Progress 06/15/21 to 06/14/23
Outputs
Target Audience:The Chicago Horticultural Society's GusCRR project formally began on January 24, 2022. The goal of this project was to sustain and expand delivery of the Society's VeggieRx produce prescription program--delivered by its urban agriculture division, Windy City Harvest--to meet elevated demand during and following the COVID-19 pandemic. Receipt of the GusCRR award enabled Windy City Harvest to continue accelerated VeggieRx delivery, resulting in the early completion of the USDA FINI grant that supported it. Work on the GusCRR grant commenced immediately following, and sustained a high volume of VeggieRx program delivery in communities hit hard by food insecurity during and in the aftermath of the pandemic. During the reporting period, the VeggieRx program directly served 1,796 unique Supplemental Nutrition Assistance Program (SNAP) clients. SNAP enrollment is verified at VeggieRx distributions by running balance inquiries on participants' Electronic Benefit Transfer (EBT) cards, and receipts are kept in participant enrollment files. Based on participant survey responses: 24% identified as Black/African American, 69.5% as Latinx/Hispanic, 2% as White/Caucasian, and 4.5% other or not reported. Participants were 74% female, 23% male, and 3% other or not reported. 49 was the average adult participant age and 12 the average youth participant age Windy City Harvest (WCH) delivered the VeggieRx program during the reporting period in four target Chicago neighborhoods. In order to reach its target audience and address community-specific challenges, VeggieRx partnered closely with four Federally Qualified Heath Centers (FQHCs) that are deeply rooted assets in each community to identify appropriate patients and refer them into the program. Partner FQHCs referred patients into the program with a diagnosed diet-related health condition or a risk of developing one. These healthcare institutions were: Lawndale Christian Health Center (LCHC), PCC Austin Family Health Center (PCC Austin), PCC Salud Family Health Center (PCC Salud), and Esperanza Heath Centers (Esperanza). Three partner organizations delivered VeggieRx throughout the full GusCRR grant period: LCHC, PCC Austin, and PCC Salud. Both LCHC and PCC have a long history of partnership with WCH that predates the existence of the VeggieRx program. WCH has run a healthcare garden at PCC Austin since 2015 and LCHC has partnered with WCH on a variety of projects since 2007, including on its youth development programs, the launch of VeggieRx, and the establishment of WCH's headquarters, the Farm on Ogden. Esperanza became a VeggieRx partner in 2021 at their Brighton Park location, meeting one of the primary goals of the GusCRR grant. The partnership was highly successful, serving 573 new participants during the reporting period, with Esperanza particularly focused on targeting childhood obesity. After partnering with VeggieRx through 2021 and 2022, Esperanza began running its prescription produce program independently of WCH in 2023. A fifth FQHC partner from 2018 through 2021, Loyola Medicine/Proviso Partners for Health (PP4H), partnered with WCH through the completion in January 2022 of a USDA FINI grant that helped fund it, at which time PP4H also established an independent program. WCH is proud to have helped build PP4H and Esperanza's capacity to deliver produce prescription programs and to meaningfully connect their communities to the local food system. A portion of the produce the project provided was grown at WCH farm sites by its youth and workforce development program trainees, including beginning farm businesses in its Farm Incubator program. More than 80% of these trainees identified as BIPOC (Black, Indigenous, and people of color) and were economically disadvantaged--in keeping with WCH's mission to provide economic uplift through paid jobs training and youth development opportunities. Changes/Problems:Due to the rapid growth of the VeggieRx program that continued through 2022, WCH achieved its expansion goals without also including individuals receiving Medicaid/CHIP, as originally proposed to GusCRR. USDA NIFA was notified of this procedural shift by email on June 6, 2022. During the reporting period, WCH continued to develop and refine the use of its data management system (DMS) on the Microsoft Dynamics platform, initially implemented in 2021, which has had a significant positive impact on the VeggieRx program. The DMS provides in-depth insight into program metrics, and reports and visual dashboards of key metrics can be shared in real-time with staff and healthcare partners to demonstrate the growth and impact of the program. The DMS also streamlines operations and improves participant experience; for example, during enrollment, participants now complete electronic surveys on tablets that integrate directly to the DMS, reducing both participant and staff time spent on the process. The success of the initial VeggieRx DMS implementation and the need for its continued development led WCH in early 2022 to hire a full-time data strategist, Tiffany Simons Chan, Ph.D., to lead data management, analysis, and strategy for all WCH programs. WCH continued in other ways during the reporting period to augment VeggieRx program delivery. To build on year-end participant feedback sessions