Source: UNIV OF MINNESOTA submitted to NRP
PUTTING DOWN ROOTS IN RURAL AMERICA: A PLACE-BASED, MULTI-COMPONENT APPROACH TO IMPROVE HEALTHY FOOD ACCESS FOR IMMIGRANTS
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
ACTIVE
Funding Source
Reporting Frequency
Annual
Accession No.
1030302
Grant No.
2023-68015-39602
Cumulative Award Amt.
$969,980.00
Proposal No.
2022-08684
Multistate No.
(N/A)
Project Start Date
Apr 15, 2023
Project End Date
Apr 14, 2027
Grant Year
2023
Program Code
[A1344]- Diet, Nutrition and the Prevention of Chronic Disease
Recipient Organization
UNIV OF MINNESOTA
(N/A)
ST PAUL,MN 55108
Performing Department
(N/A)
Non Technical Summary
This project addresses food security challenges faced by one of the fastest growing sectors of our population who are also most likely to experience economic and health disparities. In Minnesota, the fastest population growth is expected among Hispanic, Black, and Asian communities. Currently, 21% of Minnesotans identify as people of color, while 32% of children 4 years and under are of color. Huge income inequity exists, with 80% of Somali and 59% of African-American people living in poverty and near poverty in Minnesota (compared to 21% of white population).Regionally, more people of color are moving to rural areas of the state. While the Somali population in the Minneapolis-St. Paul metro doubled between 2005 and 2019, the number of Somali residents in Greater Minnesota grew by more than six-fold during the same period. Families in rural Minnesota experience poverty to a greater extent than those living in suburban or urban areas (11.5% in rural areas compared to 8.9% in urban areas). Minnesota ranks seventh worst in the nation for healthy food access, particularly with significant decreases in grocery stores in rural Minnesota in recent years.We partner with a Somali-American community in Central Minnesota. Somali immigrants are one of the largest African populations to resettle in the U.S. since the early 1990s. In Minnesota, the Somali community is one of the largest immigrant communities, with an estimated population of 80,000, of which 10,000 reside in Stearns County and surrounding areas. We will use a human-centered design (HCD) approach to develop place-based solutions to improve food-related health outcomes in the study community. Centered on the people experiencing the problem, HCD is an effective way to develop interventions that are both community-based and place-based. We will conduct needs assessments of the study community in Year 1, co-design intervention strategies in Year 2, and field test the strategies that were developed into prototypes. The learning from the HCD approach and co-designed, field-tested strategies with shared with the wider audience.We will also contribute to the emergent literature on transferability assessment of public health interventions in immigrant communities in rural areas. We will work with the technical advisors on our project who have led similar community-based efforts to address food systems and/or food-related health in other immigrant communities. Together, we will sort through the transferability factors identified by the past studies to identify factors which may specifically influence the transferability of the project process and outputs to other immigrant communities and develop hypotheses about the ways these factors may influence transferability. We will examine the hypotheses by analyzing a panel workshop with technical advisors and members of various immigrant communities to gather evidence in the project work and in their lived experiences.
Animal Health Component
50%
Research Effort Categories
Basic
(N/A)
Applied
50%
Developmental
50%
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
6086050301025%
7036050301025%
7246050117025%
9016050308025%
Goals / Objectives
The overall objective of this project is to improve food access and nutrition security of immigrant communities in rural U.S., by amplifying their capacity to lead and sustain efforts to strengthen their food system. The study will take place in collaboration with a prominent Somali-American community in Central Minnesota. The proposed main output from the project is a place-based, multi-component framework with field-tested strategies to promote healthy eating among a key immigrant community in rural Minnesota. The potential transferability of project processes and outputs to other immigrant communities will be examined in collaboration with a panel of experts and community leaders across the Midwest. Specifically, the objectives of this proposal are to:Identify and characterize profiles of food system needs, values, and barriers of a partnering immigrant community in rural MinnesotaCo-design promising interventions across food security components with partnering community members and leadersField-test intervention products and processes to address the identified needs and barriers for food access and nutritional security in the partnering communityEvaluate transferability of the project process and outputs to other immigrant communitiesCo-develop and disseminate materials for rural immigrant communities and organizations that serve them to enhance equitable and inclusive food system and nutrition education outreach
Project Methods
