How to Make the Healthy Choice the Easy Choice Using Food Systems Practices

Transcription

1 How to Make the Healthy Choice the Easy Choice Using Food Systems Practices Linda Gobberdiel, MA RD LD, Food System Coordinator Eat Greater Des Moines October 22, 2014

2 The Food System The large systems that produce, process, distribute, make accessible and dispose of the food we eat. The systems and the food provided greatly influence our health, our economy, our environment, and fairness. Source: A. Tagtow and S. Roberts, Cultivating Resilience, 2011

3 Food System Sectors

4 Food System Connections

5 Food System Tiers Global National Regional Community Household

6

7 Impacts of Current Food System Human Health Economic Health Ecological Health Social Health

8 Goal in food system work: To support health from the farm to the food we put into our mouths.

9 Potential impacts of the food system on health Availability and choices Quality, quantity and safety of food supply Incidence of obesity, diabetes, heart disease and cancer along with increase in fast and convenient foods

10 Connection between food and health is now well documented and known Incorporating more fruits and vegetables is good Less processed, more fresh Knowing where and how our food is grown A food system to support this

11 Mission to identify, develop and connect resources with the broader community to support the entire food lifecycle in central Iowa.

12 Regional Food System Working Group (RFSWGs) Group comprised of geographically-based practitioners and community leaders with a goal to increase the investment in and support for local and regional food businesses in Iowa. Currently 15 local groups that participate and jointly manage this group.

13 How do we make the healthy choice, the easy choice ENGAGE consumers in growing and in choosing fresh and local Consumer demand drives market Make the healthy choice CONVENIENT

14 Growing - Gardening

15 Markets, CSAs, and Coops

16 Resources:

17 Access to fresh and healthy food for all.

18 Food System Connections State: Iowa Food Systems Council Leopold Center for Sustainable Agriculture Practical Farmers of Iowa

19 County: Polk, Dallas, and Marion Linda Gobberdiel, MA RD LD Eat Greater Des Moines

20 How to Make the Healthy Choice, the Easy Choice Using Food Systems Practices CAROL VOSS, MED, RD, LD IOWA DEPARTMENT OF PUBLIC HEALTH

21 Purpose Share policy, environment and system changes related to food systems that been infused into Department of Public Health programs. Share an example of evidence-based practice related to food systems.

22 Nutrition Environment Measures Survey NEMS-S, NEMS-R and NEMS-V Funded by the

23 NEMS tools are research tested, valid and reliable instruments: NEMS-S: Stores NEMS-R: Restaurants NEMS-V: Vending machines NEMS * was originally developed for research * can be used for community assessment, advocacy, and intervention

24 What does NEMS measure? Community and Consumer Nutrition Environments Community nutrition environments = Type & location of food outlets Accessibility (e.g., hours, drive-thru) Consumer nutrition environments = Availability of healthful food choices Pricing, promotion, placement Information availability

25 NEMS-Stores (NEMS-S) NEMS-S Measures: Availability o Of healthful choices Price o Healthy vs. less healthy o Grocery vs. convenience stores Quality o For fresh produce

26 Measures of the Nutrition Environment in Stores Core Categories of Foods Milk Ground Beef Baked Goods Fruits Hot Dogs Bread Vegetables Frozen Dinners Chips Soda Fruit Juice Cereal

27 NEMS-Restaurant (NEMS-R) Measures The Type of Restaurant: Sit-Down (SD) Restaurants - Offers table service with wait staff who take your order at the table. Fast-Casual (FC) Restaurants - Similar to fast food although generally has higher quality of food. Order and pay at the counter but food is often delivered to table. Fast-Food (FF) Restaurants - Minimal service and food is supplied quickly after ordering.

28 What Are We Measuring? Availability of healthy foods Entrees and main dish salads Side dishes Fruits Non-fried vegetables Baked chips Whole grain bread Children s menu options Beverages

29 What Are We Measuring? (cont d) Barriers to healthful eating All-you-can-eat Promotions Super-sized items Discouraging special requests Marketing Promotions/signs for healthful and/or unhealthful eating Facilitators to healthful eating Healthy entrée notations Offering reduced portions Pricing Are healthy foods more or less expensive than their unhealthy counterparts?

