Presented by: Janet Leader MPH, RD, Director of Services, Second Harvest Food Bank of Santa Clara and San Mateo Counties

Transcription

1 Presented by: Janet Leader MPH, RD, Director of Services, Second Harvest Food Bank of Santa Clara and San Mateo Counties Madoka Gaspar, Nutrition Program Manager, Second Harvest Food Bank of Santa Clara and San Mateo Counties

2 Increase in produce distribution lead to the need for improved nutrition education.

3 1. Help people prevent obesity and diabetes by eating more produce. 2. Most know that Fruits and Veggies are healthy, but don t know how to prepare it. 3. Focus on minimal nutrition information, more preparation and tasting. Only 26 % of Americans eat 5 servings per day of vegetables.

4 Family Harvest Senior Brown Bag Produce Mobile Mobile Pantry Our Food Distributions Direct Service Sites and Partnering Agencies

5 1. Long lines, clients don t want to leave 2. Belief that clients not interested in NE 3. Diverse languages 4. Unfamiliar produce 5. County EH regulation for samples 6. 2 nutritionists, 140 distribution sites

6 Develop 3-5 minute lessons to teach in line to clients Simple objectives A little bit of nutrition information Include a food demonstration or food sample tasting

7 Nutritionists place the lesson materials on cart. Cart is pushed along the line of clients. Nutrition display is interactive and engaging

8 Recruit and train Health Ambassadors to help teach in a bilingual/bicultural manner

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11 Low Literacy Basic Nutrition Storage Info Simple Recipe (5 ingredients or less) Focus on Food Bank Foods

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13 Stickers are popular with kids and adults!

14 Pair with sites distributing fresh fruits and vegetables and other healthy foods

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16 Janet Leader, MPH, RD Director of Services Madoka Gaspar, BS Nutrition Program Manager Second Harvest Food Bank of Santa Clara and San Mateo Counties 750 Curtner Avenue, San Jose

17 Nutrition Education & Produce Distribution Toolbox Evaluation CAFB Conference: April 23, 2013 Nutrition Education Evaluation & Strategies Breakout session

18 Background Long-time SNAP-Ed implementing partner ~ 10 years Over 2 dozen FB member & nonprofit agencies participate in CAFB s Network nutrition education program

19 SNAP-Ed & Obesity Prevention attention to access to healthy food not only nutrition education (Nut-Ed) CAFB s Farm to Family Program tremendous increase in access

20 Nut-Ed at Produce Distribution - Phase 1 ( ) Draft Toolbox: Based on review of literature & 66 nutrition education lessons, interactive games, cookbooks, videos, etc. Member & client feedback Evaluation Perales & Associates

21 Phase 2: Evaluate Toolbox Further develop brief lessons tailored to produce distribution setting. How can the opportunity of the distribution line best be used? Can education reinforce produce distributed for greater utilization and sustained impact? Second Harvest Food Bank of San Mateo & Santa Clara Counties collaboration to implement & evaluate client impacts Perales & Associates

22 Evaluation Design 6 control & 6 intervention sites Sites not randomly assigned Received same produce Controls - no education Client interviews at all 12 sites Post-test only 1 month after education

23 Intervention Group June & July Brief lessons SHFB Tip Cards Recipe tastings August SHFB Tip Cards only

24 Intervention Brief interactive nutrition lessons: Reinforced MyPlate both lessons Tri-fold display Key messages Food tasting & recipe to match featured produce Educational handout

25 Assessing the Impact of Nutrition Education at Produce Distributions Presented by Perales & Associates Evaluation Services 1

26 SETTING 12 Family Harvest Sites All but 1 site in Santa Clara County Clients receive ~100 lbs. of food per month Average HH income $1,438/month of 4 88% of HH 1 or more child 6 yrs. Locations: low-income multi-unit housing complexes, churches, schools, and community centers 2

