Section B. Goals, Objectives, Projects, Campaigns, Evaluation, and ...

FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration Section B. Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration Overview: During FFY2013, OSU convened and supported 10 SNAP-Ed workgroups, each with a focus on reviewing best practices for working with different audiences (e.g. developmental, literacy, and culturally-appropriate strategies); conducting a brief statewide needs assessment with staff to identify gaps in educational materials; and reviewing and selecting curricula and supplementary materials. These workgroups were highly productive, yielding evidence-based and evidence-informed individual and group nutrition education and other health promotion intervention strategies for incorporation into our proposed FFY2014 Plan. In addition, OSU took the following steps to prepare a Plan that shifts the collective focus toward more comprehensive, public health approaches: • Working hand-in-hand with the Oregon Department of Human Services (DHS)

developing strategies to assist SNAP eligible audiences, and collaborating on other funded grant and contract programs to increase SNAP participation and promote SNAP-Ed healthy eating and obesity prevention strategies. One example is that an OSU faculty member is serving on the Search Committee for the DHS program analyst positions that will assist with the SNAP-Ed program in Oregon.

• Convening roundtable discussions among workgroups to begin incorporation of strategies and interventions that utilize comprehensive, multi-level and community approaches to improve nutrition and physical activity among SNAP recipients and SNAP-eligibles.

• Meeting with statewide partners (e.g. Child Nutrition Programs, Oregon Food Bank,

WIC, and Nutrition Council of Oregon) to obtain strategic input and identify opportunities for collaboration.

• Seeking internal (OSU) and external (partner) opportunities to leverage innovative

strategies and assessment tools that might be applied to SNAP-Ed in Oregon.

• Conducting a 2-day strategic planning session with OSU SNAP-Ed administrators, county-based faculty, a core evaluation team, and DHS SNAP administrative partners, resulting in development of a comprehensive plan for Oregon’s SNAP-Ed goals, objectives and indicators. That plan was subsequently aligned with the Western Region SNAP-Ed Nutrition, Physical Activity, and Obesity Prevention Outcomes Evaluation Framework (June, 2013).

OSU SNAP-Ed Units (a Unit is a county or grouping of counties) have sought and incorporated local and regional partner input based on relationships and resource-sharing to generate their strategic plans. OSU utilized an electronic survey tool to allow individual county units to opt into OSU’s proposed 2014 Projects. Data were compiled statewide to demonstrate momentum and anticipated state-wide progress and impact. Units are required to participate in each of the 3 proposed Projects.

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration OSU’s proposal reflects data-driven input and highly collaborative approaches, and contains a strategic progression of activities and anticipated impacts. OSU will focus on developing staff competencies around multi-level/comprehensive and public health approaches this year, with an expectation that Oregon’s program activities and resources will be devoted to a greater extent to these types of approaches than in previous years, resulting in greater and more sustainable impact. In summary, Oregon SNAP-Ed will:

• Reach adults and youth through multiple channels using the social-ecological model;

• Deliver messages multiple times through class series, social marketing and public events;

• Continually refine the program, based on participant feedback, evaluation data, and agency input;

• Select and utilize curricula and materials that are evidence-based and/or informed, behaviorally-focused, learner-centered and hands-on;

• Train faculty, staff and volunteers in effective program delivery and evaluation; • Maintain close linkages with state and community partners.

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration 1. State-Level Goals and Objectives Notes: (a) The codes that follow the Key Impact Indicators correspond to the short-term (ST), medium-term (MT), and long-term (LT) outcomes identified in the Western Region SNAP-Ed Outcomes Evaluation Framework (June 2013). (b) The three objectives listed under Goal 1 are framed in terms of targeted change in the mean score, calculated for all participants, on outcomes from baseline to post-program. We have chosen that approach over the approach used more often in SNAP-Ed programs, which is to describe the desired change in terms of the percentage of the participant group who improve their scores from pre to post. We believe that our selected approach is the more sound option from a measurement perspective, because mean score change, unlike group proportion measurement, (i) incorporates change from all of the participants, rather than only counting those who improved, and (ii) is impacted by the extent of the change, whether positive or negative. Therefore it is a more complete summary description of the measured sample. (c) For the three objectives under Goal 1, we have selected a target improvement level of 10% over baseline, which is consistent with the target levels identified by the federal government for nutrition and physical activity objectives in Healthy People 2020 http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=29.

GOAL 1: Persons and families eligible for SNAP will consume a healthy diet within a limited budget, and balance energy intake with energy expended through physical activity.

Objective 1(a): Consumption of fruits and vegetables. The adults and children who participate in a SNAP-Ed class series will increase their consumption of fruits and vegetables by 10%, on average, from baseline levels at the start of their classes. Key Impact Indicators:

• Frequency of planning meals and snacks that include (a) fruits and (b) vegetables

• Frequency of preparing meals and snacks that include (a) fruits and (b) vegetables

• Consumption of fruits in meals and snacks [MT1-iid; LT2-a] • Consumption of vegetables in meals and snacks [MT1-iie; LT2-b]

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http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=29

FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration Objective 1(b): Physical activity and calorie balance. The adults and children who participate in a SNAP-Ed class series will increase their levels of physical activity, reduce levels of sedentary behavior, and/or increase their utilization of recommended strategies for achieving calorie balance (for examples, see below under Indicators), by 10%, on average, from baseline levels at the start of their classes. Key Impact Indicators:

• Time spent in moderate to vigorous physical activity [MT3-ii; LT7] • Time spent in screen time and other sedentary behaviors [MT3-I; LT8] • Extent of utilization of strategies for achieving calorie balance, such as:

o Participants’ estimation of their calorie needs, based on individualized factors such as age, gender, and physical activity level

o Participants’ monitoring of their dietary intake [LT1] o Participants’ reading of food labels for calorie information when shopping

[ST2-b; MT2-b] o Participants’ replacement of high-calorie foods and beverages with nutrient-

dense foods and beverages [LT5]

Objective 1(c): Food security and the promotion of a predictable supply of healthy foods. The adults who participate in a SNAP-Ed class series will increase their utilization of recommended food resource management strategies by 10%, on average, from baseline levels at the start of their classes. Key Impact Indicators:

• Frequency of planning meals • Frequency of comparing prices when shopping • Frequency of using a grocery list when shopping [ST2-a; MT2-a] • Frequency of cooking and preparing foods at home

GOAL 2: SNAP-Ed programs will create partnerships with other organizations and institutions to create opportunities for community-level changes that can improve the dietary quality and physical activity levels of individuals and families.

Objective 2(a): Community-level change. SNAP-Ed Program units will conduct activities or programs (consistent with SNAP-Ed guidelines) that result in changes to the social or physical environment, including schools, organizations, communities, etc. These environmental changes will encourage improvements in dietary quality and/or physical activity levels in SNAP-eligible audiences.

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration Key Impact Indicators:

• Number of community-level organizations, institutions, or businesses that have made changes in practices or capacities to promote healthy food choices. Examples may include acceptance of EBT cards by farmers’ markets, increases in availability of produce in retail outlets, etc. [MT4; LT9]

• Number of school sites that have made changes in policies or capacities to promote healthy food choices and/or increased physical activity. Examples may include more time allocated in the school day for physical activity, introduction of school gardens, upgrading of outside facilities to encourage physical activity, the development and adoption of nutrition standards consistent with USDA Dietary Guidelines for snacks sold in afterschool clubs, centers, etc. [MT4; MT5; LT9; LT11]

• Number of community sites that have improved access or infrastructure to promote physical activity, generally as the result of joint community efforts. Examples may include access to safe walking or bicycle trails, improved hours of operation of recreational facilities, etc. [MT5; LT11]

Objective 2(b): Organizational collaboration. All SNAP-Ed Program units will collaborate with partner organizations on joint efforts aimed at improving dietary quality and/or increasing physical activity. Key Impact Indicators:

• Units’ participation in policy-focused committees and coalitions, such as school wellness committees, community food councils, chronic disease task forces, etc. [ST6]

• Units’ collaboration with other organizations to conduct assessments of community and/or school environments, with regard to promotion of healthful eating and physical activity. [ST6]

