the treatment and prescription angle.”
Now an assistant professor of exercise science in the Arnold School of Public Health, Adams’ research looks at healthy diet patterns to prevent pediatric obesity along with public policies that improve access to healthy food. Those research efforts include a 2024 National Institutes of Health grant to test strategies aimed at increasing the awareness and uptake of Supplemental Nutrition Assistance Program incentives.
“I'm just really passionate about helping kids, and particularly families and kids that have low income, that aren't afforded the resources that many others have,” she says. “Healthy food costs a lot of money. I don't want that to be a barrier to kids being able to have the nutrition they need to grow up healthy, do well in school and thrive.”
Her current research grew out conversations with a pediatrician about food access and food security issues seen among families at the clinic. Adams says the pediatrician’s office was handing out paper flyers to patients experiencing food insecurity, showing them where food and other services were available.
“Healthy food costs a lot of money. I don't want that to be a barrier to kids being able to have the nutrition they need to grow up healthy, do well in school and thrive.”
“But there were so many additional steps for these families to actually know how to use these resources, to figure out how to get the food, where to go, how to order it,” Adams says. “There were just so many barriers.”
Adams partnered with the pediatrician on a pilot study to see if there was a way to better connect food insecure families with available resources.
The pilot study led to a $3.2 million NIH grant, with a goal of increasing SNAP recipients’ use of a fruit and vegetable incentive program to improve diet quality and reduce food insecurity.
Two years into the five-year study, Adams has enrolled about 75 families of the 300 eventually expected to be included. Clinicians at five partnering pediatric offices in Richland County are trained to talk to families about the study, and participants are offered home delivery of fruits and vegetables.
Once they are approved for the study, the families agree to related assessments that measure the parent and child’s dietary intake. Participants start with three free fruit and vegetable boxes from FoodShare, a South Carolina nonprofit that promotes access to nutritious food. These boxes include an assortment of in-season produce with recipe cards. A $40 value, FoodShare provides the boxes for $20; SNAP recipients pay $5, and the remaining $15 is subsidized by the state.
The study pays for home delivery of the boxes, and Adams’ team tracks to see if more people use the healthy box program when home delivery is available.
“If you have the SNAP incentive program that makes the fruits and veggies cheaper, but families can't physically get there to pick them up, or they have no idea that the program even exists, or they have no idea what even comes in these boxes, then the program is not going to be used to its potential,” she says. “There are studies showing these programs have great outcomes when used, but they're not being utilized enough. So we're trying to get them utilized more.”
Adams hopes the program will improve diet quality and increase fruit and vegetable intake. She also hopes, policy-wise, providers take a more comprehensive approach to helping families access these resources.
“These fruit and vegetable incentive programs do have pretty good evidence behind them that when used, they're helpful, they improve diet quality,” she says. “They have the potential to save a lot for health care by lowering disease risk. I feel confident that these programs are valuable. I just think they're underutilized.”
