Source: TULSA COMMUNITY FOUNDATION submitted to
DOUBLE UP OKLAHOMA | EXPANDING ACCESS TO FRUITS AND VEGETABLES FOR LOW-INCOME OKLAHOMANS
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
EXTENDED
Funding Source
Reporting Frequency
Annual
Accession No.
1024399
Grant No.
2020-70030-33156
Project No.
OKLW-2020-06243
Proposal No.
2020-06243
Multistate No.
(N/A)
Program Code
FIP
Project Start Date
Sep 30, 2020
Project End Date
Sep 29, 2022
Grant Year
2020
Project Director
Comeau, R.
Recipient Organization
TULSA COMMUNITY FOUNDATION
7030 S YALE AVE STE 600
TULSA,OK 741365749
Performing Department
Hunger Free Oklahoma
Non Technical Summary
Double Up Oklahoma (DUO), seeks to increase fruit and vegetable purchase and consumption amongst Supplemental Nutrition Assistance Program (SNAP) recipients, improve livelihoods of farmers, and increase food security by incentivizing produce purchases at the point-of-sale. Hunger Free Oklahoma (HFO) will achieve these goals by increasing the number of DUO participating firms, expanding firms to traditional grocery stores, increasing redemption rates for DUO, utilizing direct-to-consumer targeted marketing strategies, and empowering a diverse advisory committee and four regional SNAP participant workgroups. Included in this project is a comprehensive evaluation focused on growth through incentive redemption and firm participation and, secondly, focused on DUO participant experience and behavior change in fruit and vegetable consumption. Crucial to project success is coordinated advertising and promotion, strategic expansion in low-income, low-access areas, ongoing technical assistance to DUO firms, and the work of a diverse advisory committee and four regional SNAP participant workgroups focused on program evaluation and improvement. The project meets the GusNIP FIP goal of incentivizing purchases of fruits and vegetables at the point-of-purchase. DUO meets GusNIP priorities by maintaining a 65% benefit ratio to total project budget, using direct-to-consumer marketing, targeting locally grown produce, using a produce-for-produce model in traditional grocery stores (open extended hours), coordinating diverse stakeholders, and offering a mobile grocer model and transportation in high-need communities. The project is administered by HFO which has a proven track record of providing services in underserved communities and large scale statewide program implementation.
Animal Health Component
0%
Research Effort Categories
Basic
(N/A)
Applied
(N/A)
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
7036099301034%
7036099303033%
7036099302033%
Goals / Objectives
Double Up Oklahoma seeks to increase the purchase of fruits and vegetables by low-income Oklahomans participating in SNAP by providing incentives at point-of-sale, increase access to DUO for low-income Oklahomans to incentive firms, and improve the economic livelihoods of local farmers by increasing SNAP consumer demand.Goal 1: Increase the purchase of fruits and vegetables by low-income Oklahomans participating in SNAP by providing incentives at point-of-sale.HFO will partner with ONIE, Fair Food Network, and firms to implement innovative strategies to advertise directly to potential shoppers to increase to 4,000 participants annually.Goal 2: Increase access to DUO for low-income Oklahomans to incentive firms.HFO will expand the number of participating firms from 11 to 30 a 270% increase from 2019. This will include 7 rural/semi-rural grocery stores, 2 nonprofit/mobile markets, and 21 farmers markets located across 19 LILA census tracts and adjacent to 16 additional LILA tracts by end of Grant Year 2.HFO will expand existing Tulsa DUO mobile market serving low-income areas lacking transportation and store options. HFO is partnering with INCOG to provide expanded transportation services to participating firms and markets for individuals who are elderly and/or disabled in the Northeastern region of the state. HFO will continue to partner with local churches and synagogues, and nonprofit organizations such as LIFE Senior Services and Morton Comprehensive Health Care Services to expand transportation for low-income households to attend farmer markets and/or mobile grocery sites.DUO includes 1 nonprofit grocer who will add up to 2 additional stores during the grant and 7 traditional grocery stores (10 total) open year-round with extended hours.Goal 3: Improve the economic livelihoods of local farmers by increasing SNAP consumer demand. All DUO markets currently provide at least 70% locally or regionally grown produce. DUO participating firms and grocers must commit to increasing local produce purchased by 1% annually unless the majority (>50%) of their annual produce purchase is already sourced locally.
