Progress 09/01/23 to 08/31/24
Outputs
Target Audience:Food on the Move (FOTM) is a year-round mobile produce market that brings fresh, healthy produce to the people and places that need it most. FOTM makes healthy food more affordable by offering a 50% discount on produce to customers who make purchases using Supplemental Nutrition Assistance Program (SNAP) funds. FOTM is informed by over a decade of research, including two NIH randomized controlled trials, which found significant increases in fruit and vegetable consumption among participants. FOTM aims to help SNAP recipients afford more nutritious food, reduce food insecurity, and better manage diet-related chronic diseases. Food insecurity remains high among Rhode Islanders. According to the 2023 RI Community Food Bank report, a record number of state residents needed food assistance with nearly one in three Rhode Island households reporting they were unable to afford adequate food. This issue continues to disproportionately affect minority populations within the state. Over 48% of Black households and 51% of Latinx households experienced food insecurity, compared to 23% of White households. FOTM prioritizes serving a highly diverse customer base, specifically communities of color who are at highest risk for food insecurity. In order to evaluate FOTM's efforts in reaching target populations, all customers are asked to complete a basic demographic questionnaire when they first shop at FOTM. They receive a loyalty card, also known as a rewards card. As of August 1, 2024, we have collected demographic data from 890 individuals. Customers at FOTM tend to be older adults, with the average age of a shopper being 68 years old. A vast majority (69%) of customers are women. FOTM serves a diverse population, with 66% of customers identifying as a race other than White or Caucasian, 52% identifying as Hispanic/Latinx, 14% as Black or African American, and 4% as American Indian or Native American. A majority of shoppers (69%) live alone, and 79% have an income that falls below 200% of the federal poverty level. Additionally, the majority of customers (77%) receive SNAP benefits. During this reporting period, FOTM served five active market sites across Providence, Pawtucket, and Central Falls in Rhode Island. FOTM locations are all public-housing sites where high-need populations reside including low-income older adults and disabled individuals. These sites have diverse populations that are often at risk for food insecurity due to issues with mobility and access to healthy foods. Three sites, Charlesgate, Hillcrest, and St. Elizabeth, are located in Providence. As a note, operations were suspended at the Charlesgate site at the beginning of 2024 due to changes in building management. FOTM serves two market sites outside of Providence: Forand Manor in Central Falls and Fogarty Manor in Pawtucket. These two sites are unique because both locations are open to the public, therefore community members can to these FOTM markets and benefit from its programming. Reaching these communities specifically is a priority, as they have limited access to healthy foods. A priority for FOTM going forward will be to continue to grow awareness of its program in these areas to provide its needed services. Changes/Problems:Food on the Move (FOTM) faced several new challenges in the early part of 2024. Several long-time staff members left the program for new opportunities, and staffing markets became a challenge as the program faced difficulties finding replacements. This is a high-impact, if expensive program to run, and we continually search for new funding programs to sustain the effort. What opportunities for training and professional development has the project provided?One of RIPHI's core values is the mentorship and training of public health professionals. The organization hosts multiple students across its programs every year. During this reporting period, Food on the Move (FOTM) had 4 students contribute to activities for the FOTM program. Roles that students usually take on are either part-time market staff members or internships with the program. In these, students are able to grow their public health knowledge and learn about real-world public health work. They are encouraged to pursue interests across the organization if they have multiple public health interests. The responsibilities in these placements ranged from working in market operations, survey and data collection, data analysis, and marketing activities. Many of our new staff members with MPH degrees have also worked on this program, which has contributed to their professional development in developing real-world solutions to enhance nutrition security for people living in poverty. How have the results been disseminated to communities of interest?The following evaluations and peer-reviewed articles have been published about Food on the Move programs: Evans, E. W., Lyerly, R., Gans, K. M., Alexander Scott, N., Cohen, E. D., Lawson, E., & Nunn, A. (2021). Translating Research-Funded Mobile Produce Market Trials Into Sustained Public Health Programs : Food on the Move. Public health reports (Washington, D.C. : 1974), 333549211012409. Advance online publication. https://doi.org/10.1177/00333549211012409 Rummo, P. E., Lyerly, R., Rose, J., Malyuta, Y., Cohen, E. D., & Nunn, A. (2021). The impact of financial incentives on SNAP transactions at mobile produce markets. The international journal of behavioral nutrition and physical activity, 18(1), 26. https://doi.org/10.1186/s12966-021-01093-z John, S., Lyerly, R., Wilde, P., Cohen, E. D., Lawson, E., & Nunn, A. (2021). The Case for a National SNAP Fruit and Vegetable Incentive Program. American journal of public health, 111(1), 27-29. https://doi.org/10.2105/AJPH.2020.305987 Lyerly, R., Rummo, P., Amin, S., Evans, W., Cohen, E. D., Lawson, E., Hallett, E., De-Oliveira, S., Rose, J., Sutten Coats, C., & Nunn, A. (2020). Effectiveness of mobile produce markets in increasing access and affordability of fruits and vegetables among low-income seniors. Public health nutrition, 23(17), 3226-3235. https://doi.org/10.1017/S1368980020002931 Rummo, P. E., Lyerly, R., Rose, J., Malyuta, Y., & Nunn, A. (2020). Evaluating the Impact of Financial Incentives on SNAP Transactions at Mobile Produce Markets. The Obesity Society Annual Meeting. Oral Presentation. November 2-6 2020. Virtual. We are currently working on drafting additional scientific manuscripts which will be submitted for publication in the coming months. What do you plan to do during the next reporting period to accomplish the goals?During the next reporting period, Food on the Move (FOTM) plans to maintain and build upon the work done so far for this grant. This includes continuing efforts to increase the market utilization at its four currently active sites through continued collaboration with its housing partners and targeted marketing in the building. Additionally, FOTM will seek to further expand its customer base of community members at its publicly accessible sites, to allow the wider population to benefit from its program. Traditionally, FOTM conducts comprehensive marketing and outreach efforts, including additional flyer distribution, social media blasts, and use of referral programs. To ensure the program attracts new customers, FOTM will seek to build upon its targeted social media advertisements on Meta and Instagram in Pawtucket and Central Falls.? Further, FOTM staff will continue to conduct rigorous evaluation activities across all aspects of the program and plans to disseminate findings to disseminate findings from our work. Specifically, we have started to and will continue analyzing data from FOTM's longitudinal study and plan to publish the results as soon as possible. It will be a program priority to share the results of this study through peer-reviewed literature, presentations, and reports accessible to the program's customer base. Additionally, this information may be shared with state policymakers to inform decisions surrounding the statewide Retail SNAP Incentive Program. Results from this study will examine the impact FOTM and SNAP incentives may have on food insecurity, fruit and vegetable consumption, and chronic disease management.
