Progress 06/01/17 to 05/31/21
Outputs
Target Audience:The Food Trust's (TFT) Food Bucks program engaged participants and other stakeholders across the public and private sectors. SNAP Users: TFT's Food Bucks program makes fresh fruits and vegetables more affordable for shoppers using SNAP. Over the course of this grant, over 75,000 households in key regions of Pennsylvania (PA) and New Jersey (NJ) earned incentives, including over 50,000 households in the final year. With increased SNAP enrollment and higher benefit amounts due to the financial hardships of the COVID-19 pandemic, more households than ever before participated in the Food Bucks program in 2020. Although not all farmers markets were able to open for the 2020 season, and some smaller brick and mortar retailers experienced temporary closures, existing sites saw increased volume and a new supermarket partner made Food Bucks available to two additional communities. The continued success of the corner store program at Fayers Market and Junior Supermarket in Camden, NJ, enabled roughly 7,000 households to receive Food Bucks. In Philadelphia and nearby Chester, approximately 55,000 households earned Food Bucks at seven supermarkets, a corner store, and across TFT's farmers markets network. Shoppers in central PA accessed more fresh produce at the York Fresh Food Farms mobile market and Butcher's Farm Market, with over 1,000 households receiving Food Bucks in that region. In western PA, programming reached roughly 12,000 households using SNAP at 24 retailers.* The Food Bucks Rx (FBRx) program also reached patients and families receiving SNAP who were at risk of diet-related diseases and often food insecure. By fall 2019, when TFT's ongoing FBRx work was transitioned to a 2019 GusNIP PPR award, nearly 1,500 patients had received FBRx coupons. FBRx can be used to purchase fresh fruits and vegetables at eligible firms, including the majority of those participating in Food Bucks. Patients came from a variety of settings, including a hospital-located Healthy Food Center that operates a food pantry, a diabetes clinic in a high-Medicaid setting, pediatric well visit locations, and a WIC clinic. These initial FBRx pilots provided the groundwork to grow the program and reach many more eligible households and communities with support from the GusNIP PPR award. *Note: Since few sites can provide the number of unique program users, the above numbers represent our best estimates of households reached based on the number of SNAP transactions and data from comparable sites. Brick-and-Mortar Firms: Across the grant, project staff supported a variety of grocery settings, including superettes, food co-ops, and independent supermarket chains. In the final year of the grant, TFT focused on strengthening and sustaining programming at current sites, and boosting the incentive model when possible to respond to increased food insecurity associated with the COVID-19 pandemic. TFT also added Cousins Fresh Market in Chester, PA, the only supermarket serving this community that includes many SNAP-eligible households. 21 brick-and-mortar firms participated in Food Bucks over the course of this grant: Camden: Fayers Market, Junior Supermarket Central PA: The Marketplace at Shermans Dale, Butcher's Farm Market Philadelphia: The Fresh Grocer (five locations), Olivares, Corner Food Market, Cousins Fresh Market (two locations) Western PA: The East End Food Co-op, Shop 'n Save (two locations), Dylamato's Market, Carl's Cafe, Produce Marketplace, Rocks Express, In 'n Out Corner Market Healthcare Institutions: TFT has heard from a wide range of healthcare workers (social workers, community health specialists, dieticians, physicians, nurses, etc.) that participating in the FBRx program improves their and their colleagues' morale and makes patients feel cared for. Most resources addressing social determinants of health involve an application process and/or waiting list, so being able to offer this type of immediate assistance is greatly appreciated on all sides. Under this FINI award, TFT worked with six healthcare partners in NJ and PA to provide FBRx to patients receiving SNAP benefits: Cooper Pediatrics, Camden, NJ Einstein Healthcare Network, Community Practice Center Diabetes Program, Philadelphia, PA Children's Hospital of Pittsburgh, General Academic Pediatrics Clinic, Pittsburgh, PA Allegheny Health Network, Healthy Food Center, Pittsburgh, PA Adagio Health WIC and Medical Offices, New Castle, PA Penn State Health St. Joseph's Hospital, Reading, PA (TFT served as an advisor) Farmers: Much work was done to support farmers through Food Bucks programming over the course of this grant, and project staff continued to expand opportunities for farmers in the final year. These programs benefited over 100 farmers across PA, and in addition to increasing SNAP sales at farmers markets, have generated more than $250,000 in Food Bucks redemptions for fresh produce at farm-direct sites since 2017, including $179,000 in 2020, a 190% increase over 2019. Other State and Community Partners: In each active geography, TFT fostered relationships with government, foundation and community partners. In Camden, NJ, TFT has been part of a 10-year partnership with Campbell Soup Healthy Communities Initiative, which has helped identify new corner stores and healthcare partners. Additionally, staff participated in the Camden Food Access Working Group, which brought together multi-sector, community-based partners in the areas of healthcare, affordable housing, emergency food, urban agriculture and community development to identify assets and solutions for increased food access. TFT also partnered with the Cooper Foundation to expand FBRx into an on-site health clinic at KIPP Lanning Square and is working with multiple partners as part of the Roots to Prevention BUILD Health project, which has facilitated further expansion of FBRx and Food Bucks outreach in Camden. In southeastern PA, TFT continued longstanding partnerships to enhance Food Bucks programming, including the Philadelphia Department of Public Health, Farm to City, Lankenau Medical Center, SHARE Food Program, Jefferson Health, and others. TFT is also a partner in COACH (Collaborative Opportunities to Advance Community Health), a group of hospitals and nonprofit partners working together on community health efforts. In central PA, TFT coordinated with several regional partners, including the Perry and Franklin County Assistance Offices, Central Pennsylvania Food Bank, York County Charitable Food System, The Health Bureau of York County, Penn State Extension/Nutrition Links and the Partnership for Better Health, who are working together and coordinating efforts to better serve over 23,000 SNAP participants. Food Bucks programming in Reading is enhanced by support from the Friends of Reading Hospital and the Greater Reading Chamber Alliance. Many of these partners brought new retailers to the project. In Pittsburgh and western PA, strong partnerships with Just Harvest, the Greater Pittsburgh Community Food Bank, the Pittsburgh Food Policy Council and the Allegheny County Health Department continued to enable the Food Bucks program to serve a wide range of neighborhoods and communities. Additionally, TFT strengthened relationships with other grantees through the Nutrition Incentive Hub, GusNIP's National Technical Assistance and Evaluation (NTAE) Center. TFT is participating in the Hub both as a grantee in a learning capacity as well as a partner/TA provider. TA staff have been convening communities of practice focusing on incentive programming in corner stores, as well as SNAP-Ed/nutrition education. Finally, TFT's national Center for Healthy Food Access, funded by the Robert Wood Johnson Foundation, supported both nutrition incentives and healthcare partnerships, such as produce prescription programs. Changes/Problems:Below are several key challenges faced during the project, though none led to major changes in the core objectives and deliverables of this project. COVID-19 Pandemic: Like many FINI grantees, the COVID-19 pandemic affected TFT's programming under this grant, creating both challenges and opportunities. Challenges included: Disruptions in retail operations Difficulty in collecting survey data from shoppers and patients, and store sales data from retailers Inability to provide SNAP-Ed nutrition lessons and accompanying outreach on-site. However, the pandemic also provided opportunities to strengthen programming in significant ways, primarily by increasing the incentive to provide a 100% match at farm-direct firms and supermarkets and by distributing more produce incentives as a result of the recent increase in SNAP enrollment. Pre-pandemic, The Food Trust had always utilized a 40% match ratio for nutrition incentives; generally, shoppers earned a $2 Food Buck for every $5 in SNAP they spent on eligible items. This was modeled after the successful Health Bucks program implemented in New York City, and has supported the goals of the FINI/GusNIP program by increasing produce purchasing and consumption, while costing less to implement than 1:1 match programs. However, in May 2020, and in response to the impacts of COVID-19--massive job losses and increased food insecurity and SNAP participation, The Food Trust temporarily raised the match to 100% at farmers markets and supermarkets, where incentives are earned primarily by purchasing fresh produce. In that month alone, SNAP spending at farmers markets doubled, and continued to increase even more as the season progressed. There were increases in both dollars spent and number of transactions, suggesting that new customers were using the program, and customers were spending more on each shopping trip. Additionally, TFT received multiple COVID-response grants that benefitted the Food Bucks program, from supporting markets in implementing safety protocols and purchasing supplies, to increased market promotion. Retail Technology and Reporting: An ongoing difficulty since the outset of the FINI program has been the inability of stores' POS systems to identify the tender (payment) type early enough in the transaction to distribute a coupon tied to the use of SNAP benefits. TFT continues to customize solutions for stores to effectively distribute incentives based on eligible SNAP purchases. These solutions have led to substantial increased reach of incentives to households relying on SNAP. In addition, while TFT aims to collect as much data from stores as possible (including SNAP sales, produce sales, and number of unique shoppers) to show the impact of FINI programs, not every store provides this data consistently or has bandwidth to do so. One solution has been for TFT staff to directly run reports from a store's POS system during in-person visits. Retailer/Partner Turnover and Delays: Ultimately, project staff rely on retailers, farmers market operators and their staff in order to successfully launch and adjust incentive programs. While TFT staff are often able to accelerate the development of new programs given expertise and strong networks, the team has faced challenges in implementing Food Bucks at several sites, especially when retailers have other operational delays. Some supermarkets have experienced delays when navigating a large corporation that controls IT/coupon updates or when transitioning ownership and POS systems, and some farmers markets and smaller retailers have had challenges with maintaining SNAP-EBT capacity and compliance. Additionally, during COVID-19, supermarkets were overwhelmed with high volume, and some other partners pivoted to emergency food distributions. Project staff have addressed these delays by maintaining many retail partners in the pipeline and being responsive whenever opportunities arise to advance programming. What opportunities for training and professional development has the project provided?Over the course of this grant, many opportunities for professional development have arisen both for project staff, and for retail and healthcare partners. As new staff members joined the project team, they received training in preparation for their work on outreach, community engagement, program implementation and reporting. Non-FINI TFT staff working in the community on other projects also received training about the nutrition incentives program so they could provide information about Food Bucks along with other resources. Ongoing training on implementation, tracking, data collection and promotion of the Food Bucks program was provided to all retail partners, and healthcare partners received similar training for their role in the Food Bucks Rx program. TFT also provided trainings on the Food Bucks program (covering eligibility, redemption sites, and how to access the program) to organizations serving or working with low-income populations. These trainings reached over 100 staff members across more than 20 organizations in PA and Camden, NJ. Additional opportunities for training and professional development included: TFT staff in Camden and Philadelphia, along with FBRx healthcare partners, attended a Trauma-Informed