Project Methods
Double Up Oklahoma (DUO) is an intervention that: 1) increases access to fruits and vegetables for low-income and food-insecure Oklahomans; and 2) improves the livelihoods of local farmers who grow and sell crops. This grant will expand and improve the existing DUO program and provide opportunities to innovate and test new markets across Oklahoma. To increase the purchase of fruits and vegetables by SNAP recipients, this project provides incentives at the point-of-sale (POS) at authorized firms. DUO incentives can be used to purchase GusNIP qualifying fruits and vegetables including fresh, canned, frozen, and dried fruits and vegetables (without additives such as sodium, sugar, or fat).HFO will grow the number of participating firms from 11 to 30, a 270% increase from 2019. This will include 7 rural/semi-rural grocery stores, 2 nonprofit/mobile markets, and 21 farmers markets located across 19 LILA census tracts and adjacent to 16 additional LILA tracts by end of Grant Year 2.HFO addresses price, access, and knowledge by increasing low-income Oklahomans' purchasing power by doubling SNAP dollars to buy approved produce, increasing the number of firms in LILA areas, growing public-private partnerships, and by implementing direct to consumer marketing and nutritional education.HFO will grow the DUO Advisory Committee and SNAP recipient work groups and consult with them on program implementation and assessment.The efficacy of the program's efforts will be measured and assessed, with advice and input from public health faculty at OUHSC as detailed in the list below. (Measures are for all firms unless otherwise noted.)General MeasuresRequired Site and Project Information for Annual Reporting (NIFA)Required Incentive Program Information for Annual Reporting (NIFA)Project-Specific Process MeasuresWeekly Market and Grocer Checklist (Proper marketing signage is in place; weather; number of fruit and vegetable vendors present; variety of fruits and vegetables available; special events held; estimated attendance, and proper functioning of EBT machines)Mid-Season and End-Season Market Manager and Market Vendors survey (to capture process, challenges, and success of implementation and operations; recommendations for improvement and ongoing expansion) (FARMERS MARKETS ONLY)DUO/SNAP Participant Experience survey (to capture shopping experience, demographics, household size, frequency of program use, market or firm's proximity to home and transportation, fruit and vegetable knowledge and behavior checklist, attendance/benefit of nutritional education/cooking demonstrations, likelihood of return, how learned about DUO, recommendations for DUO improvement and ongoing expansion, and interest in participation in the Committee or Workgroups)Quarterly Grocery Store Manager survey (to capture process, challenges, and success of implementation and operations, and recommendations for improvement and ongoing expansion) (GROCERY STORES ONLY)Marketing Effectiveness (website hits; DUO/SNAP participant, SNAP recipient Workgroups and Committee surveys; shopper spikes data with dates of targeted marketing; perceived benefit of fruit and vegetable education and cooking demonstration)Project-Specific Outcome MeasuresIncentive firm-level (total number of urban, and rural/semi-rural markets, mobile grocers, and small and large grocers participating in DUO program; amount of locally grown produce at non-farmers market participating firms; dollar of incentive transactions)Individual-level (Number of unduplicated participants)Quarterly and Annual incentive redemption rate

Progress 09/01/20 to 08/31/21

Outputs
Target Audience:The target audience for this project is individuals and households participating in SNAP in Oklahoma. According to data provided by the Oklahoma Department of Human Services, there were 804,641 unduplicated Oklahomans participating in SNAP in 2019. Hunger Free Oklahoma (HFO) currently operates the Double Up Oklahoma (DUO) program in 23 counties with a total of 532,555 unduplicated SNAP participants, 66% of all eligible participants. This project is specifically focused on SNAP participants living in rural/non-metropolitan areas and in Low Income, Low Access (LILA) census tracts. Fifty-seven percent of counties with a DUO program are designated as non-metropolitan areas by the Office of Management and Budget. Non-metropolitan and rural communities in Oklahoma have fewer supports than metropolitan areas, including fewer hospitals and grocery stores. Twenty-one participating firms are in LILA census tracts, where low-income participants lack adequate access to nutritious foods. Thirteen participating firms are located adjacent to one or more LILA tracts. Hunger Free Oklahoma is also committed to reaching historically marginalized communities across Oklahoma including Black, Hispanic, and Native American populations. Double Up Oklahoma is currently operating in three firms in historically Black communities, and all firms are located within Indian Tribal Organization service areas. In addition to SNAP participants, HFO works with a broad