Impacts
What was accomplished under these goals?
Food on the Move has successfully met the main goal and all associated outcomes under this grant. More detailed descriptions of FOTM impact and successes under each outcome are outlined below. From September 1, 2023 through August 1, 2024 Food on the Move (FOTM) held 141 markets where over 450 unique individuals were served. FOTM sold over $73,000 in produce across all five sites through 3,663 transactions. The majority (86%) of this produce was paid for through EBT benefits and SNAP incentives. FOTM processed over 2,900 SNAP transactions. By utilizing the SNAP incentive system, SNAP customers were able to purchase $62,754 worth of fruits and vegetables for just $31,556. Outcome One: Through FOTM's loyalty card system, we are able to capture person-level purchasing data and connect this information with participant demographic data. Additionally, customers earn points every time they shop with FOTM which can be redeemed to purchase additional produce. Pairing this loyalty card data with information from the market's point-of-sale (POS) system allows FOTM to monitor changes in produce purchases over time. During this reporting period, FOTM enrolled 81 new shoppers in its loyalty card program. Through four years of this grant, we have been able to achieve an average market utilization rate of 64% (with a range of 44%-97%) across our sites. All five of our market sites maintained a utilization rate above 40% over the past year, keeping FOTM above target for its goal. Market utilization rates are calculated using the number of housing site residents enrolled into our loyalty card program divided by the total number of residents residing at the market site. FOTM opened three Providence market sites at the beginning of this project in 2020: Charlesgate, Hillcrest and St. Elizabeth. These sites had utilization rates of 44%, 78%, and 97%, respectively, over the past year. Two of FOTM's market sites are located outside of Providence in the Rhode Island urban core cities of Central Falls and Pawtucket. The Central Falls location, Forand Manor, was opened in 2021 and has reached a utilization rate of 47% among building residents. FOTM's newest site, Fogarty Manor, opened in 2022 and earlier this year reached a 50% utilization rate, indicating that FOTM now serves over half of this building's residents. In an effort to increase FOTM's reach to the Central Falls and Pawtucket communities, both the Forand Manor and Fogarty Manor sites are open to the public. Members from the community are allowed to come to these sites and shop at FOTM markets. Community members from these sites are not included in the market utilization calculations for these sites. In an effort to reach more community members, FOTM has engaged in far more social media marketing efforts over the past year. This effort has increased FOTM's non-resident shoppers to almost 200 people across these two market locations. Community members now account for 18% of this program's customer base. FOTM's reach continued to grow over the past year, while maintaining its goal resident utilization rates across its sites. These accomplishments can be attributed to the effective marketing and outreach activities the program in collaboration with housing site management and community partners to reach new customers. Outcome Two: FOTM seeks to build partnerships with mission-aligned community organizations to meet the needs of the people it serves. One of our closest, long-term partnerships has been with the University of Rhode Island's SNAP-ED program, whose mission is to help teach SNAP participants how to choose and prepare healthy foods on a budget. Representatives from the SNAP-ED come to all FOTM markets, on average once a month, to engage with FOTM shoppers. Over the past year, SNAP-ED was present for a total of 38 markets. SNAP-ED serves as a vital resource to FOTM customers by providing individualized recipes based on their purchases, preferences, and dietary restrictions in both English and Spanish. Nutrition education is one of FOTM's most highly requested activities at its market. As such, over 250 FOTM shoppers participated in conversations with SNAP-ED representatives and overwhelmingly reported that the SNAP-ED program is a helpful and insightful tool for them. Further, we have formed partnerships during the history of this grant with the Rhode Island Department of Health (RIDOH) and Rhode Island Community Food Bank as part of our comprehensive efforts to connect our vulnerable customer base to health resources that they need the most. FOTM seeks to consistently evaluate its program and the impact that markets have on the communities served. Of particular interest to FOTM's population is healthy food access and chronic disease management. Part of these evaluation efforts included conducting longitudinal surveys with customers to evaluate the impact of our SNAP incentive model on healthy food access. Customers who were interested in participating in this effort were asked to complete surveys when they first began shopping with FOTM (baseline), and then at 6 and 12 months. Data collection for this longitudinal effort concluded during this reporting period. However, data analysis is ongoing. Preliminary results found that FOTM had a positive impact on the management of chronic conditions and healthy food access. An overwhelming majority (93%) of our customers report having at least 1 chronic condition. Over the survey period, there was a 15% decrease in customers reporting experiencing difficulty buying appropriate food to help manage their chronic conditions. Additionally, there was an 11% decrease in people reporting they could not afford to eat balanced, healthy meals from baseline to 12-months. Overall, people who shop at FOTM rely on the market ,with over 77% reporting they shop there multiple times per month and 88% reporting a positive or very positive experience. Outcome Three: Food on the Move has helped build an evidence base to propel RIPHI's policy work in food access. The research and evaluation efforts conducted at FOTM demonstrated that a 50% SNAP incentive greatly improves food access and increases healthy eating behaviors. RIPHI formed the NOURISH RI coalition in 2022 to advocate for . The NOURISH RI coalition consists of community organizations across sectors that gathered to advocate for a statewide Retail SNAP Incentive Program (RSIP). As a result of this evidence and the work of the RIPHI-led coalition, the RI Department of Human Services received an $11.5 million dollar appropriation in Rhode Island's Fiscal Year 2023 budget to operationalize a pilot version of the statewide retail SNAP incentive program. The pilot, called Eat Well, Be Well, launched in January 2024. We believe this is the most important achievement to emerge out of this grant, as this is the first and only statewide program in the nation; the program serves 140,000 SNAP recipients and all Walmart Super Centers and Stop n Shop stores in the state of Rhode Island participate. RIPHI has continued to work on the Eat Well Be Well program by serving as the evaluator for the state. RIPHI anticipates publishing its full findings of the evaluation of Eat Well, Be Well in the coming months. These results will further inform the scientific and political communities of the impact that SNAP incentives may have on healthy eating behaviors and their effectiveness in combating food insecurity, with wide-reaching implications in the field.