Care and Organizational Practices workshop organized by COACH (Collaborative Opportunities to Advance Community Health), which focused on the effects of trauma on health disparities and tips for applying trauma-informed strategies to our work Staff participated in Wholesome Wave's Learning Collaborative for nutrition incentives in grocery retail, which provided for internal capacity building as well as external knowledge sharing among many FINI grantees and other incentive practitioners Pittsburgh staff completed the FreshLink Ambassador Training program, a "peer to peer model for increasing awareness and social connection to local farmers' markets," and participated in a two-day Health Equity training as part of a collaborative CDC REACH grant awarded to the Allegheny County Health Department TFT staff participated in Asset-based Community Development training and Leah's Pantry's Trauma-Informed Nutrition Security course Staff attended the Office of Partnerships and Public Engagement annual Community Prosperity Summit, a USDA-led conference on workforce and economic development in rural areas, and the National Grocers Association Annual Convention, where they participated in the nutrition incentives track Staff attended USDA Project Director meetings in 2017-2019, connecting with other FINI grantees and sharing key findings Staff were involved with two virtual Nutrition Incentive Hub Convenings, as session organizers, presenters, and attendees How have the results been disseminated to communities of interest?Results have been shared through a variety of venues to reach interested stakeholders: Attended Pittsburgh Housing Authority tenant leaders meetings and presented on SNAP incentive programs, highlighting Food Bucks Presented nutrition incentive work during the Central Pennsylvania Food Bank's Child Hunger Summit, which brought together parties working to fight hunger in the region; the Food and Nutrition Service Mid Atlantic Regional Office's webinars for local FINI grantees; the Society for Applied Anthropology's Innovative Ways to Address Food Insecurity panel in Philadelphia; the Eco El Paso conference on food access and sustainable development; a FINI-related panel at the American Public Health Association's Annual Meeting and Expo; 100 for Hunger: An Interactive Meeting on Food Insecurity hosted by Action Tank; and Plan for a Healthier Allegheny's quarterly meeting, a working group convened by the Allegheny County Health Department Online release and social media push for the Power of Produce report (a resource co-authored by TFT, Fair Food Network and Wholesome Wave that features the history and impacts of SNAP incentives), which reached over 50,000 Twitter followers Several notable media pieces initiated by both project staff and participating retailers: "Broccoli, Eggplants, and Avocados, How 'Food Bucks' Bring Produce Into Neighborhoods," a piece on local NPR station WESA that featured a corner store owner. Accessible at: wesa.fm/post/broccoli-eggplants-avocados-how-food-bucks-bring-produce-neighborhoods "Turning Food Deserts Into Oases," an op-ed in the Pittsburgh Post-Gazette that highlights the impacts of the Hill District Shop 'n Save, co-authored by TFT and American Heart Association staff. Accessible at: post-gazette.com/opinion/Op-Ed/2018/02/11/Turning-food-deserts-into-oases/stories/201802110101 National Healthy Retail Call, convened by DC Central Kitchen, bringing together several organizations who work on healthy corner store initiatives or similar nutrition-based efforts in smaller retail settings "Incentivizing Fruits and Vegetables: The Latest on the USDA GusNIP (FINI) Program and Beyond" webinar presented to hundreds of attendees by healthyfoodaccess.org and TFT's Center for Healthy Food Access Presentations to Philadelphia College of Osteopathic Medicine Medical Student Advocates, who volunteer in the community to conduct social needs assessments and connect respondents with appropriate resources, and to Jefferson University medical students participating in the JeffSTARS advocacy program The PA Department of Health featured the Food Bucks program in its quarterly newsletter, reaching 400 subscribers interested in public health issues. TFT staff presented on a Community Engagement/DEI panel as part of the Nutrition Incentive Hub's first annual convening Presentations during FINI/GusNIP Project Director meetings and annual convenings (see "Training" section above) In addition to sharing results with communities of interest, program staff continue to connect with potential participants and promote the Food Bucks program across all sites to engage more shoppers. Outreach efforts promoting the program at Pittsburgh-area farmers markets reached nearly 1,400 potential participants through a combination of presentations, tabling at events, distributing (non-USDA funded) Community Food Bucks, and organizational partnerships. Across all sites where SNAP-Ed is provided, educators promoted the Food Bucks program to shoppers during in-person nutrition education, and continued linking participants to Food Bucks once lessons were moved online in response to the pandemic. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
The project brought incentives to new key geographies, refined technology in retail settings, and connected with healthcare partners to introduce new fruit and vegetable prescription programs for patients enrolled in SNAP. These efforts reached over 75,000 households, with redemptions increasing each year across 21 brick-and-mortar firms and over 100 farm-direct sites and mobile market stops, providing a boost to local food economies and enabling families to put more fruits and vegetables on the table. Annual FBRx redemptions increased from $6,500 in 2018 to $37,500 in 2019, and Food Bucks redemptions increased from $150,000 in 2018 to $375,000 in 2020. This growth reflected the expansion of the network to include new firms, increased SNAP and Food Bucks sales at existing sites, and an increased incentive ratio from 40% (spend $5, earn $2) to 100% (spend $2, earn $2) at some sites in response to rising rates of food insecurity related to COVID-19. Data Collection: Staff worked with each firm to create systems for tracking Food Bucks distribution and redemption. Firms use various data collection methods (e.g., paper tracking, POS systems) to serve as inputs for the Food Bucks database, where Food Bucks distributions/redemptions are tracked individually by serial number. To validate the POS systems' data, staff collected and compared receipts with POS figures. Below are metrics and other data collected from firms and program participants to assess impacts (note: not all metrics are collected from each site): # of individual Food Bucks coupons distributed and redeemed $ amount of Food Bucks distributed and redeemed (and % redemption) # of outreach organizations and materials Monthly SNAP sales and # of SNAP transactions # of unique SNAP households Customer surveys and general customer feedback # or value of produce items sold at corner stores # of vendors/farmers at farmers market stops Corner store sales receipts from customer purchases where incentive is redeemed Sales data from POS systems, including $ of produce and SNAP sales Major Activities and Findings: Objective 1: Improved access to affordable fresh produce in the Camden, NJ, Promise Zone through a Food Bucks program for SNAP participants at a healthy corner store, a mobile market serving six neighborhoods, a farmers market, and one of the city's only full-service supermarkets. Major Activities Completed Launched and refined incentive program at Fayers Market, including collecting baseline data, programming the POS system for a produce coupon button, documenting sales trends and enabling complementary nutrition/health programming at the store. Provided capacity to Camden Farmers Market at Virtua Hospital to accept SNAP/EBT payment and offer Food Bucks. Launched Food Bucks at Junior Supermarket, an important source of fresh produce early in the COVID-19 crisis when other neighborhood stores temporarily closed. Continued planning with Wakefern and Ravitz Family ShopRite and with Virtua Hospital's mobile markets. Engaged in initial planning with two urban farms in Camden to join the Food Bucks network in summer 2021. Summary Statistics and Key Outcomes Shoppers redeemed over $145,000 in Food Bucks for fresh produce at two brick-and-mortar firms. Over the first six months of Food Bucks programming at Junior Supermarket, monthly produce sales, SNAP sales and Food Bucks redemptions more than doubled. Produce sales grew from 4.7% to 8.7% of the store's total sales. Of the 17 Camden participants who completed surveys, 65% reported that their fruit and vegetable consumption had increased since they began using Food Bucks, and 100% said that Food Bucks were important in helping them purchase fresh produce. Objective #2: Development of a new FBRx program with healthcare systems in Camden, NJ, Philadelphia and Pittsburgh, PA, serving at-risk patients enrolled in SNAP. Major Activities Completed Developed, launched, implemented and evaluated FBRx programming with six healthcare partners across NJ and PA serving at-risk patients enrolled in SNAP. Summary Statistics and Key Outcomes Combined, healthcare partners distributed FBRx to approximately 1,500 patients, who redeemed $29,000 for fresh produce. TFT collected 582 patient surveys (8/2018-9/2019) from patients receiving FBRx at these healthcare sites, 20% of whom reported having used FBRx before. Findings include: Among patients who had used FBRx before: 92% of respondents thought Food Bucks were either important or very important in helping to purchase fruits and vegetables. 70% of respondents reported that their fruit and vegetable consumption had increased since they started using Food Bucks/FBRx. 43% of patients who had previously used FBRx reported consuming fruits or vegetables one or more times per day, compared to 29% of patients who had not previously used FBRx. Objective #3: Expanded network of food retail partners and scaling up of a new digital redemption system for Food Bucks across multiple grocery stores into new regions of PA and NJ. Major Activities Completed Launched Food Bucks at 15 brick-and-mortar firms across PA and in Camden, NJ. Developed and refined automated Food Bucks incentive solutions at Fresh Grocer, Cousins Fresh Market and East End Food Co-op. Planned for automated Food Bucks incentive programs at additional supermarkets across PA and southern NJ. Assisted store owners in making better use of the capabilities of their stores' POS systems to support incentive tracking and efficient distribution models. Promoted Food Bucks in conjunction with SNAP-Ed nutrition education programming across the Food Bucks network. Note additional Camden programming under #1. Summary Statistics and Key Outcomes Combined, brick-and-mortar firms redeemed over $400,000 in Food Bucks for fresh produce Redemptions at brick-and-mortar firms increased from $105,000 in 2018 to $227,000 in 2020, as new partners were added, existing partners increased distribution, and more shoppers participated in the program. Of the 127 surveyed shoppers who reported using Food Bucks at brick-and-mortar firms, 77% reported that their fruit and vegetable consumption had increased since they began using Food Bucks, and 92% said that Food Bucks were important (18%) or very important (74%) in helping them purchase fresh fruits and vegetables. Objective #4: Increased redemption and positive impact of Food Bucks and SNAP benefits among SNAP participants at farmers markets in Chester, Pittsburgh, and central PA, and Camden, NJ, leading to increased sales and consumption of local fresh fruits and vegetables. Major Activities Completed Sustained successful Food Bucks programming across over 100 farmers markets and other farm-direct sites. With support from a CDC REACH grant, increased staff capacity to promote the Food Bucks program at farmers markets in Western PA. Launched Food Bucks at the following farm-direct sites: York Fresh Food Farms mobile market, making 15 stops; Germantown Kitchen Garden, an urban farm, and KleinLife community resource center in Philadelphia; North Square farmers market in Chambersburg, PA; Blue Mountain Farmstand at Penn State Health in Reading, PA. Increased incentive offered at all farmers markets (from May-Sept 2020) from 40% to 100% match in response to COVID-19. Summary Statistics and Key Outcomes Combined, farm-direct firms redeemed over $225,000 in Food Bucks for fresh produce, serving an estimated 8,500 households. Redemptions at farm-direct firms increased from $48,500 in 2018 to $179,000 in 2020, as the program expanded and evolved. SNAP sales more than doubled and Food Bucks redemptions more than tripled at farmers markets in May-Nov 2020, compared to May-Nov 2019. Of 58 surveyed Pittsburgh farmers market shoppers who had used Food Bucks, 76% reported that their fruit and vegetable consumption had increased, and 87% said that Food Bucks were important in helping them purchase fresh fruits and vegetables.