initiated in 2020, in fall 2022 VeggieRx added mid-year participant feedback sessions. Last year the program also introduced suggestion boxes during distributions to help respond to participant feedback and ideas in real time.In addition, as described in the "Accomplishments" section, WCH committed to further enhancing the program's important nutrition education component. In 2022, in-person nutrition education and cooking demonstrations were reinstated, and the program also continued to offer virtual nutrition/cooking education options that had begun during the pandemic. This new hybrid model was developed through input from VeggieRx participants, who have found value in having flexibility in nutrition education opportunities, allowing them agency over the frequency and method in which they engage with the program. In 2023, with a grant from Fair Food Network, WCH began a formal strategic planning process to structure VeggieRx for the greatest impact on participants' food security and health. Recognizing that other emergency food sources are available in the community, one of the changes made this year is to focus on partner health clinic patient referrals only. VeggieRx is returning to its core goal of deepening participant engagement over extended periods of time to support participants in managing diet-related illnesses. This approach addresses two primary challenges. For patients, it offers a tangible way to follow up on providers' dietary recommendations, backed by a supportive community to help reinforce their goals. For providers, VeggieRx is a valuable tool that helps bridge the gap between clinical care and social determinants of health, one of which is access to nutritious foods. What opportunities for training and professional development has the project provided?During the reporting period, VeggieRx has supported the following training and professional development activities: Though not supported by USDA GusCRR funds, in 2023 WCH provided intensive training and mentorship for the U.S. Botanic Garden and American Public Gardens Association's Urban Agriculture Resilience Program Capstone Cohort of staff from seven U.S. public gardens. Trainings occurred both during and after the grant period and included information about how botanic gardens can adapt VeggieRx to their partnerships and locations. In March 2022, WCH consulted with Minnesota Landscape Arboretum on VeggieRx best practices, successes, and challenges in order to help them start their own produce prescription program. This led to their successful proposal to the USDA GusNIP grant program. Ketaurah James, VeggieRx manager, completed a two-day management training from The Management Center, developing her managerial skills for program operations and planning. James also received Conscious Ambassador of Trauma Informed Care certification from DePaul University and Hansra Consulting, helping her understand and respond to the diverse perspectives and lived experiences of program participants and staff. While not funded under the USDA GusCRR grant, WCH provides extensive urban agriculture, business, and career readiness training through its workforce development pathway programs. A significant portion of the food grown by trainees is aggregated into VeggieRx, enabling them to contribute to food access and health in their communities while developing their career skills and experience. How have the results been disseminated to communities of interest?As a recognized leader at the intersection of urban agriculture and community health both locally and nationally, WCH is well-positioned to share the results of its work with a diverse community of practitioners and stakeholders. WCH staff are actively involved in volunteer leadership roles within food access, health, and community coalitions, and share program results and best practices with agriculture, social service, and healthcare institutions in the region. During the reporting period, these include the Illinois Public Health Institute's Alliance for Health Equity Food Access and Security Workgroup, the North Lawndale Community Coordinating Council's Health and Wellness Working Group, Advocates for Urban Agriculture, Chicago Food Policy Action Committee, and Austin Eats, focused on growth and consumption of nutritious local food in Chicago's Austin community. Through these efforts, demand for prescription produce programs continues to build, and the model has been adapted at hospitals and clinics across the Chicago area. In addition, WCH shares VeggieRx best practices and knowledge gained at a national level through the GusNIP NTAE Center's Produce Prescription Community of Practice meetings. During the project period, WCH staff continued to convene quarterly evaluation meetings with healthcare partners, which were established in 2021. The focus of these meetings is sharing best practices and aligning outcome tracking across VeggieRx sites. Facilitated by WCH's new data management system (described below in the "Changes" section), VeggieRx began working more closely with partners to understand the value of reporting/evaluation alignment and shared metrics in order to compare the efficacy and impact of interrelated programs across the sector. The meetings also enable all partners to see themselves as part of a unified produce prescription program, and not operating