Needs assessment (Year 1)For the needs assessment, we plan to recruit 50 participants for 6 focus groups. Each focus group will consist of ~8-10 participants, be held at a conveniently located site, last ~60-90 minutes, and be moderated by a trained facilitator and community staff for translation, as needed. We will recruit participants, ensuring that we have diversity in gender, age, and number of years living in the US. In previous work, we have successfully conducted recruitment with Somali Americans living in rural Midwest areas. We will consult with community advisors to identify events, organizations, and locations frequented by the community. We will also gather data via in-depth interviews with key informants identified by the community advisors and others. These may include leaders in the Somali-American community and/or leaders of organizations that serve this community. We will use a snowball strategy, where at the end of each interview we ask respondents who else we should interview. We plan to interview 15 stakeholders but will continue data collection if saturation is not reached. A quasi-deductive content analysis approach will be used to analyze qualitative data to identify commonalities organized by themes.HCD fidelity evaluation (Year 2)The study is based on HCD, which implies that actual outputs (strategies, interventions) that will be field-tested will not become known until the needs assessment and co-designing processes are completed.The project evaluation will assess the degree to which project activities--e.g., needs assessments, prototype development--are aligned with HCD principles. For instance, in developing the prototype, this fidelity evaluation will assess: (a) the extent to which the needs and values of the community are directly reflected in the developed prototype, (b) the degree to which community members actively participate in ideation and co-design, and (c) the extent to which the prototype is customized to ensure usability and convenience among community members during iterative refinement. To assess these issues, the evaluation team will lead a facilitated dialogue with community stakeholders at the beginning of Year 4 after the completion of Activities 2-4. These sessions will not be attended by other project staff members. They will be recorded, transcribed, de-identified, and analyzed for themes. A report of overall themes, devoid of all individual identifiers, will be reported back to the project team and action items will be identified for moving forward.Prototype evaluation (Year 3)We will recruit field test participants from the Somali community who will complete the appropriate evaluation for each prototype product. Prototype evaluation will focus on feasibility, acceptability, dose, and reach of the final prototype. We will quantitatively assess participants' reactions to the prototype (e.g., satisfaction with the program, willingness to recommend it to others, desire to participate again), participant engagement (e.g., participation, attendance), program delivery fidelity (e.g., to the extent program activities delivered as planned), and learning from the program. Evaluation metrics will be tailored to best suit the specific prototype that is developed and will be determined in collaboration with community stakeholders, reflecting best practices for equitable co-design. The prototype evaluation will also include a qualitative component to identify the key achievements of and domains/outcomes affected by the prototyped intervention that could be evaluated in a future impact evaluation, lessons learned during implementation, and changes to consider to the programming to enhance usability in the future. A full-powered evaluation of the impact of the intervention on changes in health outcomes is beyond the scope of this project but will mark an important next step in future work.Assessment of transferability (Years 1-4)For assessment of transferability, we will adapt the multi-stage TRANSFER approach developed for evaluating the transferability of scientific evidence included in systematic reviews (Munthe-Kaas et al., 2020). We will collaborate with the technical advisors on our project who have led similar community-based efforts to address food systems and/or food-related health in other immigrant communities. At the beginning of the project, we will compile an aggregated list of transferability factors that have been published on public health interventions (e.g., Munthe-Kaas et al., 2019; Schloemer & Schröder-Bäck, 2018; Cambon et al., 2012) and share with the technical advisors. In Years 1-2, the project team and technical advisors will refer to the list of factors as the project progress is reported to the technical advisors. In Year 3, we will follow the TRANSFER Conversation Guide to identify and prioritize transferability factors which may influence the transferability of the project process and outputs to other immigrant communities. In the conversation, we develop hypotheses about the ways these factors may influence transferability. Munthe-Kaas et al. (2020) suggest including three to five factors and associated hypotheses to keep the assessment analysis feasible. In Year 4, we will convene a panel that comprises technical advisors and members of various immigrant communities for a workshop. The purpose of the workshop is to gather evidence in the project work and in their lived experiences related to the transferability hypotheses. The meeting will be audio-recorded, transcribed, and analyzed per the qualitative analytic methods described above to examine the transferability hypotheses.

