Progress 09/15/23 to 09/14/24
Outputs
Target Audience:Prescription for Healthy Oakland targets specific municipalities in Oakland County that have higherconcentrations of people of color and experience challenges around the social determinants of health. The city of Pontiac is comprised of 49% Black residents and 16% Hispanics/Latino residents. Areas of southern Oakland County also have more diverse communities - Southfield is comprised of 70% Black residents and 56% of Oak Park's residents are Black (U.S. Census Bureau, 2020). United Way ALICE data shows that cities within this region have a high percentage of households that are below the financial threshold to make ends meet, including Oak Park (48%), Southfield (48%), Pontiac (67%), Waterford (30%), and Auburn Hills (37%), compared to Oakland County, which has 30% of residents living below the ALICE threshold (Alice 2021 Michigan report, data sheet). The current participants in the program have an average age of 47, with an age range from 19 to 91 years old. 29% of program participants live in Pontiac, 12% are from Southfield, 12% are from other Southeastern suburbs that are closer to Detroit, and the rest are from other suburbs like Waterford, Auburn Hills, Bloomfield Township, and Lake Orion. 29% of program participants are Black, 38% are white, 4.8% are Asian, 1% are Native American, 17% are more than one race, and the rest declined to answer. In terms of ethnicity, 16% are Hispanic/Latino, and 4.15% are Middle Eastern or Northern African. 25% of participants have completed high school or a GED, 25% have completed some college, 9.7% have an associate's degree, 14% have a bachelor's degree, and 8.3% have a graduate degree. Project staff have made attempts to reach the target audience through several efforts. Staff have been present at special farmers market events in Oak Park and Waterford designed to draw community residents with needs to the markets. These events provided an opportunity to have a presence in the community, engage directly with the target audience, and promote the program. Staff have also made presentations to community coalitions, such as Healthy Pontiac, We Can, to engage with residents and organizations serving our target audience and get their feedback and collaboration. Changes/Problems:There were no major changes or problems to report for this year. Project activities were met as written and without major difficulties or challenges. What opportunities for training and professional development has the project provided?Project staff continue to participate in the Michigan Farmers Market Association (MIFMA) PPR Statewide Learning Network and attend monthly meetings. Staff have also provided input and feedback to help shape the Medicaid In Lieu of Services (ILOS) efforts to reimburse for produce prescription programs in Michigan. There has also been collaboration with MIFMA on technology platforms to streamline participant management, which will continue in project year three. Oakland University graduate students working on the project work alongside senior project staff and offers mentorship opportunities as they work on project goals together. Prescription for Healthy Oakland holds outreach training meetings with grocers and community organizations to teach them about the program, how to refer or enroll people, what types of food are included, and what are the benefits or outcomes of the program. Prescription for Healthy Oakland participants have been selected to engage in an Oakland County Food Landscape Study, which is being conducted by Public Sector Consultants. Particpants are being reimbursed to share their experiences around food security and using the emergency food system. How have the results been disseminated to communities of interest?Project staff have presented at conferences in project year two. These include: Great Lakes Society of Public Health Educators 2024 ConferenceHow Technology Can Impact Food Security: Barriers and Facilitators to Successful Produce Prescription Program (PPR) Implementation Megan Page, MPH, CHES; Hanna Sandzik, B.S, and Dr. Laurel Stevenson, Ph.D, MPH Produce Prescription Programs (PPRs) are a promising avenue to address food security and chronic disease risk in underserved communities. However, integrating technology into implementation for PPRs is fraught with challenges. We will discuss successes andchallenges with technology in PPR implementation. National Association of County and City Health Officials (NACCHO) 360 Annual Conference A Public Health and Academic Partnership to Address Food Insecurity and Nutrition through a Produce Prescription Program Megan Page, MPH, CHES; Carrie Hribar, MA; and Dr. Laurel Stevenson, Ph.D, MPH Prescription for Healthy Oakland is a produce prescription program partnership between Oakland County Health Division and Oakland University that addresses food insecurity and healthy eating habits. Key partners also include health clinics, community organizations, and grocery stores and farmers markets to help improve outcomes in disenfranchised communities. The partnership between the health department and a university allows for critical research to build the evidence base for this type of intervention, and the leveraging of resources. Prescription for Healthy Oakland has made key impacts on participant food security and nutrition. Staff also participate in several local coalitions focusing on food or nutrition, including the Oakland County Food Policy Council, Healthy Oakland Partnership, and Healthy Pontiac, We Can. Staff share updates, successes, and barriers about the program with local partners. Project staff are also working on submitting articles to peer-reviewed journals in year three. What do you plan to do during the next reporting period to accomplish the goals?A major focus for year three is to complete program evaluation and identify key outcomes and behavior change that have resulted from the produce prescription program. Another important goal is to explore Medicaid In Lieu of Services (ILOS) and develop partnerships with health plans to secure sustainable funding for Prescription for Healthy Oakland. Additionally, we will continue to work with MIFMA and technology partners to pilot platforms to streamline participant management.