their programs in isolation. A practice honed over the reporting period that has improved health clinic partnership effectiveness has been monthly meetings with frontline care coordinators (initiated in 2020) and leadership teams (established in 2021). Frontline staff, who play a key role in supporting, communicating, and recruiting for the program, are kept informed of the latest information and updates, and also share feedback from patients and staff. Identified "champions" at each partner site lead communication of VeggieRx information to healthcare providers, and are essential to the program's success. Equally important, the meetings provide a forum for frontline staff to openly and regularly share feedback from patients and their teams, enabling VeggieRx staff to respond quickly and make changes as needed. Leadership team meetings focus on strategic planning and growth, discussing evaluation priorities, and sharing participant feedback. The Chicago Botanic Garden's director of government affairs regularly hosts visits to WCH sites by public officials. During the reporting period these included: USDA Deputy Secretary Dr. Jewel Bronaugh USDA Deputy Assistant Secretary Dr. Penny Brown Reynolds (in Washington, DC) U.S. Senator Dick Durbin Chicago Outreach Director for U.S. Senator Tammy Duckworth, Jessica Sewell Illinois Lieutenant Governor Juliana Stratton In June 2022, WCH hosted a day-long multi-site visit by approximately 100 representatives from the Midwestern Association of State Departments of Agriculture (MASDA). MASDA is comprised of the Commissioners, Secretaries, and Directors of Agriculture from Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, Oklahoma, South Dakota, and Wisconsin. Illinois Director of Agriculture Jerry Costello served as host. Additional examples of WCH's commitment to sharing the VeggieRx model with a broad audience during the reporting period included: WCH has educated the community about VeggieRx through Farm on Ogden tours for thousands of community leaders, elected officials, funders, school groups, local residents, and other stakeholders. Written communications about WCH and VeggieRx were sent to federal, state, and local officials. WCH was the subject of or was mentioned in several media articles on urban agriculture and food-as-medicine programs. In March 2023, a Rush University College of Nursing doctoral student published the results of an independent longitudinal study of VeggieRx data to assess program impact and resource utilization. The study concluded that VeggieRx facilitates perceived and measurable benefits to participants as relates to food insecurity, vegetable intake, diet change, improvements in health, financial and logistical access to produce, and more. Highlight results (using data from 2016-2022) included finding overall a 19% increase in mean cups of vegetables participants consumed per day, a 12.5% decrease in participants reporting running out of food before having money to buy more, and an 18% decrease in participants worrying about running out of food before having money to buy more. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
During the reporting period, WCH delivered VeggieRx weekly from February through November (40 weeks per year). Each distribution included provision of free produce boxes, in-person and virtual nutrition and cooking education, and information on how to store and prepare the fruits and vegetables provided. Since 2020, supported by USDA FINI funding, VeggieRx achieved remarkable expansion in response to vastly increased community need during the COVID-19 pandemic. Each of the communities where VeggieRx operates was disproportionately affected by the pandemic. As job loss and poverty soared, VeggieRx played an increasingly important role in food security and individual and community health during the crisis. From 2019 through 2022, VeggieRx increased annual distribution of produce boxes to SNAP participants by 577%; direct participants grew from 448 to 1,598 individuals, and produce servings distributed expanded from 17,257 to 116,743. During the FINI grant, WCH incorporated important adjustments to support and sustain this growth, which were continued during the GusCRR grant. For example: a new data management system streamlined the check-in and verification process; a vibrant Facebook group (currently with 810 members) drew record numbers of participants to nutrition/cooking education; an expanded partnership with produce distributor Midwest Foods enabled WCH to meet increased demand by supplementing produce and packing boxes; and one of WCH's Farm Incubator businesses began running two VeggieRx farm stands in 2021. In 2022, WCH significantly expanded the depth and reach of nutrition and cooking education. WCH created a new Culinary Nutrition Coordinator position to oversee and enhance this central component of the program. The coordinator, who started in May 2022, is a Registered Dietitian Nutritionist (RDN) and a certified ServSafe manager. In-person nutrition/cooking classes returned in 2022, bi-monthly at each VeggieRx site, in addition to weekly virtual classes. Both were offered in English and Spanish, provided by staff from Chicago Partnership for Health Promotion, a key WCH partner since the program's inception. Virtual classes were also posted to the VeggieRx Facebook group--initiated during the pandemic--for participants who prefer virtual attendance and/or need flexibility in viewing time and location. Lastly, in 2022 VeggieRx piloted new hands-on cooking courses in 6-week cohorts in English and Spanish, in partnership with Chicago-based Good Food is Good Medicine. These courses saw high demand from participants and were continued in 2023. Activities advanced progress on each of the broader project objectives during the reporting period (1/24/22 - 4/30/23). 