Recipient Organization
LOCAL FOOD HUB, INC.
556 DETTOR RD STE 108
CHARLOTTESVILLE,VA 22903
Performing Department
(N/A)
Non Technical Summary
Local Food Hub is a central Virginia-based nonprofit that advances equitable access to fresh food, independent farms and fairness in farming. It has extensive experience developing and implementing produce prescription programs, sourcing local food, and managing farmers markets. This proposal combines Local Food Hub's expertise with that of a major health care system, striving to improve nutritional outcomes for food-insecure families.In the first year of the grant, Local Food Hub will increase access to its Fresh Farmacy: Fruit and Veggie Prescription Program to one hundred families cared for at the University of Virginia Children's Center with low food access and diet-related disease. Participants will receive bi-weekly shares of locally-sourced fruits and vegetables, along with farm information, recipes, and access to cooking and nutrition educational programming.Over the subsequent eighteen months, participants will progress to a model where they pay what they are able for one Fresh Farmacy share per month, and receive a second free of charge. In addition, they will receive monthly farmers market shopping incentives. Community advocates and an incentive coordinator will be recruited from the patient pool to encourage participation and build community self-engagement and ownership. Clinicians and social workers will monitor impact using quarterly surveys and health checks every six months. The program's length, 30 months, is long enough to demonstrate real, lasting results in behavior and health.
Animal Health Component
(N/A)
Research Effort Categories
Basic
(N/A)
Applied
(N/A)
Developmental
(N/A)
Goals / Objectives
Goal 1: Improve dietary health through increased consumption of nutrient-dense fruits and vegetablesGoal 2: Reduce individual and household food insecurity through increased access to fruits and vegetables?Goal 3: Reduce healthcare use and associated costsGoal 4: Build a body of knowledge about local food incentive strategies and benefit redemption methodsGoal 5: Develop comprehensive approaches to addressing food insecurity and diet-related disease that engage participants and multiple public and private sectors partnersGoal 6: Support local farmers in reaching a broader customer base and increasing sales
Project Methods
Local Food Hub seeks to increase the motivation of patients with low incomes who are at risk for diet-related disease to buy and consume more fruits and vegetables. This will be a component of their medical plan to improve health outcomes. Local Food Hub will do this by (1) providing free bi-weekly shares of fresh, locally sourced, culturally appropriate produce, (2) having shares available for pick-up at accessible locations or home delivery, (3) providing farm source, product handling, and cooking information with each share, ensuring culturally relevant content (4) making available cooking and nutrition classes, and (5) introducing incentives for the further purchase of fresh fruits and vegetables through subsidized Fresh Farmacy shares and at local farmers markets.Local Food Hub will implement Fresh Farmacy, a produce prescription program in partnership with UVA Health and Sentara Healthcare. Local Food Hub will demonstrate and evaluate the success of the program by assessing impact in (1) the improvement of dietary health through increased consumption of fruits and vegetables, (2) the reduction of individual and household food insecurity, and (3) the reduction in healthcare use and associated costs. The specific success of outcomes will be assessed by patients' investment in healthy eating as reflected by consistently picking up shares, their consistent use of the produce in their shares, their knowledge about how healthy eating impacts their health, their stated motivation to change their eating habits, their knowledge about preparing produce for themselves and their family, their intention to buy more produce and/or increase their daily servings of produce, their participation in the subsidized Fresh Farmacy share program and use of farmers market credits, changes in health outcomes consistent with the core metrics outlined by GusNIP, and reductions in healthcare use and costs.??Local Food Hub is collaborating with a local evaluation firm which specializes in working with small nonprofits. The CEO of Partnerships for Strategic Impact®, Maryfrances Porter, Ph.D., brings more than 25 years of research experience and using data to lead local change initiatives across a wide range of service providers, including evaluating service system collaborations across sectors. She has expertise in assessing opportunities for growth, developing strategic vision and action, and facilitating collaborative, strengths-based problem solving across diverse groups. Dr. Porter has designed an evaluation methodology that includes both process (developing and monitoring indicators of progress towards objectives) and outcomes. The process