Progress 04/01/15 to 09/30/19
Outputs
Target Audience:Overall Reach Across All Outlets. In the bottom section of Table 3.1 (see submitted AMENDED Fresh Savigns Evaluation Report_October 30 2019), we present estimates of the overall number of SNAP participants reached by Fresh Savings (i.e., received coupons or tokens) through Kroger, farmers markets and other token-based outlets combined each year and total. First, row V lists estimates of the overall cumulative SNAP participants at all outlets who received coupons or tokens across all months within each year and total. These numbers represent the sum of a) the annual cumulative SNAP participants receiving tokens in farmers markets (row I), b) the annual cumulative SNAP participants receiving tokens in produce stands/small grocers (row P) and c) an estimate of the annual cumulative SNAP participants receiving coupons in Kroger stores. The annual cumulative number had to be estimated for Kroger since it was not provided in the data reports. To generate this estimate for Kroger, for each month we chose the lowest of two options: 1) the number of coupons distributed in the month, or 2) the number of unique SNAP households shopping at the stores (data not shown), then added these monthly numbers together for each year. Second, we calculated the average number of SNAP participants at all outlets who received coupons or tokens per month (row W) by dividing row V by 12. Third, row X reports estimates of the number of new, unique (unduplicated) SNAP participants receiving Fresh Savings coupons or tokens per year and overall across the entire period. We added together the actual number of new SNAP participants receiving Fresh Savings tokens in any of the token-based outlets and an estimate of the number of new SNAP participants receiving a Fresh Savings coupon at a Kroger store. The Kroger estimate was calculated based on the assumption that 95% of the SNAP participants were repeat customers (only 5% new customers each month), thus assuming that the pool of grocery store shoppers would be more consistent than that of farmers markets, and yielding a conservative estimate of new customers. Based on these estimates, AARP Foundation far exceeded the goal of reaching 67,000 SNAP households with Fresh Savings, reaching over 224,000 unique SNAP households across the 43 months of implementation. The vast majority of SNAP households were reached via Kroger (row Y: 211,302 households, 94.2%), compared to token-based outlets (row Z: 12,956, 5.8%). Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided?
Nothing Reported
How have the results been disseminated to communities of interest?In addition to sharing the infomration with AARP leadership, results were shared at the Academy Health - Annual Conference on the Science of Dissemination & Implementation in Health, December 4-6, 2019; Arlington, VA https://www.academyhealth.org/events/2019-12/12th-annual-conference-science-dissemination-and-implementation-health What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
Objective 1: Develop an innovative, replicable and scalable fruit and vegetable incentive redemption system that is broadly supported by retail grocers, farmers markets and farmer vendors Rollout of Fresh Savings to Retail Outlets. AARP Foundation implemented Fresh Savings in token-based outlets starting September 2015 through March 2019 (43 months) and in Kroger stores October 2015 through December 2018 (39 months). AARP Foundation added the Fresh Savings Rx component, effective March 2018 through March 2019. In total, Fresh Savings was implemented in 27 Kroger stores (10 in Mississippi, 17 in Tennessee) and 55 token-based outlets (21 in Mississippi, 34 in Tennessee). The token-based outlets included 42 farmers markets, 6 produce stands and 7 small grocers. Nearly two-thirds of Kroger stores and token-based outlets (63%) were located in Tennessee, although all of the produce stands were located in Mississippi. Did Fresh Savings reach 67,000 SNAP households in Mississippi and Tennessee with the incentive program? AARP Foundation reached over 224,000 SNAP households, far exceeding the goal. We defined "reach" as the number of SNAP participants who were exposed to the project through receiving printed Fresh Savings coupons at Kroger during checkout or receiving Fresh Savings tokens at token-based outlets. The vast majority of SNAP participants were reached via Kroger (211,302 households, 94.2%), compared to token-based outlets (12,956, 5.8%). Fresh Savings Rx reached an additional 1,500 SNAP participants through distribution of Fresh Savings Rx booklets in participating clinics, half of whom were age 50 years and older. Was the incentive system refined each year as needed based on project implementation learnings and processes evaluated? If so, how was the system refined and what subsequent changes were observed? AARP Foundation refined Fresh Savings over time in response to transaction data and feedback from outlet managers to expand reach. Modifications included changing the qualifying purchase criteria, adding new outlet types, adding Fresh Savings Rx, and adjusting marketing strategies. The biggest impact on reach was achieved through broadening the eligibility of the qualifying purchase to enable more people to receive Fresh Savings coupons in Kroger and to increase the value of the dollar-for-dollar match in token-based outlets. Was the method and system for receiving financial incentives accessible, user-friendly