1) SNAP recipients gain access to fresh, locally produced, and culturally appropriate fruits and vegetables. 11,043 produce boxes (approximately eight pounds per box) were redeemed by SNAP-enrolled healthcare partner patients and their families (47% higher than the two-year goal of 7,500 boxes). This healthy food reached 1,796 unique individuals (260% over the project goal of 500) and provided increased food access to 5,388 people (based on an average household size of three). SNAP participants obtained an estimated 88,344 pounds of produce, equating to 126,206 servings. 93% of repeat participants reported consuming more than half of their VeggieRx box, and 73% of repeat participants reported consuming all the produce in their box. 632 participants (35%) attended 5-9 VeggieRx distributions, and 390 (22%) attended 10 or more. WCH met the proposed goal of expanding its operations through a partnership with Esperanza Health Center, serving 573 direct participants and distributing 2,380 produce boxes (19,040 pounds and 27,200 produce servings) at that site. VeggieRx participants redeemed $32,535 in double-value incentive coupons (project goal: $8,250). WCH farm markets are located at each VeggieRx site, and participants reported appreciating the convenience of shopping for additional produce during VeggieRx pickups. 2) Low-income community members gain a greater understanding of the importance of a good diet to overall health through dietary counseling. 1,436 SNAP participants attended in-person nutrition and cooking education sessions, and virtual nutrition/cooking sessions logged 1,927 views. For online resources, staff were no longer able to count unique participants, instead measuring participation by number of views. Nutrition/cooking education was offered in both English and Spanish--the primary languages of the service population--to ensure that language was not a barrier to access and education. 74 Youth Farm trainees (100% of participants) received nutrition education. Youth farmers are eligible to enroll in VeggieRx if they belong to a SNAP-eligible household. Using a new database system and electronic surveys, WCH documented improvements in healthy eating habits. For example, during the reporting period, participants reporting no intake of fruits or vegetables per day fell in pre- to post-program surveys from 6% to 1%. WCH also documented a striking decrease in participants reporting that food preparation knowledge is a barrier to consuming fresh produce. From pre- to post-surveys during the reporting period, SNAP participants reporting that they "don't know how to cook" decreased by 66%. Participants reporting that VeggieRx produce and recipes "take too much time to prepare and cook" fell 100%. Participant input was collected through online surveys, end-of-year convenings of participants and partner organizations, and informal interactions. Many participants have expressed gratitude for the program, especially for its continuation and even expansion during the pandemic. Participant comments from 2022 that reflect impacts on diet and health include: "I've lost weight to where I'm no longer considered insulin dependent. So I threw away my meter this week. I lost about 70 lbs." "I'm learning a lot. I'm gaining knowledge. I didn't know how to eat right. Here I am thinking I'm eating ok, but I'm not putting enough vegetables or fruit... I'm understanding a little better how what I eat impacts my blood sugar." "I love talking to other participants and sharing recipes on vegetables we are not used to. I learned how to eat everything in the box. I now have added kale to my meals. Something that I did not know how to use." "I know I'm doing good because my A1C went from a 10 to an 8!" 3) Doctors gain a greater understanding of dietary health and incorporate nutrition education into their practice. During the reporting period, WCH conducted 4 information sessions with healthcare partner providers and held 58 quarterly evaluation, frontline care coordinator, and leadership team meetings. 4) Train participants in WCH education and training programs 173 trainees, 86% from economically disadvantaged backgrounds and 90% BIPOC, learned about sustainable urban agriculture while growing produce for VeggieRx. Outcome data demonstrate that VeggieRx has the ability to impact participants' food security and health. Survey data from 2022 reflect a 19% decrease (from 87% to 68%) in participants reporting that they sometimes or often ran out of food before having money to buy more. Preliminary results shared by health partners suggest that VeggieRx patients show improvements in A1c levels, hypertension, and depression. These results indicate that VeggieRx is not only responding to short-term health and food security needs, but is helping participants make long-term behavioral changes regarding health and nutrition.
