Partnering to support nutrition incentive programs at farmers markets provides increased access to healthy food for CalFresh recipients and generated over $380,000 in revenue for local farms.

The Issue

For low-income community members, CalFresh/SNAP incentive programs can increase their purchasing power, help reduce hunger, and improve nutrition. Farmers market nutrition incentives provide economic benefits to local farmers and communities, reduce food miles traveled, and can increase access to healthy food in low-income communities. In San Luis Obispo County eight year-round farmers markets accept CalFresh and offer the market incentive Market Match. However, these programs are underutilized, and many low-income shoppers are unaware or uncertain about where and how to use their CalFresh card.

How UC Delivers

To increase access to farmers market incentive programs and address barriers, UC staff convened partners through the EBT at Farmers Markets working group of the San Luis Obispo Food System Coalition. The work group includes partners from multiple sectors, including agriculture, government, private industry, and community-based organizations. The purpose of the work group is to increase the use of CalFresh at farmers markets to 1) create equitable access to healthy food and 2) support for local farmers. Through this work group, partners have collaborated to increase the visibility of farmers market incentives through social media, text messaging, materials distribution to local client-serving organizations, press releases, paid advertisements, and promotion at local food bank distributions and farmers markets.

Key work group partner representatives (n=6) were surveyed in September 2021 using the Wilder Collaboration Factors Survey. This survey includes 44 evidence-based items for collaboratives. Strengths are indicated by an average score of 4.0 to 5.0, while areas needing attention are 3.9 or lower. Strengths reported by respondents included: skilled leadership (4.3), unique purpose (4.3), mutual respect and trust (4.4). Weaknesses and areas of growth included: adequate funds (2.7) and time (2.7), and having all the organizations that we need as members of the group (3.2).

To address some of the issues related to time and resources, the work group applied for and received $30,000 in funding from the Danone Foundation to pilot a Farmers Market Navigator program to increase access to farmers market incentives among Hispanic and Latino customers who use CalFresh.

The Impact

Since 2017, when UC started convening the EBT at Farmers Markets work group, we have seen a 171% increase in CalFresh and Market Match redemption. Research has shown that access to fruits and vegetables supports healthy eating behaviors and improved health outcomes. Additionally, these purchases have generated a total of $386,000 in direct income to local farmers and farmers markets.

In addition, the work group has supported two additional markets in launching their Market Match program and has advocated for and achieved a regional standard incentive amount of $15 from Paso Robles in northern San Luis Obispo County to Lompoc in northern Santa Barbara County. This regional standard simplifies communication to low-income clientele and ensures a meaningful and standardized food budget when clients shop at local farmers markets.

Increasing access to local fruits and vegetables supports UC ANR's public values of safeguarding abundant and healthy food for all Californians and promoting healthy people and communities.

Our favorite quote:

“This work group really helped our market to be accepted into the Market Match program. I think without the visibility and partnership that this work group provided, we would not have been considered for Market Match. So you all should really feel good about that and thank you.”

– Farmers market manager and work group partner

UCCE Santa Barbara County educators partnered with P.E. teachers to boost enrolled classes  by 53% during COVID-19 distance learning. About half of the students surveyed indicated intentions to drink more water and increase activity, contributing to improved youth health.

The Issue

The CalFresh Healthy Living, University of California Cooperative Extension (UCCE) program serving Santa Barbara County has partnered with elementary schools in the Santa Maria-Bonita School District (SMBSD) for several years to provide evidence-based curriculum and trainings in nutrition and physical activity. SMBSD serves over 16,900 students with 87.2% of the students qualifying for free or reduced-price school meals.[1] During the COVID-19 Pandemic, many families, especially those with young children, experienced an increase in food insecurity, making them more vulnerable to negative health outcomes.[2] Unfortunately, during the same time UCCE educators in Santa Barbara County experienced a decrease in K-6th grade classroom teachers being able to partner to provide nutrition and physical activity support, limiting access to important resources and information on diet and exercise habits that promote healthy living.[3-4]

How UC Delivers

Working closely with school partners, UCCE educators pivoted programming to meet the needs of school communities to promote health and increased the total number of enrolled classes by 53% compared to the start of the 2020-21 school year.

Specifically, three SMBSD P.E. Specialists expressed interest in signing up as program extenders for nutrition lessons in their 1st-6th grade P.E classes. This new approach in partnering with P.E. Specialists, instead of focusing on classroom educators to deliver nutrition education, increased the program's overall reach and aided extenders in meeting their nutrition education standards for physical education. UCCE educators adapted the lessons using online learning technologies, incorporating physical activity into each lesson and interactive features such as collaboration boards, drawing, and polls to increase youth participation during each lesson. In addition to lessons, students received recipes and asynchronous assignments to complete. This innovative format allowed students to engage with one another and the material in a variety of ways.

