Scaling up the Snap-ED toolkit interventions to improve fruit and vegetable consumption across counties in Georgia: An agent-based model

The Supplemental Nutrition Assistance Program (SNAP)-Ed Toolkit includes a set of interventions to increase the fruit and vegetable (FV) consumption of SNAP-eligible households on a limited budget. It is unclear how the interventions affect dietary choices in local populations. This study combines detailed local data with an agent-based model (ABM) to assess the potential cost-effectiveness of scaling up the SNAP-Ed Toolkit interventions in 13 selected metro-Atlanta counties in Georgia. The ABM drew insights from prior research on healthy eating choices and was empirically validated. The model predicted the actual FV consumption levels ( $\mathrm{R}^{2}=0.951,\ \mathrm{P} ). If the interventions could successfully enhance community healthy eating norms by 10% and 20%, they would significantly increase FV consumption. The cost per year to bring one person to consume at least two servings of FV daily) was $23 (95% confidence interval [CI]: $18 - $29), and $10 (95% CI: $9 - $12) in each scenario.