Approaches for Implementing Healthy Food Interventions in Settings With Limited Resources: A Case Study of Sodium Reduction Interventions in Emergency Food Programs Addressing Food Insecurity

Purpose This study describes how recipients of the Centers for Disease Control and Prevention funded Sodium Reduction in Communities Program (SRCP) worked with emergency food programs to improve access to healthy food to address chronic conditions. Design SRCP recipients partnered with emergency food programs to implement sodium reduction strategies including nutrition standards, procurement practices, environmental strategies, and behavioral economics approaches. Setting SRCP recipients and emergency food programs in Washington County and Benton County, Arkansas and King County, Washington. Subjects SRCP recipient staff, emergency food program staff, and key stakeholders. Measures We conducted semi-structured interviews with key stakeholders and systematic review of program documents. Analysis Data were analyzed using effects matrices for each recipient. Matrices were organized using select implementation science constructs and compared in a cross-case analysis. Results Despite limited resources, emergency food programs can implement sodium reduction interventions which may provide greater access to healthy foods and lead to reductions in health disparities. Emergency food programs successfully implemented sodium reduction interventions by building on the external and internal settings; selecting strategies that align with existing processes; implementing change incrementally and engaging staff, volunteers, and clients; and sustaining changes. Conclusion Findings contribute to understanding the ways in which emergency food programs and other organizations with limited resources have implemented public health nutrition interventions addressing food insecurity and improving access to healthy foods. These strategies may be transferable to other settings with limited resources.

Neighborhood Food Environment Associated with Cardiometabolic Health among Predominately Low-income, Urban, Black Women

Objectives: This study sought to: 1) under­stand how the perceived food environment (availability, accessibility, and affordability) is associated with cardiometabolic health outcomes in predominately low-income Black residents in urban neighborhoods with limited healthy food access; and 2) examine the association of shopping at specific store types with cardiometabolic health outcomes.Methods: We report on cross-sectional data from 459 individuals participating in the Pittsburgh, PA Hill/Homewood Research on Neighborhoods and Health (PHRESH) study. Mean participant age was 60.7 (SD=13.9); 81.7% were female. We used logistic regression to examine associations between three factors (perceived fruit and vegetable availability, quality, and price; primary food shopping store characteristics; and frequency of shopping at stores with low or high access to healthy foods) and cardiometabolic and self-rated health.Results: Adjusting for sociodemographic characteristics, participants with higher perceived fruit and vegetable accessibility (AOR:.47, 95%CI: .28-.79, P=.004) and affordability (AOR:.59, 95%CI: .36-.96, P=.034) had lower odds of high blood pres­sure. Shopping often (vs rarely) at stores with low access to healthy foods was associated with higher odds of high total cholesterol (AOR:3.52, 95%CI: 1.09-11.40, P=.035). Finally, primary food shopping at a discount grocery (vs full-service supermarket) was as­sociated with lower odds of overweight/obe­sity (AOR:.51, 95%CI: .26-.99, P=.049).Conclusions: These results suggest that both perceived accessibility and affordability of healthy foods are associated with reduced cardiometabolic risk factors in this urban, low-income predominantly Black population. Additionally, discount grocery stores may be particularly valuable by providing access and affordability of healthy foods in this population. Ethn Dis. 2021;31(4):537-546; doi:10.18865/ed.31.4.537

Setting the table, not running it: An inclusive approach to access to healthy foods

Food Empowerment Project (F.E.P.) is a vegan food justice nonprofit in northern California. We focus on making a more just and sustainable food system for everyone involved. Since injustice in the food system crosses the species barrier, we work to connect the dots between the exploitation of human and nonhuman animals. We focus our efforts on four main areas: ending the use of animals in the food system, improving access to healthy foods in Black, Brown, and low-income communities, exposing the worst forms of child labor (including slavery) in the chocolate industry, and advocating for farmworker rights. These seemingly disparate areas have much in common: they are interlocking forms of oppres­sion, marginalization, and domination in the food system. We recognize that the intersecting nature of oppression necessitates a nuanced response. For example, as an organization working on both farm­worker justice and food apartheid, we cannot advocate for lowering the price of food as this would negatively impact produce workers who already suffer grave systemic injustice. Instead, we advocate for equality of access and living wages for everyone.[1] In this piece, we focus on our approach to the lack of access to healthy foods, and specifically our community-based efforts in Vallejo, California.