and "adopted" by 30,000 SNAP households after the second year of full implementation? Surveys done with store managers showed that Fresh Savings was largely seen as easy to implement. Managers perceived some benefits for customers and store sales and reported they would be willing to take part in a project like this again in the future. In the household survey, the SNAP participants who knew about Fresh Savings generally reported they had no trouble using it, both in Kroger grocery stores and in token-based outlets. Objective 2: Increase fresh fruit and vegetable purchases by participating SNAP households in Mississippi and Tennessee. Did monthly sales of fruits and vegetables to SNAP customers increase over the course of Fresh Savings implementation in incentive Kroger stores? We examined whether the Fresh Savings incentive had an impact on overall fruit and vegetable purchases among SNAP participants. Due to limitations in the way Kroger provided data on the overall sales of fresh fruits and vegetables among SNAP participants, we had to answer this question by selecting the initial group of ten Kroger stores that began implementing Fresh Savings in October 2015 and follow these same stores over the course of the 39 month study period. Average per-store fresh fruit and vegetable purchases among SNAP participants in these incentive stores stayed relatively stable over time. Since February 2017, Fresh Savings redemptions on average added approximately $3,400 in fresh fruit and vegetable purchases per store per month on top of the amount that SNAP participants were already purchasing in these stores. Were monthly sales of fruits and vegetables to SNAP customers at least 10% higher in incentive stores vs. control stores? We compared the average per-store overall sales of fresh fruits and vegetables among SNAP participants for groups of stores with the Fresh Savings incentive versus groups of designated control stores, which included a new set of comparison stores added each year. Average per-store overall sales of fresh fruits and vegetables among SNAP participants were 8.5% greater in incentive stores versus control stores, which was slightly under the target of 10%. Were self-reported fruit and vegetable expenditures in past week at least 10% greater among households exposed to Fresh Savings (utilized it at least once) vs. those who were not exposed? Based on the household survey, we did not find a significant difference in self-reported overall expenditures on fruits and vegetables based on whether or not the participants used Fresh Savings. Did monthly sales of fruits and vegetables to SNAP customers increase over the course of Fresh Savings implementation in token-based outlets? Yes, the amount of overall fruit and vegetable purchases by SNAP participants in token-based outlets, using both SNAP and Fresh Savings tokens increased significantly over time, with an average increase of $1,813 from month to month. When examining each outlet type separately, the trend was significant for farmers markets only. Did monthly redemption of fruit and vegetable incentive tokens increase over the course of Fresh Savings implementation? Yes, the monthly redemption rate for token-based outlets increased significantly over time from 55% to over 100%, with an average increase of 1.35% from month to month. Significant increases were observed for farmers markets, produce stands, and small grocers. Objective 3: Increase fresh fruit and vegetable consumption by SNAP follow-up survey participants. Baseline surveys were completed with 1,459 SNAP households sampled as shoppers or likely shoppers at selected Kroger stores and farmers markets, and 6-month follow-up surveys were completed with 74% of these households.There was a significant association between Fresh Savings use and increased vegetable consumption. Overall, vegetable intake increased from 1.8 servings per day to 2.2 servings per day, an improvement of 2.8 servings per week. Use of Fresh Savings was not associated with changes in fruit intake, which were 1.7 servings per day at baseline and 1.8 servings per day at follow-up. When combined, fruit and vegetable servings went from 3.5 servings a day to 4.0 servings per day, an increase of 3.5 servings per week. We conclude there was credible evidence that use of Fresh Savings incentives was associated with increases in vegetable consumption, but not with fruit intake. Objective 4. Strengthen the impact of the Fresh Savings project among older SNAP participants with on-site nutrition education (Grocery Guides) Baseline surveys were completed by 169 participants, and follow-up surveys were completed by 68 participants (40%). Questions assessed change in frequency, readiness to change and self-efficacy for: 1) comparing unit prices, 2) using nutrition facts labels, 3) comparing ingredient lists and 4) buying a variety of fruits and vegetables. While nearly all were using unit price comparison skills at baseline, there were significant improvements in the other three behaviors in terms of frequency, readiness to change, and self-efficacy. At follow-up, participants reported that they were more likely to choose fresh produce, low-sugar foods, low sodium foods and lean sources of protein but did not change their likelihood for choosing low-fat foods or whole grains. We conclude that there is evidence that the Grocery Guides nutrition education program was associated with beneficial outcomes for participating older SNAP recipients.