Publications
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Progress 06/15/21 to 06/14/22
Outputs
Target Audience:The GusCRR program formally began on January 24, 2022. The goal of this project was to sustain and expand delivery of the Chicago Horticultural Society's VeggieRx--a prescription produce initiative delivered by the Society's urban agriculture division, Windy City Harvest--to meet elevated demand during the COVID-19 pandemic. Receipt of the GusCRR award enabled Windy City Harvest to continue accelerated VeggieRx delivery, resulting in the early completion of the USDA FINI grant that supported it. Work on the GusCRR grant commenced immediately following and sustained a high volume of VeggieRx program delivery in communities hit hard by the COVID-19 pandemic. During the reporting period, the VeggieRx program directly served 838 unique Supplemental Nutrition Assistance Program (SNAP) clients. SNAP enrollment is verified at VeggieRx distributions by running balance inquiries on participants' Electronic Benefit Transfer (EBT) cards, and receipts are kept in participant enrollment files. Among participants surveyed: - 23% identified as Black/African American, 72% as Latinx/Hispanic, and 2% as White/Caucasian. - Participants were 76% female and 24% male - 48 was the average adult participant age (of 574 participants) - 12 was the average youth participant age (of 264 participants) Windy City Harvest (WCH) delivered the VeggieRx program during the reporting period in four target Chicago neighborhoods. In order to reach its target audience and address community-specific challenges, VeggieRx partnered closely with four FQHCs that are deeply rooted assets in each community to identify appropriate patients and refer them into the program. Partner FQHCs serve low-income households and identified in these patients a diet-related health condition or a risk of developing one. These healthcare institutions were: Lawndale Christian Health Center (LCHC), PCC Austin Family Health Center (PCC Austin), PCC Salud Family Health Center (PCC Salud), and Esperanza Heath Centers (Esperanza). A fifth FQHC partner from 2018 through early 2021, Loyola University Health System/Proviso Partners for Health, partnered with WCH through the completion of a USDA FINI grant that helped fund it, and now operates an independent program. LCHC, located in the community of North Lawndale, collaborated with WCH to launch VeggieRx in 2016 and open WCH's Farm on Ogden headquarters in North Lawndale in 2018. The partnership with PCC Salud in the Belmont-Cragin neighborhood began in 2020, the result of a successful partnership and positive patient outcomes with PCC Austin in the Austin community, which began in 2019. Esperanza became a VeggieRx partner in 2021 at their Brighton Park location, meeting one of the primary goals of the current GusCRR grant. The partnership has been highly successful, serving 325 new participants during the reporting period, with Esperanza particularly focused on targeting childhood obesity. Esperanza's Manager of Community Health Impact Ofelia Figueroa noted: "I have been at Esperanza Health Centers for 13 years and live in the Brighton Park Community. In my current role, Manager of Community Impact, I oversee the implementation of our community programs. I want to ensure that programs such as VeggieRx make the biggest impact in an already underserved community. I've heard feedback from patients that have received produce boxes, and not only do they appreciate the extra support, but the fact that its helps support a healthier lifestyle. It seems to me that eating healthier foods sometimes comes at a higher cost, but with the support of VeggieRx, we are breaking those barriers." A portion of the produce the project provided was grown at WCH farm sites by its program trainees, including beginning farm businesses in its Farm Incubator program. From 2018 to present, 80% of these trainees were economically disadvantaged--in keeping with WCH's mission to provide economic uplift through paid jobs training and youth development opportunities--and 86% were BIPOC (Black, Indigenous, and people of color). Changes/Problems:Due to the rapid growth of the VeggieRx program that continued through 2021, WCH achieved its expansion goals without also including individuals receiving Medicaid/CHIP, as originally proposed to GusCRR. USDA NIFA was notified of this procedural shift by email on June 6, 2022. During the reporting period, WCH continued to develop and refine the use of its data management system (DMS) on the Microsoft Dynamics platform, initially implemented in 2021. Though these activities were not funded by the USDA GusCRR program, they had a significant positive impact on the VeggieRx program. The DMS provides in-depth insight into program metrics, and reports and visual dashboards of key metrics can now be shared in real-time with staff and healthcare