The Impact

All three P.E Specialists expressed interest in continuing the partnership as extenders and felt the lessons were beneficial to their students. Two of the extenders reported the virtual UCCE lessons were easy to integrate into their class schedule and observed that students were actively engaged in the material and activities. Several additionalSMBSD P.E. Specialists expressed further interest in professional development around teaching nutrition curricula and have been provided access to a library of online resources and support from UCCE Educators.

Overall, this partnership resulted in reaching more than 1,000 students across two school sites with quality nutrition education using the Serving UpMyPlate and Up4It! curricula tailored to their grade level. As a result, 59% of 4th-6th grade youth surveyed (n=73) reported that when given a choice they will drink water and 45% reported that when given a choice they will try to engage in more physical activity.

According to the Physical Activity Guidelines for Americans (2018), regular moderate-to-vigorous physical activity reduces the risk of many chronic diseases among children and adults. These outcomes support UCANR's public value of promoting healthy people and communities.

 

“I have learned that in sports drinks, sodas, teas, and coffee that there is a lot of sugar and added sugar into the drinks. I have also learned that it is good to have some type of protein or dairy or anything that is on my plate when you eat.” – Rice Elementary Student (SMBSD)

References:

1.  Ed-Data: Education Data Partnership, Santa Maria-Bonita School District; Accessed on 15 June 2021, http://www.ed-data.org/district/Santa-Barbara/Santa-Maria--Bonita

2.   Wolfson JA, Leung CW. Food Insecurity and COVID-19: Disparities in Early Effects for US Adults. Nutrients. 2020; 12(6):1648. https://doi.org/10.3390/nu12061648

3.   Pérez-Rodrigo, C., & Aranceta, J. (2001). School-based nutrition education: Lessons learned and new perspectives. Public Health Nutrition, 4(1a), 131-139. doi:10.1079/PHN2000108

4.   Rivera, R. L., Maulding, M. K., & Eicher-Miller, H. A. Effect of Supplemental Nutrition Assistance Program–Education (SNAP-Ed) on food security and dietary outcomes, Nutrition Reviews, Volume 77, Issue 12, December 2019, Pages 903–921, https://doi.org/10.1093/nutrit/nuz013

After participating in UCCE's virtual Family Cook Night series, 60% of parents reported intention to not offer a treat as a reward for eating other foods and 80% would try new strategies for picky eaters, promoting healthy people and communities.

The Issue

The COVID-19 pandemic has impacted all aspects of life, including family, work, and education. The pandemic has exacerbated social inequalities, affected access to education for adults and youth and magnified food insecurity for children and families. Two US COVID-19 Impact Surveys indicated that 34.5% of households with a child ≤ 18 years old and 34.4% of households with children ≤ 12 years old were food insecure by end of April 2020. [2] 

How UC Delivers

As schools remained in distance learning, CalFresh Healthy Living, UCCE in Santa Barbara County worked closely with principals and partners at two elementary schools to find innovative ways to support the health of youth and families during these unprecedented times. Meeting virtually with partners and youth, UCCE educators realized a need for programming that involved the whole family.

UCCE educators hosted two 4-class series of evening classes via Zoom with school leadership to meet this need. Families signed up through their respective schools and got access to the virtual classrooms through school computers and district Zoom rooms. Using the Healthy, Happy Families curriculum, the families learned about topics that promote healthful behaviors. These included how to involve youth in cooking and meal preparation and using words instead of food to praise positive behavior. Families also learned basic nutrition, food safety, and the current USDA dietary guidelines. Throughout each lesson, UCCE educators encouraged families to include their children in the cooking process by demonstrating tasks appropriate for varying levels of child development.

UCCE educators continued to strengthen partnerships with Santa Barbara Food Bank (SBFB), extenders, youth, and families in Santa Barbara County. Families utilized resources available in their homes and supplemental materials provided by the SBFB and UCCE staff. Educators created dynamic lessons that provided families with the opportunity to openly share their experiences, thoughts, and welcomed participation from all family members, including fathers and male guardians. Participation from men in these classes promoted gender equality, an essential step towards addressing the double burden of unpaid caretaking work that disproportionately impacts the health and well-being of women. [4] 

 

The Impact

After attending the classes, adult participants shared that they changed their approach to feeding their children to promote healthful behaviors. Pre- and post-course survey (n=64) results indicated that the proportion of parents or guardians who would not offer a treat as a reward for eating other foods increased from 36% to 60%. Additionally, the proportion of parents or guardians who indicated that they would offer food to their child rejected more than once increased from 36% to 80%. Overall, the Family Cook Nights Series was impactful, educators and families practiced cooking healthy recipes, promoted gender equality, and changed feeding habits to encourage healthful behaviors.

