Recipient Organization
UNIV OF MINNESOTA
(N/A)
ST PAUL,MN 55108
Performing Department
(N/A)
Non Technical Summary
This project addresses food security challenges faced by one of the fastest growing sectors of our population who are also most likely to experience economic and health disparities. In Minnesota, the fastest population growth is expected among Hispanic, Black, and Asian communities. Currently, 21% of Minnesotans identify as people of color, while 32% of children 4 years and under are of color. Huge income inequity exists, with 80% of Somali and 59% of African-American people living in poverty and near poverty in Minnesota (compared to 21% of white population).Regionally, more people of color are moving to rural areas of the state. While the Somali population in the Minneapolis-St. Paul metro doubled between 2005 and 2019, the number of Somali residents in Greater Minnesota grew by more than six-fold during the same period. Families in rural Minnesota experience poverty to a greater extent than those living in suburban or urban areas (11.5% in rural areas compared to 8.9% in urban areas). Minnesota ranks seventh worst in the nation for healthy food access, particularly with significant decreases in grocery stores in rural Minnesota in recent years.We partner with a Somali-American community in Central Minnesota. Somali immigrants are one of the largest African populations to resettle in the U.S. since the early 1990s. In Minnesota, the Somali community is one of the largest immigrant communities, with an estimated population of 80,000, of which 10,000 reside in Stearns County and surrounding areas. We will use a human-centered design (HCD) approach to develop place-based solutions to improve food-related health outcomes in the study community. Centered on the people experiencing the problem, HCD is an effective way to develop interventions that are both community-based and place-based. We will conduct needs assessments of the study community in Year 1, co-design intervention strategies in Year 2, and field test the strategies that were developed into prototypes. The learning from the HCD approach and co-designed, field-tested strategies with shared with the wider audience.We will also contribute to the emergent literature on transferability assessment of public health interventions in immigrant communities in rural areas. We will work with the technical advisors on our project who have led similar community-based efforts to address food systems and/or food-related health in other immigrant communities. Together, we will sort through the transferability factors identified by the past studies to identify factors which may specifically influence the transferability of the project process and outputs to other immigrant communities and develop hypotheses about the ways these factors may influence transferability. We will examine the hypotheses by analyzing a panel workshop with technical advisors and members of various immigrant communities to gather evidence in the project work and in their lived experiences.
Animal Health Component
50%
Research Effort Categories
Basic
(N/A)
Applied
50%
Developmental
50%
Goals / Objectives
The overall objective of this project is to improve food access and nutrition security of immigrant communities in rural U.S., by amplifying their capacity to lead and sustain efforts to strengthen their food system. The study will take place in collaboration with a prominent Somali-American community in Central Minnesota. The proposed main output from the project is a place-based, multi-component framework with field-tested strategies to promote healthy eating among a key immigrant community in rural Minnesota. The potential transferability of project processes and outputs to other immigrant communities will be examined in collaboration with a panel of experts and community leaders across the Midwest. Specifically, the objectives of this proposal are to:Identify and characterize profiles of food system needs, values, and barriers of a partnering immigrant community in rural MinnesotaCo-design promising interventions across food security components with partnering community members and leadersField-test intervention products and processes to address the identified needs and barriers for food access and nutritional security in the partnering communityEvaluate transferability of the project process and outputs to other immigrant communitiesCo-develop and disseminate materials for rural immigrant communities and organizations that serve them to enhance equitable and inclusive food system and nutrition education outreach
Project Methods
Needs assessment (Year 1)For the needs assessment, we plan to recruit 50 participants for 6 focus groups. Each focus group will consist of ~8-10 participants, be held at a conveniently located site, last ~60-90 minutes, and be moderated by a trained facilitator and community staff for translation, as needed. We will recruit participants, ensuring that we have diversity in gender, age, and number of years living in the US. In previous work, we have successfully conducted recruitment with Somali Americans living in rural Midwest areas. We will consult with community advisors to identify events, organizations, and locations frequented by the community. We will also gather data via in-depth interviews with key informants identified by the community advisors and others. These may include leaders in the Somali-American community and/or leaders of organizations that serve this community. We will use a snowball strategy, where at the end of each interview we ask respondents who else we should interview. We plan to interview 15 stakeholders but will continue data collection if saturation is not reached. A quasi-deductive content analysis approach will be used to analyze qualitative data to identify commonalities organized by themes.HCD fidelity evaluation (Year 2)The study is based on HCD, which implies that actual outputs (strategies, interventions) that will be field-tested will not become known until the needs assessment and co-designing processes are completed.The project evaluation will assess the degree to which project activities--e.g., needs assessments, prototype development--are aligned with HCD principles. For instance, in developing the prototype, this fidelity evaluation will assess: (a) the extent to which the needs and values of the community are directly reflected in the developed prototype, (b) the degree to which community members actively participate in ideation and co-design, and (c) the extent to which the prototype is customized to ensure usability and convenience among community members during iterative refinement. To assess these issues, the evaluation team will lead a facilitated dialogue with community stakeholders at the beginning of Year 4 after the completion of Activities 2-4. These sessions will not be attended by other project staff members. They will be recorded, transcribed, de-identified, and analyzed for themes. A report of overall themes, devoid of all individual identifiers, will be reported back to the project team and action items will be identified for moving forward.Prototype evaluation (Year 3)We will recruit field test participants from the Somali community who will complete the appropriate evaluation for each prototype product. Prototype evaluation will focus on feasibility, acceptability, dose, and reach of the final prototype. We will quantitatively assess participants' reactions to the prototype (e.g., satisfaction with the program, willingness to recommend it to others, desire to participate again), participant engagement (e.g., participation, attendance), program delivery fidelity (e.g., to the extent program activities delivered as planned), and learning from the program. Evaluation metrics will be tailored to best suit the specific prototype that is developed and will be determined in collaboration with community stakeholders, reflecting best practices for equitable co-design. The prototype evaluation will also include a qualitative component to identify the key achievements of and domains/outcomes affected by the prototyped intervention that could be evaluated in a future impact evaluation, lessons learned during implementation, and changes to consider to the programming to enhance usability in the future. A full-powered evaluation of the impact of the intervention on changes in health outcomes is beyond the scope of this project but will mark an important next step in future work.Assessment of transferability (Years 1-4)For assessment of transferability, we will adapt the multi-stage TRANSFER approach developed for evaluating the transferability of scientific evidence included in systematic reviews (Munthe-Kaas et al., 2020). We will collaborate with the technical advisors on our project who have led similar community-based efforts to address food systems and/or food-related health in other immigrant communities. At the beginning of the project, we will compile an aggregated list of transferability factors that have been published on public health interventions (e.g., Munthe-Kaas et al., 2019; Schloemer & Schröder-Bäck, 2018; Cambon et al., 2012) and share with the technical advisors. In Years 1-2, the project team and technical advisors will refer to the list of factors as the project progress is reported to the technical advisors. In Year 3, we will follow the TRANSFER Conversation Guide to identify and prioritize transferability factors which may influence the transferability of the project process and outputs to other immigrant communities. In the conversation, we develop hypotheses about the ways these factors may influence transferability. Munthe-Kaas et al. (2020) suggest including three to five factors and associated hypotheses to keep the assessment analysis feasible. In Year 4, we will convene a panel that comprises technical advisors and members of various immigrant communities for a workshop. The purpose of the workshop is to gather evidence in the project work and in their lived experiences related to the transferability hypotheses. The meeting will be audio-recorded, transcribed, and analyzed per the qualitative analytic methods described above to examine the transferability hypotheses.