Publications
- Type:
Conference Papers and Presentations
Status:
Under Review
Year Published:
2019
Citation:
Academy Health - Annual Conference on the Science of Dissemination & Implementation in Health
December 4-6, 2019; Arlington, VA
https://www.academyhealth.org/events/2019-12/12th-annual-conference-science-dissemination-and-implementation-health
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Progress 04/01/17 to 03/31/18
Outputs
Target Audience:The AARP Foundation continues to target SNAP consumers in Tennessee and Mississippi in our target counties. Many of the counties served through April 30, 2018 are in USDA-designated Strikeforce counties - counties with some of the highest poverty rates are in rural America, with high numbers of Historically Underserved groups, including African Americans, Hispanics, Asian Americans, and Native Americans. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided?Staff: During this reporting period, AARP Foundations AARP Foundation was fortunate not to see any staff transitioning from the organization. Based on need, we did expand staff to include an Outreach and Volunteer Coordinator, Brittaney Myers, to manage the program in the Memphis and surrounding areas. The AARP Foundation has supported the continued training and development of not only the new staff members working on the Fresh Savings program, but also the existing staff that supported the program. Training activities included the following required internal training - Records Management Awareness, Workplace Violence and Threatening Behavior - as well as the following employee self-directed trainings and conferences - USDA Food Funding Mechanism Web Series, National Conversation on Hunger and SNAP, Age Out Loud Conference, National Conversation on Hunger and SNAP, Federal Compliance Training, Mississippi Department of Health Summit, and various other conferences and workshops. Volunteers: During this reporting period, the Fresh Savings field teams in Mississippi and Tennessee have recruited and trained over 200 volunteers to conduct outreach, run grocery store tours and provide administrative support for the program. Volunteers have donated over 765 hours of support to the Fresh Savings program during the reporting period. Based on volunteer role and participation, volunteers also benefit from many of the informal learnings opportunities afforded to the Fresh Savings field teams, including data collection and integrity, public speaking and presentation skills and networking. Partners: The field managers and staff have conducted 90 trainings to over 1,000 participants. The field managers have conducted regular presentations to DHS partners. During this reporting period, the field managers have conducted 40 trainings to over 600 case managers in the following counties: Mississippi: Copiah, Neshoba, Clay, Hinds, Jackson, Coahoma, Desoto, Lafayette, Tate, Harrison, Jones, Ranking, Lauderdale, and Warren Tennessee: Davidson, Shelby, Greene, Hamilton, Tipton, Montgomery, Williamson, Hablen, Knox, and Johnson. AARP Foundation continues to conduct ongoing trainings and presentations to Kroger personnel, including store managers and co-managers, produce and front-end managers and district and regional managers. In addition, all farmers market managers, vendors and volunteers continue to participate in trainings conducted by both the AARP Foundation and our program partner, Wholesome Wave. Field managers and their local outreach and volunteer coordinators provide ongoing technical assistance to Kroger and farmer's markets staff and volunteers, related to program operation, outreach, and data collection and reporting. In addition, to the items listed above, AARP Foundation holds weekly or bi-weekly meetings witch each of our program partners and funders to not only foster continued engagement with the Fresh Savings program but also to strategize any implementation or programmatic issues that might be preventing full program success. How have the results been disseminated to communities of interest?Program information and preliminary results have been shared both formally and informally. Formally through the AARP Foundation's evaluation process, we have shared monthly participation and redemption data to Foundation leadership, including the Foundation's Board of Directors and Senior Leadership. In addition, preliminary baseline evaluation data is currently being finalized and will be shared with Foundation leadership as well with the USDA FINI management. Informally, Fresh Savings program information has been shared through over approximately 150 outreach events with over 11,500 participants. These outreach events have included presentations to faith based organizations, local departments of aging, local health fairs, and local conferences. What do you plan to do during the next reporting period to accomplish the goals?During the next reporting period - April 1, 2018 - March 31, 2019 - the AARP Foundation plans to expand to 4 additional Kroger stores, with 2 planned in Mississippi and Tennessee each. AARP Foundation will continue to support our outlets by conducting training with our DHS partners and will continue to participate in outreach events, including community presentations. In addition, the Foundation will finalize analysis of the baseline and final evaluation toward determining goal success.
Impacts
What was accomplished under these goals?