• Units’ participation in partnerships or coalitions to implement community interventions and/or other initiatives; examples may include adoption of the Food Hero campaign, working with farmers’ markets to adopt EBT cards, working with retail outlets to provide point-of-purchase prompts for healthy food choices, etc. [ST6]

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration 2. Descriptions of Projects & Interventions Project A – Individual and group-based nutrition and physical activity education.

a. Related State Objectives

Objective 1(a): Consumption of fruits and vegetables. The adults and children who participate in a SNAP-Ed class series will increase their consumption of fruits and vegetables by 10%, on average, from baseline levels at the start of their classes. Objective 1(b): Physical activity and calorie balance. The adults and children who participate in a SNAP-Ed class series will increase their levels of physical activity, reduce levels of sedentary behavior, and/or increase their utilization of recommended strategies for achieving calorie balance (for examples, see below under Indicators), by 10%, on average, from baseline levels at the start of their classes. Objective 1(c): Food security and the promotion of a predictable supply of healthy foods. The adults who participate in a SNAP-Ed class series will increase their utilization of recommended food resource management strategies by 10%, on average, from baseline levels at the start of their classes.

b. Audiences. Children, youth, adults and families.

c. Focus on SNAP Target Audience. SNAP Eligible sites will be targeted. Audiences

for Project A include pre-K-high school, pregnant/parenting teens, families (adults with youth participating, including English language-learners), and adults by themselves.

d. Project Description. Interventions associated with this project will take place in

settings where children, youth, adults and families live, learn and play: K-12, Head Start and other pre-K/childcare settings, summer meal sites and camps, before/after school and after-care sites, family housing units and shelters, food pantries, libraries, faith-based centers, and other sites. Interventions will include:

• Series of classes with evidence-based curriculum/activities (Curricula Scope

and Sequence, Appendix A) – for all youth age-groups, mixed ages, and families (adults with and without youth participating).

• Indirect youth: posters, displays and bulletin boards. • Public events – youth and families: parent nights, health fairs, and other

health promotion events. • Train-the-trainer: training and monitoring volunteers and school and/or

community extenders to expand our direct and indirect reach, including parents, Teens as Teachers (OSU SNAP-Ed Assessment Tools, appendix B),

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration

librarians, teachers, principals, school health nurses, and pre-K care providers.

1) Statewide summary of Project A audiences and strategies.

Youth age groups that will be reached:

Audience Number of counties

conducting series of classes

Number of counties conducting indirect education

Pre-K 9 (25%) 8 (22%) Kindergarten 21 (58%) 20 (56%) 1st grade 26 (72%) 25 (69%) 2nd grade 31 (86%) 29 (81%) 3rd grade 31 (86%) 28 (78%) 4th grade 30 (83%) 27 (75%) 5th grade 31 (86%) 27 (75%) 6th grade 20 (55%) 16 (44%) 7th grade 13 (36%) 12 (33%) 8th grade 11 (31%) 10 (28%) 9th grade 7 (19%) 7 (19%) 10th grade 7 (19%) 7 (19%) 11th grade 7 (19%) 6 (17%) 12th grade 7 (19%) 6 (17%) Mixed ages –after school 13 (36%) 11 (31%) Mixed ages – summer 25 (69%) 18 (50%)

Additional strategies planned for expanding reach to youth in the

school environment:

Type of strategy Number of counties utilizing strategy

School staff provide reinforcements for desired behavior 21 (58%) Verbal school announcements via intercom 20 (55%) School teachers and other staff extend lessons 18 (50%) Trained Extension volunteers assist with youth lessons 13 (36%) Trained Extension teen volunteers assist with lessons for younger kids

5 (14%)

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Areas of the school environment (in addition to teaching a series of classes in the classroom) where youth will be reached:

Area Number of counties Family night 32 (89%) Parent night 31 (86%) School hallways (posters, murals, etc.) 29 (81%) Visual cues throughout school 27 (75%) School newsletters 25 (69%) School Lunch Program 21 (58%) Gym/PE 19 (53%) After school programs or clubs 17 (47%) School Breakfast Program 16 (44%) School playground 16 (44%) School office 15 (42%) School garden 13 (36%) Library 12 (33%) School food pantry/backpack program 11 (31%) School website 9 (25%) Fresh Fruit and Veggie Snack Program 7 (19%) School performance 5 (14%) Computer labs 4 (11%) Music classes 4 (11%) Art classes 3 (8%) School lockers 3 (8%) Nurses office 2 (6%) Homeless student education center 1 (3%) School vending machine 1 (3%)

Others that will support healthy eating and active living messages

within the school environment (in addition to a series of classes in the classroom):

Others supporting messaging in school environment

Number of counties utilizing this strategy

Teachers 34 (94%) Principal/vice principal 32 (89%) Instructional assistants 31 (86%) School office personnel 29 (81%) Parents/caregivers 27 (75%) School meal personnel 18 (50%) Wellness committees 16 (44%) After school program coordinators 15 (42%) School parent volunteers 15 (42%)

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Others supporting messaging in school environment

Number of counties utilizing this strategy

School backpack program coordinators 12 (33%) Librarian 12 (33%) Janitor 10 (28%) Grocery personnel in school neighborhood 10 (28%) School nurses 9 (25%) School club leaders 6 (17%) School counselors 6 (17%) School Snack Program coordinator 6 (17%) Community school outreach coordinator 6 (17%) Family liaisons 6 (17%) Church personnel in school neighborhood 4 (11%) Child care providers in school neighborhood 1 (3%) Farm-to-School farmers 1 (3%) Police resource officers 1 (3%) Migrant parent group 1 (3%)

Non-school sites in which youth reached in school will also be targeted:

Site Number of counties

targeting at site Summer Meal Programs 14 (39%) Community gardens 11 (31%) Public housing 10 (28%) 4-H groups 8 (22%) Camps 7 (19%) Community centers 7 (19%) Parks and recreation centers 7 (19%) Boys and girls clubs 7 (19%) Transitional housing shelters 6 (17%) Church 4 (11%) Tribal centers 3 (8%) OSU Extension office 1 (3%)

Strategies that will be used to reach parents of youth:

Type of strategy Number of

counties utilizing strategy

Recipes sent home 36 (100%) Newsletters 35 (97%)

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Type of strategy Number of counties utilizing strategy

Staffed demo table at parent night or conference 33 (92%) Staff teach nutrition classes to parents at school sites 24 (67%) Recruit parents at school events for series of adult or family classes

18 (50%)

Work with school personnel (e.g. counselors, principal) to recruit parents for series of adult or family classes

18 (50%)

Unstaffed display at parent night or conference 17 (47%) Work with parents involved in parent, teacher, and/or student associations

17 (47%)

Youth events to engage parents (e.g. “Iron Chef” competition) 13 (36%) Trained Extension volunteers assist in teaching nutrition classes to parents

10 (28%)

Staff display before/after school to recruit parents for series of classes

8 (22%)

Parents recruited/trained for Extension volunteer role (e.g. assist with recruiting participants, organizing/teaching classes)

4 (11%)

Conduct classes for parents at school-based health center 1 (3%) Adults and family audiences that will be reached:

Type of program Type of audience Number of counties

reaching audience Indirect Adults – all ages:

Adults – disabled Pregnant/parenting teens Adults with youth participating

31 7 4

32

(86%) (19%) (11%) (89%)

Direct – single classes

Adults – all ages: Adults – disabled Pregnant/parenting teens Adults with youth participating

25 4 3

17

(69%) (11%) (8%)

(47%) Direct – series Adults – all ages:

Adults – disabled Pregnant/parenting teens Adults with youth participating

19 7 8

22

(53%) (19%) (22%) (61%)

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Adult and family programming will be conducted at the following sites:

Type of site Number of counties programming at site

K-12 schools 30 (83%) Food pantries or Regional Food Bank 25 (69%) Head Start 17 (47%) WIC 11 (31%) Community garden 10 (28%) Farmer’s market 9 (25%) Housing sites 9 (25%) Community center 9 (25%) Clinic site (not Health Department) 7 (19%) Churches 8 (22%) College/university site 5 (14%) Health Department 5 (14%) Grocery store 4 (11%) Shelters 4 (11%) OSU Extension office 4 (11%) Pre-school sites (not Head Start) 3 (8%) DHS or SNAP offices 3 (8%) Worksite 2 (6%) Boys and Girls club 2 (6%) Summer meals programs 2 (6%) Courthouse – Women’s day treatment 1 (3%) School-based health center 1 (3%) Education Service District office 1 (3%) County fairground 1 (3%) Library 1 (3%)

2) Statewide and Unit-level strategic planning will be aligned to achieve progression in the following ways:

• OSU will continue to refine our Family Food Education Volunteer training and

oversight program (Appendix C) for extending our nutrition and physical activity lessons through volunteers, Teens as Teachers, and site staff.

