Recipient Organization
FRESH APPROACH
5060 COMMERCIAL CIR STE C
CONCORD,CA 945208508
Performing Department
(N/A)
Non Technical Summary
Several studies and community needs assessments show that diet-related health conditions are more prevalent in low-income minority populations. These health disparities among low-income populations can be attributed to food insecurity, a lack of knowledge about how to eat and cook healthy, and unhealthy food behaviors as a response to stress or trauma, among other factors. Higher rates of chronic disease contribute to decreased quality and length of life, increase financial burden on the individual, and well as high healthcare costs. By increasing access to and consumption of healthy food among low-income populations, this project directly addresses the need for preventative solutions that address the root causes of these health disparities. Farmers markets provide an outlet for accessing healthy, local foods, but may not be utilized by low-income minority populations due to lack of awareness, perceptions of high cost, lack of awareness about financial incentive programs, or feeling unwelcome. The increased awareness built by this project around farmers' markets, SNAP use, and financial incentives will show ripple and lasting effects in other regional SNAP communities by enhancing the demand for locally produced food and increasing the number of low-income shoppers at farmers' markets to create sustained impacts after this project ends.This project will work directly with healthcare providers to address root causes of health disparities in their most vulnerable patients. In partnership with the Ravenswood Family Health Center in East Palo Alto (CA), pediatric and adult patients who have been screened for food insecurity and diet-related health disorders will be enrolled in this project. The project is administered in a series of 16 weeks and there will be four series, each with 15 participants. Each series will consist of at least two health screenings and eight trauma-informed nutrition and cooking group sessions. Participants will receive food prescription vouchers with each visit, redeemable for fruits and vegetables at the nextdoor East Palo Alto Community Farmers' Market, a SNAP authorized firm that is operated by Fresh Approach, as well as other SNAP authorized regional farmers' markets, ensuring maximum accessibility. The vouchers provide increased financial access for low-income patients to implement the healthy behaviors discussed in the series, impacting their food security status and fruit and vegetable consumption. The proposed project will contribute to removing barriers to a healthy diet faced by pediatric and adult patients experiencing chronic or acute food insecurity and empower them with appropriate knowledge and resources. By enhancing access to fruits and vegetables and knowledge about nutrition and cooking, this project aims to increase food security and improve health outcomes among community members from predominantly-lower socioeconomic status.
Animal Health Component
0%
Research Effort Categories
Basic
(N/A)
Applied
(N/A)
Developmental
(N/A)
Goals / Objectives
Goal 1: Improvements in knowledge and behaviors around fruit and vegetable consumption among food insecure and at-risk pediatric and adult patients.1.1At least60 participants (4 cohorts) will be recruited by the Ravenswood Family Health Center to be engaged in the VeggieRx Program and a total of $76,800VeggieRx vouchers will be distributed to participants, supporting food access for their entire family (approximately 240 people).1.275% of the participants will report an increased consumption of fruits and vegetables of at least 1 cup/day, as measured from the pre and post VeggieRx classes surveys.1.3 At least 80% of participants will increase utilization of accessible local food resources, by reporting an increased number of visits from 1/first visit to at least 2 visits/month.1.4 At least 75% of participants will report that they learned how to shop on a budget/afford healthy food.1.5 At least 80% of participants will report that they learned a lot about why fruits and vegetables are good for them, and how to include more fruits and vegetables in their diet, as measured from the pre and post VeggieRx classes surveys.Goal 2: Demonstrate effectiveness of a trauma-informed nutrition program on individual resilience factors and measures of self-efficacy to make healthy lifestyle choices.2.1 At the end of the class series, 75% of participants will agree or strongly agree that they can control their own health, achieve their own health goals, and overcome most challenges.2.2 At the end of the class series, 80% of participants will agree or strongly agree that nourishing their body is a meaningful activity, and that eating nourishing foods brings them comfort.Goal 3: Demonstrate the effectiveness of the prescription program in improving health outcomes and food security levels in food insecure and at-risk adult and pediatric patients.3.1 55% of the pediatric participants show a decrease in their BMI percentile by at least 0.5 unit from pre to post intervention.3.2 60% of the adult participants show a decrease in their BMI by at least 0.5 unit from pre to post intervention.3.3 60% of the adult participants that have been diagnosed with uncontrolled type 2 diabetes show a decrease in their HbA1c pre and post intervention of 0.2 percentage point.3.4 20% reduction in the number of program participants reporting high levels of food insecurity by the end of the program.Goal 4: Demonstrate a reduction in hospital visits and associated costs among adult program participants.4.1 In partnership with Ravenswood Family Health Center, strategies to measure potential healthcare cost-savings for hospitals and clinic patients are developed and tested.4.2 Average decrease in ER visits among adult program participants by 25%.