Publications
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Progress 06/01/19 to 05/31/20
Outputs
Target Audience:The Food Trust's (TFT) Food Bucks and Food Bucks Rx (FBRx) programs have continued to engage participants and other stakeholders across the public and private sectors. SNAP Users: TFT's Food Bucks program makes fresh fruits and vegetables more affordable for shoppers using SNAP. In the 3rd year of this grant, over 48,000 households in key regions of Pennsylvania (PA) and New Jersey (NJ) have earned incentives. In Camden, NJ, the addition of Junior Supermarket to the Food Bucks network and the continued success of the corner store program at Fayers Market have enabled roughly 2,800 households to receive Food Bucks. In Philadelphia, 40,000 shoppers earned Food Bucks at five Fresh Grocer supermarkets, two corner stores, and across TFT's network of farmers markets. Shoppers in central PA have experienced increased access to produce incentives in farm-direct settings, including York Fresh Food Farms mobile market and Butcher's Farm Market, and over 500 households have received Food Bucks in that region. In western PA, programming reached roughly 4,000 shoppers using SNAP at two supermarkets, five corner stores, 17 farmers markets, and one mobile market.* The FBRx program reaches families receiving SNAP who are at risk of diet-related diseases and are often food insecure. Year 3 brought an additional 630 patients into theprogram, bringing the total reached to nearly 1,500. FBRx coupons can be used to purchase fresh fruits and vegetables at eligible firms, including the majority of those participating in Food Bucks. Patients come from a variety of settings, including a hospital-located Healthy Food Center that operates a food pantry and provides additional services, a diabetes clinic in a high-Medicare setting, pediatric well visit locations, and a WIC clinic. Through a separate GusNIP PRx grant which commenced on 9/1/2019, the initial FBRx pilots will grow to reach many more eligible households. *Note: Since not all sites can provide the number of unique program users, the above numbers represent our best estimates of households reached based on the number of SNAP transactions and data from comparable sites. Brick-and-Mortar Firms: In the past year, TFT added five new brick-and-mortar firms to the Food Bucks program in urban and rural communities in PA and NJ. Firms included a food co-op in Pittsburgh, PA, an established year-round farm market in central PA, and a superette in Camden, NJ. In addition, TFT engaged in robust planning with three additional firms, including a second location of Cousins Fresh Market in Chester, PA, as well as ShopRite and Price Rite in southern NJ. Both NJ stores are part of Wakefern Corporation, the largest retailer-owned cooperative of supermarkets in the US and a longstanding TFT partner. For both the point-of-sale and FBRx models, TFT has worked closely with retail partners to refine distribution and redemption mechanisms for maximum efficiency. All of these stores primarily serve low-income shoppers, and many have partnered with the nonprofit sector through healthy food financing initiatives, healthy corner store programs, and SNAP-Ed nutrition education. 20 brick-and-mortar firms participated in Food Bucks and/or FBRx under this grant in Year 3: Camden: Fayers Market, Junior Supermarket Central PA: The Marketplace at Shermans Dale, Butcher's Farm Market Philadelphia: Fresh Grocer (five locations), Olivares, Corner Food Market, Cousins Fresh Market Western PA: The East End Food Co-op, Shop 'n Save, Save-a-Lot, Dylamato's Market, Carl's Cafe, Produce Marketplace, Rocks Express, In 'n Out Corner Market Farmers: Much work had been done to support farmers through Food Bucks/FBRx programming prior to this grant, and project staff continue to expand opportunities for farmers. These programs benefitted approximately 100 farmers across PA, and generated over $58,000 in revenue in the last year, a 14% increase over Year 2. In addition to increasing redemptions at existing markets, TFT has also conducted outreach to new sites, particularly in central PA and in rural communities, to continue to grow the Food Bucks network to new geographies. In the last year, TFT began supporting SNAP incentives at York Fresh Food Farms, a mobile market (central PA), and a year-round indoor market (Pittsburgh, PA). Butcher's Farm Market (central PA), which is listed above under brick-and-mortar firms and is open six days a week, primarily sells produce grown on the family's farm, located just two miles from their retail site. Healthcare Institutions: TFT worked with five healthcare partners in NJ and PA to provide FBRx to patients who receive SNAP benefits. Current partners include: Cooper Pediatrics, Camden, NJ Einstein Hospital, Community Practice Center Diabetes Program, Philadelphia, PA Children's Hospital of Pittsburgh, General Academic Pediatrics Clinic, Pittsburgh, PA Allegheny Health Network, Healthy Food Center, Pittsburgh, PA Adagio Health WIC and Medical Offices, New Castle, PA As noted above, a USDA GusNIP grant will fund continued FBRx work with additional clinical partners, including Children's Hospital of Philadelphia, the Cooper Health Center at KIPP Lanning Square (Camden, NJ), and Duquesne School of Pharmacy (Pittsburgh, PA). Other State and Community Partners: In Camden, TFT continued a partnership with Campbell Soup Healthy Communities Initiative to implement the FBRx program at Cooper University Health's pediatrics department. Additionally, staff participated in the Camden Food Access Working Group, which brings together multi-sector community-based partners like hospital systems, affordable housing, emergency food, urban agriculture, and community development to identify assets and solutions for increased food access. TFT also partnered with the Cooper Foundation to expand FBRx into an on-site health clinic at KIPP Lanning Square and is working with multiple partners as part of the BUILD Health project, which will include further expansion of FBRx and Food Bucks outreach in Camden. In southeastern PA, TFT continued longstanding partnerships to enhance Food Bucks and FBRx programming, including the Philadelphia Department of Public Health, Greensgrow, SHARE and COACH (Collaborative Opportunities to Advance Community Health), a group of hospitals and nonprofit partners (including The Food Trust) that work together on community health efforts. In central PA, TFT coordinated with several regional partners, including the Perry and Franklin County Assistance Offices, Central Pennsylvania Food Bank, York County Charitable Food System, The Health Bureau of York County, Penn State Extension/Nutrition Links andPartnership for Better Health, who are working together and coordinating efforts to better serve over 23,000 SNAP participants. Food Bucks programming in Reading is enhanced by support from the Friends of Reading Hospital and the Greater Reading Chamber Alliance. Many of these partners brought new retailers to the project. In Pittsburgh and western PA, strong partnerships with Just Harvest, the Greater Pittsburgh Community Food Bank, Adagio Health, Pittsburgh Food Policy Council and the Allegheny County Health Department continue to enhance the Food Bucks and FBRx programs. Additionally, TFT is strengthening relationships with other grantees through the Nutrition Incentive Hub--GusNIP's National Technical Assistance and Evaluation (NTAE) Center--providing technical assistance and support to grantees and core partners. TFT is participating in the Hub both as a grantee in a learning capacity as well as a partner/TA provider. TA staff will be convening communities of practice focusing on incentive programming in corner stores, as well as SNAP-Ed/nutrition education. Finally, TFT's national Center for Healthy Food Access, funded by the Robert Wood Johnson Foundation, supports both nutrition incentives and healthcare partnerships, such as produce prescription programs. Changes/Problems:COVID-19 Pandemic: Like many FINI grantees, the COVID-19 pandemic has affected our programming, creating both challenges and opportunities. Challenges included: The temporary closing of multiple firms (all have since re-opened) Difficulty in collecting survey data from shoppers and patients, and store sales data from retailers Inability to continue providing SNAP-Ed nutrition lessons and accompanying outreach on-site. However, the pandemic also provided opportunities to strengthen programming in significant ways, primarily by increasing the incentive to provide a 100% match at farm-direct firms and supermarkets and by distributing more produce incentives as a result of the recent increase in SNAP enrollment. Pre-pandemic, The Food Trust had always utilized a 40% match ratio for nutrition incentives; generally, shoppers earned a $2 Food Buck for every $5 in SNAP they spent on eligible items. This was modeled after the successful Health Bucks program implemented in New York City, and has supported the goals of the FINI/GusNIP program by increasing produce purchasing and consumption, while costing less to implement than 1:1 match programs. However, in May, and in response to the impacts of COVID-19--massive job losses and increased food insecurity and SNAP participation--The Food Trust raised the match to 100% at farmers markets and supermarkets, where incentives are earned primarily by purchasing fresh produce. In that month alone, SNAP spending at farmers markets doubled, and continued to increase even more as the season progressed. There were increases in both dollars spent and number of transactions, suggesting that new customers were using the program, and customers were spending more on each shopping trip. Additionally, TFT received multiple COVID-response grants that benefitted the Food Bucks program, from supporting markets in implementing safety protocols and purchasing supplies, to increased market promotion. Retail Technology and Reporting: An ongoing difficulty throughout this process has been the inability of stores' POS systems to identify the tender (payment) type for each transaction and distribute a coupon tied to the use of SNAP benefits. TFT continues to customize solutions for stores to effectively distribute incentives based on eligible SNAP purchases. In addition, while TFT aims to collect as much data from stores as possible (including SNAP sales, produce sales, and number of unique shoppers) to show the impact of FINI programs, not every store provides this data consistently or has bandwidth to do so. One solution has been for TFT staff to directly run reports from a store's POS system during in-person visits. Camden Delays: TFT staff has continued to face challenges in implementing Food Bucks at several sites in Camden. There has not been a consistent farmers market with SNAP/EBT capacity for several years, and, as a result, the agency was unable to offer Food Bucks at a farmers market during the 2019 season. TFT has also not been able to implement a Food Bucks program thus far with the Virtua Mobile Market, which transitioned to emergency food distribution at the start of the COVID-19 crisis. However, the partnership between TFT and Virtua has strengthened through shared work on a BUILD Health collective impact project, through which TFT, Virtua and several other partners are working on nutrition, gardening, and disease prevention in Camden. Discussions continue about offering Food Bucks when the Virtua mobile market resumes operation. Lastly, the programming at Price Rite, the only supermarket in Camden, has relied on communication and technology updates from Wakefern, the store's parent company and supplier, which have been more challenging and time-consuming than anticipated. What opportunities for training and professional development has the project provided?Opportunities for professional development have arisen both for project staff, and for retail and healthcare partners. Within the last year, several previously part-time positions were combined and one new full-time staff member joined the FINI team, overseeing programming in Camden, NJ; Philadelphia, PA; and central PA. Ongoing training on implementation, tracking, data collection and promotion of the Food Bucks program continued to be provided to all retail partners. TFT staff worked closely with healthcare partners to ensure they would be able to screen patients for eligibility, accurately track and report FBRx distributions, and administer patient surveys using Zoho, an online survey tool. TFT employed two Community Outreach Associates in Pittsburgh through January 2020, who promoted the Food Bucks program and connected shoppers with sources of fresh produce in their communities. Last August, the Pittsburgh team traveled to Cleveland to complete the FreshLink Ambassador Training program, a "peer to peer model for increasing awareness and social connection to local