30 Measures of Nutrition Environments in Restaurants < Fast-Food & Sit-Down Restaurants > Sources of Information: Internet Menu Visit, observation Interview manager

31 Kid s Menu Review

32 Kid s Menu Review (cont d)

33 Simple Data Analysis Tools NEMS-S and NEMS-R scoring sheets NEMS-S and NEMS-R excel spreadsheets Sample graphs

34 Nutrition Environment Measures Survey Vending (NEMS-V)

35 Nutrition Environment Measures Survey Vending - NEMS-V Developed to assess workplace vending machines Originally based on the Institute of Medicine s Nutrition Standards for Foods in Schools with some modifications Criteria has been updated to match Health and Sustainability Guidelines for Federal Concessions and Vending Operations (2012). Intended to have an easy to use coding system: red, yellow and green Voss, C, Klein, S, Glanz, K, Clawson, M. Nutrition Environment Measures Survey Vending: Development, Dissemination, and Reliability. Health Promotion Practice : 425

36 NEMS-V Coding RED food and beverages are not as healthy and fall outside the Dietary Guidelines for Americans. YELLOW food and beverages are healthy foods that meet the Dietary Guidelines, may provide a serving of fruit, vegetable, low-fat dairy or whole grain but does not meet the strictest sodium guidelines. GREEN food and beverages are considered the healthiest, are consistent with the Dietary Guidelines for Americans, provide a serving of fruit, vegetable, low-fat dairy or whole grain and meet the strictest sodium guidelines.

37 NEMS-V Website Features NEMS-V Tools Tutorial: 15 minute online demonstration on how to complete a NEMS-V assessment NEMS-V Healthy Choices Calculator and phone applications: Used to determine green, yellow, or red colorcoding for food/beverage choices NEMS-V Healthy Choices Calculator Tutorial: 5 minute online demonstration on how to use the Healthy Choices Calculator

38 Message Selected Nearly 6 in 10 respondents thought message worked best to communicate the snack rating system clearly. Respondents liked that it illustrated examples of foods, which made the color coding system very clear. The main message was focused on encouraging people to choose better snacks at least some of the time. Many noted they had never seen vending machines with healthy options stocked in them.

39 Focus Group Findings White collar workers don't expect to find healthy choices in vending machines; they are more likely to pay attention to the nutrition facts; and they rationalize eating unhealthy snacks if they have eaten well or exercised that day. Blue collar workers focus on the enjoyment of eating a snack; not very likely to look at nutrition labels, however, are willing to change their eating habits if tasty, healthy choices are available Rest area visitors more likely to adopt an on the road mentality - let go of everyday healthy eating habits to have a treat / indulgence

40 Resources for Worksites, Rest Areas, Parks Worksite Promotional Signage (Blue Collar and White Collar) Table Tents Bathroom Signs Pledge Cards Snack Tracking Calendars Paystub Stuffers Messages Bi-monthly Newsletters - print-ready and editable

41 Resources (continued) Vending machine clings, signs, banners and floor clings Videos - worksite video (10 min.); vendor video (5 min.) NEMS-V Report Card and Certificate New beverage poster

42 Iowa Healthy Vending Initiative Ultimate Goal: Project will lead to having a policy in place for state facilities to provide a minimum of 25% of food and 50% of beverage choices in vending machines as healthy options (green or yellow) based on NEMS-V criteria Project will serve as a model for other businesses across the state.

43 Healthy Vending Implementation: 13 Worksites Model This model was used for establishing Healthy Vending Iowa as a practice-tested intervention Application The project coordinator must have attended The Healthy Iowa Worksites Conference Completed NEMS-V assessment in worksite with at least one beverage and one snack machine Signature of worksite CEO/vending machine decision maker

44 Healthy Vending Iowa Practice-Tested Intervention Intent Overview Health Equity Consideration Resources Required Implementation Evidence Summary Potential Public Health Impact Intervention Materials Training and Technical Assistance Evaluation Materials

45 Healthy Hispanic Retail Pilot in Muscatine County Complete pre-assessments; present assessment results and program options to retailers for feedback. Assist retailer with suggestions of healthy options to stock in support of the program elements that will be implemented. Provide program elements and technical assistance with implementing program. Conduct post assessment and assist retailer with determining next phase of implementation.

46 Iowa Community Transformation Grant (CTG) Active Living and Healthy Eating

47 NEMS-V Assessments and Healthy Vending Hancock - One worksite in Garner, Iowa, was able to begin the first steps in creating a healthier workplace by meeting their goal of offering 25 percent healthy options in all vending machines. Woodbury - The Siouxland District Health Department CTG program partnered with UnityPoint Health - St. Luke s and set a goal of 30 percent healthy options was set (baseline 11%), and after contacting their vending companies to increase healthy options, they surpassed their goal and were awarded a Bronze Site Award.