According to Jensen (2020), “besides a direct relation with higher intake of unhealthy foods, frequent use of food as a reward may also increase the risk of being overweight through long-term effects on eating behavior”. [3] This intervention fostered healthy behaviors as part of the UC ANR's commitment to promoting healthy people and communities.

When asked about the class series, one school principal remarked: "Our families enjoyed it and had fun. Cooking is community building. We appreciate the thoughtfulness of the food bank and CalFresh." -Liberty Elementary School Principal

Sources:
1. Nalita James, Virginie Thériault. (2021) Reimagining community and belonging amid COVID-19. Studies in the Education of Adults 53:1, pages 1-3. https://doi.org/10.1080/02660830.2020.1811474
2. Bauer L. The COVID-19 crisis has already left too many children hungry in America. 2020. https://www.brookings.edu/blog/up-front/2020/05/06/the-covid-19-crisis-has-already-left-too-many-children-hungry-in-america/. Accessed June 18, 2021
3. Jansen PW, Derks IPM, Mou Y, et al.Associations of parents' use of food as reward with children's eating behaviour and BMI in a population-based cohort. Pediatric Obesity. 2020;15:e12662.https://doi.org/10.1111/ijpo.1266210 of 10 JANSEN ET AL.
4. Kate Power (2020) The COVID-19 pandemic has increased the care burden of women and families, Sustainability: Science, Practice and Policy, 16:1, 67-73, https://doi.org/10.1080/15487733.2020.1776561

 

75% of teen-teachers reported being physically active on 5 or more days while gaining confidence and leadership skills through innovative Healthy Choices in Motion programming in San Mateo County.

 

The Issue

Increasing physical activity in San Mateo County is vital, as 67% of SNAP-Ed-eligible adults and 23% of SNAP-Ed-eligible children ages 12-17 were overweight or obese in 2019. Additionally, there is a lack of leadership opportunities for teens especially for those in remote school districts in their county. 

How UC Delivers

CalFresh Healthy Living, University of California Cooperative Extension (CFHL, UCCE) in San Mateo County sought to address these issues with innovative teens-as-teachers programming in which older youth led younger youth in Coordinated Approach to Child Health (CATCH) activities as part of a summer school program. Once a week teens would facilitate approximately 30 minutes of structured physical activity (PA) games that build PA engagement and skills.

While this creative approach was a hit with school teachers and students, CFHL, UCCE looked to further improve the project by increasing their teen-teachers' self-confidence as leaders, as well as their PA knowledge. In response, the UC Davis Center for Nutrition in Schools (CNS) and CFHL, UCCE collaborated to pilot the addition of Healthy Choices in Motion (HCIM) to this innovative teens-as-teachers project in the summer of 2019.

Led by UCCE San Mateo educator Marisela Ceron, five HCIM lessons were taught to increase the teen-teachers' PA knowledge and the understanding of the overall importance of PA before leading CATCH activities for younger youth. HCIM is one of the curricula featured as part of the Shaping Healthy Choices Program, a multi-component, evidence-based intervention that is implemented across California in partnership with CFHL, UCCE. This curriculum features lessons about the benefits of PA, the five components of physical fitness, recommendations across the lifespan, and why a variety of PA is important.  

Through this novel programming, teen-teachers were able to gain teaching and leadership experience in their community, in addition to their own growth in the practice of PA and PA knowledge. To assess the success of the addition of HCIM to the existing CATCH teens-as-teachers program, PA knowledge questionnaires were administered before and after the HCIM lessons. Teen teacher surveys and a focus group were conducted near the project's end, after which teen teachers taught one additional CATCH acitivity lesson.The project spanned 1 month in Summer 2019.

The Impact

Overall, the teen-teachers increased their physical activity and felt that they gained confidence and leadership and life skills. Upon completion of the HCIM lessons, teens significantly increased their PA knowledge (pre = 11.65 ± 2.9; post = 14.70 ± 3.1; p = .001). When asked about their own physical activity engagement in the teen teacher survey, 41.7% of teens that participated in the project reported being physically active for more than 60 minutes 5 days the previous week and 33.3% reported being active all 7 days.

With ample opportunities to gain involvement in leadership and teaching during this project, students were also asked to rate their level of agreement on statements related to engagement and experiences in the program on a four-point Likert scale. Some noteworthy results were: I am more confident in helping others (83.3%) and in myself overall (83.3%), I gained skills through serving my community that will help me in the future (83.3%), I can apply knowledge in ways that solve "real life" problems through community service (75%).

A focus group with the teen-teachers showed common themes and testimonials of enjoyment working with younger students and being more physically active (Table 2). 

Being active in childhood is linked to being active as an adult, in addition to improving heart health, mood, sleep, and strengthening muscles and bones (2009 review, 2018 guidelines). In this way, CFHL, UCCE contributes to health for all and the public value of promoting healthy people and communities.