TEAM FOOD DESERTS

Carolina AguiarValerie CaplanEmily ChangSophia ChangJennifer KuoMoses LaheyRutvij PandyaKate Richard

Kelci Schexnayder

Monique Thornton

Rachel White

Dr. Stephanie Grutzmacher

November 7, 2011

Presentation Overview

Mission Statement & Literature Review Research Question & Hypothesis Methodology & Research Breakdown Target Population & Markets Data Collection Future Plans Advice to Future Teams

Mission Statement Our research aims to

evaluate the issue of healthy food accessibility among lower-income families by analyzing the attitudes and behaviors of federal nutrition program participants at three local farmers’ markets. Specifically, our research addresses the self-efficacy and home nutrition environment of SNAP and WIC users shopping in the farmers’ markets.

Federal Nutrition Assistance Programs

SNAP: Supplemental Nutrition Assistance Program EBT: Electronic Benefit Transfer System

WIC: Women, Infants, and Children

Literature Review Food Insecurity

More than 12 million children in the U.S. live in a food insecure household

WIC and SNAP In Washington DC, one in five residents are on

SNAP benefits Currently, WIC provides for about 9 million women,

infants and children every month Farmers’ Markets

A pilot program in which each vendor stand had its own EBT machine resulted in increased usage of the farmers’ market

Accounted for about $1.2 billion in sales in 2007

Perceived self-efficacy: a belief about what one can do under different sets of conditions with whatever skills one possesses

influence goals and aspirations shape outcomes people expect their efforts to produce determine how people view obstacles and impediments

People with stronger perceived self-efficacy set higher goals for themselves have firmer commitment to them view obstacles as surmountable and tend to stay committed

Literature Review

Research Question

What is the effect of parental self-efficacy on the home nutrition environment?  We have defined the home nutrition

environment as a combination of three variables: Perceived barriers to food access Fruit and vegetable offerings in the home Family health behavior

Hypothesis Parental self-efficacy will be a

significant predictor of the home nutrition environment

SELF EFFICACY

HOME NUTRITION

ENVIRONMENT

PERCEIVED BARRIERS

FRUIT AND VEGETABLES IN THE HOME

FAMILY HEALTH BEHAVIOR

PHASE 1

Market AnalysisWhat percent of sales can be attributed to SNAP and WIC shoppers?

Initial SurveyCross-sectional survey. To what extent does a parents’ self-efficacy influence the home-nutrition environment?

PHASE 2InterviewsTalk in depth to market coordinators and initial survey participants retained through the market season.

Mentor and SPH grad students run a nutrition education program aimed at improving parent self-efficacy with Initial Survey participants. Parents will receive education materials and cooking and shopping tips to use with their children.

Follow-up SurveyWhat was the participants’ experience with the education program, and have there been any changes in the home nutrition environmental or in parental self-efficacy?

NUTRITION EDUCATION PROGRAM

Methodology & Research Breakdown

Drop-out SurveyMail surveys to initial survey participants who did not return to the market about their decision not to complete the program.

Farmers’ Markets Riverside,

Washington, DC Riverdale Park,

MD College Park, MD

Target Population and Recruitment

Parents enrolled in federal nutrition programs (SNAP or WIC) with: A child or children between the ages of 4

and 10 No serious dietary restrictions in the family

Cash incentive $5 for initial survey Additional $20 if retained for follow-up

survey

Overall Data Collection 72 total initial survey responses

A handful of participants with 100% attendance throughout nutrition education program

Other sporadic attendance through market season

EBT machine only at one market, expanded our data to include WIC parents as well

Currently in the last month of data collection Final nutrition education program meetings Follow-up and drop-out surveys, interviews all

forthcoming or currently occurring

Riverside Data Collection One vendor with limited fruit and

vegetable offerings Only market to accept SNAP benefits June: 34 survey participants