Publications
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Progress 09/01/22 to 08/31/23
Outputs
Target Audience:Food on the Move (FOTM) is a year-round mobile produce market that brings fresh, healthy produce to the people and places that need it most. FOTM makes healthy food more affordable by offering a 50% discount on produce purchased with Supplemental Nutrition Assistance Program (SNAP) dollars. FOTM was informed by over a decade of research, including two NIH randomized controlled trials, which found significant increases in fruit and vegetable consumption among participants. FOTM aims to help SNAP recipients improve nutrition and food insecurity and better manage diet-related chronic diseases. Food insecurity in Rhode Island is on the rise and 3 times more prevalent among all households compared to pre-pandemic levels. In 2022 alone, 31% of all Rhode Island households were food insecure and households of color were disproportionately impacted. Over 43% of Black and over 46% of Latinx households experienced food insecurity, compared to 26% of White households. FOTM serves a highly diverse customer base and the most vulnerable households at the highest risk for food insecurity. In an effort to ensure Food on the Move is reaching our target populations, all customers are asked to sign up for a loyalty card, or rewards card, through which we collect basic demographic data. As of August 1, 2023, we have collected demographic data on 788 unique individuals. The majority of our customers (68%) are female and the average age of a FOTM customer is 67 years of age, ranging from 22 to 100 years old. We serve a diverse population, with 68% of our population identifying as any race other than White or Caucasian; 51% identifying as Hispanic/Latinx, 14% as Black or African American, and 4% as American Indian or Native American. The vast majority of our population live alone (70%) and 80% (of those who responded to a question about income) have an income less than 200% of the federal poverty level. Additionally, the majority of customers (77%) receive SNAP benefits.? During this reporting period, September 1, 2022, through August 1, 2023; FOTM has held 209 markets, served 521 unique individuals and signed up 154 new customers into our loyalty card program. We are currently holding markets at five low-income, older adult subsidized housing sites where we have sold over $112,000.00 in produce, 82% of which was paid for using EBT benefits and SNAP incentives. Changes/Problems:COVID-19 continued to present challenges to market operations in late 2022 and 2023. However, we enforced strict COVID-19 safety protocols and have successfully operated FOTM markets in a safe and effective manner throughout the year. We continue to evaluate FOTM on an ongoing basis to ensure our program is safe for FOTM's high risk customers and staff. Despite these challenges, we remain committed to our program goals. What opportunities for training and professional development has the project provided?RIPHI has a long-standing record of mentorship and training of public health professionals, hosting multiple student team members every year. This reporting period, we had 5 students work across different activities in the FOTM program. Activities for students working with FOTM have spanned across multiple aspects including survey and data collection, quality assurance procedures, marketing activities, and market operations. Further, FOTM employs additional part-time staff throughout the year to ensure the program is operationally sound. Part-time staff are offered opportunities to learn additional components of the program and go through training that may be beneficial to them within the part-time staff role and beyond. How have the results been disseminated to communities of interest?The following evaluations and peer-reviewed articles have been published about Food on the Move programs during this project period: Evans, E. W., Lyerly, R., Gans, K. M., Alexander Scott, N., Cohen, E. D., Lawson, E., & Nunn, A. (2021). Translating Research-Funded Mobile Produce Market Trials Into Sustained Public Health Programs: Food on the Move. Public health reports (Washington, D.C.: 1974), 333549211012409. Advance online publication. https://doi.org/10.1177/00333549211012409 Rummo, P. E., Lyerly, R., Rose, J., Malyuta, Y., Cohen, E. D., & Nunn, A. (2021). The impact of financial incentives on SNAP transactions at mobile produce markets. The international journal of behavioral nutrition and physical activity, 18(1), 26. https://doi.org/10.1186/s12966-021-01093-z John, S., Lyerly, R., Wilde, P., Cohen, E. D., Lawson, E., & Nunn, A. (2021). The Case for a National SNAP Fruit and Vegetable Incentive Program. American journal of public health, 111(1), 27-29. https://doi.org/10.2105/AJPH.2020.305987 Lyerly, R., Rummo, P., Amin, S., Evans, W., Cohen, E. D., Lawson, E., Hallett, E., De-Oliveira, S., Rose, J., Sutten Coats, C., & Nunn, A. (2020). Effectiveness of mobile produce markets in increasing access and affordability of fruits and vegetables among low-income seniors. Public health nutrition, 23(17), 3226-3235. https://doi.org/10.1017/S1368980020002931 Rummo, P. E., Lyerly, R., Rose, J., Malyuta, Y., & Nunn, A. (2020). Evaluating the Impact of Financial Incentives on SNAP Transactions at Mobile Produce Markets. The Obesity Society Annual Meeting. Oral Presentation. November 2-6 2020. Virtual. What do you plan to do during the next reporting period to accomplish the goals?We have two main priorities for the next reporting period. We first plan to make efforts to continuously increase our market utilization at our current housing sites in the coming year. Traditionally, Food on the Move has conducted exhaustive marketing and outreach efforts, including additional flyer distribution efforts, social media blasts and use of referral programs. To keep reaching new customers, we will continue to publish targeted social media advertisements on various social media platforms in Pawtucket and Central Falls to attract new customers to our markets. Previously, FOTM markets have been restricted to residents of the public housing sites. However, FOTM now operates two public market sites in Central Falls (2021) and Pawtucket (2022). Through these sites, we hope to reach new community members from the public. Further, we will continue to conduct rigorous evaluationacross all FOTM activities. Specifically, we will conclude the survey collection for our longitudinal study, analyze the data, and further disseminate results. We plan to disseminate this data through peer-reviewed literature, conferences, and trainings, as well as to policymakers to inform decisions surrounding the statewide Retail SNAP Incentive Program that will launch in the next reporting period. Results from this study will examine the impact FOTM and SNAP incentives may have on food insecurity, fruit and vegetable consumption and chronic disease management.