analysis, an assessment of Local Food Hub's success in developing and operating a viable project, will document the process, challenges, and successes of implementation and operations. Dr. Porter's team will speak monthly with all project staff and UVA and Sentara partners to ensure high-quality data collection, as well as to capture information about the challenges and successes of program on-boarding, implementation, and data collection processes. At the conclusion of each program year, Dr. Porter will facilitate focus groups with participants to get feedback on satisfaction with, and improvements for, program operations. Dr. Porter will also facilitate an annual meeting of project staff and health system partners about what they experienced as the challenges and successes of each program season. All of this qualitative information will be analyzed alongside the degree to which the program was able to meet participant recruitment goals, source and deliver food, and keep to the annual work plan. The conclusions of analyses will be presented back to Local Food Hub staff for discussion every 6 months, and specific action plans will be developed to address challenges and programming weaknesses for ongoing operations.The outcome assessment will evaluate, document, and disseminate the project's effectiveness in increasing fruit and vegetable consumption/purchases among participants. Specifically, Dr. Porter's team will evaluate the success of the program by assessing impact in (1) behavioral changes through self-reported increased consumption of fruits and vegetables for each participant household; (2) the reduction of individual and household food insecurity by increasing immediate access to and ongoing familiarity with a variety of produce (through both self report and use of incentives); (3) the improvement of dietary health through self report and clinical biometric data, and (4) the reduction in healthcare use and associated costs through self reporting, as well as an assessment of non-routine doctors visits and Medicaid reimbursement requests.Participant households will also be surveyed quarterly asking about the extent to which they use all the produce in their shares, their knowledge about how healthy eating impacts their health and healthcare usage, their motivation to change their future eating habits, their knowledge about preparing produce for themselves and their family, and their purchases of fresh fruits and vegetables outside the program.At recruitment and every six months participants will have their weight, BMI and blood pressure recorded. At these points, the previous six months of healthcare usage and costs will also be captured. At the conclusion of each programming year (e.g., grant month 15 and 33), Dr. Porter will facilitate focus groups with participating patients at each site in order to get deeper feedback about how the program did or did not change families' eating, produce buying habits, and overall health.While a comparison group will not be used, the following strategies will be used to assess the real impacts on participants:Self reported and medical records indicating positive health changes in those who use incentives versus those who do not, including examining changes every 6 monthsHealth care use for those consistently picking up, receiving, and using shares versus those who do not, including examining changes every 6 monthsSelf-reported independent purchases (e.g., outside of program participation) of fruits and vegetables increased due to participation in the programAll the outcome data will be analyzed each year and presented to the staff at Local Food hub for discussion; conclusions and action steps for going forward will be identified. Dr. Porter will write reports, visualizations, and data dashboards to share with participants, clinic management, other community stakeholders, as well as researchers, evaluators, practitioners, and other interested parties. Preliminary results after grant month 12 shall be included in an annual report to NIFA and the NTAE centers. A final report, including process and outcome evaluation results, will be completed by the end of the grant period (month 36). Outcome evaluation will follow the guidelines developed by the NTAE centers collaboration with grantees to ensure an appropriate level of comparability of methods, outcomes, and measures. Local Food Hub and Partnerships for Strategic Impact® will fully cooperate with the NTAE centers.Local Food Hub and its partner clinics have a long history of measurement and evaluation. Since its inception, the Fresh Farmacy program has conducted surveys with each share delivery, comprehensive surveys at the midway point of each season, and focus groups at the conclusion of each program season. Health practitioners monitor health outcomes including weight, BMI, blood pressure, and sometimes A1C. Both of these evaluation tools have demonstrated measurable improvements in health outcomes and behavior change. Most importantly, participants report changes in eating habits that appear to be enduring.