Progress 04/15/24 to 04/14/25

Outputs
Target Audience:The project team continued to work with the study community members throughout the reporting period. The project progress and findings were shared out to the community members through local Somali-American media outlets. Our human-centered design approach and findings were shared with practitioners and scholars working on food access challenges, particularly those working with other immigrant communities in rural U.S. Students at the University of Minnesota learned about the project and a few participated during the reporting period. Changes/Problems:The project team feels that asking the community organizations to collect information on behalf of the community, rather than student assistants under the project team supervision, certainly helped address the lack of co-ownership of the project and solutions ideas from the community we perceived at the end of last year. We plan to identify other ways to increase community participation in the coming years. As the path forward is clearer, we plan to engage more students as well. What opportunities for training and professional development has the project provided?There has been much continued learning by the project team members about the community, their values, and culture, including food. The PI supervised a PhD student in Applied Economics to study the halal food market in the United States. We have drafted a manuscript for a peer-reviewed publication. An undergraduate student, originally from a Somali-speaking region of Ethiopia, assisted the project team under the PI supervision to engage with community advisors and prepare translated materials. How have the results been disseminated to communities of interest?The local Somali-American TV station has created a segment on the findings from the focus groups, which was disseminated on various SNS platforms. Several community members were contacted by community organizations with the MOUs with the project team about topics specific to the MOUs, such as their interest and prior experience in farming. The project team presented at the Society of Nutrition Education and Behavior International Conference and American Public Health Association Annual Meeting in August and in October, respectively. The project team has been accepted for presentation at the Agriculture, Food, and Human Values Society annual meeting, which will take place in June 2025. What do you plan to do during the next reporting period to accomplish the goals?The next stage of the project is for the project team to use the community findings regarding the potential solutions to assess their feasibility. We expect a few iterations between the project team, the community organizations with MOUs, the community advisors, and the technical advisors to finalize the feasibility assessment and identify one or two potential solutions to develop as a prototype. The developed prototype(s) will be assessed for user experience. The project team has made multiple presentations but will spend this year drafting manuscripts for publication. We will also initiate our conversation about examining the transferability of this work to other communities through panel discussions.

