Performing Department
(N/A)
Non Technical Summary
The Arizona Community Health Workers Association, will lead Comiendo Fresco CF- Eating Fresh in Douglas, Arizona, an under-resourced, primarily Hispanic (Mexican-American) rural community in Cochise County on the U.S.-Mexico border. Leveraging community assets, CF will bring together diverse partners: Chiricahua Community Health Centers, Cochise Health and Social Services, University of Arizona Cooperative Extension-Cochise, SEAGO Area Agency on Aging, the City of Douglas, UA Center for Rural Health, local vendors and an active coalition, to steer, implement and evaluate the PPR. The community of focus has high rates of dietary-related health conditions, food/nutrition insecurity, social vulnerability, and limited access to fruits and vegetables (FV). CF will expand FV access and purchasing from local vendors to 150 eligible participants through weekly $20 vouchers over 9 months across three cohorts. Participants will receive culturally centered nutrition education and related activities, support from Community Health Workers (CHWs) to address health related social needs (HRSN) that influence dietary patterns and health outcomes. Improvements in participants' FV consumption and nutrition knowledge/skills will be evaluated, along with reduced HRSN via CHW support. Health improvement will be assessed by participants' self-reported health status and pre/post changes on health condition biomarkers (HbA1C, blood pressure and BMI). Local access to FV, impacts on food/nutrition insecurity and changes in policies, systems and environments will assessed, as well as impacts on preventable hospital visits and associated costs, the local economy and food system. Ultimately, Comiendo Fresco PPR will benefit the community by building a more sustainable, integrated health and food system.
Animal Health Component
0%
Research Effort Categories
Basic
20%
Applied
50%
Developmental
30%
Goals / Objectives
The goal of theComiendo Fresco- Eating Healthy Produce prescription Programis to improve integration of the health and social care and food systems to improve health and food security status among participants in the Douglas community.CFis a community driven innovative nutrition incentive program in a predominantly Hispanic community with high rates of dietary-related health conditions, food/nutrition insecurity, social vulnerability, and limited access to FV. AlignedwiththeGusNIPPPRgoalsandobjectives,CFobjectives are as follows:1.By the end of each project year, 95% of participants will increase purchasing of FVthrough redemption of FV vouchers atlocal stores, farmers markets and growers.2.By the end of each project year, increase average daily dietary intake (consumption) of FV in 75% of participants.3.By the end of each project year, 60% of participants will show improvements on self-reported health status and/or 40% of participants will have reduction in one or more biomarkers (HbA1c, BP, BMI).4.By the end of each project year, decreased food/nutritionsecuritystatusin75% ofparticipants uponcompletion.5.By the end of each project year, 75% of participants in evidenced-based nutrition education and activities will show improved knowledge, skills, and dietary patterns.?6.By the end of each project year, 90% of participants will report on CHW's effectiveness in providing support, retention, and referrals to address HRSN.7.By the end of the POP, 75% of participants will report reduced need for HRSN.8.By the end of the POP,CFwill demonstrate improved health care utilization and reduced unnecessary care/costs in 40% of participants (PCP, hospital & ED's/urgent care visits).
Project Methods
Implementation Phase: Identify, Screening and Referral1)Chiricahua identify eligible participants, screen and verify and refer to AzCHOW2)Develop health care deidentified data collection parametersEnrollment3)PC provides CF information sessions, meets 1:1 with referred participants, verifies eligibility, enrolls 150 over 3 years, (30 in year 1, 60 years 2 & 3), complete baseline surveys, develop support plan and set goals, identify HRSN, provide vouchers.4)Conduct pilot with cohort 1 to refine program flow and outcomes5)SUWD meets monthly and receives updates and requests for guidance and engagement onCFactivities to reach communityVoucher Redemption6)Project lead will track FV voucher redemption, number of individuals and amount and preferred locations monthly and identify issues and barriers7)Document barriers and challenges to redemption and address and share with project leadership and SUWD and local vendors as neededContinued Support and Linkages8)PC/CHW follow up on participant progress, satisfaction, referrals to nutrition education/activities and HRSN to review progress, address barriers to access and redeeming vouchers9)Weekly updates on nutrition education, activities and events shared with participants via social media and text messages10)Track participation in nutrition education/activities11)Track uptake of HRSN referrals through Resource Hun feedback loopVoucher Reimbursement12)Track reimbursement of FV vendors monthly and address issues13)Provide ongoing training to FV voucher vendors as neededProgram Close-Out14)PC/CHW completes post-program surveys with vendors/sites, firms/partners, SUWD members and healthcare partner15)Complete participant post-program data including survey, biometrics, and self-reported health outcomes and/or behavior changes and distribute final FV incentive16)Collect participant completion of nutrition education from partners and evaluation findings17)Attend GusNIP PPR grantee meeting (Project Director)Identify changes for program improvement with participants, partners, vendors, project leadership and SUWD