Fresh Savings has surpassed the first goal. The intervention has reached over 132,000 SNAP households in Mississippi and Tennessee, has expanded to 25 Kroger stores and is currently in over 55 farmers markets, produce stand and local grocery stores. Based on preliminary results from the baseline data, Fresh Savings is positioned to achieve goals 2-4. Final analysis of the data will reveal results and program outcomes related to each goal; results will be distributed to USDA through both the final annual progress report and the final reports. During the reporting period of April 1, 2017 - March 31, 2018, the Fresh Savings Program has been focused on supporting our existing outlets (Krogers and farmers markets), expanding to new outlets (Krogers and farmers markets), conducting programs trainings to partners (including outlets and non-outlets), participating in outreach events, including community presentations, recruiting and supporting volunteers for outlets and program support, hiring and training staff, refining program marketing material to increase impact Results at Kroger: During the reporting period, the AARP Foundation added four new Kroger grocery stores to the Fresh Savings program. Mississippi and Tennessee both added 2 stores - Cleveland and Greenville for Mississippi and Covington and Millington for Tennessee. AARP Foundation had 21 Kroger partnerships operating the Fresh Savings Program. During this reporting period, 105,632 distinct SNAP shoppers have received over 778,434 Fresh Savings Coupons at participating Kroger stores. Of those, a total of 139,387 coupons have been redeemed, for an average redemption rate of 17.9% (coupons redeemed/coupons issued). Through the program, there were over 852,653 discounted fresh fruit and vegetable items. The average discount per Fresh Savings transaction was $6.00, with a per item discount of $1.00. From the program initiation to the end of the reporting period, there have been over 132,000 distinct SNAP shoppers that have received over 1,095,310 coupons and redeemed 174,465 coupons for a redemption rate of 15.9%. Results at Farmers Market: During this reporting period, AARP Foundation expanded our footprint with farmers markets, produce stands and retail grocery by adding 19 new outlets - 7 in Mississippi and 12 in Tennessee. During the period covered by this reporting period, The AARP Foundation had 61 farmers markets and produce stands. At the end of this reporting period, these outlets were able to disseminate $417,415 in Fresh Savings tokens to over 25,339 new and repeat SNAP customers. Of those, a total of $329,628 tokens have been redeemed, for a total redemption rate of 78.9% (tokens redeemed/tokens issued). Since the program's inception, these outlets distributed $465,492 in fresh savings tokens with redemption of $372,058 for a redemption rate of 79.9%. There have been 30,413 SNAP customers served through these outlets since program inception. Grocery Guides: During the reporting period, the AARP Foundation continued our volunteer-led in-store nutrition education curriculum, Grocery Guides, at our Fresh Savings Kroger outlets. We continued to recruit SNAP participants and removed the age restriction of ages 50 and over. During this reporting period, there were 173 tours scheduled. Of the 268 individuals that registered to participate in the tours, 112 attended and completed the tours. Since the program's inception, we have had 165 individuals attend and complete the Grocery Guide tour.
Publications
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Progress 04/01/16 to 03/31/17
Outputs
Target Audience:The AARP Foundation continues to target SNAP consumers in Tennessee and Mississippi in our target counties. Many of the counties served through April 30, 2017 are USDA-designated Strikeforce counties - counties with some of the highest poverty rates are in rural America, with high numbers of Historically Underserved groups, including African Americans, Hispanics, Asian Americans, and Native Americans. In the Strikeforce counties we served through our Fresh Savings program this reporting period, this all holds true. In MS, 59.4% live below 130% of poverty, the median household income is $36,647, 8.6% are unemployed, and 25.3% of the population is food insecure - all rates higher than the state averages. The health implications of poverty and food insecurity are stark, with a 38% adult obesity rate, 13.4% rate of diabetes, and 19.8% of individuals uninsured. The demographic breakout in the MS Strikeforce counties is 43.9% white, 53.8% black, 2% Hispanic, and 1.1% Asian. In our TN Strikeforce counties, 57% live below 130% poverty, the median household income is $42,294, 7.4% are unemployed, and 18.9% of the population is food insecure. In these same counties, adult obesity is at 33.3%, 12.7% are diabetic, and 17.3% are uninsured. The ethnic breakout in these TN Strikeforce counties is 64.6% white, 31.7% black, 6.8% Hispanic, and 1.6% Asian. Our efforts in all counties included the delivery of a fresh fruit and vegetable incentive for SNAP shoppers at targeted farmers markets and Kroger grocery stores, as well as grocery store nutrition education tours designed for older adults (Grocery Guides). We engaged volunteers to provide outreach and program support for all stores and farmers markets, and to deliver the nutrition education tours. Changes/Problems:During this reporting period, the program experienced the transitions of several key positions, including the project director (i.e. national program manager), field outreach and evaluation coordinator and Wholesome Wave outreach coordinator, including the regular turnover of staff and volunteers at our Kroger and farmers market outlets. In addition, in March 2017, the AARP Foundation authorized a change in the qualifying purchase requirement for the Fresh Savings coupon to print. AARP Foundation intended for the qualifying purchase requirement to change from $10 fresh fruit and vegetable spend using SNAP tender to $10 SNAP eligible items using SNAP tender. Kroger's coupon vendor, Catalina, didn't implement the change accurately, which resulted in a higher number of coupon prints for March and April. What opportunities for training and professional development has the project provided? Staff: During the second year of the Fresh Savings, AARP Foundations saw the transition of several positons supporting the Fresh Savings Program. In addition to the departure of the national program manager, the program also saw the transition of one volunteer and outreach coordinator and one Wholesome Wave field coordinator. Each position has been successfully field with new