• Small workgroups will continue to review and monitor new or emerging evidence-based nutrition education strategies.

• Units will focus on relationship-building to identify opportunities for further integration into a site or setting.

• Units will increase program saturation at targeted program sites and achieve dosage recommendations to maximize behavior change.

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• Program focus will transition to a greater degree of multi-level interventions, with all Units dedicating a portion of time and resources toward multi-level, comprehensive intervention strategies (Project B).

e. Summary of Research. OSU’s SNAP-Ed curricula workgroups have conducted

literature reviews on best practices for health promotion strategies at the individual and group education level, with special attention to specific audiences. In addition, we’ve interviewed our field staff to understand gaps and needs relevant to Oregon’s geographic, economic and ethnic makeup. We’ve combined the information in this section to justify our curricula choices for Project A:

Developmentally appropriate strategies for youth.

Pre-K/K. Providing food tasting and other activity-based experiences in Pre-K/Kindergarten classroom settings exposes children to new foods and allows exploration. Research shows nutrition education of young children should include the play approach, defined as ‘‘a learning process that is intrinsically motivated, enjoyable, freely chosen, nonliteral, safe, and actively engaged in by young learners’’ (Rickard, et al., 1995). Nutrition programs involving multiple senses have a greater impact on a young child’s willingness to try new food than taste alone. An evaluation of Color Me Healthy, an interactive nutrition and physical activity program for preschool children, showed significantly increased consumption of fruit and vegetable snacks among children in childcare settings (Witt & Dunn, 2012). Further, Piper and Whaley (2007) suggest that healthy eating behaviors are positively associated with strong cognitive environments, especially in low-income Hispanic families with young children. Interventions to prevent childhood obesity in this group may therefore benefit from including a home literacy component. Early childhood is a critical time to develop food preferences and eating patterns. Parents have great influence during this period of time to shape both the experience and the environment (Carruth et al., 1998). Parents, particularly mothers, generally determine dietary intake in young children (Birch et al., 1998). Providing parents with knowledge has been shown to promote success in feeding and in toddlers learning healthful eating behavior (Hammer 2009). Research has shown that preschool children will expand the variety of foods eaten if given the opportunity to experience new foods in a positive environment (Birch, 1998; Birch et al., 1980). Birch and colleagues report it may take 8 to 15 exposures for a child to explore, taste, and eat each new food (Birch et al., 1980). Unfortunately, parents who are unaware of the need for repeated exposures to new foods may assume the child does not prefer these foods, leading to restriction of foods and reduced variety and diversity of food intake. Thus, OSU SNAP-Ed staff will link parent outreach and education opportunities with all programming conducted with this age group.

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Elementary school. Schools are an ideal setting in which to reach large numbers of children with nutrition education/obesity prevention interventions. The school environment is known to influence children’s eating behaviors (Power et al., 2010; Hart et al., 2003). Through the Healthy Hunger-Free Kids Act provisions around school meals, students will have increased access to fruits, vegetables and whole grains. Therefore, we’ll intentionally align interventions with emphasis on foods offered at school, school gardens (indoor, outdoor, and mural), the Fresh Fruit and Vegetable Snack Program, and additional touch-points throughout the school (including parents) to reinforce messages. A number of approaches with 1st through 5th grade youth have shown promise with respect to healthy eating behaviors: Prelip et al. (2010) recommend focusing on consumption, attitudes, beliefs, and students’ perceptions of peer, parent and teacher attitudes about fruits and vegetables in educational interventions for this age group; many other approaches utilize the Social Cognitive Theory, emphasizing activities that reinforce self-efficacy and decision-making skills (McKenzie et al., 2001; Perez-Rodrigo et al., 2001; Anderson et al., 2005; Elder et al., 2010). Numerous studies indicate that garden-based, experiential education activities are effective vehicles for increasing fruit and vegetable consumption and promoting healthy food choices in young children. Research shows that garden-based nutrition education programs impact youth by increasing nutrition knowledge and positive attitudes, consumption and preferences for vegetables and fruits (Heim et al., 2009; McAleese & Rankin, 2007; Morris et al., 2000; Morris & Zidenberg-Cherr, 2002). Graham and Zidenberg-Cherr (2005) found that teachers perceive school gardens as an “effective nutritional tool to promote healthful eating habits”. OSU SNAP-Ed programs with elementary-aged youth will feature a strong nutrition and gardening experiential education track, with heavy emphasis on skill-building and self-efficacy.

Middle and High School. Adolescent eating patterns are established through a complex process involving internal and external factors such as food preferences and availability, body weight perception, and parental, peer and environmental influences (Videon, 2003). Middle-schoolers experience a growing awareness of the world they live in and begin to question the value of what they are learning. Infusing relevance, authenticity, and choice into curriculum and learning activities can make learning more purposeful (Caskey et al., 2007). Curricula that allow students to link nutrition concepts to their daily lives and past experiences extend learning beyond the classroom and into a community context. In addition, research shows that actively engaging young adolescents in disciplined inquiry helps learners address preconceptions, build on prior knowledge to then develop a deeper understanding, integrate new information, and use the knowledge in new ways (American Academy of Pediatrics). Curricula chosen for FFY2014 will equip middle and high school-aged youth with skills to make real-life choices and to set goals regarding nutrition and physical activity.

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Successful approaches with pregnant and parenting teens. OSU’s SNAP-Ed paraprofessionals that conduct group education with pregnant and parenting teens indicate that one key to success is surveying the teens (mostly mothers) about what they want to learn, and what resources they have or lack (cooking facilities, kitchen tools, access to food, etc.). Addressing the problem of whether or not their basic food/nutrition needs are being met is a critical step before teen parents are willing to engage in an educational activity. This strategy aligns well with research showing that adolescent mothers are more likely to stay in school and to improve health behaviors respond when educational approaches incorporate personal experience, problem-solving, skill-building and development of other coping strategies (Harris & Franklin, 2009; Basch 2011; Hoelscher et al., 2002). Social modeling is a powerful influence on teens, who look to family, media and peers in developing their shopping habits. In a study of teenage girls and their grocery purchases, Bevlander et al. (2011) found that teens will adjust their purchasing and consumption behaviors to mimic their peers, and in fact will match their food purchases to a “confederate” teen shopper, especially when the confederate makes unhealthy purchases. Implications from this study suggest that it would be beneficial to include a grocery shopping trip with pregnant/parenting teen groups to help inform their shopping decisions, and to incorporate peer teaching strategies. In rural settings, the internet and other technological resources are useful when teen parents have transportation, distance and other barriers to in-person education, especially when the stages of change theory is utilized to adapt messages and skill-building activities to participants’ readiness and willingness to change (Atkinson et al., 2010; Bensley et al., 2006; Howard et al., 2011). In an effort to ensure multiple linkages with SNAP-eligible pregnant and parenting teens, Foodhero.org (Project C) will be promoted with this audience, both in rural and urban settings. English language learners in Oregon. Language and culturally relevant strategies are fundamental in community nutrition education interventions targeting the Spanish speaking Latino population. For example, nutrition education participants should be encouraged to attend series of classes multiple times. Research indicates that 50 contacts are needed to support behavior change (Olander, 2007). This strategy is supported by the Latino culture in which relationships are fundamental and time is needed to support and strengthen social connections. Translating a proven practice and/or evidence based curriculum from English to Spanish will not produce the optimal results. Educators must acknowledge the sociological and environmental factors of their participants. The educator and curriculum must be competent to face the complex cultural issues that go beyond the Spanish language. To meet the needs of the Latino population we have to be sensitive to cultural cues, recognize their challenges, respect their immigrant heritage and level of acculturation, and be flexible to needs of the family (Broyles et

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al., 2011). Therefore, a curriculum needs to be culturally adapted and then tested for fidelity of original program design or a curriculum needs to be designed specifically with the target population in mind. Likewise, attention to culturally relevant strategies, such as acknowledging and respecting sociological and environmental factors, is a critical component of programs reaching non-Latino (e.g. Somali, Russian) immigrants. OSU SNAP-Ed will utilize the Minnesota curriculum “Simply Good Eating for English Language Learners”, which has been useful with Hispanic, Russian, and Somali audiences, as well as very low literacy English-speakers.