farmers' markets." The training provided education and tools which enhanced community engagement efforts. As part of a collaborative CDC REACH grant awarded to the Allegheny County Health Department, TFT's Pittsburgh team also participated in a 2-day Health Equity training. Other outreach efforts in Pittsburgh included providing trainings on the Food Bucks program (covering eligibility, redemption sites, and how to access the program) to organizations serving or working with low-income populations. Trainings reached 81 staff members across seven organizations, including the YMCA, Community Health Workers with the Consumer Health Coalition, and nutrition education staff at Adagio Health (a SNAP-Ed partner). Additional opportunities for training and professional development included: Staff in Philadelphia and Camden, along with FBRx healthcare partners, attended a Trauma-Informed Care and Organizational Practices workshop organized by COACH (Collaborative Opportunities to Advance Community Health), which focused on the effects of trauma on health disparities and tips for applying trauma-informed strategies to our work. TFT staff attended the National Grocers Association Annual Convention and participated in the nutrition incentives track. How have the results been disseminated to communities of interest?Results have been shared through a variety of venues to reach interested stakeholders. Findings from both this grant and TFT's 2019 GusNIP PRx grant were shared in the following settings over the last year: National Healthy Retail Call, convened by DC Central Kitchen, bringing together several organizations who work on healthy corner store initiatives or similar nutrition-based efforts in smaller retail settings "Incentivizing Fruits and Vegetables: The Latest on the USDA GusNIP (FINI) Program and Beyond" webinar presented to hundreds of attendees by www.healthyfoodaccess.org and TFT's Center for Healthy Food Access. Presentation at a monthly meeting of CDC REACH grantee partners in Pittsburgh. Presentation at a monthly meeting of PCOM (Philadelphia College of Osteopathic Medicine) Medical Student Advocates, medical students who volunteer in the community to conduct social needs assessments and connect respondents with appropriate resources The PA Department of Health featured the Food Bucks program in its quarterly newsletter, reaching 400 subscribers interested in public health issues. TFT staff presented on a Community Engagement/DEI panel as part of the Nutrition Incentive Hub's first annual convening In addition to sharing results with communities of interest, program staff continue to connect with potential participants and promote the Food Bucks program across all sites to engage more shoppers. Outreach efforts promoting the program at Pittsburgh-area farmers markets reached over 1,400 potential participants through a combination of presentations, tabling at events, distributing (non-USDA funded) Community Food Bucks, and organizational partnerships, like the Cooking Matters program. The program was also featured in Farm to Table's Local Food Guide to Western PA, which distributed 60,000 copies. Across all sites where SNAP-Ed is provided, educators continue to promote the Food Bucks program to shoppers and reached over 675 shoppers before the COVID-19 pandemic began. What do you plan to do during the next reporting period to accomplish the goals?The no-cost extension year will focus on spending down the remaining incentive dollars with existing partners and continuing to support and promote the Food Bucks program and partnering firms during the COVID-19 pandemic. Grocery Stores: In NJ, TFT continues to work toward launching Food Bucks at two grocery stores owned by the Ravitz family under the Wakefern banner: Price Rite and ShopRite. Incentive distribution at ShopRite will be less reliant on cashiers to ensure that coupons are distributed to all eligible shoppers. Utilizing a solution developed at Fresh Grocer stores in Philadelphia, shoppers using SNAP will automatically receive Food Bucks through the store's loyalty card (Catalina) and POS software. Store staff at both sites will receive training about the program to support effective implementation. TFT staff will closely monitor and compare distribution and redemption numbers at both stores and make adjustments as needed. The technology is now in place to offer a Food Bucks program at Cousin's Fresh Market, which took over the former nonprofit supermarket, Fare & Square, in Chester, PA. This site serves as the only full-service supermarket in the city of Chester, where residents have noted challenges with consistent food access. However, due to the additional demands imposed by COVID-19, the store has not had the capacity to complete the training necessary for launch. Food Bucks launched at a different Cousin's location, in West Philadelphia, in March 2020, and project staff expect Food Bucks to launch in Chester this summer. The Marketplace at Shermans Dale (central PA) transitioned ownership in early 2020, which forced a pause on incentive programming. The owner of the new business at that site, Food Plus, has expressed an interest in reinstating the program, which is a goal for the upcoming year. Corner Stores: Under this grant, TFT has successfully implemented Food Bucks in 11 corner stores across NJ and PA--well exceeding the five included in the original proposal. Corner Store programming will continue with existing firms through the no-cost extension. SNAP-Ed/nutrition education will resume in-store if possible, depending on the duration of the COVID-19 pandemic. Food Bucks Rx: TFT has successfully partnered with five healthcare systems across NJ and PA to introduce and implement FBRx. Through a 2019 GusNIP PPR grant, incentive programming is ongoing with current clinical partners and continues to expand to new settings. Farmers Markets/Mobile Markets: TFT will continue to support the 100% match at farm-direct sites, as the program budget allows. Planning for Program Sustainability: Across PA, TFT and partners are working together on a range of state-level policy recommendations related to food access. One goal is to include funding for Food Bucks as part of an annual appropriation from the Commonwealth.
Impacts
What was accomplished under these goals?
From June 2019 to May 2020, TFT added eight new firms in six counties to the Food Bucks/FBRx programs, encompassing both urban and rural communities, as well as farm-direct and brick-and-mortar sites. The program's growth, both through new firms and through increased engagement at existing firms, reached a combined 48,000 shoppers, resulting in nearly $300,000 in Food Bucks and FBRx redemptions. Additionally, in response to rising rates of food insecurity related to COVID-19, TFT increased its incentive ratio from 40% (spend $5, earn $2) to 100% (spend $2, earn $2) at farmers markets and supermarkets, where incentives are earned primarily by purchasing fresh produce. Data Collection: Staff worked with each firm to create systems that collect the number of Food Bucks and FBRx distributed and redeemed. Firms use various data collection methods (e.g., paper Food Buck tracking, POS systems) to serve as inputs for the Food Bucks database, where Food Bucks and FBRx distributions and redemptions are tracked individually by serial number. To validate the POS systems' data, staff have collected and compared receipts with POS figures. Below are the metrics and other data collected from firms and program participants to assess impacts (note: not all metrics are collected from each site): # of individual Food Bucks coupons distributed and redeemed at all sites $ amount of Food Bucks distributed and redeemed at all sites (and % redemption) # of outreach materials created and distributed # of organizations outreached to Monthly SNAP sales and # of SNAP transactions # of unique SNAP households Customer surveys and general customer feedback # or value of produce items sold at corner stores # of vendors/farmers at farmers market stops Corner store sales receipts from customer purchases where incentive is redeemed (for quality assurance period) Sales data from POS systems, including $ of produce and SNAP sales Major Activities and Findings: Objective 1: Improved access to affordable fresh produce in the Camden, NJ, Promise Zone through a Food Bucks program for SNAP participants at a healthy corner store, a mobile market serving six neighborhoods, a farmers market, and one of the city's only full-service supermarkets. Major Activities Completed Launched Food Bucks and SNAP-Ed programming at Junior Supermarket: shoppers who use SNAP earn one $2 Food Buck for every $5 spent using SNAP. This site provided an important source of fresh produce early in the COVID-19 outbreak when other neighborhood stores temporarily closed. Continued Food Bucks programming at Fayers Market, including outreach in conjunction with SNAP-Ed and health screenings. Continued planning with Wakefern and Ravitz family for Food Bucks launch at Price Rite. Continued planning with Virtua Hospital to offer Food Bucks at its Camden mobile market and farmers market. Summary Statistics and Key Outcomes Shoppers at Fayers Market redeemed $38,862 in Food Bucks for fresh produce. Shoppers at Junior Supermarket redeemed $6,154 in Food Bucks for fresh produce. Objective #2: Development of a new FBRx program with healthcare systems in Camden, NJ, Philadelphia and Pittsburgh, PA, serving at-risk patients who use SNAP. Major Activities Completed Continued FBRx distribution with five healthcare systems in Camden, Philadelphia, and Pittsburgh. Summary Statistics and Key Outcomes Combined, healthcare partners distributed $31,700 in FBRx to 630 patients, resulting in over $13,800 redeemed for fresh produce. 582 patient surveys (Aug. 2018-Sep. 2020) have been collected from patients receiving FBRx, 20% of whom reported having used FBRx before. Findings include: Among patients who have used FBRx before: 92% of respondents thought Food Bucks were either important or very important in helping to purchase fruits and vegetables. 70% of respondents reported their fruit and vegetable consumption increased since they started to use Food Bucks/FBRx. 43% of patients who had previously used FBRx reported consuming fruits or vegetables one or more times per day, compared to 29% of patients who had not previously used FBRx. Objective #3: Expanded network of food retail partners and scaling up of a new digital redemption system for Food Bucks across multiple grocery stores into new regions of PA and NJ. Major Activities Completed Launched Food Bucks at five brick-and-mortar firms: Junior Supermarket (Camden) Cousins Fresh Market (Philadelphia) Corner Food Market (Philadelphia) Butcher's Farm Market (central PA) The East End Food Co-op (Pittsburgh) Continued successful implementation of automated Food Bucks incentives at Fresh Grocer. Promoted Food Bucks in conjunction with SNAP-Ed nutrition education programming at eight brick-and-mortar locations. Planning to implement Food Bucks using automated distribution systems at ShopRite in southern NJ and at Save-a-Lot in western PA. Note additional Camden programming under Objective #1. Summary Statistics and Key Outcomes Combined, new brick-and-mortar firms redeemed $15,000 in Food Bucks. Shoppers at PA supermarkets redeemed $34,200 in Food Bucks for fresh produce. Healthy corner stores that participated in Food Bucks in Year 2 and Year 3 saw nearly a 10% increase in Food Bucks redemptions, totaling over $80,000. Objective #4: Increased redemption and positive impact of Food Bucks and SNAP benefits among SNAP participants at farmers markets in Chester, Pittsburgh, and central PA, and Camden, NJ, leading to increased sales and consumption of local fresh fruits and vegetables. Major Activities Completed Increased incentive offered at all farmers markets from 40% to 100% match in response to COVID-19. Launched Food Bucks at the York Fresh Food Farms mobile market, making 15 stops. Launched Food Bucks at the East End Cooperative Farmers Market (Pittsburgh's only year-round, indoor farmers market) as a Food Bucks redemption site. Launched Food Bucks at the Germantown Kitchen Garden, a new urban farm in Philadelphia. Collaborative efforts in Reading, PA supported increased produce purchasing at 17 firms. Summary Statistics and Key Outcomes Across all participating farmers markets, over $70,000 in Food Bucks were distributed to roughly 4,800 shoppers, resulting in $58,000 in redemptions. Successful COVID response: SNAP sales and Food Bucks distributions and redemptions at farmers markets in May 2020 more than doubled, compared to May 2019. As noted under Objective 3, Butcher's Farm Market, in Newport, PA, a new farm-direct retailer, distributed nearly $5,000 in Food Bucks. Henry Got Crops, a Philadelphia CSA partner, saw a 115% increase in SNAP usage in its second season of participating in Food Bucks.
