Progress 06/15/23 to 06/14/24
Outputs
Target Audience:This reporting period encompasses the final six months of the 2023 Skagit Fruit and Vegetable Prescription (Skagit FVRx) Program, as well as the recruitment period and first six months of the 2024Skagit FVRx Program. Recruitment for the 2024 cohort continued to prioritize outreach to Latinx and Spanish-speaking residents of Skagit County through connections with our partner clinic, Sea Mar. A wait list of folks who were unable to join the 2023 program provided the main source of enrollment for our 2024 program. This year's program had alower enrollment cap of 80 participants, as we moved from operating on two funding sources (our original GusNIP award as well as this GusCRR expansion) to operating on the GusCRR award only. Of our 80 enrolled participants, 50 identified Spanish as their primary language, which meets our program goal of 50% or more Spanish-speaking participants. All participants are low-income and either at-risk-for or currently managing a chronic, diet-related condition such as diabetes, high blood pressure, or high cholesterol. Changes/Problems:One of the biggest challenges this reporting period continued to be navigating the IRB process, due to the shift in the University of Nebraska's IRB agreement with the NTAE. We have been working with a local university, Western Washington University (WWU), to move through the IRB process. However, the WWU experienced a turnover of IRB board members, which has contributed to the slow nature of the process. We have now been able to submit all requested documentation and are awaiting further communication from WWU. Our hope is to obtain exemption or approval before implementing our final program-end survey for our 2024 cohort. Another challenge this reporting period was that we were not successful in our application for continued GusNIP funding for this project. We will continue to look towards other ways of supporting this work, and are hopeful that this will provide an opportunity for increased community support and engagement. What opportunities for training and professional development has the project provided?
Nothing Reported
How have the results been disseminated to communities of interest?Results of ourFVRx cohorts have been shared with our board of commissioners, and our partner clinics in presentations, emails, and infographics. What do you plan to do during the next reporting period to accomplish the goals?The next reporting period will encompass the final six months of our 2024 FVRx cohort, as well as an additional six months for program wrap-up, evaluation, and exploration of possible forms of moving forward with this program in the future. We will continue to engage participants in quarterly gatherings, will distribute and collect program-end surveys, and will analyze feedback to be shared with program stakeholders. Debrief meetings with clinic partners and retail sites will provide additional perspectives on program value to the community and will shape our continued search for additional funding.
Impacts
What was accomplished under these goals?
Goal 1: Extend FVRx to Sea Mar Community Health Center in Mount Vernon to improve food security and individuals' self-management of diet-related health risk factors, with a focus on providing culturally appropriate services to Spanish-speaking residents. Objective:Servetwo additional cohorts of 108 participants, in which at least 50% of participants speak Spanish as their primary language. This goal/objective was met as of our last progress report. With the No-cost extension we received for this grant, we have been able to serve an additional cohort of 80 participants, 50 of whom identified Spanish as their primary language. Goal 2: Increase accessibility of Skagit FVRx to Spanish-speaking and Latinx participants through focused recruitment and the development of culturally and linguistically appropriate programming. Objective: Adapt existing 12-months of program materials and services to the needs of Spanish-speaking participants. As the years have gone by, the awareness of this program in the Latine and Spanish-speaking communities of Skagit Valley has grown significantly. We continue to get calls from folks in the community who have heard about the program through family members and friends. Participants ask us about how they can help individuals they know enroll. These many inquiries are, to us, indications that the program is proving useful and welcoming to our Latine participants. We are grateful for the expertise of our partners at Sea Mar Clinics, who offer culturally-appropriate resources to individuals via additional, personalized appointments. We know we can continue to adapt and refine FVRx program offerings to best meet the needs of our community, but are proud of the progress we have made in the course of this grant. All materials are bilingual and we continue to review for relevancy and accessibility to our participant base. Goal 3: Expand FVRx evaluation to encompass new cohorts and collaborate with NTAE centers to document and analyze program process and impacts. Objective: Administer pre-program, midpoint, and post-program surveys capturing both qualitative and quantitative measures to all participants in their primary language. We wrapped up our 2023 cohort with a post-program survey, which was analyzed by our external evaluator, Rainier Theory. In 2024, we shifted our survey administration strategy, having participants fill out the program-start survey at our first FVRx quarterly gathering. We will administer our program-end survey in the same manner this December. Objective: Produce post-program summary report to be shared with stakeholders and the community. Data from our 2023 surveys was compiled and analyzed by our external evaluator, Rainier theory, and data reports were shared with stakeholders and the community. Data from our 2024 cohort is being similarly analyzed and shared. Of note, we have been in the process of obtaining IRB approval this year through Western Washington University. We were previously under the shared IRB with the University of Nebraska, but t