Building meal planning and food preparation skills. Parents, particularly those of low-income, frequently cite limited time for meal preparation (Fulkerson et al., 2008; Fulkerson et al., 2011) and list “learning to cook quick, healthful meals” and “new, healthy recipes” as strategies that would encourage them to cook from scratch. The 2010 USDA Dietary Guidelines recommend improved cooking skills as a strategy to aid consumers in achieving calorie balance and meeting nutrient needs (http://www.cnpp.usda.gov/dietaryguidelines.htm). Gaining and improving food preparation skills can lead to increased self-efficacy, knowledge of healthy eating, increased incidence of cooking at home, and may lead to increased consumption of fruits and vegetables (Condrasky et al., 2006; Condrasky, 2006; Byrd-Bredbenner, 2004). Additionally, studies show that the capacity for maintaining a healthy diet through following dietary recommendations may be mitigated by cooking skills (Contento et al., 2002; Short, 2003).

A growing number of dietitians and health education professionals include hands-on cooking activities in nutrition education programs to teach participants the skills needed to put dietary recommendations into practice (Levy et al., 2004; Condrasky et al., 2010; Brown et al., 2005). Successful programs utilize the Social Cognitive Theory (Bandura, 1986; Baranowski et al., 1997), which emphasizes increasing knowledge, positive attitude, and self-efficacy related to cooking and healthful eating (Condrasky et al., 2006). Additional research has shown that hands-on cooking activities are a successful way to improve meal-management self-efficacy, mealtime coping strategies, and eating habits of families (Horodynski et al., 2004; Clark & Foote, 2004; Meloche, 2003; Morin et al., 2013).

Focus on family is critical. The nutritional quality of children’s diets may be higher when they eat meals with their families (Gillman et al., 2000; Neumark-Sztainer et al., 2003). The 2010 US Dietary Guidelines offer the following as a potential strategy in the area of calorie intake: cook and eat at home more often, preferably as a family. Based on the Oregon Healthy Teens Survey (2007), 41% of 8th grade students and 26% of 11th grade students eat meals with their family 7 or more times per week. This question was not asked in subsequent years.

Studies indicate that family involvement through joint parent-child lessons enhances the effectiveness of school-based youth programs (Katz et al., 2008; Stables et al.,

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2005; Doak et al., 2006), particularly with younger children (Peterson et al., 2007). Children’s consumption of targeted foods/food groups is correlated with parental intake, supporting the importance of family programming, family meals and behavior modeling (Cooke et al., 2004; Wardle et al., 2005; Fischer et al., 2002; Cullen et al., 2001; Galloway et al., 2005).

Parents play a critical role in shaping children’s dietary and physical activity patterns through control of resources, availability of food, and other decisions (Golan et al., 1992; Contento et al., 1992; Luepker et al., 1996; Nader et al., 1989; Baronski et al., 1990; Kumpfer et al., 2003). Numerous studies indicate positive impact of adult-focused nutrition education on the consumption patterns of the family as a whole (Fulkerson et al., 2011; Gross et al., 2010; Ritchie et al., 2010).

f. Modification of Projects Methods/Strategies. None planned.

g. Use of Existing Ed Materials. OSU has identified evidence-based and evidence-informed curricula (Curricula Scope and Sequence, Appendix A) and materials for children and youth by age, and for adults, with special attention to literacy, cultural preferences, presence of actionable strategies, and other critical variables (NEP Curricula Criteria, Appendix D). We will also continue use of the OSU-developed Balanced Energy Physical Activity Tool-Kit (BEPAT – see summary, Appendix E).

h. Development of New Education Materials. None

i. Key Performance Measures/Indicators.

Youth and Adults: • Frequency of planning meals and snacks that include (a) fruits and (b)

vegetables • Frequency of preparing meals and snacks that include (a) fruits and (b)

vegetables • Consumption of fruits in meals and snacks [MT1-iid; LT2-a] • Consumption of vegetables in meals and snacks [MT1-iie; LT2-b] • Time spent in moderate to vigorous physical activity [MT3-ii; LT7] • Time spent in screen time and other sedentary behaviors [MT3-I; LT8] • Extent of utilization of strategies for achieving calorie balance, such as:

o Participants’ estimation of their calorie needs, based on individualized factors such as age, gender, and physical activity level

o Participants’ monitoring of their dietary intake [LT1] o Participants’ reading of food labels for calorie information when shopping

[ST2-b; MT2-b] o Participants’ replacement of high-calorie foods and beverages with nutrient-

dense foods and beverages [LT5]

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Adults only: • Frequency of planning meals • Frequency of comparing prices when shopping • Frequency of using a grocery list when shopping [ST2-a; MT2-a] • Frequency of cooking and preparing foods at home

Project B –Comprehensive, multi-level approaches. a. Related State Objectives:

Objective 2(a): Community-level change. SNAP-Ed Program units will conduct activities or programs (consistent with SNAP-Ed guidelines) that result in changes to the social or physical environment, including schools, organizations, communities, etc. These environmental changes will encourage improvements in dietary quality and/or physical activity levels in SNAP-eligible audiences. Objective 2(b): Organizational collaboration. All SNAP-Ed Program units will collaborate with partner organizations on joint efforts aimed at improving dietary quality and/or increasing physical activity.

b. Audience: Partner organizations, program site staff, adults, youth, children and

families.

c. Focus on SNAP Target Audience. SNAP Eligible sites will be targeted.

d. Project Description. OSU will maximize integration of nutrition and physical activity interventions into the broader school, neighborhood and other targeted environments by developing relationships with partners that are changing or considering changing the food and physical activity environment. Through those relationships, OSU will support readiness to change or adoption of changes that increase environmental access and appeal for improved dietary and physical activity choices, using the following strategies:

Conducting environmental assessments using evidence-based and

evidence-informed tools (see Appendix B for description of tools):

Assessment tool Number of counties conducting in FFY2014

1. School Nutrition and Physical Activity (SNPA) 20 (56%) 2. Healthy Eating/Active Living Mapping Attributes (HEAL MAPPS)

18 (50%)

3. Youth Advocates for Health (YA4-H!) using Teens as Teachers

6 (17%)

4. Healthy Pantry Assessment Tool 12 (33%)

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Other comprehensive approaches and strategies planned for FY 2014:

Approach Number of

counties utilizing approach

Supporting/assisting in development and implementation of wellness policies in schools or other sites

18 (50%)

Interacting with food pantry staff/volunteers to implement healthier pantry options and other strategies

17 (47%)

Supporting or assisting in the development of community or school-based gardens

17 (47%)

Interacting with school-based Nutrition Services to align nutrition education with new School Lunch meal pattern

14 (39%)

Working with partners to develop a healthy eating/physical activity-based coalition/committee in a non-school setting

10 (28%)

Working with partners to develop a healthy eating/physical activity-based coalition/committee in a school setting

10 (28%)

Supporting or assisting in the development/adoption of nutrition standards consistent with USDA Dietary Guidelines for food/beverages sold/offered in targeted settings

9 (25%)

Supporting or assisting in the development/adoption of physical activity standards consistent with US Physical Activity Guidelines in targeted settings

8 (22%)

SNAP-Ed contributing to joint application(s) for grant or capacity-building funding

8 (22%)

Joint health promotion events with other stakeholders within a Coordinated School Health Model

7 (19%)

Supporting or assisting in the development of active transportation groups, clubs, or events related to schools or other community sites

6 (17%)

Work with existing farmers’ markets to accept EBT 6 (17%) Supporting or assisting in the development of farmers’ markets that accept EBT

5 (14%)

Working with retail outlets in providing point-of-purchase prompts for healthy food choices

3 (8%)

SNAP-Ed contributing to joint application(s) for awards 3 (8%) Supporting or assisting in the development/adoption of "joint use" agreements for places to be physically active (such as school playground use for community members)

2 (6%)

Explore how CSA's could take EBT in our communities 1 (3%) Partner and provide consultation, education to group developing Healthy Retail Foods program in sites near SNAP-Ed target schools

1 (3%)

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Approach Number of counties utilizing approach

Supporting or assisting in the expansion of the school garden to a production garden

1 (3%)

Encourage farm to school partnerships at SNAP Eligible schools

1 (3%)

e. Summary of Research.