Impacts
What was accomplished under these goals? World café sessions with members of the Somali American community in the Greater Saint Cloud area were held to hear their thoughts about various solutions to address the community needs expressed during the earlier focus groups. Three sessions were held on June 6, 18 and 24, 2024 at the University of Minnesota Extension office in groups of 12 to 17 participants, involving a total of 43 community members. The participants included 58% male and 42% female, representing a range of generations. The participants included those who had come to the US two months ago to those who have lived in the Saint Cloud area for 25 years, as well as second generation Somalis who were born and raised in the Saint Cloud area. The project team identified three conservation topics from the previous focus groups to gain further input: access to fresh and community-grown foods, access to knowledge and nutritious meals, and professional representation of community members in the food system. There were three tables with respective conversation topics. Participants were grouped into three groups and spent 15 to 20 minutes at each table. All participants joined the conversations at all tables. The conversations took place in Somali, and notes were taken in English on a large poster board. When all groups had spent time at all takes, all attendants came together for a large group debrief session, where the facilitators from each table shared the main ideas they heard and the group was invited to add. The facilitators debriefed in Somali in the first and last sessions, and in English in the second session. The large group debrief sessions were recorded and translated into English or transcribed, which were shared with the project team. A systematic content review of all notes was conducted. The findings aligned with and helped further expand the key themes identified in previous focus groups - insufficient food availability in terms of desired quality and variety, the desire to grow own food, disconnect from food assistance programming, and limited expertise within the community. The findings pointed to food system areas for solution-oriented work, including community farming and ranching, improving community-based food assistance, career development opportunities related to food and agriculture, and halal collective purchasing to increase product availability in community grocery stores. To foster project co-accountability among the community members, the project team took the findings from the world cafes to draft memorandums of understanding (MOUs) with community organizations to study the opportunities and challenges further on behalf of the community. The project team solicited input from the community advisory group and narrowed down to four solution areas: community-based farming, community-based food assistance, professional development opportunities in food and agriculture for community members, and collective buying among halal grocery stores. The MOUs outlining expectations were signed in November-December 2024. The organizations, the project team, and the community advisory group met a few times in early 2025, and the final reports were received by the project team at the end of March. The project team has started to meet with the organizations for clarifications in preparation for using the findings as inputs into feasibility analysis of potential solutions. One topic that the project team did not include in the world café sessions was access to halal foods, in part because there has been some work already completed outside this project. To better inform the project team, an integrative review of the halal food market in the United States was conducted by a graduate research assistant under the PI supervision. The community advisory group was continuously engaged during the reporting period with 8 individuals, with one member changing to another individual. They provided input into identifying facilitators for the world café sessions and critically reviewing the draft MOUs and suggesting community organizations to work with. The project team met with the technical advisors in August 2024 after the world café sessions. They provided insights regarding what they have observed regarding how leadership and accountability emerge in communities. The project team has also engaged and consulted with the HCD expert Jess Roberts joined the technical advisors meeting and provided feedback into the draft MOUs.

Publications

  • Type: Conference Papers and Presentations Status: Published Year Published: 2024 Citation: Peterson, H.H., M. Laska, S. Mamedov, H. Karnik and P. Brady. Putting down roots in rural America: Baseline needs assessment in a Somali-American community in Central Minnesota. Poster presented at Annual International Conference of the Society for Nutrition Education and Behavior, Knoxville, TN, July 29  August 1, 2024.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2024 Citation: Peterson, H.H., M. Laska, S. Mamedov, and H. Karnik. Putting down roots in rural America: A place-based, multi-component approach to improve healthy food access for immigrant communities. Selected presentation at Annual Meeting of the American Public Health Association, Minneapolis, MN, October 27-30, 2024.