partners to demonstrate the growth and impact of the program. The DMS also streamlines operations and improves participant experience; for example, during enrollment, participants now complete electronic surveys on tablets that integrate directly to the DMS, reducing both participant and staff time spent on the process. The success of the initial VeggieRx DMS implementation and the need for its continued development led WCH in early 2022 to hire a full-time data strategist, Tiffany Simons Chan, Ph.D., to lead data management, analysis, and strategy for all WCH programs. WCH continued in 2022 to augment VeggieRx program delivery. For example, a suggestion box was added to VeggieRx distributions to help the program respond to participant feedback and ideas in real time.As previously referenced, WCH committed to further enhancing the important nutrition education component by hiring a full-time Culinary Nutrition Coordinator, Katie Pinkston, RDN, in spring 2022 to oversee, augment, and implement the nutrition education curriculum. In-person weekly nutrition education and cooking demonstrations were reinstated, and the program also continued to offer virtual nutrition/cooking education options that had begun during the pandemic. This new hybrid model was developed through input from VeggieRx participants, who have found value in having flexibility in nutrition education opportunities, allowing them more autonomy over the frequency and method in which they engage in the program. In addition, WCH implemented more in-depth monthly live cooking demonstrations--held at each VeggieRx site--provided by staff from Chicago Partnership for Health Promotion, a key WCH partner since the program's inception. What opportunities for training and professional development has the project provided?During the reporting period, VeggieRx has supported the following training and professional development activities: WCH participated in the GusNIP NTAE Produce Prescription community of practice to share and discuss best practices and knowledge gained about VeggieRx and other PPR programs. WCH created a new VeggieRx role of Culinary Nutrition Coordinator to oversee and enhance the nutrition and cooking education portion of program. The coordinator is a Registered Dietitian Nutritionist (RDN) and a certified ServSafe manager. Ketaurah James, VeggieRx manager, completed a two-day management training from The Management Center, and also received Conscious Ambassador of Trauma Informed Care certification from DePaul University and Hansra Consulting. How have the results been disseminated to communities of interest?WCH is recognized within its core communities as a critical resource for food, health, and jobs, and operates its programs in collaboration with and input from more than 100 community partners, with whom program information and results are regularly shared. Seventy percent of WCH staff--including the current VeggieRx program manager and program coordinator--are WCH program alumni, who understand the needs and capabilities of the communities in which they live and work. WCH staff are actively involved with food access, health, and community coalitions, and share program results and best practices with agriculture, social service, and healthcare institutions in the region. During the reporting period, these include the Illinois Public Health Institute's Alliance for Health Equity Food Access and Security Workgroup, the North Lawndale Community Coordinating Council's Health and Wellness Working Group, and Austin Eats, a food and urban agriculture workgroup convened to advance the Quality of Life Plan for Chicago's Austin community. Through these efforts, demand for prescription produce programs continues to build, and the model has been adapted at hospitals and clinics across the Chicago area. In addition, WCH shares best practices and lessons learned nationally through the GusNIP Nutrition Incentive Program Training, Technical Assistance, Evaluation, and Information (NTAE) Center's Produce Prescription Community of Practice meetings. During the report period, WCH staff continued to convene quarterly evaluation meetings that were established in 2021. The focus of these meetings is sharing best practices and aligning outcome tracking across VeggieRx sites. Facilitated by WCH's new data management system (described below in "Changes" section), VeggieRx began working more closely with partners to understand the value of reporting/evaluation alignment and shared metrics in order to compare the efficacy and impact of interrelated programs across the sector. The meetings also enable all partners to see themselves as part of a unified produce prescription program, and not operating their programs in isolation. WCH also continued monthly meetings at partner health clinics with frontline care coordinators and leadership teams. Frontline staff, who play a key role in supporting, communicating, and