Penn Med receives 5-year NIH grant to study SNAP benefits

Penn researchers recently received a five-year grant from the National Institutes of Health to broaden their investigation into whether the timing of monthly food assistance benefits influences how reliably patients take medications for chronic diseases.

The study focuses on the Supplemental Nutrition Assistance Program, the largest federal food-assistance service in the United States. It will expand on an earlier finding that showed a 12 percentage point difference in HIV medication adherence over the monthly SNAP cycle.

The original study only examined 54 people living with HIV. The expanded study will extend to 400 patients across Penn Medicine to see whether the pattern holds among older patients taking medication for chronic conditions.

“We’re going to be looking at chronic diseases in general,” project researcher and Division of Infectious Disease professor Aaron Richterman said. The participants will include those with diabetes, high blood pressure, and high cholesterol, “all of whom are taking one pill once a day.”

Richterman said that the earlier study provided preliminary evidence that changes in financial scarcity may affect daily medication-taking habits.

“It’s not conclusive,” Richterman said. “It’s an early-stage suggestive study, but it certainly fits with what we hypothesized we were going to see.”

SNAP recipients receive their monthly benefits on different days depending on when they apply. The pilot study found that medication adherence rose after participants received their benefits but fell later in the month. Richterman said adherence increased for roughly 19 to 20 days before declining, even though most recipients’ benefits run out within 10 to 14 days.

Division Chief of Health Policy, Medical Ethics and Health Policy professor, and researcher Harsha Thirumurthy said financial stress can distract from other daily responsibilities.

When individuals are financially stressed and a SNAP payment is not provided, those individuals now “have to worry about how they’re going to pay for food, how they’re going to pay their monthly rent,” Thirumurthy said. “That takes mental attention away from other daily behaviors like medication adherence.”

The expanded study will use electronic pill bottle caps that signal when opened to track medication-taking behavior. Researchers will also measure participants’ mental bandwidth, food security, and financial health. The study will also examine whether scarcity affects one-time behaviors. Participants will receive invitations to services such as free financial counseling and preventive health reviews at different points in the SNAP cycle.

The NIH grant will allow researchers to recruit participants across Penn Med over roughly three years, then follow them for a longer period.

Last month, the Trump administration began drafting an executive order to create a committee with the power to veto NIH research awards that do not align with the White House’s political agenda. The proposal would expand the administration’s authority over the NIH grant portfolio at a time when universities face uncertainty over federal funding.

Richterman said that through the larger study, the team will determine whether the initial findings extend beyond HIV, providing a more precise picture of the relationship between financial scarcity and medication adherence.

“The basic idea is to reproduce our findings in a much larger sample size,” Richterman said.

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