Impacts
What was accomplished under these goals?
From September 1, 2022 through August 1st, 2023; FOTM held 209 markets, served 521 unique individuals, and signed up 154 new customers into our loyalty card program. We have sold over $112,000 in produce across five subsidized housing sites in Providence, Central Falls, and Pawtucket, RI; 82% of which was paid using EBT benefits and SNAP incentives. FOTM processed a total of 5,222 transactions, of which 3,901 were transactions using SNAP benefits. SNAP customers purchased $91,833.79 worth of fruits and vegetables for $45,938.46 as a result of the SNAP incentive. Outcome One: The Food on the Move (FOTM) loyalty card program allows us to collect demographic information, track person-level purchasing data and connect this information with survey data. Additionally, the loyalty card program allows us to track changes in produce purchases over time. Customers earn points every time they shop with FOTM and points can be used to purchase produce. During this reporting period, we have significantly expanded our customer base by enrolling 154 new customers into FOTM's loyalty card program. After three years of this grant, we have been able to reach an average utilization rate of 64% (range 41%-88%) across our five sites, exceeding our goal for outcome one. All five of our market sites have utilization rates over 40%. Market utilization rates are calculated using the number of housing site residents enrolled into our loyalty card program divided by the total number of residents residing at the market site. Of market sites opened at the start of this project period in 2020 (Charlesgate, Hillcrest and St. Elizabeth), we have exceeded 70% utilization rates with 88%, 74%, and 71% respectively. Our 2 newest market sites Forand Manor (opened in 2021) and Fogarty Manor (opened in 2022) have utilization rates of 41% and 44% respectively. Additionally, the market sites at Forand Manor in Central Falls, RI, and Fogarty Manor in Pawtucket, RI are open to the public. Members from the community were not included in the calculations for these sites. However, we have served over 120 community members at these two market locations. Community members currently make up 15% of our customer base. The accomplishment of outcome one can be largely attributed to cumulative efforts across marketing and outreach strategies. Food on the Move continues to collaborate with housing site management and community partners to reach new customers. One of the biggest highlights of this reporting period, was the launch and initial visits of a new market site, Fogarty Manor in Pawtucket, RI. The welcome event, held on August 29, 2022, garnered media attention and attendance by local officials. Thanks to the support of this site's leadership, we were able to open this FOTM market to the public in Pawtucket and surrounding neighborhoods. All FOTM customers are asked to sign up for a loyalty card, or rewards card, through which we collect basic demographic data. Since the Fogarty Manor welcome event on August 29, 2022; we have enrolled 131 total customers (site residents and community members) at this new site into our loyalty card program. Although we have already reached 40% of residents at this site, we continue to collaborate with housing site management and community partners to reach new community members living outside the building through an exhaustive list of outreach methods including social media blasts. Outcome Two: Food on the Move (FOTM) prioritizes partnerships with community organizations whose goals are mission-aligned with that of FOTM. For example, we have a long-standing partnership with the University of Rhode Island's SNAP-ED program, whose mission is to teach SNAP participants to choose and prepare healthy foods on a budget. Representatives from the SNAP-ED program were at each market site on average once a month, for a total of 35 markets, throughout the reporting period. SNAP-ED serves as a resource to FOTM customers by providing individualized recipes based on their purchases, preferences, and dietary restrictions both in English and Spanish. In total, 371 FOTM customers participated in conversations with SNAP-ED representatives and reported that the SNAP-ED program is helpful and insightful. Further, in an effort to increase our selection of local produce, we have continued a years-long summer partnership with Southside Community Land Trust (SSCLT) to source local produce from Rhode Island-based farmers. Finally, we have formed partnerships in this reporting period with the Rhode Island Department of Health (RIDOH) and Rhode Island Community Food Bank as part of our comprehensive efforts to connect our vulnerable customer base to the health resources that they need the most. Food on the Move continues to collect person-level data, including purchase and survey data to evaluate the impact that our SNAP incentive model. While we have not finished collecting or analyzing data, preliminary results showcase the FOTM has an impact on both food security and management of chronic conditions. About 90% of our customers report having at least 1 chronic condition. We saw a 24% decrease in customers reporting having difficulty buying the food they need to follow doctors' recommendations for their condition(s) and a 15% decrease in people reporting that they have been hungry but didn't eat. Additionally, FOTM has become a staple in our populations' lives with 89% of customers report a very positive or positive experience with FOTM. Over 82% shopped at FOTM at least once per month, with over 50% shopping three or four times per month. Outcome Three: Food on the Move serves as the evidence base for RIPHI's food access policy work. In the 2022 reporting period, RIPHI led the NOURISH RI coalition to advocate for an appropriation from the American Rescue Plan Act (ARPA) federal funding to implement a statewide Retail SNAP Incentive Program (RSIP). This program enables all SNAP recipients in the state to receive the same 50% SNAP incentive discount that our customers received at FOTM, on their fresh fruit and vegetable purchases at retail grocery stores across Rhode Island. Our research and evaluations efforts across FOTM have demonstrated that the 50% SNAP incentive discount greatly improves food access and increases healthy eating behaviors. As a result of building this evidence base and the advocacy efforts of our coalition, the RI Department of Human Services received an $11.5 million dollar appropriation in Rhode Island's Fiscal Year 2023 budget to operationalize a statewide retail SNAP incentive program, now anticipated to to launch in Q4 of this year. Based on our experience operating and evaluating FOTM, RIPHI was selected to serve as a consultant and lead evaluator for the statewide RSIP program, which has been named the Eat Well, Be Well Rewards Program. RIPHI's Deputy Director, Kerri Connolly, served as a panelist at the USDA NTAE conference in June of this year to share lessons learned when implementing SNAP incentive programs in grocery stores. Food on the Move (FOTM) receives grant funding from the American Association of Retired Persons (AARP) to cover other programmatic costs such as staffing and other costs. As part of Food on the Move's ongoing evaluation efforts and AARP deliverables, our team conducts a longitudinal study with customers to better understand the impact FOTM may have on food insecurity, fruit and vegetable consumption and chronic disease management. Surveys are collected at baseline, 6-month, and 12-month follow-up time points. In this reporting period alone, our team has collected 70 baseline and 133 follow-up (6 and 12-month time points) surveys. Since the start of this funding opportunity in 2020, we have collected 282 baseline and 254 follow-up (6 and 12-month time points) surveys. Preliminary findings are presented above in outcome 2; we will report on the final outcomes in next year's report.