July: 3 returners August: 1 returner September: 1 returner October: 0 returners

Riverdale Park Data Collection Larger market with many offerings Spanish and English speaker survey

participants Only accepts WIC benefits June: 37 survey participants

18 English, 19 Spanish July: 19 returners August: 3 returners September: 1 returner October: 1 returner

College Park Data Collection

Larger market with offerings Many interested shoppers who did not

meet our survey criteria Only accepts WIC benefits 1 survey participant

Returned every month

Fall Data Collection

New components to address low retention Drop-out survey Updated follow-up survey

Interviews Collecting market sales data Will complete data collection by the end

of November

Data Analysis Created database using SPSS

Will be analyzing relationship between parental self-efficacy and the home nutrition environment by running regressions Independent variable: self efficacy Dependent variable: home nutrition environment

Nutrition education market acceptance of federal nutrition benefits self efficacy

Will transcribe and code interviews in atlas.ti Looking for themes in responses

Interviews Market Coordinators

Goals for the market The importance of offering healthy foods to low

income individuals Barriers to implementing EBT machines

Participants (who attended three or more market sessions) What kept them coming back to the market Whether the nutrition education lessons were

useful Comparing the farmers market to their usual

shopping location

Team Timeline

Fall 2011 Spring 2012Winter 2012 Fall 2013 Spring 2013

•Continue work on thesis•Attend local conferences•Present at Undergraduate Research Day

•Polish thesis•Submit research to pertinent academic journals•Submit material to present at conferences

Advice for Future Teams Working with partners and other

organizations Communication is key Can gain access to great information

Always have a back-up plan Don’t be afraid of social sciences Delegation is key

Thank You To: Dr. Stephanie Grutzmacher, our amazing mentor School of Public Health grad students: Lauren Messina,

Stephen Flegg, Katie Spears, Ash Munger, Brian Schram, Micaela D’Alvinar

Spanish translators Meghan Mallari, Elizabeth Rojas, Rene Pizzaro

Team librarian Judy Markowitz The Gemstone staff: Dr. Wallace, Rebecca Thomas, Vickie

Hill Partners: Maryland Food Supplement Education, Prince

George’s County Extension, Maryland Department of Agriculture, Riverdale Park Farmers’ Market, College Park Farmers’ Market, Riverside Farmers’ Market

Questions

Bibliography Glanz, K., J.F. Sallis, B.E. Saelens, and L.D. Frank. 2005. Healthy

nutrition environments: Concepts and measures. American Journal of Health Promotion 19:330-333.

Hu, F.B., and W.C. Willett. 2002. Optimal diets for prevention of coronary heart disease. Journal of the American Medical Association 288:2569-2578.

Just, R., & Weninger, Q. (1997). Economic evaluation of the Farmers’ Market Nutrition Program. American Journal of Agricultural Economics, 79(3), 902. Retrieved from Business Source Premier database.

Kunkel, Mary E., Lucia, Barbara, Moore, Archie C. (2003). Evaluation of the South Carolina Seniors Farmers' Market Nutrition Education Program. Journal of the American Dietetic association 103(7), 880- 883. doi:10.1016/S0002-8223(03)00379-1.

Bibliography United States. Department of Agriculture. Agricultural Marketing Service &

Nutrition Service Project or Public Spaces, Inc. (2010, June). Supplemental Nutrition Assistance Program (SNAP) At Farmers Markets: A How-To Handbook. Retrieved October 25, 2010 from the United States Department of Agriculture website: http://www.ams.usda.gov/AMSv1.0/ams.fetchTemplateData.do?template=TemplateJ&page=WFMPublications

Vozoris, N., & Tarasuk, V. (2003). Household food insufficiency is associated with poor health. The Journal of Nutrition, 133, 120–126.

Whitacre, P., Tsai, P., Mulligan, J., Institute of Medicine (U.S.). Board on Population Health and Public Health Practice., National Research Council (U.S.). Food and Nutrition Board., & National Research Council (U.S.). Board on Agriculture and Natural Resources. (2009). The public health effects of food deserts : workshop summary. Washington, D.C.: National Academies Press.

Yu, ManSoo, Lombe, Margaret, Nebbitt, Von E. (2010). “Food stamp program participation, informal supports, household food security and child food security: A comparison of African American and Caucasian households in poverty.” Children and Youth Services Review (32) 767–773. doi:10.1016/j.childyouth.2010.01.015. Used data from the 2003 Food Security Survey, a supplement to the Current

Population Survey (CPS) (N=3,799