staff eager to support the continued success of the Fresh Savings program - both nationally and locally. The AARP Foundation has supported the continued training and development of not only the new staff members working on the Fresh Savings program, but also the existing staff that supported the program. Training activities included the following topics: accounting, finance (for managers and non-managers) and non-profit leadership. Professional development opportunities included the following: Ethics in End of Life Care, Social Work Ethics: Confidentiality, Geriatric Case Management, Dangerous Teenage Behaviors, Causes and Treatments, Cultural Competencies in Mental Health, ODD Treatment & Best Practices, Conscious Discipline One Day Overview, Social Work Practice and Diversity in the 21st Century, 15th Annual MS Child Welfare Institute Conference, and Situational Leadership. In addition to external training and professional development opportunities, through the AARP Foundation's Foundation University and Online Learning Program, Fresh Savings national program manager, field program managers and outreach and volunteer coordinators have had the opportunity to attend - in person or virtually - the following courses: Determining Pay for Success Feasibility: Lessons from the Experience Corps Program, Grocery Guides Implementation Evaluation Findings and Recommendations, AARP Security Awareness, AARP How We Do Business, AARP Exhibit Integrity, AARP Records Management Awareness, AARP Foundation Message Training, Using Qualitative and Quantitative Methods in Program Evaluation, Generating Program Demand Workshop, and Lunch and Learn: Work for Yourself 50+. Lastly, in addition by the nature of the work down through the Fresh Savings programs, there have been several non-formal learning opportunities including learning about data collection and integrity, public speaking and presentation skills, verbal and non-verbal communication and networking. Volunteers: During this reporting period, the Fresh Savings field teams in Mississippi and Tennessee have recruited and trained over 500 volunteers to conduct outreach, run grocery store tours and provide administrative support for the program. Volunteers have donated over 1,070 hours of support to the Fresh Savings program during the reporting period. Based on volunteer role and participation, volunteers also benefit from many of the informal learnings opportunities afforded to the Fresh Savings field teams, including data collection and integrity, public speaking and presentation skills and networking. This is an additional benefit to volunteers since many of them are college students. The field team continues to recruit and train older adult volunteers, which is consistent with our mission to not only serve older adults but to also provide ongoing engagement and socialization opportunities for this population. Partners: The field managers and staff have conducted 67 trainings to over 1,000 participants. The field managers have conducted regular presentations to DHS partners. During this reporting period, the field managers have conducted 29 trainings to over 560 case managers in the following counties: Mississippi (253 case managers): Copiah, Neshoba, Clay, Hinds, Jackson, Coahoma, Desoto, Lafayette, Tate, Harrison, Jones, Ranking, Lauderdale, and Warren. Tennessee (311 case managers): Davidson, Shelby, Greene, Hamilton, Tipton, Montgomery, Williamson, Hablen, Knox, and Johnson. One of the early lessons learned from the implementation of the Fresh Savings program with both the national retailer and the local farmers market is that there is constant turnover of staff and volunteers. As a result of that turnover, the field team, with assistance from the national program manager, continues to conduct ongoing trainings and presentations to Kroger personnel, including store managers and co-managers, produce and front-end managers and district and regional managers. In addition, all farmers market managers, vendors and volunteers continue to participate in trainings conducted by both the AARP Foundation and our program partner, Wholesome Wave. Field managers and their local outreach and volunteer coordinators provide ongoing technical assistance to Kroger and farmer's markets staff and volunteers, related to program operation, outreach, and data collection and reporting. As a component of our partnership with both the Kroger stores and farmers markets, the AARP Foundation provides our partners with various outreach and communication material to support program implementation, including banners, flyers, brochures, posters, social media marketing material, etc. In addition, to the items listed above, AARP Foundation holds weekly or bi-weekly meetings witch each of our program partners and funders to not only foster continued engagement with the Fresh Savings program but also to strategize any implementation or programmatic issues that might be preventing full program success. How have the results been disseminated to communities of interest?Program information and preliminary results have been shared both formally and informally. Formally through the AARP Foundation's evaluation process, we have shared monthly participation and redemption data to Foundation leadership, including the Foundation's Board of Directors and Senior Leadership. In addition, preliminary evaluation data has been presented to FINI. Informally, Fresh Savings program information has been shared through over approximately 150 outreach events with over 11,500 participants. These outreach events have included presentations to faith based organizations, local departments of aging, local health fairs, and local conferences. What do you plan to do during the next reporting period to accomplish the goals?During the next reporting period - April 1, 2017 - March 31, 2018 - the AARP Foundation plans to expand to 8 additional Kroger stores, with 4 planned in Mississippi and Tennessee each. The stores will be brought on to the program in June/July 2017 and November/December 2017. In addition, the program plans to bring on two additional farmers markets/produce stand outlets during the next reporting period. In addition to the Kroger and farmers market expansion, the Fresh Savings field managers and team will continue to support our outlets by conducting training with our DHS partners and will continue to participate in outreach events, including community presentations. In addition, based on the aforementioned high turnover at both the Kroger stores and farmers markets, the Fresh Savings field team will continue to provide technical assistance to all of our participating outlets.