Publications
- Type:
Journal Articles
Status:
Published
Year Published:
2021
Citation:
Rummo, P. E., Lyerly, R., Rose, J., Malyuta, Y., Cohen, E. D., & Nunn, A. (2021). The impact of financial incentives on SNAP transactions at mobile produce markets. The international journal of behavioral nutrition and physical activity, 18(1), 26. https://doi.org/10.1186/s12966-021-01093-z
- Type:
Conference Papers and Presentations
Status:
Other
Year Published:
2020
Citation:
Rummo, P. E., Lyerly, R., Rose, J., Malyuta, Y., & Nunn, A. (2020). Evaluating the Impact of Financial Incentives on SNAP Transactions at Mobile Produce Markets. The Obesity Society Annual Meeting. Oral Presentation. November 2-6 2020. Virtual.
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Progress 09/01/21 to 08/31/22
Outputs
Target Audience: Food on the Move (FOTM) is a year-round mobile produce market that brings fresh, healthy produce to the people and places that need it most. FOTM makes healthy food more affordable by offering a 50% discount on produce purchased with Supplemental Nutrition Assistance Program (SNAP) dollars. FOTM was informed by over a decade of research, including two NIH randomized controlled trials, which found significant increases in fruit and vegetable consumption among participants. FOTM aims to help SNAP recipients improve nutrition and food insecurity, better manage diet-related chronic diseases, and maintain independence. Rhode Island has a rapidly aging population. According to a 2021 report from the Rhode Island Food Policy Council, 19% of Rhode Island adults ages 60 and older reported being food insecure. Additionally, the U.S. Department of Agriculture reports Rhode Island having one of the highest rates of SNAP usage among low income older adults in the country. On a statewide level, the Rhode Island Department of Human Services reported that adults ages 60 and older were nearly 22% of the total statewide 2021 SNAP caseload and 100% of the population who live in poverty participated in SNAP. For this reason, FOTM specifically targets sites that serve low-income older adults. Further, the Rhode Island Latinx population experiences significant food access barriers. These barriers worsened during the COVID-19 pandemic. According to the Rhode Island Community Food Bank, Latinx households experienced the highest levels of food insecurity of any population in Rhode Island in 2021. Specifically, 34 percent of Hispanic/Latinx households in the state reported food insecurity in 2021. Currently, over 21,000 Latinx Rhode Islanders participate in the Supplemental Nutrition Assistance Program (SNAP). Over 50% of our current customer base self-identify as Hispanic/Latinx. In an effort to ensure Food on the Move is reaching our targeted populations, all customers are asked to sign up for a loyalty card, or rewards card, through which we collect basic demographic data. Thus far, we have collected demographic data on 569 unique individuals. The majority of our customers (68%) are female and the average age of a FOTM customer is 66 years of age, ranging from 20 to 99 years old. We serve a diverse population, with 64% of our population identifying as any race other than White or Caucasian; 53% identifying as Hispanic/Latinx, 31% identifying as White or Caucasian, 16% as Black or African American and 4% as American Indian or Native American. The vast majority of our population live alone (70%) and 90% (of those who responded to this question) have an income less than 200% of the federal poverty level. Additionally, the majority of customers (77%) receive SNAP benefits. The COVID-19 Pandemic has only exacerbated the already overwhelming burden of food insecurity and chronic disease within our population. To better understand our population and the impact FOTM may have on food insecurity, fruit and vegetable consumption, and chronic disease management, we are conducting a longitudinal survey of interested customers. Of those who responded to the FOTM survey, an overwhelming 94% of our population reports having at least one chronic condition they are living with and 41% report it difficult to buy the food they need to follow doctors' recommendations for their conditions. Our customer base struggles with food insecurity; less than 50% of our customers note that SNAP benefits last them the entire month, at baseline. However, in our secondary surveys, we found that 62% of SNAP enrollees felt that their benefits were enough to last them the entire month. This may be indicative of Rhode Island's mandated "maximum benefit allowance" that all SNAP recipients received during the state of emergency resulting from the COVID-19 pandemic. During this reporting period, September 1, 2021 through August 19, 2022, FOTM has held 150 markets, served almost 500 unique individuals, and have signed up 258 new customers into our loyalty card program. Serving four low-income subsidized housing sites, we have sold almost $73,000 in produce, 82% of which was paid using EBT benefits and SNAP incentives. Changes/Problems:Due to the high transmission of the Omicron COVID-19 variant, Food on the Move closed markets for the first 3 weeks of January 2022. After this pause, 2022 markets began on 1/24/2022. We continue to have strict COVID-19 safety protocols and have been successfully operating FOTM markets in a safe and effective manner throughout 2022. We continue to evaluate FOTM on an ongoing basis to ensure our program is safe for FOTM's high-risk customers and staff. It is possible that the COVID-19 pandemic may require program changes and pauses to ensure the safety of everyone involved. Despite these challenges, we remain committed to our program goals. What opportunities for training and professional development has the project provided?RIPHI has a long-standing record of mentorship and training of public health professionals, hosting multiple interns every year. During this reporting period, we had 4 interns work across different activities in the FOTM program. Activities for interns working with FOTM have spanned all FOTM aspects including survey and data collection, quality assurance procedures, and reporting and marketing activities. Additionally, FOTM employs part-time staff throughout the year to ensure the program is operationally sound. Part-time staff areoffered opportunities to learn additional components of the program and go through training that may be beneficial to them within the part-time staff role and beyond. During this reporting period, we have made specific and sincere organizational efforts to train, retain, and develop part-time market staff that show a commitment to the Food on the Move program and improving food access in Rhode Island overall. In April, we added a Program Support Specialist full-time role which was filled by an existing Food on the Move market part-time staff member. This role is largely dedicated to supporting