What Clients Are Saying About Your Pantry

#CAUSINGCHANGEMFB

View Slide

How can food pantries successfully improve
their stocking and distribution of healthier
foods and beverages?
Bengucan Gunen – Candidate, Master of Science in Public Health
Bloomberg School of Public Health
Johns Hopkins University
[email protected]
Sally Yan – Candidate, Master of Science in Public Health
Bloomberg School of Public Health
Johns Hopkins University
[email protected]

View Slide

How can food pantries successfully
improve their stocking and
distribution of healthier foods and
beverages?
Bengucan Gunen, Sally Yan, Tim Regan, Joel Gittelsohn
September 21, 2018

View Slide

© 2014, Johns Hopkins University. All rights reserved.
©2018, Johns Hopkins University. All rights reserved.
Gap 1: Limited Healthy
Food/Beverage Access
• Baltimore residents in low-income neighborhoods
have high access to energy- dense foods, but limited
access to healthier foods and beverages (D’Angelo
2011)
• Large percentages of food pantry users did not
meet the recommendations for A, C, D, and B
vitamins, or iron, magnesium, and zinc (Simmet
2017)
• Inadequate intakes of fruits, vegetables, and
dairy
• Pantries have limited ability to offer fresh foods

View Slide

Freshplace
• Founded by Foodshare (FS), Chrysalis
Center (CC), Inc., and Junior League of
Hartford (JLH), Inc.
• Designed and evaluated by the
University of Connecticut
• Intervention: 1 pantry in Hartford, CT
• switched to client choice model
• monthly motivational interviewing with
project manager
• referrals to community services
• Comparison: 1 “traditional” food
pantry distributing pre-packed bags of
food in Hartford, CT
• Improved food security, self-sufficiency
• Increased fruit and vegetable
consumption by one serving per day

View Slide

Pilot Food Bank Intervention Featuring Diabetes-
Appropriate Food
• 1/3 of households that use food bank services have at
least one household member that had diabetes
• Provided diabetic food pantry users with diabetes-
appropriate food at 32 pantries in TX, CA, and OH
• Box consisting of whole grains, lean meats, beans, low-sodium
vegetables, no sugar added fruit, and shelf-stable dairy products
• Additional fresh produce, milk, yogurt, cheese, bread, and frozen
lean meat
• Improvements in pre-post analyses of:
• Hemoglobin A1c (decreased from 8.11 percent to 7.96 percent)
• Fruit and vegetable intake (which increased from 2.8 to 3.1
servings/day)
• Self-efficacy
• Medication adherence

View Slide

SuperShelf
• Multi-component approach to increase
the availability and uptake of healthy
options at food pantries in MN
• Transform participating food pantries
(n=8 transformation; n=8 control):
• Creating an appealing, dignified
experience for clients
• Highlighting healthy options
• Collect pantry- and client-level data
• FAST to assess healthfulness of
foods/beverages at food pantry
• Client surveys on diet, health
outcomes
• For more details, visit supershelfmn.org

View Slide

Gap 2: Need for Reliable Assessment Tool
for Food Bank/Pantry Food Quality
• Foods to Encourage (F2E)
• Binary
• F2E percentage: [ Foods to encourage / total food ] * 100
• Detailed Foods to Encourage
• Based on F2E, but excludes processed products high in
sodium, total sugar, saturated fat, trans fat
• Choosing Healthy Options Program (CHOP)
• Created by Greater Pittsburgh Community Food Bank
• A ranking tool to assess nutrition of specific food products
• Stoplight system
• Takes into account calories, saturated fat, fiber, protein, vitamins
A and C, calcium, and iron

View Slide

Baltimore City Food Pantries
From a previous trial (B’more
Healthy Communities for Kids):
• 40% of residents in low-income
neighborhoods are food insecure
• 15% of a sample of low-income
households used food pantry in last
month
Maryland Food Bank supplies
food to 225 partners in Baltimore
City
Food pantries are commonly
located in schools, churches,
community organizations
Some food pantries offer
additional services (job training;
referrals to other programs)

View Slide

Progress/Funding for Studying Baltimore
City’s Food Pantries
1. BAHI Seed Grant on Obesity and the Food System: Formative
research in 15 medium and large food pantries
2. UHI Student-Community Small Grant Awards: Formative
research in 7 small food pantries
3. Lerner Center Community Scholars Grant: Pilot Trial to Test
the Feasibility of Interventions to Improve Healthy Food
Access in Baltimore City Food Pantries