Project Methods
Recruitment:Program participants will be recruited by staff and providers at Ravenswood Family Health Network. Providers will identify patients who have screened positive for food insecurity. In addition to food security status, in year one of the project, recruitment will focus on pediatric patients who have elevated BMI percentiles. In year two, recruitment will focus on adult patients with elevated BMI and/or uncontrolled diabetes. Identified patients will be referred by their provider to the VeggieRx program.Efforts Used:Patients will be recruited to join a cohort (two pediatric cohorts in year one, and two adult cohorts in year 2). Each cohort will participate in a 16 week program that includes formal classroom instruction in the format of 8 trauma-informed nutrition and cooking classes (in-person person or online format).Classroom instruction covers topics that include eating healthy on a budget, how to incorporate more fruits and vegetables into a diet, whole grains and healthy fats, cooking tips, and how to eat seasonally and locally. The classes will also address emotional regulation, confidence building, and building positive relationships with food. Staff leading the class are trained in recognizing the signs of trauma, and will facilitate activities that help the group process challenging emotions, form authentic relationships, and improve self-regulation. Classes will also address some of the ways previous trauma impacts an individual's food behaviors and health status, by teaching coping strategies and reframing negative behaviors to remove shame.At the end of each workshop, $40 per person in the participant's household in VeggieRx Vouchers will be provided to purchase fresh produce until the next class in 2 weeks (or sent via mail if class is virtual). Participants will be invited to spend their vouchers at the East Palo Alto Community Farmers' Market, as well as at other farmers' markets located throughout the county and greater Bay Area, which will be promoted in a brochure provided.Additionally, each participant will participate in two health screenings, one at the beginning of the 16 week program, and one at the end. Each health screening will include:Collection of standard medical measurements of diet-related health indicators, including BMI percentile for the pediatric patients; BMI and HbA1c measurements for the adult patients;Pre and post survey evaluations of food security level, knowledge, self-efficacy, and health behaviors, (i.e. changes in the daily consumption of fresh fruits and vegetables, confidence in food preparation skills, belief in ability to make improvements in health);Self-reported number of ER visits.Data Collection and Evaluation:Data on Program Reach: Class attendance records will be tracked on a spreadsheet using unique IDs for each patient to maintain confidentiality. Participant household size will be recorded as well to determine the amount of vouchers distributed to each attendee each week.Key milestones:At least 60 participants (4 cohorts) will be recruited by the Ravenswood Family Health Center to be engaged in the VeggieRx ProgramData on Program Impact: Program impact will be measured by the amount of VeggieRx vouchers distributed and redeemed, changes in pre and post behavioral health assessments, and changes in pre and post health screeningsVeggieRx vouchers distribution and redemption rates are tracked in Salesforce using unique barcodes on each voucher.Pre and post behavioral health assessment surveys will determine food insecurity level, knowledge, attitudes, and behaviors surrounding vegetable and fruit purchasing and consumption, and number of ER visits.Health screenings will collect height, weight, and BMI measurements, as well as HbA1c for adult participants.Key milestones:VeggieRx distribution: A total of $76,800 VeggieRx vouchers will be distributed to participants, supporting food access for their entire family (approximately 240 people). Voucher redemption rate 9-months after the final class will be at least 75%Pre and post behaviors surveys: At least 75% of the participants will report an increased consumption of fruits and vegetables of at least 1 cup/day, as measured from the pre and post VeggieRx classes surveys. At least 80% of participants will increase utilization of accessible local food resources, by reporting an increased number of visits from 1/first visit to at least 2 visits/month. At least 75% of participants will report that they learned how to shop on a budget/afford healthy food. At least 80% of participants will report that they learned a lot about why fruits and vegetables are good for them, and how to include more fruits and vegetables in their diet, as measured from the pre and post VeggieRx classes surveys. At the end of the class series, 75% of participants will agree or strongly agree that they can control their own health, achieve their own health goals, and overcome most challenges. At the end of the class series, 80% of participants will agree or strongly agree that nourishing their body is a meaningful activity, and that eating nourishing foods brings them comfort.Health screenings: 55% of the pediatric participants show a decrease in their BMI percentile by at least 0.5 unit from pre to post intervention. 60% of the adult participants show a decrease in their BMI by at least 0.5 unit from pre to post intervention. 60% of the adult participants that have been diagnosed with uncontrolled type 2 diabetes show a decrease in their HbA1c pre and post intervention of 0.2 percentage point. 20% reduction in the number of program participants reporting high levels of food insecurity by the end of the program. Average decrease in ER visits among adult program participants by 25%.Data format will be in various easily readable and accessible forms for future or public use. Raw data from behaviour surveys responses will be collected via Google Forms (or papers as back-ups) and analyzed in the standard format (.xls). Health screening parameters will be collected by the health care partner, de-identified and sent via secure email to Fresh Approach in the standard format (.xls). Data from participants' attendance sheet will also be generated and stored in spreadsheet format .xls. Furthermore, data generated from VeggieRx vouchers distribution and redemption will be tracked and stored in the Fresh Approach's Salesforce cloud system.