array of stakeholders to facilitate this program. Organizations working on food access, anti-poverty, health, and local agriculture are all key constituents in this work. In addition, grocery retailers, medical professionals, universities, and community leaders are interested in the outcomes of this work, as it has implications on the health, food security, and financial stability of their communities. Hunger Free Oklahoma partners with community-based organizations serving specified populations to disseminate information and build trust with these target populations. In the second year of this project, HFO will partner with community health providers and the University of Oklahoma Health Sciences Center to educate medical professionals about DUO and provide them resources to assist clients in eating healthier foods through DUO. Changes/Problems:There have been no substantive changes to the project plan, approach, or methods. Our implementation in new firms was delayed due to COVID-19. However, strong participation and redemption rates have resulted in the use of incentive funds faster than originally anticipated. A GusCRR award will allow us to maintain our goal of offering the program in 30 firms while doubling the amount of incentives available to participants. Therefore, we are on track to complete this program by the end of the grant term. The DUO Program Manager position was unfilled for three months due to FMLA leave and then vacant for one month of this program year due to staff turnover. Reduced staffing delayed accomplishment of Goal 3 and the development of the DUO Participant Advisory Group. However, all other primary objectives and outcomes for this grant have been accomplished in program year one. The primary unexpected outcome of this program year has been the rate of redemption for DUO at participating brick and mortar stores. In our original proposal, we estimated DUO incentive expenditures using a 15% redemption rate, which was in line with information provided by other incentive programs. Currently, our redemption rate at grocery stores is around 33% while our redemption rate at farm direct firms is 87%. Because our expansion to brick and mortar stores happened during COVID and an influx of benefit programs to aid low-income families, we are not sure what impact that has had on redemption rates or will have as those COVID relief programs begin to end. Our evaluation team will continue to assess the data to better understand relevant causal relationships between COVID, relief programs, and our efforts on redemption rates. What opportunities for training and professional development has the project provided? Nothing Reported How have the results been disseminated to communities of interest?Hunger Free Oklahoma has two primary audiences for this work - end users and state and community organizations. HFO communicates the results of this program to state and community organizations through multiple stakeholder groups and our DUO Advisory Committee. Our DUO Advisory Committee represents 23 nonprofits, healthcare networks, businesses, and state agencies. We currently have three stakeholder groups including Farmers Markets (21 organizations), Nutrition Education and Outreach (six organizations), and Research and Evaluation (five organizations). The DUO Advisory Committee is currently in the process of building a DUO Participant Advisory Committee, which will represent DUO participants from across the state. Hunger Free Oklahoma and our evaluators at OUHSC have provided three quarterly reports to Advisory Committee and stakeholder group members. Additionally, HFO staff have made 12 presentations to the groups about progress towards achieving our goals. HFO has also met with 15 community-based organizations in program communities to discuss the project and its results and provided outreach material to over 45 organizations. The DUO Participant Workgroup is one of the primary avenues HFO has for communicating program results and getting valuable input from program participants. This workgroup is still under development, but HFO anticipates having it operational in the next program year. In addition, HFO has released 5 press releases in participating communities and statewide to provide program updates and increase awareness about the program and its benefits to potential participants. During this program year, HFO collected 150 participant surveys to get program feedback. At the end of this grant period, HFO and OUHSC will publish a final report and summary documents and make them available online and in print to any interested audiences. What do you plan to do during the next reporting period to accomplish the goals?HFO is confident that all of the objectives in this grant will be accomplished by the end of the grant term. Future evaluation efforts will expand on our robust sales and firm-level data to gather more information from DUO participants and further evaluate outcomes.DUO is on track to expend all incentive funds before the end of the grant period. However, over the next program year we will continue this work