View Slide

Formative Research

View Slide

Specific Aims of Formative Research in Food
Pantries
1. To conduct formative research on the role of food pantries
in Baltimore City's food environment and on pantry
operations
2. To develop and pilot a food pantry data collection
instrument (Food Pantry Environmental Checklist, FPEC)
3. To assess the variability of healthy foods and beverages
offered at food pantries

View Slide

Formative Research Methods
• 22 food pantries (annual distribution)
• 7 small (<10,000)
• 10 medium (>=10,000 to <25,000)
• 5 large (>=25,000)
• In-depth interviews with food pantry managers (n=23)
• Direct observations of food pantry settings (n=23)
• 3 repeated FPEC visits, approx. 1 month apart (n=22)

View Slide

FPEC Data Collection
Table 1. Food Pantry Distribution Methods
Small
(n=7)
Medium
(n=10)
Large
(n=5)
Distributes pre-packed
bags, %
71 80 60
Follows the client choice
model, %
71 40 40
Fills bags per client
requests, %
14 50 60

View Slide

Table 2. Food Pantry Guidelines for Food Procurement,
Distribution and Policy Changes
Small
(n=7)
Mediu
m
(n=10)
Large
(n=5)
Gives suggestions on cooking, % 100 60 60
Escorts clients into the food pantry, % 71 50 40
Makes changes to orders based on client
feedback, %
57 50 60
Encourages clients to pick up items, % 43 70 80
Has a limit on how often a client can pick
up food, %
43 40 100
Requires permission from
board/supervisor to implement changes,
%
43 40 60
Allows clients to swap out items from
bags, %
29 70 40

View Slide

Header/Full Bleed Image
Name/Subject Subhead
Title/caption
Title/caption
0.0
0.5
1.0
1.5
2.0
2.5
3.0
FPEC1 FPEC2 FPEC3
Average Nutrition Education Materials Score*
Small
(n=7)
Medium
(n=10)
Large
(n=5)
* Maximum score is 3; food pantries receive 1 point each for the availability of shelf labels, posters, and flyers.
Availability of Nutrition Education Materials in Baltimore City Food
Pantries

View Slide

Title/caption
Title/caption
0
50
100
150
200
250
300
350
Average Number of Clients Served
in Last 2 Weeks
Small
(n=7)
Medium
(n=10)
Large
(n=5)
FPEC 2 FPEC 3
FPEC 1
Client Volume in Baltimore City Food Pantries

View Slide

Title/caption
Title/caption
0
100
200
300
400
500
600
700
FPEC1 FPEC2 FPEC3
Average Number of Estimated Volunteer
Hours in Last 2 Weeks
Small
(n=7)
Medium
(n=10)
Large
(n=5)
Volunteer Hours at Baltimore City Food Pantries

View Slide

Title/caption
Title/caption
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
FPEC1 FPEC2 FPEC3
Average Lean Meat Availability Score*
Small
(n=7)
Medium
(n=10)
Large
(n=5)
*Maximum score is 5; food pantries receive 1 point each for the availability of unseasoned fresh/frozen chicken
breast, unseasoned fresh/frozen turkey, >85% lean fresh/frozen ground beef, canned chicken in water, and canned
fish in water.
Availability of Canned and Fresh Lean Meats in Baltimore City Food
Pantries

View Slide

Title/caption
Title/caption
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
FPEC1 FPEC2 FPEC3
Average Produce Availability Score*
Small
(n=7)
Medium
(n=10)
Large
(n=5)
*Maximum score is 4; food pantries receive 1 point each for the availability of unseasoned frozen vegetables,
unsweetened frozen fruits, fresh vegetables, and fresh fruits.
Availability of Fresh and Frozen Fruit/Veg in Baltimore City Food
Pantries

View Slide

Title/caption
Title/caption
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
FPEC1 FPEC2 FPEC3
Average Whole Grain Availability Score*
Small
(n=7)
Medium
(n=10)
Large
(n=5)
*Maximum score is 4; food pantries receive 1 point each for the availability of brown rice, 100% whole wheat pasta,
100% whole wheat bread, and plain oatmeal
Availability of Whole Grains in Baltimore City Food Pantries

