University of South Carolina School of Medicine & Arnold School of Public Health


FoodShare is a PSE change intervention designed to improve food security and health outcomes through fresh food access and affordability. Every 2 weeks residents can order a Fresh Food Box using cash or SNAP/EBT. The program is a SNAP Healthy Bucks site (a state SNAP healthy incentives program), which allows SNAP recipients to receive a $10 healthy incentive to go towards the cost of their box. Each Fresh Food Box contains 12-14 varieties of culturally appropriate fruits and vegetables, always with a mix of more common items (e.g., apples) and less common items (e.g., radishes). A recipe card that is culturally relevant to participants and based on the produce in the box in a given week is also included. The program is situated within an academic medical center and community-based hospital system. A screening and referral process was created that links patients to FoodShare.

Target Behavior: Healthy Eating, Food Insecurity/Food Assistance

Intervention Type: PSE Change

Intervention Reach and Adoption

A total of 33 churches, clinics, and community-based organizations are serving as Fresh Food Box ordering and pick-up sites, and 28,000 food boxes (585,000 pounds of fresh produce) have been packed and distributed to community participants. Of these food boxes, 56% were purchased using SNAP. The following is a list of the community settings that currently serve as partner sites and the percentage of total FoodShare participants served: 4 clinics (13.3%), 15 churches (50%), 1 day care center (3.3%), 2 apartment complexes (6.7%) 2 Senior Centers (6.7%), 2 Parks & Recreation Centers (6.7%), 2 libraries (6.7%), and 2 schools (6.7%). The FoodShare program serves a number of Hispanic/Latina and African American families with preferences for foods based on personal experience and cultural significance. There are 6 cities within South Carolina in various stages of replicating the FoodShare model, with three of those cities having successfully launched FoodShare hubs. Of the 3,225 screened for food insecurity in 6 medical clinics, 1,687 screened positive for food insecurity (52%).

Setting: Child care (Learn), Community (Live), Faith-based community, Health care, School (Learn)

Target Audience: Pregnant/Breastfeeding Women, Parents/Mothers/Fathers, Adults, Older Adults

Race/Ethnicity: All

Intervention Components

The FoodShare program includes a Fresh Food Box component with a SNAP incentive and partner site capacity building materials. These intervention components provide participants with access to fresh, affordable produce and assist organizations in capacity building to improve health through fresh food access. The core component includes the Fresh Food Box and complementary components include food insecurity screening and referral.

Intervention Materials

Intervention materials include a hub readiness toolkit, partner site readiness toolkit, application to become a partner site, pre-order SNAP form, clinic food insecurity screener, food box order form, healthy bucks log, sample recipe card, SNAP manual voucher, tips for English/Spanish food box, calendar, and a web-based order tracking system.

Intervention Costs

Materials are available at no cost.

Evidence Summary

An obstacle to lifestyle changes is the cost associated with making healthy choices. A successful program aimed at low wealth, ethnically diverse individuals with chronic diseases must address both the cost of, and accessibility to, healthy foods. The FoodShare program addresses these barriers by creating a network of partner sites and neighborhood coordinators who accept orders for Fresh Food Boxes, pick up boxes, as well as takes the box back to the community in which the participant lives. Additionally, a screening and referral process within clinics has allowed the program to reach more participants.

Evidence-based Approach: Emerging

Evaluation Indicators

Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.

Readiness and Capacity – Short Term (ST) Changes – Medium Term (MT) Effectiveness and Maintenance – Long Term (LT) Population Results (R)
Environmental Settings ST5 MT5
Sectors of Influence
  • ST5b and ST5c: 33 partner sites and 6 new FoodShare hubs demonstrated need and readiness
  • MT5d: 33 partner sites and 3 new FoodShare hubs have adopted the model

Evaluation Materials

The following evaluation materials are available upon request: 1) a semi-structured interview guide to assess readiness and need to adopt the FoodShare model among potential new sites/organizations, 2) a semi-structured interview guide to confirm adoption of the FoodShare model among new partner sites and new FoodShare hubs, and 3) data tracking forms to track number of unique customers to determine reach.

Additional Information

Website: The FoodShare website includes information on how the program works, the FoodShare team and partners, the various programs, resources and recipes, and ways to get involved.

Contact Person:
Beverly Wilson, MPH