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Progress 06/15/22 to 06/14/23
Outputs
Target Audience:This reporting period encompasses the final six months of the 2022 Skagit Fruit and Vegetable Prescription (Skagit FVRx) Program, as well as the recruitment period and first six months of the 2023 Skagit FVRx Program. Recruitment for the 2023 cohort continued to prioritize outreach to Latinx and Spanish-speaking residents of Skagit County through connections with our partner clinic, Sea Mar. A wait list of folks who were unable to join the 2022 program due to space provided another source of enrollment for our 2023 program. Other continued recruitment efforts included promotion via a local Spanish-speaking radio station, referrals from our other partner clinics, word of mouth through past participants, and social media posts. By the program start date of January 1, 2023, 100 participants were enrolled under GusCRR funding,51 of whom identified Spanish as their primary language. This meets our program goal of 50% Spanish-speaking participants under GusCRR funding. All participants are low-income and either at-risk-for or currently managing a chronic, diet-related condition such as diabetes, high blood pressure, or high cholesterol. Since January 2023, these participants have received monthly vouchers for purchasing fresh fruits and vegetables, nutrition education materials and resources, and periodic check-ins with a dietitian or health educator through their primary clinic (if an FVRx partner clinic) or with United General staff. Changes/Problems:Currently, the greatest challenge we are facing is strategizing on how to carry this program forward into the future from a funding perspective. We applied for another round of GusNIP funding, but were not awarded. A No-Cost Extension will provide the opportunity for a small 2024 cohort to sustain partnerships with clinics and our community while we seek additional funding. We will also be analyzing our existing program structure and looking for ways to improve and adapt to a smaller cohort. One other challenge we are currently navigating is obtaining IRB exemption or approval, as we were informed earlier this year that grantees such as us who were under the University of Nebraska's IRB with the NTAE are no longer covered by that IRB due to a change in the University's policies. We are working with a local university, Western Washington University, to move through the IRB process in as timely a manner as is feasible, but may not be able to secure approval/exemption in time to report 2023 post survey data to the NTAE. What opportunities for training and professional development has the project provided?
Nothing Reported
How have the results been disseminated to communities of interest?So far, the results from the 2022 Skagit FVRx program have been shared primarily in infographic form to communities of interest via parnter clinics and through United General communication channels. Additional results will be shared after the 2023 program year comes to a close. What do you plan to do during the next reporting period to accomplish the goals?Goal 1: Extend FVRx to Sea Mar Community Health Center in Mount Vernon to improve food security and individuals' self-management of diet-related health risk factors, with a focus on providing culturally appropriate services to Spanish-speaking residents. Objective:Servetwo additional cohorts of 108 participants, in which at least 50% of participants speak Spanish as their primary language. This goal/objective have been met. However, we are currently applying for a No-cost Extension for this GusCRR grant. If received, we will serve a smaller cohort of participants through our existing partner clinics and continue to seek additional funding to continue this program, which is now in high demand in our community, forward into the future. Goal 2: Increase accessibility of Skagit FVRx to Spanish-speaking and Latinx participants through focused recruitment and the development of culturally and linguistically appropriate programming. Objective: Adapt existing 12-months of program materials and services to the needs of Spanish-speaking participants. Program Coordinators and United General staff will continue to revise and adapt program materials for the remaining half of the 2023 Skagit FVRx program. After multiple years of targeted recruitment, we continue to receive interest from Latinx community members regarding future years of the Skagit FVRx program and have developed a wait list as we pursue additional funding to carry the program beyond the culmination of the GusCRR grant. Goal 3: Expand FVRx evaluation to encompass new cohorts and collaborate with NTAE centers to document and analyze program process and impacts. Objective: Administer pre-program, midpoint, and post-program surveys capturing both qualitative and quantitative measures to all participants in their primary language. A 2023 post survey is being revised and adapted and will be distributed to program participants in December in English or Spanish, depending on the participant's indicated preference. Objective: Produce post-program summary report to be shared with stakeholders and the community. Data from baseline and post surveys for 2023 will be analyzed by our contracted evaluator, Rainier Theory, and a summary report developed in combination with 2022 results. This report will be shared out in print and electronic form to community and program stakeholders.