Publications
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Progress 06/01/18 to 05/31/19
Outputs
Target Audience:During the second year of the project, The Food Trust's (TFT) Food Bucks and Food Bucks Rx (FBRx) programs have continued to engage participants and other stakeholders across the public and private sectors. SNAP Users:TFT is reaching nearly 4,500 families who rely on SNAP in several key regions of Pennsylvania (PA) and New Jersey (NJ). For the first time, many shoppers in Central PA now have access to produce incentives at the Marketplace at Shermans Dale, an IGA supermarket, and the Blue Mountain Academy Farm Stand in Hamburg, PA, and so far, over 200 households have received Food Bucks in that region. The corner store program at Fayers Market has continued to be very successful, reaching over 800 families in Camden. In Western PA, programming reached 2,600 shoppers using SNAP at two supermarkets and five corner stores. Thanks to the growing partnerships with healthcare institutions in Camden, Philadelphia and Western PA, the FBRx program is connecting with families receiving SNAP who are at risk of diet-related diseases and often food insecure. In the last year, 800 families have received FBRx, which can be used to purchase fresh fruits and vegetables at participating retail locations. Patients come from a variety of settings including: a hospital-located Healthy Food Center (which provides emergency healthy food items and other services to patients who have been identified as food insecure) a diabetes clinic in a high-Medicare setting, pediatric well visits and WIC clinics. *Note: Since not all sites can provide the number of unique program users, the above represents our best estimates of households reached based on the number of SNAP transactions and data from comparable sites; there may be some Food Bucks users who were double-counted or undercounted. Grocery Retailers: In the past year, 10 supermarkets and corner stores participated in Food Bucks or FBRx programming. TFT engaged in robust planning with an additional four retailers, including Cousin's Supermarket in Chester, PA, and Weis Markets in Central PA, with plans to launch Food Bucks at those sites in Year 3. Another key partner from the grocery industry is Wakefern Corporation, the largest retailer-owned cooperative of supermarkets in the US, and parent company to FINI partners, ShopRite and PriceRite, among other store banners. TFT has been working with Wakefern for over a decade on various partnerships with stores in lower-income communities, and will launch Food Bucks at the Camden, NJ PriceRite in Year 3. Another prominent banner, Shop 'n Save, has put into place the back-end programming necessary to easily roll out Food Bucks to additional locations. For both the point-of-sale and FBRx models, TFT has worked closely with retail partners to refine distribution and redemption mechanisms for maximum efficiency. All of these stores primarily serve low-income shoppers and many have partnered with the nonprofit sector through healthy food financing initiatives, healthy corner store programming, and nutrition education. Current grocery partners participating in Food Bucks and/or FBRx under this grant: Camden: Fayers Market Central PA: The Marketplace at Shermans Dale Western PA: Shop 'n Save (2), Save-a-Lot, Dylamato's Market, Carl's Cafe, Produce Marketplace, Rocks Express, In 'n Out Corner Market Farmers: Much work has been done to support farmers through Food Bucks programming prior to this grant, and project staff are continuing to expand opportunities for current and new farmers. The new FBRx programming is benefitting more than 100 farmers across the state, and brought in over $5,000 in new revenue in the last year. TFT has also conducted outreach to farmers markets, particularly in Central and Southwest Pennsylvania and in more rural communities, to continue to grow the Food Bucks network to new geographies. In the last year, TFT has begun supporting SNAP incentive redemptions at the North Square Farmers Market in Chambersburg and has implemented Food Bucks at the Blue Mountain Academy Farm Stand. Three additional locations, Butcher's Farm Market in Central PA, York Fresh Food Farms, and the Wilkes-Barre farmers market, all began Food Bucks programming in June 2019 and will be reported on for Year 3. Healthcare Institutions: TFT is now working with six healthcare partners in NJ and PA to provide FBRx to patients who receive SNAP benefits. Current partners: Cooper Pediatrics, Camden, NJ Einstein Hospital, Community Practice Center Diabetes Program, Philadelphia, PA Penn State Health St. Joseph's Hospital, Reading, PA (TFT serving as advisor) Children's Hospital of Pittsburgh, General Academic Pediatrics Clinic, Pittsburgh, PA Allegheny Health Network, Healthy Food Center, Pittsburgh, PA Adagio Health WIC and Medical Offices, New Castle, PA In addition, TFT has had planning conversations with Philadelphia's Health Center 9 and Children's Hospital of Philadelphia (CHOP). TFT has continued its partnership with Virtua Hospital, which runs the Camden Farmers Market and a mobile market. Other State and Community Partners:In Camden, TFT continued its partnership with Campbell's Soup Healthy Communities Initiative and Camden Coalition of Healthcare Providers to implement the FBRx program at Cooper University Health's pediatrics department. Additionally, staff joined the Camden Food Access Working Group, which brings together multi-sector community-based partners like hospital systems, affordable housing, emergency food, urban agriculture and community development to identify assets and solutions for increased food access. TFT is also in planning discussions with the Cooper Foundation to expand FBRx into an on-site health clinic at KIPP Lanning Square. In Southeastern PA, TFT continued longstanding partnerships with key groups to enhance Food Bucks and Rx programming, including the Philadelphia Department of Public Health, Greensgrow, SHARE, and COACH (Collaborative Opportunities to Advance Community Health), a group of hospitals and nonprofit partners (including The Food Trust), working together on community health efforts. In Central PA, TFT coordinated with several regional partners, including Dickinson College, the Perry and Franklin County Assistance Offices, Central Pennsylvania Food Bank, York County Charitable Food System, The Health Bureau of York County, Project SHARE, Penn State Extension/Nutrition Links, and the Partnership for Better Health, who are working together and coordinating efforts to better serve over 23,000 SNAP participants. Many of the retail partners for this project came out of these new relationships. In Pittsburgh and Western PA, strong partnerships with Just Harvest, the Greater Pittsburgh Community Food Bank, Adagio Health (SNAP-Ed provider and FBRx partner), the Pittsburgh Food Policy Council and the Allegheny County Health Department continue to enhance the Food Bucks program. Lastly, TFT continues to foster relationships with other national partners, including Fair Food Network and Wholesome Wave, along with numerous other FINI grantees. These networks lead to increased capacity for advocacy and building a community of practice. Notably, TFT's Center for Healthy Food Access features both nutrition incentives and healthcare partnerships such as produce prescription programs. Changes/Problems:Camden/Virtua Delays: TFT staff has faced challenges this year implementing Food Bucks at several sites in Camden. At the Camden Farmers Market, neither Virtua Hospital (who operates the market) nor the sole farmer vendor have the ability to accept SNAP and reported having trouble securing the necessary resources to supply the service. During the 2018 season, TFT secured funding to staff a market manager, process SNAP and conduct outreach; however, this may not be possible in subsequent years. At the Virtua Mobile Market, TFT planned for a launch in the spring of 2019 following initial planning calls and a successful site visit, but partners running the market faced administrative restructuring which delayed the start of Food Bucks until fall 2019. Lastly, the programming at PriceRite, the only supermarket in Camden, relied on communication and technology updates from Wakefern, the store's parent company and supplier, which has taken longer than anticipated but is expected to resolve for a 2019 launch. Closing of Shop 'n Save: The Hill District Shop 'n Save closed in March 2019, which was a blow to the community and to the Food Bucks program there. With the closing of the store, TFT is looking to bring the program to a corner store in the neighborhood, Ann's Market. The Green Grocer Mobile Market recently added two stops in the Hill District, and community groups have rallied to establish a monthly farmers market to provide fresh produce, which will also offer Food Bucks. Technology limitations in supermarkets: As noted previously, a challenge in supermarkets has been dealing with the limitations of POS systems. The main difficulty throughout this process has been the inability of the store's POS system to identify the tender (payment) type for each transaction and distribute a coupon tied to the use of SNAP benefits. After experimenting with various cashier-reliant and discount models, with mixed success, TFT and Fresh Grocer have recently developed a more accurate, automated and comprehensive distribution system for Food Bucks, resulting in substantial increases to the value of Food Bucks being distributed. Based on that success, TFT intends to implement a similar distribution model in Western PA with Shop 'n Save. The East End Food Co-op, a new site for expansion, has agreed to pay for upgrades to its POS system in advance of the program launch, which will enable a seamless integration of Food Bucks into eligible customer transactions. PriceRite and ShopRite will also be implementing more automated distribution processes in the next year. What opportunities for training and professional development has the project provided?Opportunities for professional development have arisen not only for project staff, but also for retail and healthcare partners. Within the last year, four new staff members have joined the FINI team, two from within TFT's Philadelphia office, and two new hires in Pittsburgh as part of a CDC REACH grant awarded to the Allegheny County Health Department, through which TFT is a partner. New staff received training and orientation on the Food Bucks program and the Philadelphia team is currently working to create an onboarding and training guide for FINI team members. Creating this resource includes formalizing intake screenings and processes for onboarding new retail partners and developing data collection templates, and will be vital as the team continues to grow. TFT staff attended the Office of Partnerships and Public Engagement annual Community Prosperity Summit, a USDA-led conference on workforce and economic development in rural areas. The goal is to bring together 2501 grantees, HBCU's, tribal governments, Land-Grant Universities and others from both the public and private sector to bring hope and opportunity, wealth creation, and asset building to the forefront of economic development. Additionally, in spring 2018, TFT began its Community Nutrition Ambassador (CNA) program, a new community-based, volunteer program for individuals who want to become involved in the organization's nutrition education programming. The program recruited interested professional and community representatives from across Philadelphia to promote the organization's programs and discuss basic nutrition principles in five Fresh Grocer locations. This new program has been a major asset to FINI, as the CNAs provide increased capacity for programming in Food Buck sites, identify outreach and cross-programming opportunities, and leverage their own professional networks to support the growth and expansion of the Food Bucks program. Ongoing training on implementation, tracking and promotion of the Food Bucks program was provided to all retail partners. TFT staff worked closely with healthcare partners to ensure they would be able to accurately screen patients for eligibility, accurately track and report FBRx distributions, and administer patient surveys using Zoho, an online survey tool. Staff also worked with farmers market managers and corner store staff to ensure accurate FBRx redemption data collection and tracking. How have the results been disseminated to communities of interest?Results have been shared through a variety of venues to reach interested stakeholders. Findings from both this grant, and TFT's 2015 FINI grant were shared in the following settings in the last year: The "Farm Bill Working Group Report: Why The Farm Bill Matters" report, which includes mention of the FINI program, was widely disseminated FNS-organized webinar during which TFT Project Staff presented key FINI learnings to new grantees Farm Bill panel at the annual Convening on Healthy Food Access in Washington, DC, featuring other key FINI leaders such as Fair Food Network FINI Leaders pre-meeting before the annual Convening on Healthy Food Access, including several FINI grantees and other stakeholders Continued dissemination of the SNAP incentives report "The Power of Produce," co-authored by TFT, Wholesome Wave, and Fair Food Network, and featuring many FINI grantees University of Texas El Paso Institute for Healthy Living - webinar/video conference on TFT's FINI programming Presentation at Eco El Paso conference on food access and sustainable development Included on a FINI-related panel at the American Public Health Association's Annual Meeting and Expo, specifically in an abstract titled "Utilizing the SNAP-Ed Evaluation Framework to Integrate and Maximize Results of SNAP-Ed and FINI Programming " 100 for Hunger: An Interactive Meeting on Food Insecurity hosted by Action Tank "Let's SNAP to It" Panel Discussion for Partnership for Better Health PA Central Food Bank: Annual Partner Meeting College of Physicians Public Health Day Philadelphia FIGHT- Critical Path Learning Center - led a presentation with information and resources around TFT's Food Bucks Network Plan for a Healthier Allegheny quarterly meeting presentation- a working group convened by the Allegheny County Health Department Chatham University Food Studies Masters students class presentation In addition, The Farmers Market Coalition released an assessment on Pittsburgh-area farmers markets, and recommendations for improvement in 2018. TFT was consulted on this report regarding the history and expansion of the Food Bucks program and its impacts on local farmers markets. The report is accessible at: https://farmersmarketcoalition.org/wp-content/uploads/gravity_forms/1-66fc51da018bd946fb1dfb74f4bea1e7/2019/03/Pittsburgh_FarmersMarkets_Jan2019FINAL.pdf