48 Black Hawk County CTG The Black Hawk County Board of Supervisors voluntarily passed a wellness policy. Black Hawk County shall promote and give preference in all countyowned facilities to the access of healthy food and beverages for employees and the public during the workday in a manner that makes the healthy choice the easy choice.

49 Live Healthy Lee County (LHLC) Reached out to several area restaurants to help assess their current menus and provide suggestions on how to market their existing healthy menu items to customers. Developed an LHLC logo to help indicate healthy foods on the menu; advertised the participating restaurants as places that provide healthy options on their website. Provided door signage that indicated the restaurant as a LHLC participant

50 Cerro Gordo CTG Developed a smart phone application that assists residents in locating local restaurants based upon their nutrition environment, location, or cuisine type. A few restaurants have voluntarily made their entrees healthier by switching ingredients or providing a new healthy entree. Nearly every restaurant in the county chose to participate in the app.

51 Convenience Stores - Van Buren County CTG program Completed NEMS-CS assessment Implemented Green Smart Choice Checkmark system indicate healthy options available in the store. agreed to post in-store signage on healthy options and will continue the Green Smart Choice Checkmark system on new healthy products that are added.

52 Woodbury County CTG 2 of 5 Sioux City swimming pools implemented healthy changes to their concession stands. Replacing regular chips with baked chips adding a granola bar and a cheese stick to the menu. They have also added a warm soft pretzel to the menu at the largest aquatic center. New menus, pricing strategies, creative naming, and larger font sizes are being used to grab the consumer s attention to the healthier options.

53 Iowa CTG Food System Assessment Examine a broad range of issues and assets from farm to fork. Create informed plans that ensure all Iowans have equal access to healthful food and clean water, and Iowa s food system supports human, environmental, social, and economic health.

54 Food System Project Process Tools and resources were developed to introduce food system assessment and planning processes to local public health agencies CTG counties completed a comprehensive food system assessment and identified at least one plan.

55 Leading Food System Priorities Sector Production Production Access & Consumption Access & Consumption Access & Consumption Access & Consumption Production Indicators Number of community gardens (public, private, faith) Number of school gardens Percentage of youth consuming less than 5 fruits and vegetables/day Percentage of food insecurity rate (child food insecurity) Percentage of adults consuming less than 5 fruits and vegetables/day Percentage of food insecurity rate (adult food insecurity) Number of acres harvested vegetables, potatoes, and melons

56 Leading Food System Priorities (cont.) Sector Waste Management Access & Consumption Access & Consumption Access & Consumption Access & Consumption Production Access & Consumption Indicators Percentage of total food waste Number of pounds or number of meals distributed by food pantries Percentage of farmer s markets accept SNAP EBT, WIC, CVV, WIC FMNP, Senior FMNP Number of food pantries or emergency food providers Percentage of redemption of food and nutrition assistance program benefits Number of acres in orchards Food deserts

57 Community Food System Plan Lee County Section 1 Food System Priority (indicator): Food System Sector(s): Food System Objective: Description of the Objective (why is it a priority): Number of People Reached: # pounds or # meals distributed by food pantries # food pantries or emergency providers Food desert Access & Consumption Improve the access of the food pantry location and system of how food is distributed. The Ft. Madison Food Pantry is currently located in the basement of a local church. Volunteers are needed to box the food for patrons because of the small space and stairs leading down to the pantry. They also don t have sufficient storage for cold or frozen foods. Their record keeping system needs to be updated as well to help with recording how much of food is being taken in and leaving the pantry people per month

58 Community Food System Plan Siouxland Sample of Implementation Action Plans Collaborate with the Blue Zones Community Policy group to change City policy that ensures community gardens and farmer s markets are allowable uses of the city property. Work with the farmers market and physician offices to create a mobile market that can be stationed at each office weekly. Work with the local food bank to provide information and fruit/veggies to students in the Back Pack program. Begin an educational program to teach gardening in the schools and churches.

59 Why Important? Positions counties to apply for future funding opportunities Food system elements and resources were integrated into the Community Healthy Needs Assessment & Health Improvement Plan (CHNA&HIP) materials. The two-part community food system assessment and planning documents were updated and will be made available to all local public health agencies as they prepare their CHNA&HIP

60 Resources NEMS Resources NEMS-S and NEMS-R - NEMS-V - CTG Resources Iowa Community Transformation Grant Newsletters Healthy Communities Magazine 14/index.html

61 Iowa Department of Public Health Carol Voss