27 Interviewers 5 bilingual young women: 3 college students 2 food bank clients Training to Conduct Interviews: Protocol for Interviewers Client Consent Role Playing Observed nutrition intervention Team Branded with Network for a Healthy California aprons & caps in Spanish and English 3

28 » 261 Intervention Group Client Interview» 254 Control Group Client Interviews One on One Before food distribution Client Consent Client Interviews 4

29 Client Demographics Participants predominantly female Mean age Majority self-identified as Hispanic/Latino Almost two thirds between 25 and 44 years Spanish primary language Approximately 95% of children <18 yrs. living at home 5

30 Evaluation Questions Do clients exposed to multiple nutrition education interventions: 1. Recall the messages? 2. Apply the knowledge and change their or their family s behavior? 3. Does adding food tastings increase preparation of distributed recipes at home? 4. Does adding food tastings and recipe distribution increase consumption of featured produce at home? 5. Does the distribution of fresh produce and corresponding education increase clients confidence to use the distributed produce? 6

31 Intervention Group Eating Healthier Message and MyPlate Recall Recall hearing message about eating healthier in June and/or July? 16% 3% Yes No DK Do you remember hearing about MyPlate in June and/or July? 4% 31% Yes 65% No DK 81% 7

32 Percent that Heard about MyPlate 77% Control 22% Intervention 8

33 What do you remember about how to use MyPlate for feeding your family? 0% 5% 10% 15% 20% 25% 30% Make half of plate fruits and vegetables Myplate made up of 5 different food groups Make at least half of your grains whole 5% 4% 2% 10% 18% 27% Add lean protein 4% 7% Eat low fat dairy 0% 3% Eat from 5 food groups throughout day 2% 5% Control Intervention 9

34 How have you used MyPlate to prepare food for your family? 0% 10% 20% 30% 40% 50% Prepare more vegetables 10% 46% Giving them more fruit Eating from 5 food groups throughout day 3% 4% 9% 25% Giving them lean meats 2% 8% Giving them more whole grain Control 0% 4% Intervention 10

35 Qualitative Results Intervention Participants : How have you used MyPlate to prepare food for your family? Key themes Adding at least two of the five food groups to meals Substituting more fish and poultry for red meats Eating less fast food Preparing/eating less fatty foods Using to control health condition A few said changing eating habits lead to weight loss 11

36 Where have you heard about MyPlate? 0% 10% 20% 30% 40% 50% 60% Here: food distribution site 22% 51% WIC Other (clinic, Headstart) 4% 22% 17% 47% Nutrition classes 9% 27% Media (TV, Radio, etc) 5% 22% Child's school 8% 20% Control (N=45) Intervention (N=201) 12

37 Percent of Intervention Group that Prepared the Recipe at Home 40% 30% 20% 10% 0% Broccoli 37% 34% Stone fruit 13

38 Qualitative Results Some participants Modified the Stone Fruit Recipe by adding ingredients their families like, such as raisins, apples, and other fruit 14

39 Where food bank clients acquired broccoli 0% 20% 40% 60% 80% 100% Food Bank 89% 88% Grocery Store 65% 76% Farmer's Market Other (flea market, friends/family) 2% 2% 2% 7% Control Intervention 15

40 Where food bank clients acquired broccoli 0% 20% 40% 60% 80% Grocery store* *Statistically significant p<.05 Intervention group 1.6 times (60%) more likely to purchase in grocery store. 65% 74% Not bought at Grocery store 26% 35% Control Intervention 16

41 Where food bank clients acquired stone fruit 0% 20% 40% 60% 80% 100% Food Bank Grocery Store 73% 76% 76% 88% Farmers' Market Other (Flea market, friend/family, etc) 3% 2% 2% 7% Control Intervention 17

42 How confident are you that you can make the fruits and vegetables you take home today in such a way that your family will like and eat it? Very Sure 95% 94% A little sure 4% 6% Not at all sure 3% 1% Control Intervention 18