Impacts
What was accomplished under these goals?
Goal 1: Extend FVRx to Sea Mar Community Health Center in Mount Vernon to improve food security and individuals' self-management of diet-related health risk factors, with a focus on providing culturally appropriate services to Spanish-speaking residents. Objective:Servetwo additional cohorts of 108 participants, in which at least 50% of participants speak Spanish as their primary language. The partnership with Sea Mar Community Health Center in Mount Vernon continues to be an integral part of the success of the Skagit FVRx program. This year, both a registered dietitian as well as a health educator based at the Mount Vernon Sea Mar office are working with our Skagit FVRx participants. They aid in recruitment, as well as patient follow up and act as a touchpoint for participants throughout the year. For the 2023 year, we enrolled 100 participants, with 51 indicating Spanish as their primary language. We capped enrollment at 100 under GusCRR funding due to the stretched capacity of clinic partners to provide nutrition education follow up. Goal 2: Increase accessibility of Skagit FVRx to Spanish-speaking and Latinx participants through focused recruitment and the development of culturally and linguistically appropriate programming. Objective: Adapt existing 12-months of program materials and services to the needs of Spanish-speaking participants. Focused recruitment strategies such as airing promotion through a local Spanish-speaking radio station continued for the 2023 FVRx program. In addition, revisions to translations of select nutrition educational materials are improving the accessiblity of program content to Spanish-speaking participants. Goal 3: Expand FVRx evaluation to encompass new cohorts and collaborate with NTAE centers to document and analyze program process and impacts. Objective: Administer pre-program, midpoint, and post-program surveys capturing both qualitative and quantitative measures to all participants in their primary language. Post-program surveys were distributed in English or Spanish to 2022 participants in December, depending on their indicated preference. Baseline surveys were distributed to 2023 participants in January and midpoint surveys in late May. Post-survey 2022 data as well as baseline 2023 survey data have been shared with the NTAE center. Objective: Produce post-program summary report to be shared with stakeholders and the community. In fall2022, Program Coordinators worked with our United General Graphc Designer to develop an infographic highlighting statistics and participant feedback gathered from the 2022 baseline and post surveys. This infographic was shared with our local clinics as well as in other strategic areas for recruitment purposes. A post-program report will be produced after the termination of the 2023 FVRx program, summarizing overall program results. This summary report will be shared out to partner clinics, FVRx retailers, other program partners, and through United General communications such as newsletters and social media.
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Progress 06/15/21 to 06/14/22
Outputs
Target Audience:This reporting period encompases the recruitment phase as well as the first six months of the 2022 Skagit Fruit and Vegetable Program. Recruitment efforts under GusCRR funding increased outreach to program-eligible, Latinx and Spanish-speaking community members. This was accomplished via direct recruitment by our partner clinic Sea Mar Mount Vernon, which serves a large portion of Spanish-speaking residents, as well as via outreach through local Spanish-speaking radio stations, Facebook groups, and community support organizations. In addition to this focus on outreach to local Latinx communities, Program Coordinators continued other avenues of outreach through social media, newsletters, recruitment through our PeaceHealth and Sea Mar Concrete clinics, and word of mouth from past participants. By the program start-date of January 1, 2022, 96 participants were enrolled in the program under GusCRR funding, 57 of whom identified Spanish as their primary language. This exceeds our program goal of 50% Spanish-speaking participants. All participants are low-income and either at-risk-for or currently living with a chronic, diet-related condition such as diabetes, high blood pressure, or high cholesterol. Since January 2022, these participants have received monthly vouchers for purchasing fresh fruits and vegetables and have also taken part in regular check-ins with a dietitian or health educator at their clinic or, if not a patient of a partner clinic, with a United General District 304 registered dietitian. Changes/Problems:Our partner clinics, both Sea Mar and PeaceHealth, have experienced staff turnover during the previous reporting period. While this has not required major changes in our program structure or implementation, it has proven a challenge for consistent engagement and communication with our partner clinics. However, we have been able to meet with the new individuals taking over Skagit FVRx participants at both clinics and are grateful that the new staff are demonstrating enthusiasm and positive engagement with the program. We look forward to continuing to work closely with these partners to strengthen our partnership in future reporting periods. What opportunities for training and professional development has the project provided?Part of our program structure is offering regular check ins for participants with a registered dietitian or health educator at their respective clinic. If a participant is not a patient of one of our partner clinics, they are able to have these regular check ins with our United General WIC registered dietitian. How have the results been disseminated to communities of interest?