Progress 04/15/23 to 04/14/24

Outputs
Target Audience:This project will co-create interventions with the study community members to improve food access in an immigrant community in rural regions in the US. The project works the closest with the study community, which is the Somali American community in Stearns County, and the project progress and findings will be shared through Somali media outlets. Our human-centered design approach and findings will be shared with other immigrant communities in rural U.S. and public and non-profit organizations that work with them on food access related challenges, including academic researchers. The project will involve students at the University of Minnesota. Changes/Problems:One of the challenges the project team felt after the focus groups and shared the findings with the community advisory group was the low sense of ownership of the project and solution ideas from the community. Indeed, community advisors have understood their role as to advise the project team and appear to be waiting for us to provide the solutions, which contradicts the co-design approach. Thus, based on the input from the technical advisors and the conversation at the project team retreat, we are taking an approach in year 2 that includes MOUs with select community organizations to co-develop actions plans with the project team to provide ownership to the community members for potential solutions. Given the high degree of learning by the project team and uncertainty with the co-designing process, we didn't hire a graduate research assistant for the project during the first year. As the world café sessions are being planned, we have identified and hired a graduate research assistant to conduct a complete review of the Halal meat market in the U.S., which would inform our work in guiding the community as they pursue possible solutions. What opportunities for training and professional development has the project provided?There has been so much learning by the project team members about the community, their values, and culture, including food. The PI also visited the community outside the community advisory meetings upon invitation of one of the community advisors to observe and celebrate the Somali Independence Day with the community. The project team has also been learning the unique feature of the co-design approach. How have the results been disseminated to communities of interest?The local Somali-American TV station has created and disseminated two segments on the project progress on various SNS platforms. In the fall, they were informed about the project and upcoming opportunities to participate in focus groups. In the spring, they were informed about the major findings from the focus groups and about upcoming opportunities to participate in world café sessions to explore solutions. The project team has submitted two presentation abstracts, which have been accepted for presentation at the Society of Nutrition Education and Behavior International Conference and American Public Health Association Annual Meeting. The work will be presented respectively in August and in October, 2024. What do you plan to do during the next reporting period to accomplish the goals?The next stage of the project is to identify potential solutions that could be both impactful in the long run and most feasible for the community to pursue at this time. The project team held a 3-hour retreat on April 15th and generated the following plan for the next 8 months. In early summer, "World Café" sessions with the community members to hold conversations about various solutions to address the community's food access. During the rest of the summer, the project team will take the findings from the World Cafés and invite organizations to co-create Memorandums of Understanding (MOUs) to develop action plans with the Project Team. Each MOU will focus on one possible solution to an identified problem area. Each MOU will entail up to $10,000 to the partnering organizations. In the fall, action plans that refine the opportunities and challenges, and identify the next steps in pursuing the solutions will be developed following the respective MOUs. The outcomes will inform the next steps of the project.

Impacts
What was accomplished under these goals? The first task was to formally establish the project advisory committee. The advisory committee will consist of two groups of advisors: community advisors, representing stakeholders in the Somali community who are leading efforts to better the community, and technical advisors, who are scholars and practitioners with expertise in food security and community-based work. The community advisory group was formed with 8 individuals who represent various community organizations. All but one are men. The project team met with the community advisory group monthly at various community location. During the first year, they provided input into designing the needs assessment process and the focus group guide. To collect food access experiences that are representative of the Somali-American community in the Greater Saint Cloud area, five focus groups were held with community members from November 2023 through January 2024, at the public library, university Extension office, and a local organization for African immigrants and refugees. There were 48 participants in total. Groups had 6 to 12 participants with a total of 48 community members. Participants included both male (n=16) and female (32) identifying individuals, representing a range of generations. Participants had a wide set of immigration experiences including those who had come to the US two months ago, those who had lived in the Saint Cloud area for 20 plus years, and second-generation Somalis born elsewhere in the US and moved to the area. Focus group guide questions were developed and reviewed by the community advisors. Focus group conversations were conducted in Somali and recorded. Facilitators took notes and listened to the recordings to construct detailed notes in English. A systematic content review of all notes was conducted to identify salient patterns based on the discussions. There were 9 themes that emerged from the focus group sessions. Residents shopped in various store types, including warehouse/big box stores, supermarkets, and Halal (Somali) grocery stores. At all store types, participants raised concerns about limited availability of fresh, Halal products (meat) and produce (most often vegetables). Financial issues and food affordability are major challenges for the community. Residents discussed influences on eating habits specific to their cultural background and challenges with adapting cultural practices to the American context. They expressed the need for knowledge and skills in preparing traditional dishes in healthier ways, preparing meals using products available in the US, and addressing challenges with feeding children. Residents have some interest in growing their own food, accessing direct-from-farm foods, and slaughtering their own meat. Residents had mixed feelings about eating outside the home, such as at restaurants, noting affordability concerns and the need for healthier options. The project team met with the technical advisors in May 2023 to introduce the project. The members include those who have worked directly with other immigrant communities across the Midwest. We followed up with them after a year to give them an update in April 2024 regarding the findings from the focus groups and gather input into thinking about our next steps. The project team has also engaged and consulted with the HCD expert Jess Roberts, particularly after the focus groups to process and figure out our next steps.

Publications