43 How much of the fresh fruits and vegetables you receive from here will your family eat in a month? All of the fruit All of the vegetables Most of the fruit Most of the vegetables 19% 17% 17% 18% 77% 79% 80% 79% 0% 10% 20% 30% 40% 50% 60% 70% 80% Control Intervention 19

44 Qualitative Results Intervention Participants : How much of the fresh fruits and vegetables you receive from here will your family eat in a month? Key themes Conserve food (i.e., freezing) Prepare creative foods like natural fruit shakes Pack fresh fruits in kids lunch and Prepare and eat food before it spoils 20

45 What do you do with the fresh fruits or vegetables that your family does not like to eat? Eat all of it 58% 65% Give it away 33% 40% Not take it Throw it away 1% 1% 1% 1% Control Intervention 21

46 Key themes Qualitative Results Intervention Participants : What do you do with the fruits or vegetables that your family does not like to eat? Conserve food by freezing or canning Throw food away when expired Give food away to family, friends, or neighbors Prepare food creatively 22

47 Participants General Comments I love receiving the recipes because I want to eat more healthy My kids love vegetables I like to make the left over fruit in shakes I make [the ingredients] in different ways so my kids will like it I freeze the fruits and vegetables my family does not eat I make juices! Especially out of the celery 23

48 MAIN OUTCOMES Greater Awareness of MyPlate 24

49 Fill ½ your plate with fruit and vegetables MAIN OUTCOMES Greater Recall of MyPlate Messages 5 food groups make up MyPlate Fill ¼ plate with grains 25

50 MAIN OUTCOMES Use of MyPlate 10.1 times more likely to use MP to give more fruits 7.7 times more likely to use MP to prepare more vegetables 5.8 times more likely to use MP to give their family more lean meat 2.3 times more likely to use MP to make sure family eats 5 food groups throughout the day 26

51 MAIN OUTCOMES More likely to prepare distributed recipes 27

52 MAIN OUTCOMES Produce introduced during the intervention were consumed and also purchased 28

53 CONCLUSIONS A well-designed nutrition education intervention, can: support healthy eating messages in the priority population's social and cultural environment, and can be successfully conducted within the 3 5 minute food distribution line time constraints, and have an impact on nutrition message awareness and consumption-related behaviors 29

54 RECOMMENDATIONS Develop more 3-5 minute lessons for the food distribution line Use interactive displays Repeat and build on MyPlate theme its flexible Link recipe cards or food demonstrations/food tasting to produce distributed Distribute colorful handouts and recipes Grow your own nutrition ambassadors Create Food Preservation Tip Card 30

55 ACKNOWLEDGEMENTS Contributing authors: Barbara MkNelly, MS, Network for a Healthy California, Research and Evaluation Section and Deborah Danielewicz, MPH, PAES Research Associate Terry Garner, MA, Program Manager, California Association of Food Banks Stephanie Nishio, MPH, RD, Director of Programs, California Association of Food Banks Janet Leader, MPH, RD, Director of Services and Madoka Gaspar, Nutrition Program Manager, Second Harvest Food Bank of Santa Clara and San Mateo Counties Khanh Ngo, MSW, Primavera Hernandez, MPH, and Janet Hung, Community Nutrition Educators, Second Harvest Food Bank of Santa Clara and San Mateo Counties Margie Erwin, MS, RD, Nutrition lessons consultant Patrick Mitchell, DrPH, Research Scientist, Network for a Healthy California, Research and Evaluation Section, statistics consultation Cheryl Mariscal Hergert, MPH, PAES Research Associate PAES Research Interviewers: Vanessa Alcantar, MPH, Erika Ayala, Evelyn Beas, Claudia Figueroa, and Amber Torres Fran McNeill, Chief Program Officer, FOOD Share Inc. of Ventura County Gail Atkins, Director of Programs, Redwood Empire Food Bank Teresa Moran, Nutrition Programs Manager, Second Harvest Food Bank Santa Cruz County 31

56 CONTACT INFORMATION Denise Cintron Perales, MS Daniel P. Perales, DrPH, MPH Perales & Associates Evaluation Services (office) 32