What do you plan to do during the next reporting period to accomplish the goals?Grocery Stores:In NJ, TFT has made significant strides preparing to launch Food Bucks at two new grocery stores owned by the Ravitz family under the Wakefern banner: ShopRite and PriceRite. Incentive distribution in both stores will be less reliant on cashiers to ensure coupons are distributed. In one store, TFT staff will enroll verified shoppers who receive SNAP into the Food Bucks program during in-store enrollment days. This will be TFT's first experience using this type of opt-in enrollment model. Additionally, since TFT staff will be overseeing the enrollment, customers will benefit from a thorough explanation of the program and its benefits. In the second store, which has a loyalty card program, shoppers using SNAP will automatically receive Food Bucks through the store's loyalty card and POS (Catalina) software. Store staff at both sites will receive training about the program to support effective implementation. TFT staff will closely monitor and compare distribution and redemption numbers at both stores and make adjustments as needed. Planning conversations have been underway with Cousin's Fresh Market, which took over the former nonprofit supermarket, Fare & Square, in Chester, PA. This site serves as the only full-service supermarket in the city of Chester, where residents have noted challenges with consistent food access. Project staff anticipate the launch of Food Bucks programming at Cousin's accompanied by SNAP-Ed nutrition education later in 2019. TFT also plans for continued growth of the Food Bucks program in Western PA. In the second half of this year, Food Bucks will expand to the East End Food Co-op, and will test the first completely automated distribution model (connected to a national network of food co-ops). Additionally, the distribution model at Shop 'n Save in New Kensington will be improved and tested, paving the way for more fruitful collaboration in the future with that chain. There is the possibility of implementing a Food Bucks POS incentive program in the New Castle Save-a-Lot, which is currently running FBRx. The New Castle owners also have a location in Duquesne, PA, which provides an additional possibility for expansion. Recent conversations with the Connellsville Redevelopment Authority open up the potential for future work in that city. TFT will continue to monitor, evaluate and refine the Food Bucks model at The Marketplace at Shermans Dale. Based on initial distribution findings, TFT aims to shift the program model from a 50% discount to a physical Food Buck model and to compare impacts. TFT will also establish evaluation tools and instruments to capture additional shopper information. TFT will also conduct in-store promotion, marketing and nutrition education in collaboration with Penn State Extension/Nutrition Links and other regional partners. Corner Stores: Building on the success of the Food Bucks program in Year 2, TFT will move forward with implementing proven program models to encourage SNAP shoppers to purchase more fruits and vegetables in small grocery retail outlets. Notably, all corner stores will be transitioning to a $2 standard Food Buck, which will enable shoppers to earn and redeem Food Bucks between all participating farmers/mobile market locations and corner stores. In Camden, the launch of FBRx programming at Cooper Health Clinic at KIPP Lanning Square will be accompanied by onboarding an additional 1-2 new healthy corner stores as redemption locations. Corner Food Market, located in North Philadelphia, will implement Food Bucks, providing shoppers with a $2 Food Buck for every $5 in SNAP spent. The market is already a key partner on healthy food access, hosting Heart Smarts nutrition education programming. Bringing in Food Bucks supports a deeper level of engagement with this store. The launch will be accomplished by community outreach to nearby schools and Temple Hospital. In Pittsburgh, TFT hopes to expand Food Bucks programming to Ann's Market, a healthy corner store in the Hill District neighborhood which recently suffered the loss of its only full-service grocery store (the Hill District Shop 'n Save, which was a FINI partner). Food Bucks Rx:In Camden, TFT will continue its partnership with Cooper University Hospital's pediatrics department, offering FBRx to food insecure children and their families who use SNAP, with Fayers Market as the flagship redemption site. TFT will also bring on an additional partner through Cooper Foundation and KIPP schools to expand the Rx program to the school's on-site health clinic. Additional corner stores are currently being researched to become potential redemption sites for KIPP households who will be receiving FBRx. Project staff will also work toward adding the PriceRite supermarket as an eligible redemption site. In Philadelphia, Einstein is planning to expand FBRx distribution into its Emergency Department in fall 2019. TFT plans to launch FBRx at Health Center 9, a city health center operated by the Philadelphia Department of Public Health, which accepts Medicare and Medicaid and offers sliding scale payments to uninsured patients. Additionally, increasing the number of supermarkets and corner stores accepting FBRx coupons will be a priority in the upcoming year, with a focus on five Fresh Grocer locations in Philadelphia, already participating in the Food Bucks program under the 2015 grant. In Pittsburgh, TFT will continue to expand the number of healthcare settings distributing FBRx, building upon successful partnerships and data collected during the first year of programming. All three healthcare partners hope to expand the FBRx program to additional sites within their networks. Allegheny Health Network will expand the successful Healthy Food Center model to additional hospital locations and will collaborate with TFT on future fundraising to support the expansion of FBRx. UPMC Children's Hospital and its network of affiliated pediatric clinics provide another ripe possibility for growth. Similarly, Adagio Health has a network of affiliated medical offices and WIC clinics throughout western PA and is committed to supporting the expansion of the FBRx program in those settings. As the WIC provider for counties outside Allegheny, Adagio's connection to supermarket retailers is an advantage in recruiting redemption locations for FBRx. Farmers Markets/Mobile Markets: TFT will continue to explore effective SNAP incentive models in Camden and in rural farmers market settings across PA and NJ. Numerous markets have been identified that are interested in accepting SNAP benefits and offering Food Bucks to shoppers, and Year 3 will see an emphasis on streamlining successful programming in these settings. Specifically, in Camden, the Camden Farmers Market and Virtua Mobile Market are top priorities for expansion (see changes/problems section for more detail). Butcher's Market, York Fresh Food Farms (a mobile produce market) and the Wilkes-Barre Farmers Market all began offering Food Bucks to shoppers using SNAP in June of 2019. TFT looks forward to supporting these sites as they grow their programming, and reporting on successes in year 3. Planning for Program Sustainability?: Finally, across PA, TFT is coordinating with partners, including the Pittsburgh Food Policy Council, to work together on a range of state-level policy asks related to food access. One aim is to include funding for Food Bucks as part of an annual appropriation.
Impacts
What was accomplished under these goals?
From June 2018 to May 2019, TFT launched four new FBRx programs and expanded incentive programming into eight new retail venues, redeeming over $80,000 in incentives for fresh produce. This work is providing critical opportunities for families in PA and NJ to afford and consume more fruits and vegetables. Highlights include: Launch and early positive impacts of the Food Bucks Rx programs. Launch of three Food Bucks programs in Central PA: The Marketplace at Shermans Dale, an independent grocery store, North Square Farmers Market, a historical farmers market in downtown Chambersburg, and Blue Mountain Academy Farm Stand. Data Collection Staff worked with each site to create systems that collect the number of Food Bucks and FBRx distributed and redeemed. Various data collection methods (e.g. paper Food Buck tracking, POS systems) are used at partnering food retailers and serve as inputs for the Food Bucks database. To validate the POS system, staff collect and compare receipts with POS figures. Below are the metrics and other data collected from retailers and program participants to assess program impacts (note: not all metrics are collected from each site): # of individual Food Bucks coupons distributed and redeemed at all sites $ amount of Food Bucks distributed and redeemed at all sites (and % redemption) # of outreach materials created and distributed # of organizations outreached to Cashier compliance with distributing Food Bucks to shoppers using SNAP Quarterly/Monthly SNAP sales and # of SNAP transactions # of unique SNAP households Customer surveys and general customer feedback # or value of produce items sold at corner stores # of vendors at farmers market stops Corner store sales receipts from customer purchases where incentive is redeemed (for quality assurance period) Sales data from POS systems, including $ of produce and SNAP sales Major Activities and Findings Objective 1: Improved access to affordable fresh produce in the Camden, NJ, Promise Zone through a Food Bucks program for SNAP participants at a healthy corner store, a mobile market serving six neighborhoods, a farmers market and one of the city's only full-service supermarkets. Major Activities Completed Refinement of Food Bucks distribution model at Fayers Market, from a 50% discount to a paper model (spend $5, get $2) with a $4 earnings cap. Planning with Wakefern and Ravitz family for Food Bucks launch at ShopRite and PriceRite. Provided capacity to offer SNAP/EBT sales and Food Bucks at Camden Farmers Market for the first time. Continued planning with Virtua Hospital to offer Food Bucks at its Camden mobile market. Summary Statistics and Key Outcomes Shoppers at Fayers Market redeemed $38,802 in Food Bucks for fresh produce. Average weekly incentive redemptions nearly doubled at Fayers, increasing to $520, after transitioning from a discount to a paper Food Bucks model. Objective #2: Development of a new FBRx program with healthcare systems in Camden, NJ, Philadelphia and Pittsburgh, PA, serving at-risk patients who use SNAP. Major Activities Completed Continued FBRx distribution at Cooper Pediatrics in Camden ($20 of FBRx per family member is distributed at well visits), redeemable at Fayers Market and Virtua Camden Farmers Market. Launched FBRx with three Western PA healthcare partners. Patients get $30/month of FBRx, redeemable at participating supermarkets, corner stores and farmers/mobile markets. Launched FBRx at Einstein Hospital. Patients get $50 of FBRx per visit as part of a diabetes management program (first effort to integrate FBRx into chronic disease prevention programming). Summary Statistics and Key Outcomes Combined, healthcare partners distributed $50,000 in FBRx to over 800 patients, resulting in over $10,000 redeemed for fresh produce. The first supermarket, Save-a-Lot in New Castle, PA, began accepting FBRx, redeeming over $1,000 in the first two weeks. 265 patient surveys were collected from patients receiving FBRx, 34% of whom reported having used FBRx before. Findings include: Among patients who have used FBRx before: 91% of respondents thought Food Bucks were either important or very important in helping to purchase fruits and vegetables. 64% of respondents reported their fruit and vegetable consumption increased since they started to use Food Bucks/FBRx. 44% of patients who had previously used FBRx reported consuming fruits one or more times per day, compared to 28% of patients who had not previously used FBRx. Objective #3: Expanded network of food retail partners and scaling up of a new digital redemption system for Food Bucks across multiple grocery stores into new regions. Major Activities Completed Launched Food Bucks at three new corner stores in Western PA utilizing a new, standardized incentive model, resulting in increased distribution and redemption. Launched Food Bucks at The Marketplace at Shermans Dale, a small-town grocery store with no loyalty card and limited technology, using a 50% discount model for fresh produce. Launched Food Bucks at the New Kensington Shop 'n Save. Shoppers who use SNAP earn one $2 Food Buck for every $5 of produce purchased. Planning to implement two variations on automated distribution systems at ShopRite and PriceRite, where shoppers are enrolled in the promotion by signing up to participate, or by using their loyalty cards. Assisted store owners in making better use of the full capabilities of their store's POS systems to support incentive tracking and efficient distribution models. Note Camden corner store programming under Objective #1. Summary Statistics and Key Outcomes $27,000 in Food Bucks redeemed at Pittsburgh corner stores (68% redemption rate) and more than 3x increase over Year 1. Increased SNAP and produce sales at corner stores: Since participating in Food Bucks, Rocks Express has increased average monthly SNAP sales by $700. Average monthly produce sales have quadrupled at Carl's Cafe, tripled at Rocks Express, and doubled at In 'n Out. $1,400 in discounts on produce provided to shoppers using SNAP at the Marketplace at Shermans Dale. Objective #4: Increased redemption and positive impact of Food Bucks and SNAP benefits among SNAP participants at farmers markets in Chester, Pittsburgh, and Central PA, and Camden, NJ, leading to increased sales and consumption of local fresh fruits and vegetables. Major Activities Completed With support from a CDC REACH grant, TFT hired two part-time Outreach Associates to promote the Food Bucks program and attract new shoppers using SNAP to farmers markets in Western PA. Launched Food Bucks at the Blue Mountain Farmstand, located on the Penn State Health campus. Began supporting the North Square Farmers Market in Central PA, which offers a token-based incentive. Summary Statistics and Key Outcomes Outreach Associates attended eight community events/meetings and distributed over 300 flyers to promote the Food Bucks program at farmers markets. In the first four months of programming, Blue Mountain Farmstand redeemed $100 dollars in Food Bucks, and boasted an 83% redemption rate. In the first month of partnership with North Square farmers market, shoppers using SNAP purchased an additional $400 worth of fresh produce.
