Recipient Organization
ELEPAIO SOCIAL SERVICES
86-260 FARRINGTON HWY.
WAIANAE,HI 96792
Performing Department
(N/A)
Non Technical Summary
The Mana Ku Produce Prescription program aims to address the significant challenge of food insecurity and the associated health issues prevalent in the Waianae Coast region of Hawaii. This issue extends beyond the direct impact on the local population, influencing the broader economic aspect, community well-being, and environmental sustainability. Addressing food insecurity and promoting healthier diets not only contributes to improved public health but also encourages local agriculture, fostering economic growth, and reducing environmental impact by decreasing reliance on imported food products.This program adds to Elepaio Social Service's currently established Food as Medicine programs, which connect good food to positive health outcomes. A total of 210 householdsidentified as food insecureby healthcare providers may qualify to receive $100 loaded onto an electronic card each month over the 12 month program ($1200 total)to purchase local fruits, vegetables and poi from the health center's farmers market.In collaboration with a localeducational farm, we will offerfourmonthly educational workshopsfocused around nutrition, food production and preparation using indigenous crops.Participants will complete surveys and health check-ups before, during and after the program to allow for tracking ofimprovements in health indicators. We will also track patient's health and encounters with providersat the Waianae Coast Comprehensive Health Center and calculate healthcare savings costs. Through this program, we hope to enhance food security, improve health outcomes, and stimulate local agriculture. The anticipated societal benefits include a healthier community, economic growth through the promotion of local produce, and a projectedreduction in healthcare costs due to improved community health.
Animal Health Component
50%
Research Effort Categories
Basic
10%
Applied
50%
Developmental
40%
Goals / Objectives
The overall goal of the MKPPRx program is to improve the health and wellness of low-income households on the Waianae coast. There are several sub-goals and objectives to achieve this.Goal 1: To decrease food insecurity, improve health related quality of life (HRQoL), and increase FV intake among program participants (parent/caregiver and household)Objective 1.1: Enroll and retain 210 low-income households to the MKPPRx program.Objective 1.2: Provide produce prescription incentives to MKPPRx participants for up to 12 months.Objective 1.3: Assess food insecurity, HRQoL, and FV intake at baseline, 6 months, and 12 months to assess changes in status and address challenges.Objective 1.4: Provide 4 monthly educational workshops/events on cooking, agriculture, and various health-related topics to promote FV consumption and purchasesGoal 2: To improve health outcomes and reduce healthcare utilization costs of program participants by enhancing program support for participantsObjective 2.1: Implement, and improve, effective communication strategies with participants to maximize program participation.Objective 2.2: Refer participants to WCCHC comprehensive support services to maximize program participation and impact.Objective 2.3: Promote health maintenance visits include regular measurements: BMI, blood pressure, Hgb A1cObjective 2.4: Examine healthcare costs of MKPPRx participants.Goal 3: To increase cooking self-efficacy (SE), willingness to try (WTT) FV, and food and nutrition(FN) knowledge for program participants (children)Objective 3.1: Assess cooking SE, WTT FV, and FN knowledge at baseline and post-programGoal 4: To strengthen Waianae Coast community food systemsObjective 4.1: Assess MKPPRx program impact on WCCHC Farmers' Market FV sales.
Project Methods
Our project will utilize several different methods to reach our desired objectives. The primary method will be a produce prescription program for patients at the Waianae Coast Comprehensive Health Center (WCCHC).We will enroll 210 parent-child pairs from 210 households over the three-year grant period. Mana Ku PPRx eligibility: 1) Households residing in Waianae, HI (96792 zip code), 2) Households with at least one child in kindergarten - 6th grade (5 - 12 years old), 3) Participating children and parents/caregivers are patients at WCCHC, 4) Parent/caregiver receives SNAP benefits OR is enrolled in Hawaii Medicaid MedQuest, and 5) Parent or child suffers from, or is at risk of developing, a diet-related health condition (e.g., pre-diabetes, diabetes, cardiovascular disease, and/or hypertension). WCCHC healthcare providers will screen patients for eligibility and send a referral through the patient's Electronic Medical Record to ESS's MKPPRx team for enrollment. MKPPRx will contact the participant to explain the program and proceed with consent and enrollment.In addition to the financial support provided through this program, participants will also have the opportunity to build their knowledge and skills around growing, harvesting, nutrition and preparation of local indigenous crops, as well as other general well-being knowledge through four free monthly educaitonal workshops. Participants will complete post-workshop evaluation surveys that will be used to improve future workshops.The following evaluations will be conducted:Process Analysis: The Process Analysis objective is to understand the process, challenges, and success of implementation and operations. As a Process Analysis framework we will use the RE-AIM framework.Reach or the number, proportion, and representativeness of individuals participating in project activities (ex: patient participants, providers/staff, FM farmers/vendors, partner organizations);Effectiveness of the activities and the overall intervention on targeted outcomes;Adoption of the activities and the overall intervention on targeted outcomes;Implementation or time, cost challenges, and fidelity to which planned intervention is delivered (ex: are the providers implementing the process as intended?)Maintenance or the extent to which a program or intervention is sustained at the level of an individual and/or setting (ex: what project activities are sustained?)Process Analysis Methods: We will use mixed-methods including surveys (ex: satisfaction, post-workshop evaluation surveys), EMR-based tracking reports (ex: number enrolled in MKPPRx and diagnosis), and post-program interviews (phone and/or face-to-face)Outcome Assessment: Outcome Assessment objectives are to assess the effectiveness of the MKPPRx program on (1) decreasing food insecurity, improving health related quality of life (HRQoL), and increasing FV intake among program participants (2) improving health outcomes and reducing healthcare utilization costs or program participants by enhancing program support for participants, (3) increasing cooking self-efficacy (SE), willingness to try (WTT) FV, and food and nutrition (FN) knowledge for program participants, and (4) strengthening the Waianae Coast community food systems. The following procedures are currently in use by ESS's Food as Medicine programs and will be adapted for the MKPPRx program:Parent/Caregiver Survey: The 77-question parent/caregiver survey will be completed over the phone with the program/research assistant at baseline, midpoint (6 months) and immediate post-program (12 months) to measure changes in food insecurity, HRQoL and FV intake.Child Survey: The 41-question child survey will be completed in person with each enrolled child at baseline and immediate post-program (12 months) to measure changes in cooking self-efficacy, willingness to try FV, and food and nutrition knowledge. Changes will be compared within individuals and between groups (children who attended workshops versus those who did not).Clinical Measures: Health measures including health maintenance visits, emergency room visits, BMI, blood pressure, HgbA1c (parent only) will be tracked for each enrolled parent and child in their WCCHC electronic medical record throughout the program. The MKPPRx team currently works with the WCCHC EMR team to extract data for its prior and existing PPRx programs. These same procedures will be used to extra MKPPRx participant's data at baseline, midpoint, and post-program. Values will be compared within individuals and across individuals.Participation Tracking: Parent-child dyads will be assigned a unique study identification number, which will be used to track incentive distribution and redemption, attendance to educational classes, preferred communication method, and clinical measures throughout the program.Electronic Benefit Card Tracking: ESS currently has an electronic card system in place at the M?keke Farmers Market for all Food as Medicine programs. MKPPRx participants will use this same electronic benefit card system. The card system will track market vendor/farmers' sales (daily, weekly, monthly, annually) and will be compared to prior year sales.Program utilization (amount of incentives used, number of educational classes attended, communication methods, and adherence to health maintenance visits and measures) will be explored as predictive variables for all outcomes, as appropriate.