Progress 06/01/23 to 05/31/24

Outputs
Target Audience: This report covers June 1, 2023 to May 31, 2024. The stated purpose of the Double Up Oklahoma (DUO) program is to increase access to fruits and vegetables for low-income and food-insecure Oklahomans. Our primary audience is SNAP participants. However, to maximize our impact and focus resources where they are needed most, Hunger Free Oklahoma and our partners have prioritized communities based on geographic, health, and income-related disparities and historically marginalized populations which experience all these disparities at rates that are higher than the state average. In practice, this has resulted in prioritizing the placement of DUO firms in rural Low-Income, Low-Access (LILA) Communities, urban LILA communities, communities where fruit and vegetable consumption is low and preventable diseases are the highest, and in communities where Hispanic, African American, and Native Americans are living and working. During this reporting period, HFO worked with 26 grocery stores, 23 farmers markets, and one mobile market with seven stops. In total, we reached 30 LILA communities and served approximately 73,915 SNAP households. HFO must work with multiple stakeholders to reach SNAP participants. During the reporting period, HFO prioritized working with small and medium-sized grocery stores that serve primarily Hispanic and WIC participating families and farm direct firms in rural and underserved areas for future expansion efforts. Additionally, we worked with community partners integrated into these diverse communities to provide outreach and education and build community trust. Additional audiences of importance included state and local government officials, Point of Sale (POS) vendors, medical care providers, DUO advisory committee members, and research partners. Changes/Problems: Our Senior Program Specialist and leader of the farmers market work left HFO to pursue another career opportunity; her last day was April 12. This left a void as farmers market season started in April/May. Interviews began in May and an offer was extended and accepted. Our new Program Specialist began on July 1. Due to this change, farmers market duties were absorbed by the remaining DUO FTEs and expansion to farm stands and farm hubs was put on hold. While we successfully launched DUO in a new retail chain, Prime Time Nutrition (12 stores) in April 2024, POS vendor issues have caused delays in launching two other grocery chains (Supermercados Morelos and Choctaw Country Markets). Discussions with Supermercados Morelos and Choctaw Country Markets initially started in March 2023 and contracts for both were finally signed in the first quarter of 2024. However, it has taken months of planning with POS providers to develop a DUO solution for these stores; we continue to deal with vendor delays in programming, testing, and have recently encountered testing issues. By the end of May 2024, we were still working diligently to launch DUO in seven stores. What opportunities for training and professional development has the project provided? Hunger Free Oklahoma has provided the following trainings/resources related to DUO: Annual Farmers Market Training - HFO and contract partner ONIE planned an all-day training for 35 attendees as part of the Oklahoma Local Agriculture Collaborative conference in February 2024. Grocery Store Training - HFO develops custom training and deploys training sessions at each grocery store prior to DUO rollout. Follow-up training is provided to the grocer as needed. One retailer, HAC Inc., developed their own LMS DUO training module for their store staff. Staff Development - Three HFO staff members attended the Nutrition Incentive Convening hosted in Arlington, VA in June 2023.Two HFO staff members attended the Nutrition Incentive Scaling convening in Philadelphia, PA in April 2023. Hunger Free Oklahoma hosted the Hungry for Action conference in Oklahoma City, OK in October 2023. Our OUHSC partners hosted a workshop where they shared lessons about the benefits of produce incentive programs and clinic-community partnerships. How have the results been disseminated to communities of interest? HFO has focused on improving access to critical information about DUO in the following ways: Developing, implementing, and expanding firm data dashboards for HFO staff, contractors, and advisory committee members to see real-time DUO data to inform decision making. Producing an annual report to cover major learnings and findings from store evaluations. Maintaining a public facing DoubleUpOklahoma.org website to help connect people seeking assistance to DUO locations and information. Our DUO for Health program team connects health care providers in communities with participating DUO grocery stores, educating SNAP patients on the health benefits of eating fresh produce to help overcome chronic health issues like diabetes and cardiovascular disease. Disseminating key information to state and local policy makers via legislative briefs and one-pagers. Presenting findings at relevant convenings - Oklahoma Public Health Association, September 2023 and American Public Health Association Annual Meeting and Expo, November 2023 On April 19, 2024, the DUO Senior Program Manager had the opportunity to present a Double Up Oklahoma overview to 300+ Department of Human Services attendees during their monthly Friday Touchpoint meeting. Those in attendance included regional directors who supervise the county health departments, program directors, administrative staff, deputy commissioners, assistant deputy commissioners, and business managers. In addition to these opportunities to share learnings and results from Double Up Oklahoma, Hunger Free Oklahoma engaged in multiple strategic initiatives to increase awarness about the program amonsgt potential participants and increase access to information about nutrition and produce preparation. Some key initiatives included: Method Cards - Similar to a recipe card, these DUO for Health Method cards explain how to cook vegetables and were developed to be handed out by health care professionals. Participating clinicians use these materials, along with our DUO for Health brochures, to talk to patients about the benefits of eating fresh fruits and vegetables. The cards include Roast It, Broil It, Sauté It, Steam It, Grill It, and Mash It! They are the newest addition to our recipe card collection and DUO for Health brochures designed specifically for SNAP/DUO participants.https://www.hungerfreeok.org/duo-for-health/ Boosted Social Media for Farm Direct Firms - 39 farmers market social media promoted posts resulting in 753,946 impressions, 6058 clicks to the DUO website, and 20,369 overall click interactions. Digital advertising - DUO geo-targeted ads resulted in 1.3M impressions, 1138 clicks, and 2,255 ad interactions from July - August 2023. The advertisements focused on educating consumers about DUO and getting them to a specific DUO participating firm based on their geographic locations What do you plan to do during the next reporting period to accomplish the goals? The DUO team will continue to work with two retail chains that are contractually committed to offering DUO in their stores (Supermercados Morelos and Choctaw Country Markets). Delays that have occurred are outlined in the Changes/Problems section below. When successfully launched, seven more stores will offer DUO. We have identified another potential retail partner in Reasor's, part of the Brookshire Grocery Company; conversations are ongoing, and contracts are under review. Truno, Reasor's POS provider, is building out a DUO model that will work in their Oklahoma stores. This will eventually add seven more retail stores that offer DUO. Further, the DUO team will: Explore adding an additional mobile market and expand into farm stands and hubs. Focus on marketing efforts to expand awareness of the DUO program to SNAP-EBT customers. Continue to incorporate more health care providers into the DUO for Health program as we expand into more grocery store communities.