Collaborative assessment and reporting leads to impact. Community-based participatory research (CBPR) is an effective collaborative approach for identifying and changing environmental conditions that affect the health of community members. It is considered an essential tool for action-oriented and community-driven impacts (Minkler & Wallerstein, 2008). Collaborative and participatory tools and processes have been used to map neighborhood assets and risks, identify key issues and communicate areas for action, and improve environments and policies (Ellis & Walton 2012). CBPR programs have been effective at educating youth and adult partners, improving participants’ cognitive and behavioral skills, and creating community contexts where youth and families can thrive (Breckwich et al., 2007).

A community-driven obesity prevention model was effective in changing nutrition and physical activity environments by mobilizing community members, engaging decision-makers, and supporting organizational partnerships (Schwarte et al., 2010). Evidence supports that community-engaged collaborative approaches are effective in changing children’s food and activity environments before, during and after school, and in the community, to prevent overweight and obesity among public school students (Economos et al., 2013) and creating community environments to enable healthy active rural lifestyles (John, McCahan, & Gaulocher 2012).

Environment/access challenges in rural Oregon. Rural community features pose unique challenges that hinder healthy eating and physical activity for children and families, and that differ from those faced by individuals residing in more metropolitan regions. For example:

• Accessibility, affordability, and availability of a variety of healthy foods, including fruit and vegetables, are limited in rural areas despite assumptions of agricultural supports.

• Availability and location of farmer’s markets, groceries, convenience stores, and restaurants influence children’s and family’s nutrition choices and habits.

• School locations often require long bus commutes, increasing daily seat (inactive) time and preventing walk/bike to school programs, and limit access to and/or provide few structured physical activity programs before and after school and during the summer.

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• Rural communities often have few or no outdoor (neighborhood parks and playgrounds) and indoor amenities (community centers, swimming pools, and sport courts) for children to play actively and safely, they contain spatial features that prevent children and families engaging in active transportation to/from destinations.

Although communities and schools are key sites for delivering nutrition and physical activity education and promoting healthy behaviors among adults and youth, programs are typically implemented without considering the environmental context, and are more successful and sustainable when multi-level approaches are employed (Economos et al. 2013). Additionally, educational programs promoting healthy dietary and physical activity habits teach behavioral skills that may not be adequately supported by environmental conditions. Story and colleagues (2009) argue that schools offer many opportunities to develop strategies to prevent obesity by creating environments in which children eat healthfully and engage regularly in physical activity. Recently, Taber and colleagues (2013) found an association between stronger school meal standards and more favorable weight status among low-income students. A systematic review of obesity prevention programs found comprehensive, community-based approaches that incorporate multiple settings and include a school component, focus on both diet and physical activity, and ensure environmental and policy conditions that optimize healthy dietary and activity choices as the default were most effective (Bleich et al., 2013). The evidence supports the importance of understanding the context for supporting obesity preventing behaviors and collaborating with communities in the development of interventions to promote healthy dietary and activity to assure outcomes of SNAP-Ed programs translate into health impacts.

f. Modification of Projects Methods/Strategies: None planned at this time.

g. Use of Existing Ed Materials. See Appendix A.

h. Development of New Education Materials: None

i. Key Performance Measures/Indicators

• Number of community-level organizations, institutions, or businesses that have

made changes in practices or capacities to promote healthy food choices. [MT4; LT9]

• Number of school sites that have made changes in policies or capacities to promote healthy food choices and/or increased physical activity. [MT4; MT5; LT9; LT11]

• Number of community sites that have improved access or infrastructure to promote physical activity, generally as the result of joint community efforts. [MT5; LT11]

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• Units’ participation in policy-focused committees and coalitions, such as school wellness committees, community food councils, chronic disease task forces, etc. [ST6]

• Units’ collaboration with other organizations to conduct assessments of community and/or school environments, with regard to promotion of healthful and physical activity. [ST6]

• Units’ participation in partnerships or coalitions to implement community interventions and/or other initiatives. [ST6]

Project C – Community and public health approaches: Food Hero a. Related State Objectives. OSU is planning a continuation of the

process evaluation for Food Hero for FFY2014. Please see Section B3 (Evaluation Plans), Project: C - Community and Public Health Approaches - Food Hero, a social marketing campaign developed at Oregon State University for a description of this evaluation project.

b. Audience. SNAP eligible mothers who speak English and/or Spanish, have children under age 18 living in the home, and who use the Internet are the primary audience. Their children are the secondary audience.

a. Focus on SNAP Target Audience. Food Hero for FFY2014 will again be focused on parents in schools as it was in FFY2013. These parents will also be reached at other community sites and locations surrounding the school sites (such as grocery stores, WIC or SNAP offices, limited income housing, etc.). All schools and sites will meet SNAP-Ed targeting guidelines.

b. Project Description.

Overall Goals The goal of Food Hero is to deliver research-backed fruit and vegetable messages through multiple channels to a targeted and segmented audience and increase amount and variety of vegetables and fruits consumed. Secondary to measuring vegetable and fruit consumption, family meal preparation and consumption in the home will be measured although the campaign was not designed to change this behavior. Additionally a major goal is for family, friend and educator connections to occur both in person and at community events using Food Hero community kits and online through FoodHero.org and social media outlets. OSU intends to continue to use at least one campaign channel as a component of every adult SNAP-Ed contact direct and indirect, as well as through continued targeted and segmented media buys and follow-up online with participants. Campaign channels include the following, many of which can be viewed at FoodHero.org including the media:

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• Website (FoodHero.org) [a description is provided in the following section] • Community Programming Kits (County kits include: table covers, pop-up

banners, branded aprons and t-shirts for staff, car magnets, branded postcards, posters, and reinforcements: such as recipe printouts from the website, stickers, buttons, magnets, grocery pad, cookbook, and calendar)

• Media (options of outdoor billboards, theaters, online web banners, transit benches and shelters, grocery store: floor panels, “take ones” in the canned aisles, freezer decals and grocery cart banners)

• Monthly Message Package (learner-centered, actionable, and looped back to the website messages in the Food Hero Monthly publication available at https://www.foodhero.org/monthly-magazine and printed out as part of County kits; on Facebook, Twitter and Pinterest; and photo and caption highlights on the homepage of FoodHero.org including a monthly poll, plus an email signature option for educators).

FoodHero.org FoodHero.org is the primary educational component of the Food Hero campaign. All community programming, media components and monthly messages point to the website, in addition each channel itself promotes healthy eating messages. A goal of the website is to be “living” in that constant connections are being made between the target audience and their friends, family and each other; and between the target audience and the OFNP faculty and staff. Another major goal of the website is not to “tell” participants what to do but rather provide actionable content in a friendly tone that is relevant to the target population. The content of the web0site is two-fold: recipes and healthy eating tips and tools that all directly or indirectly focus on families cooking and eating together. Additional research-based components include the following:

• A process and criteria each recipe must go through to be approved for Food Hero. Details can be found here: https://www.foodhero.org/about-food-hero

• “Make it a Meal” idea for each of the hundreds of recipes, which quite often includes ideas for pairing together more than one Food Hero recipe.

• A tool for a user to ask a question of an educator or submit a tip idea • Food Hero Monthly – current edition and archived editions. The monthly

edition is not dated so these can easily be used beyond their publication date. • Nutrition label and professional photo for each recipe, plus a function for the

user to halve or double the ingredient list of a recipe and then print it. • Spanish language mirror site as recommended in the US Health Literacy

Online Guide (US DHHS, 2010) • Inclusion of information from the 2010 Dietary Guidelines and associated

publications such as the 10 Tips series of handouts. • The tip design is fully based on the research in the US Health Literacy Online

Guide (US DHHS, 2010)

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https://www.foodhero.org/monthly-magazine

https://www.foodhero.org/about-food-hero


• A function where users can share recipes and tips: to their email, phone, social media sites or download or print.