Impacts
What was accomplished under these goals?
During the reporting period of April 1, 2016 - March 31, 2017, the Fresh Savings Program has been focused on supporting our existing outlets (Krogers and farmers markets), expanding to new outlets (Krogers and farmers markets), conducting programs trainings to partners (including outlets and non-outlets), participating in outreach events, including community presentations, recruiting and supporting volunteers for outlets and program support, hiring and training staff, refining program marketing material to increase impact and Results at Kroger: During the reporting period, the AARP Foundation added two new Kroger grocery stores to the Fresh Savings program. Both stores are in Mississippi - Jacksonian Plaza and Pearl. There were several launch events at the end of this reporting period (March 31, 2017), the AARP Foundation had 17 Kroger partnerships operating the Fresh Savings Program. At the end of this reporting period, 24,000 distinct SNAP shoppers have received over 280,000 Fresh Savings Coupons at participating Kroger stores. Of those, a total of 32,916 coupons have been redeemed, for an average redemption rate of 11.7% (coupons redeemed/coupons issued). Through the program, there were over 244,110 discounted fresh fruit and vegetable items. The average discount per Fresh Savings transaction was $8.08, with an per item discount of $1.05. NOTE: AARP Foundation is reconfirming the March and April Fresh Savings data to ensure accuracy. Any updates will be communicated in the 2018 Annual Progress Report. Results at Farmers Market: During this reporting period, the AARP Foundation greatly expanding our farmers Market partnerships. The program experienced an expansion of 17 new farmers market partnerships - 10 in Mississippi and 7 in Tennessee. As a component of the new farmers markets, there were several lunch events (noted below in the partners section). During the period covered by this reporting period (March 31, 2017), The AARP Foundation had 45 farmers markets and produce stands. At the end of this reporting period, the 2017 farmers markets were able to disseminate $43,059 Fresh Savings tokens to over 4600 new and repeat SNAP customers. Of those, a total of $38,458 tokens have been redeemed, for a total redemption rate of 89.3% (tokens redeemed/tokens issued). Grocery Guides; During the reporting period, the AARP Foundation continued our volunteer-led in-store nutrition education curriculum, Grocery Guides, at our Fresh Savings Kroger outlets. We continued to recruit SNAP participants, ages 50 and over, directly from our household survey participant list during the period and continued our evaluation of the effectiveness of this model on the increased purchase and consumption of fresh fruits and vegetables.
Publications
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Progress 04/01/15 to 03/31/16
Outputs
Target Audience:We served SNAP consumers in Tennessee (TN) and Mississippi (MS) in 15 of our 26 target counties. Twelve of the 15 counties served through April 30, 2016 are USDA-designated Strikeforce counties - counties with some of the highest poverty rates are in rural America, with high numbers of Historically Underserved groups, including African Americans, Hispanics, Asian Americans, and Native Americans. In the Strikeforce counties we served through our Fre$h Savings program this reporting period, this all holds true. In MS, 59.4% live below 130% of poverty, the median household income is $36,647, 8.6% are unemployed, and 25.3% of the population is food insecure - all rates higher than the state averages. The health implications of poverty and food insecurity are stark, with a 38% adult obesity rate, 13.4% rate of diabetes, and 19.8% of individuals uninsured. The demographic breakout in the MS Strikeforce counties is 43.9% white, 53.8% black, 2% Hispanic, and 1.1% Asian. In our TN Strikeforce counties, 57% live below 130% poverty, the median household income is $42,294, 7.4% are unemployed, and 18.9% of the population is food insecure. In these same counties, adult obesity is at 33.3%, 12.7% are diabetic, and 17.3% are uninsured. The ethnic breakout in these TN Strikeforce counties is 64.6% white, 31.7% black, 6.8% Hispanic, and 1.6% Asian. Our efforts in all 17 counties included the delivery of a fresh fruit and vegetable incentive for SNAP shoppers at targeted farmers markets and Kroger grocery stores, as well as grocery store nutrition education tours designed for older adults (Grocery Guides). We engaged volunteers to provide outreach and program support for all stores and farmers markets, and to deliver the nutrition education tours. We have recruited 117 volunteers in both states, many of whom are 50 and older, most of whom are female. To a large degree the ethnic breakout of our volunteers mirrors that of the population we are serving. Changes/Problems:We were delayed in launching in our Tennessee Farmers Markets during the 2015 season, due to some confusion with the Tennessee Department of Human Services around whether or not they could provide the data we needed for our evaluation. Our plan was to collect baseline data during the summer of 2015, and we were unable to do so in the manner we had described in our proposal. We were able to clear up the confusion with TDHS, by obtaining assurances from USDA's FNS that it was allowable for TDHS to provide the data, but by then it was too late in the farmers market season to launch in most markets. Therefore, our evaluators revised their process for comparison between markets for TN, so that we could launch in all TN markets at the beginning of the 2016 farmers market season. This was a minor glitch in the grand scheme of things, but worth noting for future grantees. The takeaway is that state Departments of Human Services can play a critical role in providing the data necessary for evaluation. However, they each operate differently