operations at our Food on the Move markets and advocacy work for the Retail SNAP Incentive program. Further, we provided training and opportunities for Food on the Move market staff members to take part in summer community outreach events for our food access policy work with NOURISH RI. We will continue to build upon the opportunities that staff and interns are provided to aid in training and development. Staff retention, training, and development are important components of the FOTM program and the broader RIPHI agenda. How have the results been disseminated to communities of interest?The following evaluations and peer-reviewed articles have been published about Food on the Move programs during this project period: Evans, E. W., Lyerly, R., Gans, K. M., Alexander Scott, N., Cohen, E. D., Lawson, E., & Nunn, A. (2021). Translating Research-Funded Mobile Produce Market Trials Into Sustained Public Health Programs: Food on the Move. Public health reports (Washington, D.C.: 1974), 333549211012409. Advance online publication. https://doi.org/10.1177/00333549211012409 Rummo, P. E., Lyerly, R., Rose, J., Malyuta, Y., Cohen, E. D., & Nunn, A. (2021). The impact of financial incentives on SNAP transactions at mobile produce markets. The international journal of behavioral nutrition and physical activity, 18(1), 26. https://doi.org/10.1186/s12966-021-01093-z John, S., Lyerly, R., Wilde, P., Cohen, E. D., Lawson, E., & Nunn, A. (2021). The Case for a National SNAP Fruit and Vegetable Incentive Program. American journal of public health, 111(1), 27-29. https://doi.org/10.2105/AJPH.2020.305987 Lyerly, R., Rummo, P., Amin, S., Evans, W., Cohen, E. D., Lawson, E., Hallett, E., De-Oliveira, S., Rose, J., Sutten Coats, C., & Nunn, A. (2020). Effectiveness of mobile produce markets in increasing access and affordability of fruits and vegetables among low-income seniors. Public health nutrition, 23(17), 3226-3235. https://doi.org/10.1017/S1368980020002931 What do you plan to do during the next reporting period to accomplish the goals? We have three main priorities for the next reporting period. The first of these priorities is to continue increasing our market utilization at current housing sites. To do so, we plan to continue and expand marketing and outreach efforts including additional flyer distribution efforts, social media blasts, and the use of referral programs. Specifically, we plan to expand the use of Unite Us, the new referral technology mentioned above. During the next reporting period, we plan to expand to our fifth market site at Fogarty Manor in Pawtucket, Rhode Island. Pawtucket is an area of high need for our program. The United States Census Bureau reports that over 11% of Pawtucket households have incomes below the federal poverty line. Further, the Rhode Island Department of Human Services reports nearly all of these households to participate in the SNAP/EBT program. We will host a launch event on August 29, 2022, to welcome residents to FOTM, conduct baseline surveys, and create an educational community event that encourages people to feel comfortable utilizing FOTM markets. We plan to hold our first market at Fogarty Manor on August 30, 2022. We will continue to operate this market on a weekly basis in the next reporting period. Finally, we will continue to conduct rigorous evaluation across all FOTM activities. We plan to disseminate this data through peer-reviewed literature, conferences, and trainings, as well as to policymakers to inform decisions and implementation of the upcoming statewide RSIP. RIPHI will serve as a consultant for the Rhode Island Department of Human Services and retailers across Rhode Island during the implementation of the RSIP and will be leading the evaluation of the 2023 RSIP.
Impacts
What was accomplished under these goals?
Throughout the funding period, the COVID-19 pandemic provided challenges to operating FOTM in our regular capacity. However, we have remained informed, vigilant, and flexible through this difficult time and have managed to ensure the safe operation of FOTM markets at our partnering sites. Despite the challenges posed by the pandemic, during this reporting period of September 1, 2021 through August 19, 2022, FOTM has held 150 markets and served almost 500 unique individuals. Further, we have signed up 258 new customers into our loyalty card program. We have sold $72,976.75 in produce across four subsidized housing sites in Providence and Central Falls, RI, 82% of which was paid using EBT benefits and SNAP incentives. FOTM processed a total of 3,642 transactions, of which 2,618 were transactions using SNAP benefits. SNAP customers purchased $59,577.87 worth of fruits and vegetables for$29,788.37 as a result of the SNAP incentive. Outcome One: The FOTM loyalty card program allows us to collect demographic information, track person-level purchasing data, and connect this information with survey data. Additionally, the loyalty card program allows us to track changes in produce purchases over time. Customers earn points every time they shop with FOTM and points can then be used to purchase produce; for every $2.00 a customer spends, they earn 1 point, and once they reach 100 points they receive $5.00 off their purchase. During this reporting period, we have significantly expanded our customer base by enrolling 258 new customers into FOTM's loyalty card program, which is over a 250% increase from the last reporting period when we enrolled 71 new customers. After two years of this grant, we have been able to reach an average utilization rate of 49% (range 38%-71%) across our four sites, exceeding our goal for outcome one. Market utilization rates are calculated using the number of housing site residents enrolled in our loyalty card program divided by the total number of residents residing at the market site. We have two market sites for which we are just shy of hitting our goal at 38% utilization (Charlesgate and Forand Manor) and two sites (Hillcrest Village and Saint Elizabeth's) that have exceeded our goal with a market utilization rate of 68% and 71% respectively. Additionally, the market site at Forand Manor in Central Falls, RI is open to the public. Members from the community were not included in the calculation for this site, however, we have served over 50 community members at this market location. The increase in market utilization during this reporting period can be largely attributed to cumulative efforts across marketing and outreach strategies. Food on the Move continues to collaborate with housing site management to reach new customers through social media, and written communications including posters in common areas and door-to-door flyer distribution across all housing site residents. In addition to these outreach efforts, we also implemented a refer-a-friend program at all sites in January 2022. This program allows existing FOTM customers to receive