Impacts
What was accomplished under these goals?
Prescription for Healthy Oakland was designed to help low-income participants in Oakland County improve their fruit and vegetable consumption and become more comfortable purchasing, cooking, and consuming produce. Program participants in year two continued to reaffirm that the program is meeting those outlined goals. Participant 950 stated "I have enjoyed the information provided in each session. I only hope that the Prescription for a healthy oakland program will be able to continue because many people need to be educated about eating well and the vouchers provided will help them afford fresh fruits and vegetables". Interest and enrollment in Prescription for Healthy Oakland remained strong throughout project year two and we met or exceeded many of our goals. The following accomplishments were completed under the project goals: Establish or renew contracts for produce voucher reimbursement with at least 6 produce vendors by January 2023. Contracts were maintained for 10 vendor shopping locations in 2024 - six brick and mortar stores and 2 farmers markets. There was just over $50,400 spent in project year two at the 10 produce vendor locations. Establish referral partnerships with at least 5 healthcare and/or community partners by March 2023. We maintained a subcontract with a Federally Qualified Health Center, Honor Community Health, to help with referrals and enrollment. Other partnerships were with several other referral sources, including Trinity Health Oakland hospital, Oakland County WIC, and more. Of the 12 referral partners there were 6 healthcare providers or clinics, 1 insurance company, and 5 community organizations Enroll at least 250 participants in the Prescription for Healthy Oakland between May 2023 and April 2024. There were 125 participants enrolled in project year 2, with a total of 397 referred or enrolled since GusNIP funding began. 111 have dropped the program over the two project years, which is a 28% drop rate. Ensure that at least 125 program participants complete all health education sessions and receive coaching and support between June 2023 and May 2024. 225 participants have completed the program since enrollment began, and 221 of those participants have matched pre and post test surveys. There are currently 27 active participants in the program as of the end of November 2024. 20 participants completed 1 health education session 18 participants have completed 2 health education sessions 18 participants have completed 3 health education sessions 8 participants have completed 4 health education sessions 1 participants have completed 5 health education sessions (final session before "graduating" from the program) Conduct evaluation activities, track voucher use, and collect program data from at least 100 participants between May 2023 and August 2025 to provide insight on behavior change and progress towards program goals. 225 participants have completed the program since enrollment began, and 221 of those participants have matched pre and post test surveys. The program data from these participants will be analyzed in project year three to gain insight on behavior change and other program outcomes.
Publications
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Progress 09/15/22 to 09/14/23
Outputs
Target Audience:Prescription for Healthy Oakland targets specific municipalities in Oakland County that have higherconcentrations of people of color and experience challenges around the social determinants of health. The city of Pontiac is comprised of 49% Black residents and 16% Hispanics/Latino residents. Areas of southern Oakland County also have more diverse communities - Southfield is comprised of 70% Black residents and 56% of Oak Park's residents are Black (U.S. Census Bureau, 2020). United Way ALICE data shows that cities within this region have a high percentage of households that are below the financial threshold to make ends meet, including Oak Park (48%), Southfield (48%), Pontiac (67%), Waterford (30%), and Auburn Hills (37%), compared to Oakland County, which has 30% of residents living below the ALICE threshold (Alice 2021 Michigan report, data sheet). The current participants in the program have an average age of 48, with an age range from 19 to 91 years old. 29% of program participants live in Pontiac, 12% are from Southfield, 12% are from other Southeastern suburbs that are closer to Detroit, and the rest are from other suburbs like Waterford, Auburn Hills, Bloomfield Township, and Lake Orion. 28% of program participants are Black, 56% are white, 4.8% are Asian, and 2% are Native America. In terms of ethnicity, 11% are Hispanic/Latino, and 4.15% are Middle Eastern or Northern African. 25% of participants have completed high school or a GED, 25% have completed some college, 9.7% have an associate's degree, 14% have a bachelor's degree, and 8.3% have a graduate degree. Project staff have made attempts to reach the target audience through several efforts. Staff have had tables at special farmers market events in Oak Park and Waterford designed to draw community residents with needs to the markets. These events provided an opportunity to have a presencein the community, engage directly with the target audience, and promote the program. Staff have also made presentations to community coalitions, such as Healthy Pontiac, We Can, to engage with residents and organizations serving our target audience and get their feedback and collaboration. Changes/Problems:The most major change to our program was regarding our timeline. We started approximately a quarter after we estimated, due to our grant agreement process and getting contracts established for the program. Our program enrollment start was also timed to begin with peak farmers market season. However, we are ahead of our enrollment goals for where we are in our timeline and this has allowed us to be on target with our project goals. What opportunities for training