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Progress 06/01/17 to 05/31/18
Outputs
Target Audience:During the first year of the project, The Food Trust's Food Bucks and Food Bucks Rx programs engaged numerous participants and other stakeholders across the public and private sector. SNAP Users:The Food Trust is reaching numerous families who rely on SNAP in several key regions of Pennsylvania and New Jersey. This is the first time many families have had access to an incentive program, particularly in Camden, NJ. The corner store program at Fayers Market has been very successful, showing a major increase in the amount of produce ($20,000) that SNAP shoppers are taking home, and reaching ~800 families in Camden. Additionally, The Food Trust has paved the way for a SNAP incentive program to launch at the only farmers market and supermarket in the city (expected during Year 2). In previous years, there was limited or no capacity to accept SNAP payments at the Camden Farmers Market, and now the market will accept both SNAP and incentives. We have also reached more than 2,000 SNAP clients in Pittsburgh, where the Food Bucks programs at the Shop 'n Save supermarket and two corner stores are the first SNAP produce incentive programs at permanent retail settings in the city. To get a better perspective from SNAP shoppers utilizing the program, The Food Trust held a focus group and conducted outreach in various community settings, including presenting information to the tenant leaders of local housing communities, setting up produce tastings in those communities, sharing information directly with residents, and answering questions and listening to feedback from residents. Thanks to the partnerships with healthcare institutions in Camden and Pittsburgh, the Food Bucks Rx program is connecting with additional SNAP families who are at risk of diet-related diseases and often food insecure. By providing incentives in a clinical setting, we are able to connect with families who may not have been aware of the Food Bucks program and introduce them to new retail venues like farmers markets and healthy corner stores. Grocery Retailers: The Food Trust is working with several large and small grocers on Food Bucks and Rx programming in Philadelphia, Pittsburgh, Chester, Camden, and Central Pennsylvania. During the first year, we made significant progress with a supermarket, Ross's Shop 'n Save (Pittsburgh, PA), and three corner stores, Dylamato's (Pittsburgh), Carl's Café (Rankin, PA), and Fayers Market (Camden, NJ). All of these stores primarily serve low-income shoppers and have partnered with the nonprofit sector through healthy food financing initiatives, healthy corner store programming, and nutrition education. Project staff have also held numerous planning conversations with retailers in Chester, Camden, Pittsburgh, and Central Pennsylvania for programming that will roll out during Year 2. One key partner from the grocery industry is Wakefern Corporation, the largest retailer-owned cooperative of supermarkets in the US, and parent company to FINI partners ShopRite and PriceRite, among other store banners. The Food Trust has been working with Wakefern for over a decade on various partnerships with stores in lower-income communities. For both the point-of-sale and Rx models, The Food Trust has worked closely with retail partners to refine distribution and redemption mechanisms that are the most efficient. Farmers: Though much work supporting farmers through Food Bucks programming had already been established prior to this grant, project staff are continuing to expand opportunities for current and new farmers. The new Food Bucks Rx programming through FINI will benefit more than 100 farmers across the state, bringing in new revenue and additional shoppers. The increased capacity to process SNAP transactions at the Camden Farmers Market will support the farmers who vend there, as will the increased frequency and number of vendors at the Chester, PA farmers market. Finally, The Food Trust has conducted outreach to new farmers markets, particularly in Central and Southwest Pennsylvania and in more rural communities, to continue to grow the Food Bucks network to new geographies. Healthcare Institutions: The Food Trust is now working with five healthcare partners in New Jersey and Pennsylvania on Food Bucks Rx programs (fruit and vegetable prescription programs) that have either already launched or will launch in Year 2: Cooper Pediatrics, Camden, NJ - launched fall 2017 Penn State Health St. Joseph's Hospital, Reading, PA - launching June 2018 (The Food Trust serving as TA provider) Children's Hospital of Pittsburgh, General Academic Pediatrics Clinic, Pittsburgh, PA - launching June 2018 Allegheny Health Network, Healthy Food Center, Pittsburgh, PA - launching July 2018 Einstein Hospital, Community Practice Center (Diabetes Clinic), Philadelphia, PA - launching August 2018 All of the above mentioned groups serve many SNAP users and are excited to be able to offer direct vouchers for fruits and vegetables, especially since much of their patient population identifies as food insecure. In addition, The Food Trust has continued to build its relationship with Virtua Hospital in Camden, who not only manages the on-site farmers market but also runs a mobile market in the area. Other State and Community Partners: In Camden, The Food Trust integrated FINI into a multi-year project with Campbell Soup's Healthy Communities Initiatives; this collective impact project is focused onfour strategic areas: ensuring access to affordable and fresh foods, increasing physical activity in a safe environment, supporting healthy lifestyles through nutrition education and partnering with the community to advance positive social change. Staff also worked with the Camden Coalition of Healthcare Providers to plan the Rx program at Cooper University Hospital's pediatric department, which offers fruit and vegetable prescriptions to food insecure children and their families who use SNAP. In Central PA, The Food Trust provided capacity building to several regional partners, including Dickinson College, Project SHARE, Penn State Extension, and the Partnership for Better Health, who are serving on a Food Systems group to assess food access and better coordinate social services in an area serving 23,000 SNAP participants. Many of the suggested potential retail partners for this project came from these new relationships. As programming moves ahead in Year 2, The Food Trust will conduct in-store promotion, marketing and nutrition education in collaboration with Penn State Extension/Nutrition Links. In Pittsburgh, important collaborations include our relationship with the Hill House Association, who owns the property where Shop 'n Save is located and is a powerful resident advocacy group. In addition, the agency partnered with Adagio Health to implement Heart Smarts nutrition education lessons (using The Food Trust's SNAP-Ed approved curriculum) at all Food Bucks retail locations. Just Harvest remains an invaluable partner for implementing Food Bucks at farmers markets and, more recently, for identifying corner stores for the Food Bucks program. The Greater Pittsburgh Community Food Bank continues to be a critical partner in implementing Food Bucks and Food Bucks Rx at their Green Grocer Mobile Market. Finally, Philabundance remains a key partner as next steps for incentive programming at a supermarket in Chester, PA are developed, though Philabundance is no longer directly involved with the day-to-day operations of a grocery store. Changes/Problems:Small Store Models One notable lesson learned through operating SNAP incentives in Philadelphia and New Jersey is that there is not a "one size fits all" model for small grocery retail. The first pilot The Food Trust rolled out was at a small corner store in Philadelphia selling items more typically found in a convenience store, while the other is at a superette in New Jersey (Fayers), a compact food market that sells a wider variety of grocery items. The agency originally rolled out the same incentive model in Fayers that worked well in the corner store in Philadelphia (earn $1 Food Buck for every $2 SNAP-eligible purchase), but soon after the pilot commenced it became clear that a more tailored approach would need to be taken in this unique setting. One inventory difference that made the program look different between these two retailers is the large meat department at Fayers, where many SNAP customers use their benefits to purchase protein, and in return, earn Food Bucks. This unique feature typically not found in other corner stores spurred comparatively high SNAP sales and, in turn, high Food Bucks sales. As a trial in Fayers Market, the program will be adjusted in Year 2 so that shoppers will receive a 50% discount on fresh produce for shoppers using SNAP benefits rather than earning Food Bucks on any SNAP purchase. This change was implemented because though the first model proved to be very successful, it distributed Food Bucks in such high quantities that sustaining it would become a challenge. Additionally, what was less clear about this model was whether shoppers were purchasing additional fruits and vegetables with their Food Bucks, or just using their Food Bucks to pay for their typical amount of produce. Through evaluation The Food Trust will compare these two program models to determine which was associated with a greater increase in produce purchases, and develop the most effective program structures that maximize redemptions in small retail, but are also sustainable and manageable for project staff and store employees. Food Bucks Rx Distribution A challenge with the Food Bucks Rx programming is determining how to verify that patients are SNAP recipients without stigmatizing them or causing undue burdens for retail partners. Since healthcare partners are not SNAP authorized retailers, they can only do a verbal screen with patients for SNAP enrollment. Then, Patients must either use their EBT card at the time they redeem their Food Bucks Rx, or do a balance check to confirm they are an active SNAP participant. The Food Trust continues to work with farmers markets and other retail partners toward an effective and efficient protocol. Additionally, as with the supermarket programming, the agency is currently in the process of trying out different distribution models for Food Bucks Rx. In discussions with clinics, special programs that focus on weight management or diabetes seem appealing to this program, though they may not reach as many households compared to the distribution of Rx during well visits. However, during non-recurring visits, a provider may not be certain of the next time the patient will return to the clinic--as a result, project staff have opted to distribute a greater sum of Food Bucks Rx during one-time visits. Lastly, given how coupons and vouchers are handled differently at farmers markets versus retail, it is a challenge to solidify one or more appropriate Rx formats. Project staff will continue to examine the most efficient systems and refine the program accordingly. What opportunities for training and professional development has the project provided?Opportunities for professional development have arisen not only for project staff, but also for business owners, supermarket employees, healthcare administrators, farmers, and farmers market managers. At a Pittsburgh supermarket (Shop 'n Save), cashiers received training at the program's launch, in June 2017, followed up by individual re-trainings in winter 2018. Periodic trainings and re-trainings are slated to continueand to become more streamlined. In corner stores, training and technical assistance included working with store owners to begin tracking produce sales, a new metric for most owners. This often allowed for store owners to become more familiar with their cash register's features and their POS system's reporting capabilities. One noteworthy partnership where training and training and professional development proved valuable for both Food Trust staff and store employees was the training that took place in Fayers Market in Camden. This exceptional store was very successful in hosting a Food Bucks program in the first months of the pilot, which led staff and store management to brainstorm innovative ways to reach SNAP customers. Those discussions led The Food Trust research team to train both colleagues here at the agency and employees of the store on POS integration into the program, as well as running reports using the POS software. In preparation for the launch of Food Bucks Rx, The Food Trust staff worked closely with healthcare partners to ensure they would be able to accurately screen patients for eligibility and track Food Bucks Rx distributions. Staff also worked with farmers market managers to ensure accurate redemption tracking information with vendors. Additionally, The Food Trust commenced a new training and volunteer program for community members who would like to become involved in the agency's programming. This spring, The Food Trust began its Community Nutrition Ambassador (CNA) program which recruited interested professional and community representatives from all over Philadelphia to promote the agency's programs and discuss basic nutrition principles. This new program will be a major asset to FINI since nutrition education at retail sites is an important complement to Food Bucks incentives. In addition to increased capacity, the CNA program will bring a stronger community tie to the programming. Lastly, Food Trust staff participated in Wholesome Wave's Learning Collaborative for nutrition incentives in grocery retail, which provided for internal capacity building as well as external knowledge sharing among many FINI grantees and other incentive practitioners. How have the results been disseminated to communities of interest?Initial results have been shared through a variety of venues to reach interested stakeholders. In Pittsburgh, The Food Trust attended Pittsburgh Housing Authority tenant leaders meetings and presented on SNAP incentive