a produce credit of $5.00 when a new customer (defined as someone who does not have a loyalty card with us) they refer to FOTM enrolls in our loyalty card program. Finally, we recently joined the Unite Us Platform in June of this year. Unite Us is an online referral tool that creates a network of social service organizations in Rhode Island. Organizations and healthcare providers in this network are now able to refer customers to Food on the Move (to our Forand Manor location). Several prominent Rhode Island based healthcare organizations, such as LifeSpan and Coastal Medical actively participate in this network and can refer clients to FOTM. This is an exciting opportunity and we hope to make fresh produce accessible and affordable to clients from organizations across this social service organization network. One of the biggest highlights of this reporting period, was the launch of a new market site, Forand Manor in Central Falls, RI. The welcome event, held on November 1, 2021, garnered media attention and attendance by local officials. In large part to the support of this site's leadership, we have been able to open this FOTM market to the public in Central Falls. We continue to collaborate with housing site management and community partners to reach new community members through direct outreach including social media and flyer distribution at various community events. Outcome Two: Food on the Move prioritizes partnerships with community organizations whose goals are mission aligned with that of FOTM. For example, we have a long-standing partnership with the University of Rhode Island's SNAP-ED program, whose mission is to teach SNAP participants to choose and prepare healthy foods on a budget. Representatives from the SNAP-ED program were at each market site on average once a month, for a total of 35 markets, throughout the reporting period. SNAP-ED serves as a resource to FOTM customers by providing individualized recipes based on their purchases, preferences, and dietary restrictions both in English and Spanish. In total, 279 FOTM customers participated in conversations with SNAP-ED representatives and reported that the SNAP-ED program is helpful and insightful. Outcome Three: Food on the Move serves as the evidence base for RIPHI's food access policy work. During this reporting period, RIPHI led the NOURISH RI coalition to advocate for an appropriation from the American Rescue Plan Act (ARPA) federal funding to implement a statewide Retail SNAP Incentive Program (RSIP). This program enables all SNAP recipients in the state to receive the same 50% SNAP incentive discount that our customers received at FOTM, on their fresh fruit and vegetable purchases at retail grocery stores across Rhode Island. Our research and evaluation efforts across FOTM have demonstrated that the 50% SNAP incentive discount greatly improves food access and increases healthy eating behaviors. As a result of building this evidence base and the advocacy efforts of our coalition, the statewide Retail SNAP Incentive Program has received an $11.5 million dollar appropriation in Rhode Island's Fiscal Year 2023 budget. This innovative statewide policy will have a major impact on Rhode Island's most vulnerable residents, who will have greater access to fresh, healthy fruits and vegetables. While this approach to alleviating food insecurity is the first to be successfully implemented on a statewide level in the United States, we hope the Rhode Island RSIP is not the last. We will continue to rigorously evaluate both FOTM and RSIP efforts to continue building the evidence base and reporting on successes, challenges, and next steps for both programs.
Publications
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Progress 09/01/20 to 08/31/21
Outputs
Target Audience:? Food on the Move (FOTM) is a year-round mobile produce market that brings fresh, healthy produce to the people and places that need it most. FOTM makes healthy food more affordable by offering a 50% discount on produce purchased with Supplemental Nutrition Assistance Program (SNAP) dollars. FOTM was informed by over a decade of research, including two NIH randomized controlled trials, which found significant increases in fruit and vegetable consumption among participants. Rhode Island has a rapidly aging population and ranks as one of the healthiest states for older adults, yet disparities persist. For example, 13.3% of low-income older adults in RI are food insecure, compared to 8.8% overall and 10.2% of RI households with one or more older adults participate in the SNAP program. FOTM's mission is to help Rhode Islanders improve nutrition and food insecurity and better manage diet-related chronic diseases. During the reporting period September 2020 to August 2021, Food on the Move held 54 markets safely at 3 subsidized housing sites in Providence, RI. We sold over $14,600 of produce and completed 946 transactions, 564 of which received SNAP incentives. Food on the Move specifically targets sites that serve low-income seniors. We have focused on this demographic because our previous research demonstrated that the FOTM model had an especially high impact on fruit and vegetable consumption among older adults. Furthermore, our sales data demonstrates that FOTM markets that serve low-income senior housing sites outperform other sites. These markets consistently have a high number of customers and transactions and a higher proportion of total SNAP sales than other markets. We have been able to use our novel and unique approach utilizing a "loyalty card" or rewards program to collect person-level purchase data and connect this data with basic demographic and survey response data, in a subset of our population. During the reporting period we have enrolled 71 new individuals into our loyalty card program. Over 85% of our population are older adults aged 55 or older, with an average age of 68 years of age. The majority of our customers (59%) are female. Additionally, we serve a diverse population with 49% identifying as Hispanic or Latinx, 36% identifying as White or Caucasian, 19% as Black or African American and 7% as American Indian or Native American and the majority identify as multiple races or other (38%). The vast majority of our population live alone (73%) and have an income less than 235% of the federal poverty level (88%). Most customers (76%) receive SNAP benefits. Food insecurity and chronic disease overwhelmingly burdens our population. This year we have undertaken an effort to conduct a longitudinal survey of our customers to better understand the impact FOTM may have on food insecurity, fruit and vegetable consumption and chronic disease management. We have been able to survey 159 individuals thus far. Of those that responded to our baseline survey, 63% collect disability benefits, 78% are overweight, 90% have at least 1 chronic disease and 99% have at least 1 health