Nothing Reported
What do you plan to do during the next reporting period to accomplish the goals?Goal 1: Extend FVRx to Sea Mar Community Health Center in Mount Vernon to improve food security and individuals' self-management of diet-related health risk factors, with a focus on providing culturally appropriate services to Spanish-speaking residents. Objective:Servetwo additional cohorts of 108 participants, in which at least 50% of participants speak Spanish as their primary language. During the next reporting period, we will continue our engagement with Sea Mar Mount Vernon to ensure that mateirals and services for Spanish-speaking participants are culturally responsive. Sea Mar Mount Vernon recently experienced turnover in their Health Educator position, so we are planning continued close engagement with the new hire. This individual is very engaged and excited about the FVRx program and we are looking forward to the opportunities for increasing the collaboration with them on culturally appropriate materials and meaningfulengagement of the Latinx community in Skagit Valley. Also during the next reporting period, we will be recruiting for the 2023 cohort of GusCRR participants. During the coming recruitment phase, we plan to work with the new Sea Mar Mount Vernon Health Educator to obtain referrals and learn about effective avenues of recruitment so we can meet our goal of at least 108 participants, with 50% or more speaking Spanish as a primary lan Goal 2: Increase accessibility of Skagit FVRx to Spanish-speaking and Latinx participants through focused recruitment and the development of culturally and linguistically appropriate programming. Objective: Adapt existing 12-months of program materials and services to the needs of Spanish-speaking participants. As noted above, we look forward to working closely with the new Health Educator at Sea Mar Mount Vernon to continue adapting our program content to the needs of Spanish-speaking and Latinx participants. This could mean including more culturally appropriate recipes, specific linguistic adaptations, and adapting the way health and wellness is discussed in materials, for example. Goal 3: Expand FVRx evaluation to encompass new cohorts and collaborate with NTAE centers to document and analyze program process and impacts. Objective: Administer pre-program, midpoint, and post-program surveys capturing both qualitative and quantitative measures to all participants in their primary language. Midpoint survey results will be analyzed and feedback from that survey will be incorporated into next year's programming to the extent possible. In addition, we will be implementing a post-program survey for our 2022 cohort and preparing and implementing a pre-program survey with our 2023 cohort. Objective: Produce post-program summary report to be shared with stakeholders and the community. In the next reporting period, we will analyze pre- and post-program surveys from the 2022 FVRx cohort and begin working with our in house graphic designer to prepare reports to share out with stakeholders and the community.
Impacts
What was accomplished under these goals?
Goal 1: Extend FVRx to Sea Mar Community Health Center in Mount Vernon to improve food security and individuals' self-management of diet-related health risk factors, with a focus on providing culturally appropriate services to Spanish-speaking residents. We have accomplished much under this goal during the current reporting period. We pursued conversations with Sea Mar Mount Vernon and secured their collaboration on our Skagit FVRx 2022 program. Subsequently, we worked with clinics as well as through other avenues for recruitment, ending with an enrolled cohort of 96 for our GusCRR funding. While this number is slightly short of our goal of 108, we exceeded our goal in regards to the percent of participants speaking Spanish as their primary language. Sea Mar Mount Vernon's Health Educator, who is the main point of contact for participants at that clinic, is a native Spanish speaker, which creates a linguistically inclusive space for Spanish-speaking participants. ? Goal 2: Increase accessibility of Skagit FVRx to Spanish-speaking and Latinx participants through focused recruitment and the development of culturally and linguistically appropriate programming. During the recruitment phase of this reporting period, we pursued various avenues of focused recruitment in the local Latinx community. This included posting in Spanish-language community Facebook groups, working directly with Sea Mar Mount Vernon's clinic to obtain referrals, and interviewing on a Spanish-language radio station, among other things.Over the first six months of programming (Jan-Jun 22), we have continued to expand our Spanish-language resources for participants and ensure that every educational material we offer in English is also offered in Spanish. We plan to continue working more closely with Sea Mar in future reporting periods to ensure services and educational materials are culturally appropriate and inclusive. Goal 3: Expand FVRx evaluation to encompass new cohorts and collaborate with NTAE centers to document and analyze program process and impacts. We administered a program start survey in January 2022, during the onboarding phase of this cohort. We have also sent out a midpoint survey, which focuses primarily on process evaluation and program feedback for internal use. These surveys were sent out in English and Spanish. Results from the pre and post surveys will be analyzed and used to develop summary reports in future reporting periods.
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