programs, highlighting Food Bucks. The Food Trust alsosubmits monthly updates to the Hill House Association, the community group that assisted in launching Food Bucks at Shop 'n Save. In addition, several notable media pieces that have been initiated both by project staff and participating retailers. See the links below: http://wesa.fm/post/broccoli-eggplants-avocados-how-food-bucks-bring-produce-neighborhoods (Corner store owner featured on local NPR station) http://hazelwoodinitiative.org/assets/files/March%202018%20Homepage-R.pdf (Column written by corner store owner in weekly local paper) www.post-gazette.com/opinion/Op-Ed/2018/02/11/Turning-food-deserts-into-oases/stories/201802110101 (Op-ed co-authored by Food Trust and American Heart Association staff highlighting the impacts of the Hill District Shop 'n Save) Another opportunity which allowed The Food Trust to further engage with a funder audience was the UpPrize Social Innovation Challenge, hosted by the Forbes Funds and BNY Mellon. The challenge included pitching an innovative technology solution to groups of supporters, including funders and investors. The Food Trust was named a finalist in the competition, pitching the idea of converting the current paper-based Food Bucks program to digital incentives, which would make the program easier to use for shoppers and retailers, reduce administrative time, and set up the program for longer-term sustainability. Program staff also presented on this work at several convenings during the grant year, including The Central Pennsylvania Food Bank's Child Hunger Summit in May, which brought together parties working to fight hunger in the region. Other presentations included theFood and Nutrition Service Mid Atlantic Regional Office's webinar for local FINI grantees, and the Society for Applied Anthropology's Innovative Ways to Address Food Insecurity panel in Philadelphia. Lastly, The Food Trust did a social media push of the newly published Power of Produce report (a piece written together with Fair Food Network and Wholesome Wave which features the history and impacts of SNAP incentives)--this online release reached over 50,000 Twitter followers. What do you plan to do during the next reporting period to accomplish the goals?Grocery Stores In New Jersey, The Food Trust plans to roll out Food Bucks at two supermarkets in Camden County, New Jersey, piloting two new incentive models. Both of the new models will seek to streamline the Food Bucks program by being less reliant on cashiers to ensure coupons are distributed. In one model, Food Trust staff will pre-enroll SNAP shoppers into the Food Bucks program through in-store outreach, and in the other, SNAP shoppers will be auto-enrolled into the Food Bucks program using the store's POS software to identify eligible users. At Shop 'n Save in Pittsburgh, The Food Trust is also working toward an auto-enroll program, which will enable shoppers using SNAP to be identified by their loyalty card number to trigger the incentive, rather than being identified by a cashier. This will result in more eligible shoppers receiving Food Bucks and more redemptions. The Food Trust is also working with an additional Shop 'n Save location, under different ownership, to implement the Food Bucks program. Working with two differently-owned stores will provide opportunities to compare strategies and continue working toward maximizing Food Buck redemptions. The second year of this grant will also see the rollout the Food Bucks program for the first time in a Central Pennsylvania grocery store. Corner Stores Building on the success of the Food Bucks program in Fayers Market in Year 1, The Food Trust will move forward with piloting new program models to encourage SNAP shoppers to purchase more fruits and vegetables in small grocery retail. Two noteworthy models the agency plans to pilot are 1) a 50% discount on all produce purchases for EBT customers and 2) Food Bucks Rx redemptions at a Philadelphia corner store. With Pittsburgh corner stores, The Food Trust is set to be ahead of schedule, having already launched at two stores and adding a new store into the program in July 2018. The Food Trust will also experiment with a new program design: shoppers using SNAP will receive a $2 Food Buck for making any SNAP eligible purchase, regardless of amount. In the next year, we will compare this model with the 2:1 model we have been using at other corner stores. Food Bucks Rx In Philadelphia, The Food Trust will roll out the first Food Bucks Rx program in a Philadelphia grocery store chain, The Fresh Grocer, in at least five area locations. This program will be in partnership with Einstein Medical Center to reach diabetes patients who use SNAP, and with Lankenau Medical Center to reach patients at its internal medicine and specialty practice. Food Bucks Rx coupons in Philadelphia will also be redeemable at all farmers markets and participating grocery stores, including a farmers market which operates directly outside the Einstein clinic. In Camden, The Food Trust will continue its partnership with Cooper Medical Center, offering fruit and vegetable prescriptions to food insecure children and their families who use SNAP, and adding on the Camden Farmers Market as a redemption site. Project staff will also work toward adding the PriceRite supermarket as an eligible redemption site. In Pittsburgh, The Food Trust will use data collected during the first season of the Food Bucks Rx program (June-November 2018) to work toward identifying the most effective program structure for maximizing Rx redemptions on fresh produce. The Food Trust will also work to bring Shop 'n Save on board as a Food Bucks Rx redemption location, which will greatly increase the options recipients have to redeem their prescriptions. Farmers Markets/Mobile Markets In the second year of this three year grant, The Food Trust will bring the Food Bucks Rx program to all farmers markets in The Food Trust's Philadelphia network, working with two regional healthcare systems. In Camden, The Food Trust will continue to work with Virtua Camden, a local health system, to administer EBT and operate the Food Bucks program at the Virtua Camden Farmers Market. Additionally, The Food Trust also plans to implement Food Bucks at the Virtua Mobile Farmers Market, which operates four times a week in both Camden and Burlington counties (New Jersey). The agency has also investigated a 50% produce discount model that could be more easily implemented in rural farmers markets, or smaller markets without the infrastructure to implement a paper-coupon based program. The Food Trust will connect with partners throughout Pennsylvania to continue pursuing this new model.
Impacts
What was accomplished under these goals?
From June 2017 to May 2018, The Food Trust launched Food Bucks programs in several new retail venues, identified updated technology solutions, piloted new Food Bucks Rx programs, and developed opportunities in new geographies. Two notable sites are: 1) the Pittsburgh Hill District Shop 'n Save, where community members in a historically low-income, primarily African-American neighborhood worked for years just to get a grocery store to open; and 2) Fayers Market, a corner store in Camden, NJ that has participated in healthy corner store programming and has served as one of the few places in the area to purchase a variety of fresh foods. Corner stores are seeing dramatic increases in produce and SNAP sales as a result of the program. In Pittsburgh, one store has seen a 200% increase in produce sales since the Food Bucks program began, and in Camden, one store has seen a 165% increase. Project staff also developed robust Food Bucks Rx programming, so that patients in Camden, Philadelphia, and Pittsburgh who are at risk for diet-related diseases and food insecurity will receive vouchers for fresh produce in a clinical setting. Finally, key planning took place to add on more retail sites in Camden, NJ, Chester, PA, and Central PA. In total, The Food Trust added 4 new retail sites, redeemed $50,000 in incentives for fresh produce, and formulated important Food Bucks Rx partnerships with five healthcare systems. This work is providing several opportunities for families in Pennsylvania and New Jersey to afford and consume more fruits and vegetables. Data Collection Staff worked with each site to create systems that collect the number of Food Bucks and Rx distributed and redeemed.Various data collection methods (e.g. paper Food Buck tracking, POS systems) are used at partnering food retailers and serve as inputs for our Food Bucks database. To validate the POS system, staff collect and compare receipts with POS figures. Below are the metrics and other data we collect from retailers and program participants to assess program impacts (note: not all metrics are collected from each site): # of individual Food Bucks coupons distributed and redeemed at all sites $ amount of Food Bucks distributed and redeemed at all sites (and % redemption) # of outreach materials created and distributed # of organizations outreached to Cashier compliance with distributing Food Bucks to shoppers using SNAP Quarterly/Monthly SNAP sales and number of SNAP transactions # of unique SNAP households Customer surveys and general customer feedback # or value of produce items sold at corner stores # of vendors at farmers market stops Corner store sales receipts from customer purchases where incentive is redeemed (for quality assurance period) Sales data from POS systems, including $ of produce and SNAP sales Major Activities and Findings Objective #1. Improved access to affordable fresh produce in the Camden, NJ, Promise Zone, through a Food Bucks program for SNAP participants at a healthy corner store, a mobile market serving six neighborhoods, a farmers market, and the city's only full-service supermarket. Major Activities Completed Launched incentive program at corner store (Fayers Market), including significant work with the store's POS system to collect baseline data, create a produce coupon button, and document sales trends. SNAP shoppers received a $2 Food Buck (redeemable for fresh produce) for every $5 of SNAP-eligible items purchased. Nutrition education lessons, conducted by TFT's SNAP-Ed educators, supplemented the program. Project planning with Virtua Hospital around summer 2018 launch of Food Bucks at Camden Farmers Market, while also providing TA around EBT processing and vendor procurement. Project planning with the Ravitz Family PriceRite to launch Food Bucks in Year 2. Summary Statistics and Key Outcomes Through May 31, 2018, Fayers Market redeemed $21,678 in Food Bucks with a redemption rate of 28%. Compared with pre-intervention baseline data, produce sales at Fayers increased from an average of $3,869/month (Jan & Feb) to $10,259/month (Mar to May), an increase of 165%. Objective #2: Development of a new Food Bucks Rx program with health care systems in Camden, NJ, and Philadelphia and Pittsburgh, PA, serving at-risk patients who use SNAP. Major Activities Completed In partnership with Cooper Pediatrics and Campbell's Soup Healthy Communities,The Food Trust launched the Food Bucks Rx program, aimed at supplementing fruit and vegetable access for low-income families in Camden. Families were prescribed $20 per person in Food Bucks to be redeemed at a nearby healthy corner store for fruits and vegetables (Fayers). Developed partnerships, conducted formative research and collaboratively planned with two healthcare partners in Pittsburgh and one partner in Philadelphia to develop more Food Bucks Rx programs. Summary Statistics and Key Outcomes As of May 2018, 359 prescriptions were distributed in Camden, NJ, averaginga 26% redemption rate. Objective #3: Expanded network of food retail partners and scaling up of a new digital redemption system for Food Bucks across multiple grocery stores into new regions. Major Activities Completed Launched Food Bucks at the Hill District Shop 'n Save in Pittsburgh. Shoppers who use SNAP benefits earn one $2 printed coupon for every $5 worth of produce they purchase, redeemable for fresh produce. Hosted staff trainings, coordinated nutrition education with local partners, informed retailer in-store promotion, and conducted a focus group among local residents. Launched new incentive programs at two Pittsburgh healthy corner stores. Shoppers earn a $1 Food Buck (redeemable on fresh produce) for every $2 they spend with their SNAP benefits. Conducted project planning in Chester, PA with Philabundance on grocery store intervention. Conducted research and planning to introduce Food Bucks to farmers markets and a supermarket in underserved rural areas of Central PA. Note Camden corner store programming under Objective #1. Summary Statistics and Key Outcomes Over $4,000 in Food Bucks redeemed at the Pittsburgh Shop 'n Save during the reporting period (31% coupon redemption rate). 20 Shop 'n Save shoppers interviewed during focus group. 89% of Food Bucks users at focus group reported being "somewhat" or "very" satisfied with the program. $8,600 redeemed in Food Bucks at Pittsburgh corner stores (66% redemption rate). Success attributed to owner engagement and smaller staff. Increased produce sales at Pittsburgh corner stores. As of May 2018, produce sales were up 78% over baseline at Dylamato's, and have tripled at Carl's Café. Over 500 shoppers have participated in a taste test or nutrition education lesson at Shop 'n Save. Objective #4: Increased redemption and positive impact of Food Bucks and SNAP benefits among SNAP participants at farmers markets in Chester, Pittsburgh, and Central PA, as well as Camden, NJ, leading to increased sales and consumption of local fresh fruits and vegetables. Major Activities Completed Increased presence at Chester farmers market (in a historically distressed city in Southeast PA) with greater frequency and number of vendors. Note planning activities under Objective #2 which will impact farmers markets. Summary Statistics and Key Outcomes Survey results and other key data expected during Years 2 and 3.
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