Public Health Solutions Brings Cooking Matters at the Store to Neighborhood WIC Centers

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1 DATE: 2/8/2015 Public Health Solutions Brings Cooking Matters at the Store to Neighborhood WIC Centers Between July 2013 and September 2014 more than 6,000 WIC and WICeligible individuals learned how to stretch their limited food dollars to purchase healthy food for their families. In addition to successfully integrating tours into Public Health Solution s nine Neighborhood WIC sites, this pilot serves as a model for WIC centers across the nation to effectively implement Cooking Matters at the Store.

2 ABOUT SHARE OUR STRENGTH'S COOKING MATTERS For 20 years, Cooking Matters has empowered families with the skills to stretch their food budgets and cook healthy meals so their children get nutritious food at home. As part of the No Kid Hungry \ campaign to end childhood hunger in America, Share Our Strength's Cooking Matters teaches participants to shop smarter, use nutrition information to make healthier choices and cook delicious, affordable meals. In 2010, Share Our Strength spun off the grocery store tour into a standalone program, Cooking Matters at the Store. Cooking Matters at the Store tours teach participants how to plan and budget for healthy, affordable, and delicious meals for their families. Tours can be led by any individual, in any community, anywhere people shop for food. CookingMatters.org/At-The-Store PUBLIC HEALTH SOLUTIONS Public Health Solutions is a nonprofit organization that develops, implements and advocates dynamic solutions to prevent disease and improve community health. PHS conducts comprehensive research providing insight on public health issues, creates and manages community health programs, and provides services to organizations to address public health challenges. healthsolutions.org BACKGROUND Share Our Strength s Cooking Matters at the Store program strives to ensure children get the healthy meals they need at home. Share Our Strength s Cooking Matters at the Store, part of the No Kid Hungry campaign, is a free program that provides low-income families with hands-on education to stretch their food budgets by comparing foods for cost and nutrition as they shop for food in the grocery store. Cooking Matters at the Store includes two specialized curricula - one for adults and one for Women, Infants and Children (WIC) parents. Tours are facilitated by a wide range of local volunteers including culinary professionals, community nutrition educators, Extension agents, volunteers at faith-based health ministries, or community agencies serving families in need. Participants learn how to plan and budget for healthy, affordable, and delicious meals for their families, all for under $10. Public Health Solutions (PHS), a nonprofit organization located in New York City, is dedicated to developing, implementing and advocating dynamic solutions to prevent disease and improve community health. In 2013, Share Our Strength provided a grant to PHS to pilot Cooking Matters at the Store for WIC Parents. Cooking Matters at the Store is an interactive grocery store tour that teaches low-income families to shop for healthy, affordable food. Participants learn to find whole grains, buy fruits and vegetables on a tight budget, compare unit prices, and read food labels. Cooking Matters at the Store is available in English and Spanish and includes two versions, one of which is tailored to WIC parents.

3 STRATEGIES FOR WORKING WITH WIC WIC clinics are busy so PHS stressed that it was important for volunteers to understand the program and conduct outreach and tours in a way that complemented WIC processes. Volunteers scheduled tours with the WIC office that did not interfere with regular WIC nutrition sessions. PHS also made sure volunteers were trained on working with WIC with an online training first for tour leaders followed by an in person-training so the volunteers knew what to expect when they arrived at the WIC clinics. TOUR PROMOTION AND RECRUITMENT AT WIC CLINICS PHS utilized a public health student intern to study recruitment of tour participants in the waiting room at WIC clinics. This intern spent time observing the 12 Cooking Matters volunteers who worked a daily trying to engage participants for the tours. Based on observations and experience, PHS identified a number of practices to be effective in promoting tours: 1- Promote directly in WIC center waiting rooms. Volunteer tour leaders used recruitment techniques that pointed out the participants would get $10 worth of healthy groceries and that the tours took place within walking distance to the WIC center. Participant recruitment was most successful when people were asked both individually and as a group if they would like to join the tour. Some individuals did not feel comfortable volunteering to participate when asked in front of other people. 2- Promote tours through WIC staff. WIC staff are trusted by clients and can be the best advocates for the store tours. Although the WIC site manager is the main point of contact, it is also useful to identify a staff champion who can inspire and promote tours among other staff. One WIC staff member took Share Our Strength s online Cooking Matters at the Store training and was deemed the Champion for that WIC clinic. The champion served as a point of reference for the tour volunteers and was able to update them about what was happening at the clinic and the scheduling. Additionally, PHS attended WIC staff meetings to teach WIC staff about Cooking Matters at the Store so that they could advocate for the program. 3- Anticipate and respond to skepticism. For example, volunteers found that a common response from WIC clients was I already know how to shop for healthy food and don t need a tour of the supermarket. By having the volunteers call the tours a lesson instead of a supermarket tour, more people decided to participate. Volunteers were trained specifically on how to approach and recruit participants in the WIC waiting rooms to increase participation rates, and engaging children while recruiting their parents helped to build a trusting relationship with participants. 4- Promoting advance scheduling of tours in a visible space. PHS posted tour schedules on the white boards in each of the nine WIC centers so that clients and WIC educators could see the schedule in