condition. Almost half (44%) of our respondents report difficulty buying food needed to follow doctors recommendations for health conditions. Food on the Move aims to increase access to healthy affordable foods. Changes/Problems:At this time, our biggest concerns & challenges are resulting from a possible winter resurgence of the Covid-19 Delta Variant. We will continue to evaluate FOTM on an ongoing basis to ensure our program is as safe and effective as possible. However, another large COVID surge may prompt further restrictions that hinder FOTM operations. Despite these challenges, we remain committed to our program goals and are hopeful that we will be able to complete our secondary data collection within the next reporting period. What opportunities for training and professional development has the project provided?RIPHI continuously hosts interns throughout the fall, summer and spring semesters. Interns have the opportunity to work at Food on the Move to experience a direct service public health program in person as well as learn about the data aspects of the program. How have the results been disseminated to communities of interest?The following evaluations and peer reviewed articles have been published about Food on the Move programs: Evans, E. W., Lyerly, R., Gans, K. M., Alexander Scott, N., Cohen, E. D., Lawson, E., & Nunn, A. (2021). Translating Research-Funded Mobile Produce Market Trials Into Sustained Public Health Programs : Food on the Move. Public health reports (Washington, D.C. : 1974), 333549211012409. Advance online publication. https://doi.org/10.1177/00333549211012409 Rummo, P. E., Lyerly, R., Rose, J., Malyuta, Y., Cohen, E. D., & Nunn, A. (2021). The impact of financial incentives on SNAP transactions at mobile produce markets. The international journal of behavioral nutrition and physical activity, 18(1), 26. https://doi.org/10.1186/s12966-021-01093-z John, S., Lyerly, R., Wilde, P., Cohen, E. D., Lawson, E., & Nunn, A. (2021). The Case for a National SNAP Fruit and Vegetable Incentive Program. American journal of public health, 111(1), 27-29. https://doi.org/10.2105/AJPH.2020.305987 Lyerly, R., Rummo, P., Amin, S., Evans, W., Cohen, E. D., Lawson, E., Hallett, E., De-Oliveira, S., Rose, J., Sutten Coats, C., & Nunn, A. (2020). Effectiveness of mobile produce markets in increasing access and affordability of fruits and vegetables among low-income seniors. Public health nutrition, 23(17), 3226-3235. https://doi.org/10.1017/S1368980020002931 In Development: •Health Promotion Practice: Title TBD - qualitative paper with focus group results Presentations: •"Evaluating the Impact of Financial Incentives on SNAP Transactions at Mobile Produce Markets" The Obesity Society Annual Meeting (Nov. 2020) What do you plan to do during the next reporting period to accomplish the goals?Our main priority at this time is to increase our market utilization and our current housing sites and expand our markets to new housing site partners. We plan to improve uptake of the program by distributing promotional materials and implementing a new "refer a friend" program, which will reward customers who refer another individual that enrolls in our loyalty card program. Additionally, we plan to continue our research, funded through outside grant sources, through survey administration for our longitudinal study designed to measure the effects of our markets on customer health over time. We plan to complete the second round of data collection among our customers who completed the baseline survey and to administer a baseline survey collection for our new market site.
Impacts
What was accomplished under these goals?
In March of 2020, we paused Food on the Move market operations in response to the Covid-19 crisis. Since then, we have had to remodel the Food on the Move market program several times in order to adapt to the evolving Covid-19 pandemic. In the warmer weather months, we were able to ensure the safety of our customers and our staff by holding our markets outside and implementing new sanitization and PPE procedures. We continued the outdoor market model through October 2020. The onset of colder, winter weather prevented us from continuing to hold FOTM markets outside. In response to alarmingly high rates on COVID -19 reported amongst our customers from their housing site resident coordinators and restrictions imposed by the governor on community gatherings, we made the decision to continue to pause Food on the Move until June to ensure the safety of our customers and staff. However, our markets are now up and running again. Since June of 2021 we have successfully reopened the program and have held 30 markets. We have hired a new market operations coordinator, Matt Helm. Matt has extensive experience working in logistics in the non profit setting and has brought his expertise to elevate the Food on the Move program. Additionally, we are partnering with the University of Rhode Island's SNAP Education program to offer cooking demonstrations, healthy recipes and nutrition advising services weekly at our markets. In addition to adapting the FOTM program activities, we led a statewide coalition, NOURISH RHODE ISLAND, to advocate for a Retail SNAP Incentive Program that would enable all SNAP recipients in the state to access the benefits of the 50% off SNAP Incentive at retail grocery stores. The data we have collected at Food on the Move served as the evidence base for this policy and advocacy efforts. Although the legislation did not pass, it still enjoyed widespread popular and legislative support. This program was funded outside the FINI program but ultimately will help advance SNAP incentive policy in Rhode Island. We are optimistic that funds will be allocated through the federal American Rescue Plan dollars to fund the implementation of the Retail SNAP Incentive Program.
Publications
- Type:
Journal Articles
Status:
Published
Year Published:
2020
Citation:
Lyerly R, Rummo P, Amin S, Evans W, Dexter Cohen E, Lawson E, Hallett E, De-Oliveira S, Rose J, Sutten Coats C, Nunn A. Effectiveness of mobile produce markets in increasing access and affordability of fruits and vegetables among low-income seniors. Public Health Nutr. September 4, 2020. doi:10.1017/S1368980020002931.
- Type:
Journal Articles
Status:
Published
Year Published:
2020
Citation:
John S, Lyerly R, Wilde P, Cohen ED, Lawson E, Nunn A. The Case for a National SNAP Fruit and Vegetable Incentive Program. Am. J. Public Health. 2020 December 16; 111: 27-29. doi: https://doi.org/10.2105/AJPH.2020.305987
- Type:
Journal Articles
Status:
Awaiting Publication
Year Published:
2020
Citation:
Evans W, Lyerly R, Gans K, Alexander-Scott N, Cohen E, Lawson E, Nunn A. Food on the Move: Translating Research-Funded Mobile Produce Market Trials into Sustained Public Health Programs. Public Health Rep. n.d. In press.
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