• A function for users to rate or comment on every recipe. In addition, a function for the OSU Food Hero team to follow-up on a user’s comment.

• Social media is used to talk to participants and reach them as a marketing channel with the purpose of bringing them back to FoodHero.org. The Food Hero team has created a campaign social media guidebook using the CDC Guide to Writing for Social Media (2012) and other literature. The team has also submitted a related manuscript for publication to the Journal of Nutrition Education and Behavior.

Campaign Benchmarks

The Food Hero campaign strives to meet the eight benchmarks of the Social Marketing National Benchmark Criteria (National Social Marketing Centre):

1. Consumer orientation: Continue to develop a strong research based understanding of the audience combining data from multiple sources. Sources used include continued focus groups, published literature, and talking to the audience via the available tools in Food Hero (social media, comments, emails)

2. Behavior: Have a clear focus on behavior, based on strong literature review and needs assessment, with specific behavior goals. Food Hero strives to increase fruit and vegetable intake.

3. Theory: The social cognitive theory is used to openly inform and guide development and test theoretical assumptions as part of the process. Food Hero uses social cognitive theory and also relies on the social ecological model.

4. Insight: Focus on gaining a deep understanding and insight into what moves and motivates the target audience.

5. Exchange: Clear analysis of what the consumer has to give up in order to get the benefits of healthy eating proposed through the campaign.

6. Competition: Both internal and external competition considered and addressed. Competing factors are considered and strategies created to minimize the potential impact of competition. Food Hero in its media buys and social media strives to contend with its competition.

7. Segmentation: Avoids a blanket approach and uses traditional demographic/ epidemiological targeting, as well as deeper segmenting approaches. Food Hero is always looking for ways to target the audience, including new ways to reach an audience that has already been targeted.

8. Methods mix: Identify an appropriate “mix of methods” through the use of a range of methods which may be pared down or increased depending on results. Avoid relying on a single method or approach used in isolation. Food Hero, as described above, has many channels and methods of reaching the target audience.

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FFY2014 Project Plan Food Hero is scheduled to be implemented with all mothers with children in the SNAP-Ed/OFNP program throughout FFY2014. In this capacity Food Hero is seen as continuing education after SNAP-Ed educators have reached mothers in person or indirectly. It’s a way for the targeted population to get actionable, learner centered nutrition education when they want it – available 24 hours a day, 7 days a week on-line. In many respects they can choose how they want to receive it – recipes, actionable tips, interactive tools, or social media sites. During the summer of 2013, seven focus groups related to Food Hero are scheduled to occur (they were delayed due to the funding cuts in FFY2013, but funds were available toward the end of the year). Results from these focus groups will inform updates to the tips section of Food Hero, particularly how to connect tips to recipes as described below in h. Development of New Educational Materials. Additionally there may be a move to explore (with FNS approval) a pilot class or series of classes added to Food Hero based on focus group results. Food Hero will continue to connect with partners to deliver the campaign. So far this has happened extensively at the community level at such places as schools, grocery stores, health fairs, summer feeding sites and pantries. At the state level OFNP converted relevant Oregon WIC online participant classes into tips (WIC classes can be viewed at this link: http://public.health.oregon.gov/HealthyPeopleFamilies/wic/OnlineNutritionEducation/Pages/index.aspx). The Nutrition Council of Oregon has decided to adopt Food Hero as a major strategic partner in their family meals campaign in part by featuring their messages in four Food Hero Monthly issues. In addition, Food Hero recipes are on the school lunch menus in a couple of counties and (unrelated to SNAP-Ed) Food Hero recipes are on the menu at the Women’s Correctional Facility in Oregon and part of their out-processing education program. Additional partnerships will be sought with partners that serve the SNAP-Ed eligible population. The arm of the campaign to be evaluated will include all channels of the campaign and focus on mothers in 56 targeted elementary schools and their surroundings in 26 of 36 Oregon counties, which those moms frequently visit. A second year of process evaluation will be conducted editing some components from results of the first year of this evaluation (for example extending the campaign run time to see if that affects outcomes) and in some cases reaching a school for a second year (31 schools) and determining the effect of doing so. This will be referred to as Phase V. In September FFY2013 educators will recruit mothers in selected elementary schools (see map below for a look at school locations across Oregon and Appendix F for detailed demographics on each school) to take an online or paper-based survey, nearly the same as that conducted in FFY2014) as a pre-campaign measurement. Schools are being selected based on a list of criteria: at least two public events will occur sometime throughout the school year; ability of the school to allow and be able to include multiple campaign channels; and mothers fitting the target audience. The survey contains much of the same content as that administered in the Phase I phone survey, pre and post. This was done intentionally to provide

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http://public.health.oregon.gov/HealthyPeopleFamilies/wic/OnlineNutritionEducation/Pages/index.aspx

http://public.health.oregon.gov/HealthyPeopleFamilies/wic/OnlineNutritionEducation/Pages/index.aspx


comparison data from FFY2009. Additionally questions will be addressed related to stages of change, awareness, and media outlets used. There will be some education in the survey so survey participants will get a Food Hero cookbook for completing the survey. For some adults, this may be their first exposure to the campaign, and that will be assessed. Map of 56 targeted and potential elementary schools for Food Hero school campaign in FFY2014, map copyright Google 2012.

Elementary schools were chosen as the primary target for a number of reasons. As mentioned earlier in this section, moms with children living in the home are the primary target of Food Hero. A primary audience of SNAP-Ed/OFNP is children in school and elementary schools are reached in every Unit. In Oregon most of the schools with over half of the student population receiving free and reduced meals are elementary schools. Food Hero was designed to follow-up with moms on topics their children would learn about in classes, and give them actionable ways to make the changes. It can be difficult to reach parents through a series of classes due to low participation and retention. The Food Hero needs assessment found that our target audience overwhelmingly wanted to learn about nutrition online.

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Food Hero educators can reach moms indirectly in a series (sending materials home with children) while at the same time reaching moms in person (indirectly and directly) at parent events and through means by which parents will view messages (school website, school lunch menu, administrative office display, electronic school signboard, and school newsletter). SNAP-Ed/OFNP educators tell us that parents of elementary school children are also the most involved of all the grade levels they teach so there may also be a greater chance that moms read materials that come home to them. Finally, but very importantly, the model of targeting elementary schools will mean targeting outside the school itself. A map will be created of sites where mothers gather outside of the schools, based on community feedback and available data. Food Hero will work with partners to reach moms with the same messages at locations outside of school and inside schools. Recruitment of mothers will occur in early fall of the school year. Later in the fall the campaign will begin. Part of the campaign kick-off plan is to widely distribute calendars throughout the schools to parents. The campaign will run through Mother’s Day when the post campaign will occur. At the time of writing the Plan the Food Hero Campaign team is working with community teams to identify the best approaches for participating schools and surrounding communities. It is likely the campaign will be a bit different from school to school and community to community. However, the number of exposures will be measured so this variation should not affect the evaluation. To successfully reach the target audience, especially in a metro versus isolated rural area, the campaigns will always look different. Media will be purchased during FFY2013 using existing creative pieces, although possible editing them a bit to fit purchased media specs. To secure media space takes purchasing months ahead. All targeting and creative media will be submitted to FNS before purchasing in the late summer of FFY2013. Just before Mother’s Day the post-campaign recruitment is scheduled to begin. Mothers will be offered a campaign reinforcement that is empowering for participating in the survey. The survey will again, as the pre-survey did, have some educational messages within it. The pre-survey will have a question that assesses which of a number of reinforcing materials motivates moms to eat fruits and veggies at home and prepare them for family meals. That will inform the decision of what reinforcement will go with the post-survey. In addition to the pre- and post-campaign survey, the campaign will also assess campaign success using the SNAP-Ed/OFNP parent recipe survey. A question is being developed to add to that survey asking moms the source of those recipes, such as online, the calendar, Food Hero monthly. During the summer of 2014 results will be analyzed and the Food Hero elementary school program assessed. If results are positive they will inform the continuation of the program for future SNAP-Ed funding years.