4 advance and plan accordingly. Volunteers and staff champions typically collaborated to keep the white board updated. Overall the most successful recruitment came from a combination of the waiting room recruitment and promotion from the WIC staff. TOUR IMPLEMENTATION AND METHODS AHRA found that to successfully host tours, it is imperative to have buy-in or approval from the store manager. Each store has a different approval process some may require approval from their corporate office and the process can be time consuming. The one consistent factor though is store manager approval. AHRA found that the most effective messages for store managers were: Tours build customer loyalty. Customers are more likely to visit a store again when they feel comfortable with the layout, know where items are located, and know that a store carries items they want to buy. Cooking Matters at the Store tours lead participants through almost every section of a grocery store and encourage them to get to know the various products in a store. Tours generate revenue for participating stores. Every person who participates on a tour receives a $10 gift card for the host store. On event days, upwards of 150 people may participate in tours, generating over $1,500 for a store in a single day. Tours draw positive media attention to stores. Getting people to the store for the event requires outreach through multiple media channels. Host stores are mentioned in all promotion for the event, which could include radio, television and print media. Emphasizing the tangible benefits for stores rather than focusing on the health benefits or public good of the tours helped AHRA to secure approval from a store manager in each of the target areas. After wooing the store manager, AHRA made sure to connect with at least one other member of the store staff. It is not guaranteed that the store manager will be on location on the day of the event so AHRA got contact information for another staff person who would be on duty the day of the event. This assured that someone at the store during the event day was aware of what was happening. They also made a point to make sure the store had all of their contact information. PHS offered two types of tours: traditional grocery store tours and pop-up tours Pop- up tours were held in four WIC centers as mock grocery store tours using a modified version of the Cooking Matters at the Store curricula.

5 IN-STORE TOURS In store tours required that staff strategically identify grocery stores and build relationships with store managers. Because WIC clients are often pregnant, have strollers, or are walking with toddlers, it was very important that the stores were within walking distance from centers. Staff selected grocery stores that were no more than seven blocks away from the WIC centers, which limited the number of stores available for tours. Tours were most successful if held in the mid-morning when parents older children are in school. Additionally, participation in tours decreased during the winter months, especially for the WIC population that is comprised of pregnant individuals, infants and young children. Most stores that held tours had worked with PHS on WIC Vendor management and were familiar with both the organization and the WIC Program. PHS made direct connections with store managers so that they could explain the Cooking Matters at the Store program and answer any questions. PHS found that store managers were typically supportive of hosting tours in the store because they thought that it would provide additional clarity for clients, cashiers and managers regarding the limitations of WIC allowances. Requesting gift card donations for the $10 Challenge from the store after several tours have already been conducted gave the store an opportunity to witness the benefit of the program for their community and store. The average tour included 3-4 adults with kids (about 10 people total) and lasted 20 minutes to an hour. Participants tended to stay for the entire tour if it was shorter and would often pressure the volunteer to end it early. PHS also reported from their tour observations that participants were most interested in budgeting and cooking and that the nutrition portion of the tour needed to be basic and short. While the in-store tours were generally successful and provided an opportunity for clients to learn in real life environment, there were some challenges. The store tour participants were often distracted by their children, loud music that played at several stores, and running into people they knew. POP-UP TOURS More recently, PHS began offering pop-up tours at four centers as an alternative to in-store tours. Pop-up tours were held directly in the WIC centers and lasted about 25 minutes. The larger WIC centers had better space for impromptu tours while smaller WIC centers were better for scheduled tours. Pop-up tours tended to have higher participation than the store tours with about 10 WIC clients attending per tour. Cooking Matters volunteers stored bins in the WIC centers with items they needed for the tours, such as empty cereal boxes, canned beans, fruits, nutrition labels, unit prices, dried beans and rice. The presence of the pop-up store in the WIC center provided a good opportunity to recruit curious clients who were at the center. Volunteers found that it was often easier to manage the clinic tours because there were activities to occupy children, clients did not have to

6 travel, and it provided an activity for clients who were already waiting. Despite the lack of a $10 Challenge volunteers often found the participants to be more relaxed and engaged in pop-up tours. KEY TAKE-AWAYS Consider offering pop-up tours with WIC participants as an option, especially if grocery stores are not close to the WIC centers. WIC staff can be the best promoters of the program, so it is important to engage them and get them excited about the tours. Emphasizing budgeting, rather than nutrition education, in tour promotion may be an effective way to solicit more interest. Keep the lessons as simple and straight forward as possible, especially on unit pricing. Concentrate efforts on how Cooking Matters at the Store fits into the WIC Clinic atmosphere and be mindful of the time constraints the participants have and how to use the curricula with some flexibility depending on the specifics of the WIC environment.