and professional development has the project provided?Project Director Carrie Hribar participated in the USDA Community Nutrition Project Directors Meeting in New Orleans. Project staff also participate in the Michigan Farmers Market Association (MIFMA) PPR Statewide Learning Network and attend monthly meetings. Oakland University graduate students working on the project work alongside senior project staff and offers mentorship opportunities as they work on project goals together. Program staff had the opportunity to learn about and participate in advocacy as well as share project outcomes with representatives.as part of the Michigan Farmers Market Association's Legislative Day in Lansing, Michigan. Prescription for Healthy Oakland has held training meetings with grocers and community organizations to teach them about the program, how to refer or enroll people, what types of food are included, and what the benefits or outcomes of the program are. How have the results been disseminated to communities of interest?Project staff attended the MIFMA PPR Legislative Day in Lansing in November 2023 and met with several state legislators or their staff that represent Oakland County. They discussed Produce Prescription (PPR) programs in Michigan and how the Food Is Medicine initiative can be leveraged to equitably address food insecurity, increase fruit and vegetable consumption, and improve health outcomes in our Michigan communities. Staff participate in several local coalitions focusing on food or nutrition, including the Oakland County Food Policy Council, Healthy Oakland Partnership, and Healthy Pontiac, We Can. Staff share updates, successes, and barriers about the program with local partners. Project staff will also be submitting several abstracts for conference presentations, including the National Association for County and City Health Officials annual meeting. What do you plan to do during the next reporting period to accomplish the goals? Program staff will continue to work with clients to provide coaching, goal support, and ensure they are able to complete health education sessions and use their vouchers. The first round of participants will finish the program. Project staff will conduct evaluation and ask for feedback on the program. Incentives will also be provided to ensure participants will complete the post-program survey.
Impacts
What was accomplished under these goals?
Prescription for Healthy Oakland was designed to help low-income participants in Oakland County improve their fruit and vegetable consumption and become more comfortable purchasing, cooking, and consuming produce. Program participants have stated that the program has helped them improve their food security or nutrition and healthy eating. The vouchers are really helping Participant 167 - a caregiver of 2 special needs children and her husband has been unable to work for 2 years, so the vouchers are helping fill a gap. Another participant also emphasized it helps to make ends meet: "This helped me to have accessibility to help my grocery spending, where I would run short so often. Please keep it up here in Oakland County." The health education sessions is also helping participants meet their nutritional goals. One participant stated "The program has helped me to focus on eating more vegetables and fruits and less carbohydrates/ starches. I have been making and enjoying meatless stir fry meals. I am excited and look forward to receiving my vouchers so l can purchase good quality products. My long term goal is to increase my intake of quality fruits and vegetables which hopefully will help in my weight loss." While another picked up useful shopping tips - "I like the idea of shopping only on the perimeter of the store. It helps me avoid a lot of junk food. And has given me healthier choices." The following accomplishments were completed under the project goals: Establish or renew contracts for produce voucher reimbursement with at least 6 produce vendors by January 2023. Contracts were established for 10 vendor shopping locations in June 2023 - six brick and mortar stores and 2 farmers markets. 7 were returning locations; 3 were new locations Project staff held training sessions with vendor locations in June 2023 to provide program overview and what food items are covered by the vouchers. Cashier instructions were also provided to all vendor locations. There has been $20,000 worth of voucher spending over 19 weeks Establish referral partnerships with at least 5 healthcare and/or community partners by March 2023. Subaward with Federally Qualified Health Center Honor Community Health for referrals was established in March 2023. Referral partnership relationships were also solidified with several other referral sources, including Trinity Health Oakland hospital, Oakland County WIC, Humana insurance company, and more. Of the 12 referral partners: 7 healthcare clinics, 3 health insurance companies, and 2 community organizations Enroll at least 250 participants in the Prescription for Healthy Oakland between May 2023 and April 2024. As of November 26, 2023, there have been 269 participants enrolled in Prescription for Healthy Oakland. 8 participants have left the program since enrolling. In November 2023, there are currently 261 active participants in the program. Ensure that at least 125 program participants complete all health education sessions and receive coaching and support between June 2023 and May 2024. The current breakdown of health education sessions for the 261 active participants (program progression): 215 participants have completed 1 health education session 170 participants have completed 2 health education sessions 132 participants have completed 3 health education sessions 72 participants have completed 4 health education sessions 7 participants have completed 5 health education sessions (final session before "graduating" from the program).
Publications
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