recruiting for the program, are kept informed of the latest information and updates, and also share feedback from patients and staff. Identified "champions" at each partner site lead communication of VeggieRx information to healthcare providers, and are essential to the program's success. Leadership team meetings focus on strategic planning and growth, discussing evaluation priorities, and sharing participant feedback. Additional examples of WCH's commitment to sharing the VeggieRx model with a broad audience during the reporting period include: WCH has educated the community about VeggieRx through Farm on Ogden tours for thousands of community leaders, elected officials, funders, school groups, local residents, and other stakeholders. The Chicago Botanic Garden's director of government affairs regularly hosts visits to WCH sites by public officials, for example during the report period USDA Deputy Secretary Jewel Bronaugh. Written communications about WCH and VeggieRx were sent to federal, state, and local officials. In March 2022, WCH consulted with Minnesota Landscape Arboretum on VeggieRx best practices, successes, and challenges in order to help them start their own prescription produce program. What do you plan to do during the next reporting period to accomplish the goals?WCH will continue the VeggieRx program at LCHC, PCC Austin, PCC Salud, and Esperanza. Staff have found that partnerships with federally qualified health centers are an ideal fit for the VeggieRx model. WCH will continue to develop and leverage its new data management system, enhancing program evaluation and promoting data-driven decision making. VeggieRx will deepen participant engagement by expanding opportunities for nutrition and cooking education and by improving efficiencies and participant experience at VeggieRx distributions and farm markets. WCH will also expand the depth of VeggieRx outcome evaluation to understand causal impacts of produce prescription programs on clinical health outcomes and health care utilization and costs as a collaborative partner on a research project funded by a grant from the American Diabetes Association (ADA), led by scientists at the Gretchen Swanson Center for Nutrition and evaluators for the NTAE (GusNIP Nutrition Incentive Program Training, Technical Assistance, Evaluation, and Information). In addition, WCH will be undertaking a rigorous strategic planning process for the VeggieRx program in the coming year, supported by a Fair Food Network/GusNIP NTAE Center Capacity Building and Innovation Fund grant. The grant will enable WCH to conduct a complete audit of the program's delivery model via stakeholders' interviews, surveys, and workshops, as well as a cost-benefit analysis, to develop a comprehensive plan to ensure the programmatic and fiscal sustainability of VeggieRx.
Impacts
What was accomplished under these goals?
During the reporting period, WCH delivered VeggieRx through weekly distributions of free produce boxes, in-person and online nutrition and cooking education, and information on how to store and prepare the fruits and vegetables provided. Since 2020, with USDA FINI funding, VeggieRx has achieved remarkable expansion in response to vastly increased community need during the COVID-19 pandemic. Each of the communities where VeggieRx operates was disproportionately affected by the pandemic. As job loss and poverty soared, VeggieRx played an increasingly important role in food security and individual and community health during the crisis. From 2019 through 2021, VeggieRx increased annual distribution of produce boxes to SNAP participants by 573%; direct participants grew from 448 to 1619 individuals, and produce servings distributed expanded from 17,257 to 116,183. During the FINI grant, WCH incorporated important adjustments to support and sustain this growth, which were continued during the GusCRR report period. For example: a new data management system streamlined the check-in and verification process; a vibrant Facebook group drew record numbers of participants to nutrition/cooking education; an expanded partnership with produce distributor Midwest Foods enabled WCH to meet increased demand by supplementing produce and packing boxes; and one of WCH's Farm Incubator program businesses began running two VeggieRx farm stands in 2021. Activities advanced progress on each of the broader project objectives during the reporting period (1/24/22 - 6/14/22): 1) SNAP recipients gain access to fresh, locally produced, and culturally appropriate fruits and vegetables. - 4,280 produce boxes (57% of the two-year goal of 7500 boxes in addition to the FINI goal) were redeemed by SNAP-enrolled healthcare partner patients and their families, reaching 838 unique individuals (168% of the two-year goal of 500) and providing increased food access to 2,514 people (based on average household size of three). - SNAP participants