in the following primary areas: Increasing Participation and Access: Rather than expanding physical locations, HFO will focus on the following to increase access to DUO and fresh produce: Implement new in store/market promotional campaigns including nudges at the point of sale, in store signage, and recipe cards/nutrition education resources Partnering with healthcare providers to promote the program to patients and provide educational resources to help patients eat more nutritious foods Educating community stakeholders and organizations about the program and providing them outreach resources Promoting Local Agriculture: Improving the livelihood of farmers is an important component of DUO. Our work to expand local agriculture and improve the livelihoods of local farmers is ongoing, and HFO will continue to build a baseline and work with firms and vendors to increase the amount of locally grown food accessible to DUO participants in the coming year.In order to accomplish this goal, HFO will: Finish establishing a baseline of local produce purchasing at participating firms Continue facilitating connections between firms and local producers through partnerships with ODAFF and local communities Evaluation: Program evaluation is critical to expanding and improving the program in future program years. In order to facilitate this, HFO will: Continue to assess point of sale data to understand impact of DUO on SNAP participant produce purchasing and consumption Analyze sales, environmental, and demographic data to understand correlations between community/store characteristics and program success Analyze UPC and sales data to determine produce categories with the greatest lift in SNAP sales Communicating Results: Hunger Free Oklahoma and our evaluation partners will continue developing and sharing quarterly reports and presentations Hunger Free Oklahoma will develop simplified one-pagers and data tools to share key results with broad stakeholders Hunger Free Oklahoma will continue to share results and findings with key audiences through press releases and news coverage Hunger Free Oklahoma and evaluation partners anticipate publishing at least one article about findings from our evaluation project

Impacts
What was accomplished under these goals? Oklahoma has some of the worst health rankings in the country, including 40th in obesity, 41st in diabetes-related deaths, and 49th in cardiovascular disease-related deaths (America's Health Rankings, 2019). Research shows that nutrition can positively impact adverse health outcomes. However, less than 6% of adults in Oklahoma report eating two or more servings of fruits and vegetables per day (America's Health Rankings, 2020). Among low-income households, research shows that price, access, and knowledge are some of the most limiting factors for fruit and vegetable consumption (Sacks, Yi, and Nonas, 2015). Double Up Oklahoma helps SNAP participants access and afford more fresh fruits and vegetables by offering a dollar for dollar match for fresh fruits and vegetables on SNAP purchases at the point of sale. Over the past year, HFO has made great progress towards achieving our stated goals and objectives by taking a data-driven approach to identifying sites and building strategic partnerships to grow and improve programming. Below is a description of our progress towards achieving each of our goals. Goal 1: Increase the purchase of fruits and vegetables by low-income Oklahomans participating in SNAP by providing incentives at point-of-sale. Hunger Free Oklahoma focused on two primary strategies to increase participation in DUO, thus increasing fruit and vegetable purchases. First, HFO worked with existing farmers and mobile market partners to implement strategic direct to consumer marketing including paid digital advertising, community outreach, partnerships with local OKDHS offices, and targeted promotional materials in English and Spanish. Second, HFO worked with communities and partner organizations to place new firms in areas where they were most needed (see discussion under Goal 2). As a result of this work, DUO redemptions at farmers markets grew from $98,000 in 2019 to over $120,000 in this reporting period and served 984 SNAP participants who had not previously participated in the program. Additionally, new brick and mortar firms served 3,736 unduplicated households in the last month of reporting. In total, between farmers markets and brick and mortar firms, over 4,720 unique households participated in Double Up Oklahoma this program year, representing 118% of our original goal of 4,000 unduplicated participants. This program uses the last four digits of the EBT card to track participants. HFO anticipates these estimates are under reported. There are likely participating households with the same last four digits on their EBT card. Additionally, benefits are earned in one transaction and redeemed in another. Benefit redemptions do not require an EBT card to be present thus there are spending transactions that are not tied to a specific EBT card. To more accurately estimate benefit redemption