and may interpret USDA policies and regulations differently. It may be important for USDA to provide explicit guidance to the SNAP administering agencies in order to avoid these types of pitfalls in the future. What opportunities for training and professional development has the project provided?Staff: Prior to launch, AARP Foundation's national program manager hired and trained 7 field staff - two field program managers, two volunteer and outreach coordinators, an intern, and two Wholesome Wave field coordinators. We provided our intern, an undergraduate social work student, the opportunity to collect consumer feedback and to assist our evaluation team with telephonic Household Surveys. Upon graduation, she remained on the team to provide additional program support for both states and is getting solid professional development that she will be able to leverage in the future. We have weekly team calls to discuss the program's progress and address any challenges facing staff on the ground, as well as weekly program manager calls to discuss staffing and partnership issues. These calls are supplemented by regular reports that identify best practices and lessons learned from staff in each state. All staff involved in this project are receiving tremendous professional development opportunities by virtue of the nature of the work. We are learning how to deliver a program that not only benefits consumers, but can become part of the business model of Kroger and UnitedHealthcare, increasing the likelihood of sustainability of the program beyond government funding. This necessitates that our staff exercise a wide range of skills, including program development, grassroots organizing, public speaking, marketing and corporate relationship management. We have all realized a tremendous amount of professional growth during the course of this reporting period. Volunteers: During this reporting period, the Fre$h Savings field teams have recruited and trained a total of 117 volunteers (nearly reaching our program goal) to conduct outreach, run grocery store tours and provide administrative support for the program. Many of these volunteers attend local universities and are involved in the program in order to obtain community service hours required for their degree. As a result, the Fre$h Savings program is not only engaged in professional development for its internal staff, but also provides career development opportunities for members of the communities it serves. On the other end of the spectrum, a large proportion of our volunteers are older adults. This is in line with AARP Foundation's mission to serve older adults and, in the case of our Grocery Guides tours (focused on 50+ low income consumers), having older volunteers provides a peer-to-peer exchange. Partners: Our field teams have trained nearly 400 DHS staff in both states, the majority being direct service case managers, and over 1,000 other professionals from partner and community based organizations during this reporting period, so that they can deliver the message about Fre$h Savings to the clients they serve - thus providing additional value to the service they provide. Additionally, we have trained all key Kroger store personnel about the program (eligibility and implementation) and how to address questions from SNAP consumers. During our initial Kroger training, for example, we trained over 50 key store personnel, including store managers and co-managers, produce and front end managers, and district managers. All farmers market managers, vendors and volunteers have participated in comprehensive trainings (designed and delivered in collaboration with Wholesome Wave) and receive ongoing technical assistance specifically related to: 1) the use of incentive tokens for centralized EBT markets and use of receipts and vouchers for vender EBT markets; 2) how to conduct outreach; and 3) how to collect data and meet reporting requirements. Wholesome Wave conducts training of trainers (TOT) workshops for AARP Foundation's Volunteer Coordinators and other program staff, and in addition they provide the advice, tool-kits, materials and connections to facilitate the growth and sustainability of the SNAP incentive program at Farmers Markets. Our field teams conduct ongoing training as needed with all partners, when key personnel turn over, or new market managers are introduced, or are otherwise asked to do so. How have the results been disseminated to communities of interest?We have delivered presentations or otherwise participated in multiple local conferences and events, where we have shared preliminary high level results (such as our coupon redemption rate and numbers reached) and other more qualitative results. Overall though, results have not been widely disseminated or shared, as we have only just begun receiving robust reporting from Kroger during the first quarter of this year. What do you plan to do during the next reporting period to accomplish the goals?Additional Stores and Farmers Markets: During the next reporting period (prior to April 2017), we will launch in all remaining stores and farmers markets. We will exceed our goal of number of stores, as we will have launched in 26 Kroger stores, and will meet our farmers market goal of 31 markets. Reaching SNAP Households Through Outreach and Marketing: Our program aims to reach a total of 30,000 SNAP households by the end of the second full year, for a total of 67,000 over the course of the grant. To reach this goal, program staff are working closely with local organizations to raise awareness about the program. Collaborating organizations include the Mississippi chamber of commerce, North Delta Planning and Development District, Mississippi State University, Feeding the Mississippi Gulf Coast, local mayors' food banks, SNAP outreach organizations, local WIC offices, senior centers, and churches. Additionally, both states have engaged staff at local Department