View Slide

Title/caption
Title/caption
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
FPEC1 FPEC2 FPEC3
Average Low-Sugar Drink Availability Score*
Small
(n=7)
Medium
(n=10)
Large
(n=5)
*Maximum score is 5; food pantries receive 1 point each for the availability of diet soda, diet sports drinks,
unsweetened tea/iced tea, water or sparkling water, and 100% fruit juice.
Availability of Low-Sugar Drinks in Baltimore City Food Pantries

View Slide

Summary: Opportunities for Intervention
• Food availability: No pantry had much variety of healthy
options
• Small pantries were less likely than medium or large to have low-
sodium canned items, lean meats, and fresh/frozen fruits and
vegetables
• Infrastructure: Small pantries were less likely than
medium or large pantries to have refrigerators
• Client support: Small pantries were more likely than
medium or large to have staff/volunteers escort clients
through the pantry and give suggestions on how to
prepare foods

View Slide

Title/caption
Title/caption
Food Bank Food Pantry Household Individual
Food Availability
Food Pricing
Grants for
Network Member
Capacity
Manager Training
Resources
Food Pantry
Policy
Manager Skills
Point of Selection
Promotion
Education
Annual Income
Sociodemographic
Food Security
Food Selection
Foodways
Food Preparation
Psychosocial Factors
Knowledge
Self-efficacy
Intentions
Food Taste
Outcome
Reduced intake of:
SSB and high-fat foods
Increased intake of:
Fruits, vegetables, lean
proteins, whole grains
Food Consumption
Conceptual Framework for Food Bank and Food Pantry
Operations
Proposed Intervention Framework

View Slide

Next Steps: Feasibility Trial

View Slide

Feasibility Trial: Fresh Shelves, Healthy
Pantries
• Multilevel Intervention Plan
• 6 food pantries: 1 intervention and 1
comparison from each size category (i.e. small,
medium, large)
• 3 phases, each focusing on a different food
group
• Testing out a combination of manager training,
educational/environmental strategies, and
pantry-level policy within each phase

View Slide

Title/caption
Title/caption
Intervention Plan for Fresh Shelves, Healthy Pantries
Intervention
Phase (Focus)
Food Pantry Staff Capacity
Building (In-person training)
Educational/
Environmental
Strategies
Policy
1: Lean, Low-
Sodium
Proteins
Video
Posters; Healthy
options at eye level
Minimum requirements
2: Fresh,
Frozen and
Canned
Produce
Educational display
Recipe cards; Healthy
options at entrance
Minimum requirements
3: Healthy
Carbohydrates
Booklet Shelf labels; Posters
Limits to stocking less
healthy options
Funded by the Community Scholars Grant awarded by the Lerner Center for Health Communication and
Promotion

View Slide

Title/caption
Title/caption
Months 1-2
Jul-Aug 2018
Project Start
- IRB Approval
- Recruitment
Months 3-4
Sep-Oct 2018
- Material Development
- Baseline Data Collection
Months 5-6
Nov-Dec 2018
Phase 1: Lean & Low-
Sodium Proteins
Months 7-8
Jan-Feb 2019
Phase 2: Fruits &
Vegetables
Months 9-10
Mar-Apr 2019
Phase 3: Healthy
Carbohydrates
Month 11
May 2019
Post-Intervention
Data Collection
Month 12
June 2019
- Analysis
- Manuscript and
Deliverable Preparation

View Slide

Fresh Shelves, Healthy Pantries Evaluation
Approaches
• Client bag audits, at baseline and at project
completion
– 10 clients from each food pantry
– Contents of client bags, sociodemographic characteristics,
exposure to intervention at project completion
• Food Assortment Scoring Tool (FAST) to see the weight of foods in
each food group and calculate a healthfulness score for bags

View Slide

Evaluation Approaches cont.
• Modified FPEC, at baseline and end of each phase
– Availability of promoted and de-promoted options; changes in
food pantry guidelines
• In-depth interviews with food pantry managers at project completion
– Feedback on intervention materials and new policies

View Slide

Questions?
Thank You!
Tim Regan
[email protected]
Bengucan Gunen
[email protected]
Joel Gittelsohn
[email protected]
Sally Yan
[email protected]
www.healthyfoodsystems.net

View Slide

#CAUSINGCHANGEMFB

View Slide

What Clients Are Saying About Your Pantry

What Clients Are Saying About Your Pantry

Maryland Food Bank

More Decks by Maryland Food Bank

Featured

Transcript