in the next program year, HFO has worked with our partners to develop a new unique barcode that can be tied to the benefit earning transaction. This will allow us to more accurately estimate the number of unique participants. In addition to increasing the number of participants, HFO has been tracking total DUO redemptions and SNAP produce sales. In this grant year, $404,216 in incentives was redeemed, representing a 310% increase in incentives over the base year of 2019. In participating grocery stores, SNAP produce sales grew by 104% on average during the program year, indicating that DUO is driving an increase in fruit and vegetable purchases by SNAP participants (see Quarter 3 report for a complete analysis of SNAP produce sales data). Goal 2: Increase access to DUO for low-income Oklahomans to incentive firms. In order to achieve this goal, HFO and partner organizations sought to grow the number of firms from 11 to 30 over two years, add seven rural/non-metropolitan grocery stores, expand our mobile market footprint to two firms, and grow our farmers market program to 21 participating locations by year two. In total, we sought to operate programs in 19 LILA areas and adjacent to 16 additional LILA areas over the course of the program. HFO utilized SNAP participation data, poverty data, and LILA data to target expansion. This allowed us to work with community partners to identify viable new sites in high need areas. Ultimately, locations added to the DUO program during this grant year were in or adjacent to a LILA tract, had a poverty rate greater than 9.9%, and served a rural or historically disadvantaged population. This strategic approach to site placement ultimately facilitated us achieving our objectives. During this grant year, Hunger Free Oklahoma grew the program from 11 firms to 30 and operated DUO in 10 grocery stores (eight non-metro and two metro), 19 farmers markets, and one mobile grocer. Ultimately, we have achieved our initial objective of growing the program by 270% over the base year of 2019. Additionally, Double Up Oklahoma is operating in 21 LILA tracts (10% over our objective) and adjacent to an additional 13 LILA tracts (81% of our objective). In addition to participation data, Hunger Free Oklahoma has collected key informant interviews from farmers market managers, store managers, produce managers, and other key DUO firm stakeholders. Overall, stakeholders indicate that DUO has led to an increase in produce volume and variety in their location and benefited more than just DUO participants by facilitating improved produce variety and higher produce turnover rates. Ninety-seven percent of DUO participants surveyed indicated that the program was beneficial in increasing their access to fresh fruits and vegetables. Ongoing data analysis seeks to quantify the impact of DUO on produce variety, freshness, and affordability at brick and mortar firms. Goal 3: Improve the economic livelihoods of local farmers by increasing SNAP consumer demand. During this program year, Hunger Free Oklahoma worked with participating brick and mortar firms to identify a baseline of local purchasing. The program encountered a few barriers in establishing this baseline, as much of the historical produce sales data at grocery stores is not identified based on its location of origin. We are working with employees at our partner grocery stores to identify PLU and UPC codes of locally grown produce and to build a database of historical sales of these produce items. This work is ongoing and Hunger Free Oklahoma will continue to identify opportunities to improve this baseline data. While identifying this baseline, the DUO Advisory Committee and our partner firm HAC, Inc. have been building opportunities to increase local supply for DUO firms. Through a partnership with the Oklahoma Department of Agriculture, Food, and Forestry (ODAFF) HFO is identifying barriers to local sourcing for producers and grocery stores and connecting brick and mortar firms with producers with produce to sell and/or capacity to grow more fruits and vegetables. In support of this work, HAC, Inc. recently signed a contract with a community-led urban farm in a historically marginalized community to supply fresh greens for one of their new stores located in that same community. In a survey conducted by the Oklahoma Nutrition Information and Education Project, a DUO Advisory Committee member, 70% of produce vendors surveyed (n=73) indicated that they had made more money since DUO was implemented in their community, while 54% indicated they were producing more fruits and vegetables as a result. Overall, 91% of producers indicated that DUO increased their repeat customers and increased the diversity of their customers, 96% indicated that DUO created new customer bases for their produce, and 68% indicated that they were more financially stable because of DUO. Overall, Hunger Free Oklahoma believes that the data presented indicate substantial progress towards helping SNAP participants access and afford more fresh produce.

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