Quarantine and COVID-19

The COVID-19 pandemic which have affected every part of the world have been deemed a public health concern and classified as a pandemic. The government imposing travel bans and quarantine measures have been found to be effective in preventing and reducing the spread of COVID-19. A reduction in physical activity and increase in the consumption of unhealthy foods have been observed to be some of the major implications of quarantine. Adequate physical activity and increased access to healthy foods would help in improving the psychological wellbeing of individuals thereby preventing the development of cardiovascular diseases.

Tracking Double-up Food Bucks (DUFB) Program Use Among Supplemental Nutrition Assistant Program (SNAP) Recipients and the Implications for Healthy Food Access

Acceptance of SNAP benefits has increased in farmers’ markets (FM) over the years. However, getting SNAP recipients to take up the opportunity of extra dollars for healthy food options remains a challenge. Thus, we tracked the use of the Double-up Food Buck (DUFB) program among SNAP recipients who visit participating FMs in Utah to understand the unique characteristics of the program users. Our results identified varying types of program users (multiple and single market shoppers, more frequent and less frequent shoppers). While our findings indicate a higher DUFB transaction in token value among frequent users, larger markets are more likely to have higher DUFB transactions with a higher number of market visits compared to smaller ones. In conclusion, while all types of users may add to the total revenue generated by participating FM, additional initiatives are required to encourage frequent visits and uptake of the program for better access to healthy foods.

Understanding Access to Healthy Foods and Grocery Shopping Patterns Among Community Residents in Underserved Neighborhoods in Tampa, Florida

Objectives It is widely accepted that low-income and racial/ethnic minority neighborhoods are disproportionately affected by diet-related adverse health outcomes. Access to healthy foods has also been shown to be a determinant of more optimal dietary intake and health. This study aimed to conduct a survey to examine grocery shopping patterns and food access among community residents in underserved neighborhoods; the study was conducted in partnership with community organizations. Methods A survey was administered cross-sectionally. Twenty-seven questions adapted from previous research regarding grocery shopping patterns and food access were included. Community residents aged ≥18 years in East Tampa, a designated Florida Community Redevelopment Area (CRA), were recruited at community events/meetings, and an online version of the survey was distributed through the email listserv of community partners. A total of 126 residents participated; the majority was African American, female, and ≥35 years of age. Descriptive statistics were used for data analysis. GIS mapping was subsequently used to examine the residents’ accessibility to grocery stores within the neighborhoods. Results The majority (58%) of the participants reported that they usually buy most of their groceries at supermarkets, followed by large chain stores (41%), farmers markets (11%), and discount stores (10%). There were 4 major stores in the neighborhoods identified as preferred grocery stores. Most participants indicated that they use cash (52%) or EBT card (30%) for grocery shopping, and 33% regularly get food from food pantries. Most residents use their own cars (76%) for transportation and indicated that it takes ≤30 minutes (87%) to get their groceries. Ninety participants (71%) indicated that a new supermarket nearby would help them get food easier, followed by a new farmers market. In an open-ended question, some reported that mobile food trucks or delivery services would make it easier to get the foods. A specific location for a new supermarket was identified by each participant. Conclusions Community residents demanded a new supermarket or farmers market with better variety of fresh produce. The results of this study have been discussed with the community partners and the CRA advisory committee. Funding Sources University of South Florida, College of Public Health Internal Faculty Awards.