obtained an estimated 34,240 pounds of produce, equating to 48,914 servings. - 96% of repeat participants report consuming more than half of their VeggieRx box (31% above the FINI goal of 65%), and 73% of repeat participants report consuming all the produce in their box. - WCH met the proposed goal of expanding its operations through a new partnership with Esperanza Health Center, serving 325 direct participants and distributing 1,308 produce boxes (10,464 pounds and 14,949 servings of produce) at that site. - VeggieRx participants redeemed $13,920 in double-value incentive coupons, 169% of the two-year goal of $8,250. WCH farm markets are located at each VeggieRx site, and participants report appreciating the convenience of shopping for additional produce during VeggieRx pickups. 2) Low-income community members gain a greater understanding of the importance of a good diet to overall health through dietary counseling. - 690 SNAP participants attended in-person nutrition and cooking education sessions, and virtual nutrition/cooking education sessions logged 385 views. Staff were no longer able to count unique participants for online resources, instead measuring participation by number of views. Nutrition/cooking education was offered in both English and Spanish--the most prominent primary languages of the service population--to ensure that language was not a barrier to access. - 56 Youth Farm trainees (100% of participants) received nutrition education. - VeggieRx participants reported increased knowledge of food preparation and healthy eating habits. Using a new database system and electronic surveys, WCH documented improvements in healthy eating habits. For example, during the reporting period, participants reporting no intake of fruits or vegetables per day fell from pre- to post-program surveys from 3% to 0%. WCH also documented a decrease in participants reporting that food preparation knowledge is a barrier to consuming fresh produce. From pre- to post-surveys, SNAP participants reporting this as a barrier declined from 5% to 0% during the reporting period. - In 2022 WCH expanded the depth and reach of nutrition and cooking education, hiring a Culinary Nutrition Coordinator, offering more in-depth monthly live cooking demonstrations at each VeggieRx site, and piloting a new hands-on cooking course. Participant input was collected through online surveys, end-of-year convenings of participants and partner organizations, and informal interactions. Many participants have expressed gratitude for the program, especially for its continuation during the pandemic. Examples of recent participant comments include: "VeggieRx has changed my life. I've never made my health such a priority before. I can see health changes based on this new (to me) way of eating and so can my doctors. And it trickles out to friends and family members who pay close attention." "Even though I'm an active person, my doctor was saying I needed to eat more fruits and vegetables, like colorful foods, because I was diagnosed with prediabetes. She put me on medication for it but I didn't want to be on it... With VeggieRx I was able to get off the pre-diabetes medicine... I have also learned how to cook vegetables in new ways. Videos were helpful during the pandemic. I have lost weight too." "Mr. Sanchez and I enjoyed being a part of the VeggieRx program yet again. In spite of the pandemic, I appreciated it started earlier in order to provide veggies in a season when fresh is not always feasible. It has also been helpful to encourage us to change our diet for the better because of my husband's dietary needs. Thank you for allowing us to be a part of the VeggieRx family, we're ready to experience more new fruit and vegetable options." 3) Doctors gain a greater understanding of dietary health and incorporate nutrition education into their practice. - During the reporting period, WCH conducted 3 information sessions with healthcare partner providers and held 7 quarterly evaluation, frontline care coordinator, and leadership team meetings. 4) Train participants in WCH education and training programs - 112 trainees, 80% from economically disadvantaged backgrounds, learned about sustainable urban agriculture while growing produce for VeggieRx. Outcome data demonstrate that VeggieRx has the ability to impact participants' food security and health. Survey data from 2022 reflect a 15% decrease (from 71% to 56%) in participants reporting that they sometimes or often ran out of food before having the money to buy more. Preliminary results shared by health partners suggest that VeggieRx patients show improvements in A1c levels, hypertension, and depression. These results indicate that VeggieRx is not only responding to short-term health and food security needs, but is helping participants make long-term, health-promoting lifestyle changes.
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