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Project Budget Areas for FFY2014:

• Community programming kit materials as needed (as described above) for all Units so programming can occur with Food Hero messaging at all adult and family events statewide. Each year of the campaign the kit materials are assessed with the educators to determine which content will remain or need to be updated.

• Web costs: license, updates/support, possibly minor design adjustments based on focus group results and continued literature reviews and survey results.

• Evaluation costs: printing of paper surveys as needed and recruitment flyers. • Addition of at least 12 new recipes proposed. Food costs for testing recipes

and recipe photography. • Possible development of an online class including video and interactive

sections per research/needs assessment feedback.* • Statewide media buy (focused on grocery stores and outdoor) and associated

public and media relations.* • Costs associated with proposed addition of linkages on the site as described

below in h. Development of New Educational Materials. This may include some new media creative to showcase the addition; writing support including editing and review to assure all text is actionable, literacy appropriate and punctuation is accurate; photos as needed; and graphic art to develop the look of three web “buttons”, their color and font type and size.

*A draft plan with details of the project will be sent to FNS for approval prior to implementation.

e. Summary of Research.

Social Marketing. Social marketing, as reported in the research literature, has been found to change both exercise and dietary behaviors (Stead et al, 2007). A meta-analysis conducted by the National Social Marketing Centre (2006), National Consumer Council (London) found that social marketing nutrition interventions can be effective. Of the 30 social marketing and nutrition studies reviewed, only three showed no change in nutrition behavior. A review of social marketing literature was conducted by the University of California – Davis Center for Advanced Studies in Nutrition and Social Marketing. They specifically examined social marketing campaigns targeted at nutrition and physical activity (Carroll et al, 2000). The authors made the following recommendations for future directions in social marketing, which are relevant for the Food Hero campaign:

• Employ multi-method evaluation approaches (utilizing both qualitative and

quantitative methodology) to capture the multi-channel implementation of social marketing campaigns.

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• Employ innovative evaluation strategies that appropriately tailor and combine traditional research designs and methods to better measure program impact.

• Shift the focus from measures of long-term program impact to shorter-term or

intermediate measures that are appropriate predictors of longitudinal change. • Move the emphasis of program evaluation away from attribution of change to

particular program components and instead carefully track community behavior change in general.

Fruit and Vegetable Consumption. The 2010 Dietary Guidelines reported the following from the vegetable and fruit literature:

• Moderate evidence in adults and limited evidence in children and adolescents suggests that increased intake of vegetables and/or fruits may protect against weight gain.

• A dietary pattern low in calorie density is characterized by a relatively high intake of vegetables, fruit, and dietary fiber and a relatively low intake of total fat, saturated fat, and added sugars. Strong evidence shows that eating patterns that are low in calorie density improve weight loss and weight maintenance, and also may be associated with a lower risk of type 2 diabetes in adults.

• In the United States, intakes of vegetables, fruits, whole grains, milk and milk products, and oils are lower than recommended.

• Most vegetables and fruits are major contributors of a number of nutrients that are under-consumed in the United States, including folate, magnesium, potassium, dietary fiber, and vitamins A, C, and K.

• Moderate evidence indicates that intake of at least 2½ cups of vegetables and fruits (a combination) per day is associated with a reduced risk of cardiovascular disease, including heart attack and stroke.

• Some vegetables and fruits may be protective against certain types of cancer. • Most vegetables and fruits, when prepared without added fats or sugars, are

relatively low in calories. Eating them instead of higher calorie foods can help adults and children achieve and maintain a healthy weight.

According to the State Indicator Report on Fruits and Vegetables, 37.7% of U.S. adults report consuming fruits less than one time daily and 22.6% for vegetables (CDC, 2013). And for Oregon adults, corresponding data points were 32% and 15.3%. Additionally Oregon has the highest median intake of vegetables of all US states at 1.9 (times per day). These figures indicate successes, as far as comparisons to other states, but there is still improvement needed. Influences on Fruit and Vegetable Choices. The following is an overview of the research literature on fruit and vegetable consumption and factors influencing this consumption, including cost and access, education and household demographics,

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ethnicity, age, and health benefits. Food Hero uses this research in developing and managing the campaign. Cost. The USDA Economic Research Service (Stewart et al, February 2011) determined the average retail price of 153 different vegetables and fruits in all forms (fresh, frozen, canned, dried, and 100% fruit juice) and the average price per edible cup equivalent for each using 2008 Nielsen Homescan data. Here are the major findings:

• An adult on a 2,000-calorie diet could fulfill 2010 Dietary Guideline fruit and vegetable recommendations (amounts and variety) at an average cost of $2 to $2.50 per day, or approximately 50 cents per edible cup equivalent.

• Processed fruits and vegetables were not consistently more or less expensive than fresh produce. Canned carrots (34 cents per edible cup equivalent) were more expensive than whole fresh carrots eaten raw (25 cents per edible cup equivalent). However, canned peaches (58 cents per edible cup equivalent) were less expensive than fresh (66 cents per edible cup equivalent).

• Retail prices per pound often varied substantially from prices per edible cup equivalent. Fresh broccoli florets and fresh ears of sweet corn both sold for around $1.80 per pound at retail stores, on average. After boiling and removing inedible parts, however, the sweet corn cost almost twice as much as the broccoli florets ($1.17 vs. 63 cents per edible cup equivalent).

It was found (Stewart et al, May-June 2011) using the 2008 national average food prices that low-income households can satisfy MyPyramid vegetable and fruit recommendations with a Thrifty Food Plan budget; however, many of those households spend too much of their food budget on food low in fruits and vegetables. A variety of fruits and vegetables were available for a cost of $0.40 to $0.50 per cup-equivalent. Research has been done on produce purchasing habits of limited income families. Households at >130% of poverty level spent more on fruits and vegetables over a 2-week period ($5.02/person/week) than households at <130% of poverty level ($3.59/ person/week) (Blisard et al, 2004). Small increases in income were likely to result in greater fruit and vegetable spending among higher income households, but had no impact on spending by low-income households. Additionally, being a SNAP recipient did not increase fruit and vegetable spending. For additional money to be allocated to fruits and vegetables, a household’s income needs to be slightly above 130% of poverty. Among households between 130 and 185% of poverty, a 10% increase in income increases fruit and vegetable expenditures 1.15% and 1.93%, respectively (Stewart and Blisard, 2008). When low-income families are given a small increase in income they increase their food budget in only two out of seven surveyed food categories - beef and frozen prepared foods (not fruits, vegetables, dairy, bread and baked products, or eggs). Finally, the perception of cost can influence fruit and vegetable intake. Mushi-Brunt et al (2007) examined the perceptions of cost of fruits and vegetables to consumption. They found that when

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parents and their preadolescent children perceived fruits and vegetables as high-cost items, consumption decreased. Bowman (2005) compared women food shoppers from two groups: 1) those who considered food price to be very important vs. 2) those who did not consider food price to be very important. Results showed that African American and Hispanic, low-income, food insecure, SNAP recipient, low education, renters, and service workers were more likely to consider food price very important when buying food. Those considering price to be very important ate a smaller amount of higher-priced foods such as deep green and orange vegetables, and drank more sweetened (<10% fruit juice) fruit drinks (Bowman, 2005). Finally, a study by Lallukka et al. (2010) showed that women increased their fruit and vegetable consumption when income increased across all education levels. Findings suggest that absolute cost of healthy food plays a role across income levels. In 2009 Food Hero phone survey research (n=1486) OSU Extension found that the most important factor in grocery shopping for the primary shopper in the home is foods being low cost. Approximately 50% of respondents felt that a diet high in fruits and vegetables is expensive. Access. Access to healthy, affordable fruits and vegetables is a commonly cited reason why consumers don’t eat more fruits and vegetables (Bihan et al., White House Task Force on Childhood Obesity, 2010). Education. In addition to price and access, another major predictor of increased fruit and vegetable consumption is education, especially having a college educated individual as head of household. Biham et al. (2010) showed that one primary determinant of low fruit and vegetable intake is lower education. According to 2009 BRFSS data it was found that in Oregon and nationally having a college education increases the chance of meeting fruit and vegetable recommendations. Household Demographics. Household size and make-up is related to purchasing a greater variety of fruits and vegetables. Variety is important in the prevention of diet-related disease, as is consuming adequate amounts from specific vegetable subgroups, such as deep-green and orange vegetables. ERS data shows that households with 4 members purchased 16-24 different vegetable types, compared to just 10 types for single person households. However, households with 5+ members begin to see a decline in variety. Households with greater education level also purchase a greater variety of vegetables, while households without children purchased a greater variety of vegetables than those with children. Finally, Fulkerson et al. (2009) found that when families eat together the adolescents in the family have higher fruit intakes. Thus, the family mealtime can positively improve the dietary intake of children in the home. Ethnicity. Ethnicity may also be associated with fruit and vegetable intake as a function of cultural preferences, economic status, and community environments. For