of Human Services offices to communicate the program to SNAP participants upon enrollment, and are working directly with county SNAP workers responsible for re-certifications. In the coming months, both states will continue their community outreach initiatives, and are expecting to complete a total of 19 scheduled events by the end of the calendar year. Additionally, we will be holding consumer focus groups to test initial program messaging and collateral, so that we can tweak it and fully implement our communications and marketing plan. In addition to the community outreach described earlier, this plan includes direct mail from AARP Foundation to SNAP consumers and likely SNAP eligible older adults, direct mail from Kroger to their Loyalty SNAP consumers, revamped in-store signage, an earned and paid media strategy, and grassroots outreach through farmers markets and other community partners. Nutrition Education Through Grocery Guides: In order to reach our goals of 450 SNAP participants 50+ receiving nutrition education, our volunteer-led Grocery Guides tours will ramp-up to full speed during the next reporting period. These tours will educate older SNAP shoppers about how to make heathy purchasing decisions, including training on reading nutrition labels and where to find healthy food in participating stores, with some additional focus on the importance of fresh fruits and vegetables as part of a healthy and balanced diet. We will begin to recruit more heavily for volunteers and participants, and will recruit a segment of participants directly from our Household Survey lists, so that we can track their outcomes over time - informing progress towards our goal of increased consumption among this group receiving both incentive and nutrition education. Evaluation: Our evaluation team is on track to reach our goals for numbers of participants enrolled in the Household Survey and will continue to collect baseline and follow-up data as planned. They will begin to analyze preliminary results from the first round of follow-up Household Surveys during the next reporting period, and we should begin to see whether our program is leading to increased consumption of fresh fruits and vegetables. In addition, due to full implementation of our communications and marketing plan, we expect to begin to see trends towards our stated goals around increased purchase of fresh fruits and vegetables by SNAP consumers in data reported by Kroger stores and farmers markets during this period as well.
Impacts
What was accomplished under these goals?
During the period from April 2015 through November 2015, our primary activities included the completion of over 50 vendor and partner agreements and contracts, hiring of field teams, acquisition of space, training of staff, program partners, and volunteers, development of key partnerships, development of core program messaging and collateral, launch event planning and raising awareness about the program. During the late summer and fall of 2015, we launched the Fre$h Savings incentive program in 10 Kroger grocery stores and 19 farmers markets throughout Mississippi and Tennessee. Over half of these participating locations are located in StrikeForce Counties. AARP Foundation program and communications staff, in collaboration with UHC, Kroger, and farmers market partners, raised awareness for the program through a variety of channels, including community outreach events held in collaboration with key stakeholders (UHC, Kroger, farmers markets and others); dissemination of fliers and brochures to county SNAP offices and case managers, the UHC Community Outreach network, and others; in-store and at market presence utilizing volunteers, banners, branded kiosks, brochures, and informational tear sheets; and earned media. Results at Kroger: As a result of these efforts, by the end of April 2016, over 20,000 SNAP shoppers have received 43,969 Fre$h Savings coupons at participating Kroger stores. Of those, a total of 2,752 coupons have been redeemed by 2,396 SNAP households, for an average redemption rate of 6.3% (coupons redeemed/coupons issued). SNAP participants have purchased a total of 20,703 discounted fresh fruits and vegetables through the program, with an average savings of $8.14 per transaction. Additionally, overall coupon redemption and redemption rates have steadily increasing throughout the duration of the program, from 4.2% in November 2015 to 7.8% by the end of this reporting period. This is a trend that is expected to grow aggressively as outreach efforts continue. Grocery Guides: In November of 2015, we launched our volunteer-led in-store nutrition education curriculum, Grocery Guides, at some of our Fre$h Savings Kroger outlets. During the reporting period, we have held a total of 25 tours for a total of 54 individuals ages 50 and older. We will begin recruiting SNAP participants, ages 50 and over, directly from our household survey participant list during the next reporting period and will also begin to evaluate the effectiveness of this additional component on increased purchase and consumption of fruits and vegetables. Results at Farmers Markets: We launched Fre$h Savings at farmers markets beginning very late in their 2015 season, and many had only a few days of actual operation. Additionally, we were unable to launch in most of the Tennessee farmers markets in 2015 due to issues with obtaining data needed to conduct baseline surveys from the Tennessee Department of Human Services. At the end of this reporting period (April 30 2016), the 2016 markets are only just getting started. In spite of the relatively short operational period, we have been able to disseminate over $4,857 Fre$h Savings tokens to over 688. SNAP households. Of those, a total of $4,109 tokens have been redeemed, for a total redemption rate of 84.6% (tokens redeemed/tokens issued).
Publications
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