Impacts
What was accomplished under these goals? Goal 1: Increase purchase of fruits and vegetables among SNAP Participants To align with the revised USDA grant reporting period, we have adjusted the baseline for this measure to June 2020 - May 2021. At baseline, SNAP produce purchases made up 23% of all produce sales, and when combined with DUO, they accounted for 25% of all produce sales. During the current reporting period, SNAP produce purchases accounted for approximately 28% of all produce sales at the stores measured (N=11). However, when combining SNAP and DUO, nearly 58% of all produce purchased was paid for with SNAP and/or DUO. SNAP and DUO produce purchases amounted to $4,998,130 during this reporting period, signifying a 348% increase from the baseline of $1,116,111. This measure reflects transactions at grocery stores within one chain, HAC, Inc. Two new stores in the chain began accepting DUO on April 30, 2024, but were excluded from this measure due to their recent start date. Another chain, Prime Time Nutrition (N=12), also started accepting DUO in April/May 2024 and has been excluded from this measure. Both will be included in future reports. From the start of the grant in October 2022 through May 2024, SNAP produce purchases accounted for 27% of all produce sales, while combined SNAP and/or DUO produce purchases represented 50% of all produce sales. During this reporting period, DUO redemptions reached $2,800,446, reflecting an approximate 180% increase from the base year of measurement ($1M/year). This measure includes data from participating grocery stores (N=24) across three chains: HAC, Inc. (N=11), Oasis Fresh Market (N=1), and Prime Time Nutrition (N=12). From the start of the grant in October 2022 through May 2024, redemptions totaled $4,765,642. The same stores mentioned above (N=24) were included in this measure. During this reporting period, an average of 16,290 SNAP participants used DUO monthly at Oasis Fresh Market (N=1) and HAC, Inc. stores (N=11). We anticipate a steady increase in SNAP participants as we incorporate Prime Time Nutrition stores (N=12) and eight newly added HAC stores (Clinton - 2, Frederick, Mangum, Muskogee - 3, and Shawnee) in future reports. From the start of the grant in October 2022 through May 2024, 94,352 estimated SNAP participants have used DUO at Oasis Fresh Market (N=1) and the measured HAC, Inc. stores (N=11). Goal 2: Improve nutrition security among Oklahoma SNAP participants Our September 2022 - August 2023 participant survey report showed fruit/vegetable consumption increased .15 cups (2.72) over baseline of 2.57 cups per our Sept 2020-Aug 2021 report. Our aim is to see how the food security of participants changes over time. Due to implementation delays, we do not have this data yet. This goal is part of our PROVIDE study. HFO, in partnership with the University of Oklahoma Health Sciences Center (OUHSC), is leading a comprehensive DUO Health Impact Study, now called PROVIDE (Produce is Vital in Diverse Environments). The purpose of this study is to: Understand whether DUO participation leads to improved dietary quality Understand whether DUO participation leads to reduced diet-related health risks Assess participant food security over time. This study will follow SNAP participants (N=1000) who shop at firms prior to DUO implementation and will conduct follow up surveys every three months as the participants start using DUO incentives. Data collection started in April 2024 and will continue into 2025. The results of this study will be presented at the end of the grant. We believe this will give us a more powerful measure of both fruit and vegetable consumption and food security status over time. Goal 3: Improve community access to affordable produce, including locally grown produce. The data provided in this section encompasses all grocery stores and farm direct firms (N=50) operating during the reporting period, including HAC, Inc. (N=13), Oasis Fresh Market (N=1), Prime Time Nutrition (N=12), farm direct firms (N=23), and one mobile grocer (N=1). During the reporting period, DUO operated in 15 firms in rural, low-access communities. This is 50% of our goal of 30 rural LILA firms by 2026. DUO is operating in 22 urban LILA communities, representing 73% of our goal of 30 urban LILA firms by 2026. DUO is currently offered at 13 grocery stores and one mobile grocer operating in LILA areas; the mobile grocer has seven stops in seven LILA areas. In total, DUO is accessible in 20 LILA communities representing 67% of our goal of 30 grocery stores operating in LILA communities by 2026. Twelve farm direct firms in LILA communities operated DUO during this reporting period, equaling 40% of our goal of 30 DUO farm direct firms in LILA communities by 2026. Most firms (N=38) are currently purchasing local produce. The amount or percentage of produce bought by the firms varies from 100% to 1%. All firms have committed to increasing local purchasing by at least 1% per year through. HAC, Inc. (N=11) has shown a 51% increase in local produce purchases in 2023 vs 2022.

Publications