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example, Lorson et al. (2009) analyzed NHANES III data and found that non-Hispanic African-American children and adolescents consumed significantly more dark-green vegetables and fewer deep-yellow vegetables than Mexican American and non-Hispanic white children and adolescents. Ethnicity may also drive what individuals perceive as promoters or barriers to fruit and vegetables consumption (Lucan et al., 2010). For example, Yeh et al. (2008) reported that African American participants reported more limited access to fresh produce, while Hispanic participants reported reduced quality and higher prices of fresh produce were barriers to intake. Hispanic participants also indicated the negative impact of the US culture on their health, such as the high prevalence of unhealthy foods. Finally, Morland and Filomena (2007) reported that disparities associated with neighborhood racial composition determined the availability of fruits and vegetables. In the black communities they examined there were no supermarkets, thus, limited variety and availability to buy fresh fruits and vegetables. According to 2009 BRFSS data, in Oregon and nationally, ethnically diverse audiences (Latino, Native American, and other) have a greater chance of meeting fruit and vegetable recommendations, although it could be different for fruits and vegetables. For example, it appears that Latinos eat greater amounts of fruit but not vegetables. Age. Demographic and socioeconomic factors are expected to predict change in fruit and vegetable consumption in the next 10 years. Households with members who are older spend more money on fruits and vegetables (Blisard et al., 2004). Thus, our aging U.S. population may contribute to an overall increased consumption of fruits and vegetables (with the exception of fried potatoes). Per 2009 BRFSS data it was found that in Oregon, being over the age of 65 increases the chance of meeting fruit and vegetable recommendations. Health Benefits. The research evidence strongly supports the impact of fruit and vegetable intake on health (Hyson, 2008). However, perceived health benefits of consuming a healthy diet of fruits and vegetables can also impact intake. Henry and colleagues (2006) examined the relationship between stages of change and other decision and self-efficacy values and the change in fruit and vegetable consumption among African American mothers. Women who rated themselves later in the ‘stages of change’ had stronger perceptions of health benefits and self-efficacy in eating fruits and vegetables for various eating occasions and in difficult situations. Researchers concluded that interventions for women in earlier “stages of change” should include making women more aware of health benefits and increasing self-efficacy (Henry et al., 2006). Lucan et al (2010) also found that in African American adults in Philadelphia, the number one promoter of fruit and vegetable intake was perceived ‘health and nutrition’ benefits, while it was the number one barrier to ‘fast food intake.’ The Oregon Health Authority (using 2009 BRFSS Data) reports that 58% of Oregon adults think that eating less than five servings of fruits and vegetables per day is “somewhat” or “very” harmful to one’s health, most reporting “somewhat”. Of those reporting “somewhat”, those who reported it most often were in the following

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categories: female, 25 to 44 years old, college graduates, household incomes greater or equal to $35,000, has health insurance but not the Oregon Health Plan, and is of healthy weight. Oregon Original Research. OSU OFNP faculty used three years of WIC focus group data on fruit and vegetable consumption of low income Oregonians to assist in developing Food Hero. Needs assessments and post campaign research have been conducted for the Food Hero campaign (a total of 2,289 phone surveys and 7 focus groups [n=42] and in FFY2013 an online/paper survey was conducted although at the time of writing the Plan responses were still being collected, over 700 participants had responded so far). The data are currently being compiled into publications. Responses are being analyzed and manuscripts are in progress. The following are some important highlights from the Food Hero research findings and other key research used in continued campaign development: Pre campaign development focus groups. Four focus groups were recruited and conducted in one rural and one Metro county. The OSU Extension research team explored important commonalities and differences among program participants in rural and urban areas of Oregon. Specifically, the team examined:

• The impact of family context on nutrition and eating. • Current attitudes and behaviors with respect to eating routines and habits

with particular attention paid to household fruit and vegetable consumption.

• Obstacles that may exist for limited income families to achieve and maintain “good” household nutrition (e.g., perceptions, priorities, budgets, attitudes, basic awareness) and strategies to support healthy eating.

• The ways in which different communication channels influence meal choice, recipes, and preferences (e.g., TV, friends, opinion leaders, radio, etc.)

• Reactions to similar campaigns used by other states such as “Pick a Better Snack” and “Champions for Change” to assess possible fit with Oregon’s target population.

Key findings included the following:

• Those families who had more than one adult residing in the household found it easier to cook and eat healthy meals.

• The families in this study understand the importance of integrating fruits and vegetables into their daily eating habits.

• Perceptions of cost and concerns of food perishability are obstacles to healthy eating.

• Rural families are more aware of and sensitive to seasonal impacts on the availability of fruits and vegetables than urban families.

• Rachel Ray and other media celebrities (e.g., Iron Chef) influence recipes and meals used by families.

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• These financially distressed families shop where prices are low and products are available in bulk.

• Of the earlier campaigns tested, ‘Pick a Better Snack’ was best received.

Phone survey. A total of 1487 phone surveys were conducted with recipients in five counties. The survey design was guided by the focus group data, the campaign goal of increasing fruits and vegetable consumption and variety within the target population, and a desire to learn more about the population’s media habits. Key findings include the following:

• The majority of respondents rarely have help preparing dinner (47%) • When shopping for groceries, 67% reported that “low-price” is “very important” • When shopping for groceries, “fast to prepare” and “easy to prepare” are not

as important to the majority of respondents. Only 14% reported ‘very important’

• ~60% of respondents agree that it is “easy to get their families to eat enough vegetables”

• ~66% of respondents were neutral or disagreed with the statement “Frozen vegetables are just as healthy as fresh”

• 63% ‘strongly agree’ that it is easy to get their families to eat enough fruit and in total more than 80% ‘agreed’ with the statement

• 63% disagreed with the statement “Canned fruit is as healthy as fresh” and just over 13% agreed with the statement

• 45% disagreed with the statement “Healthy food is time consuming to prepare” • 79% agreed with the statement “I know how to prepare many different types of

vegetables” • 81% agreed with the statement “I would like to serve more balanced meals” • 30% strongly agreed and 21% agreed (51% total) that “a diet that is rich in

fruits and vegetables is expensive.” • Apples, oranges and bananas are the most commonly eaten fruits • Broccoli, corn, beans, and carrots are the most commonly eaten vegetables • Consumption based on CDC Behavioral Risk Factor Surveillance System

(BRFSS) questions: o 2.75 servings per day of fruit and juice o 41% consumes <3 servings of fruit and juice (combined) each day o Mean servings of vegetables per day is slightly over 2 o 71% consumes <3 servings of vegetables each day

• Snack time is the preferred time to include more fruit with breakfast a distant second

• Dinner is the preferred time to serve more vegetables • Over 50% identified the internet as a source of information on healthy food

choices, grocery stores were mentioned by 16%, magazines by 12%, television by 9%, and newspapers by 6%

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• 28% mentioned the internet as a place to “find the most useful cooking tips/ideas”, friends/family about 25%, and cookbooks and television about 12% of the time.

• 71% of households have 1 or 2 children & 51% report that people eat dinner at home on a typical night

• ‘Eating a diet that includes a lot of fruits and vegetables is expensive’ was found to be statistically significant when cross tabulated with the number of adults in the household.

• The response to the statement ‘Eating a diet that includes a lot of fruits and vegetables is expensive’ varied by age. Those ages 35-44 and 45-54 indicated more agreement with the statement; that is, they view fruits and vegetables as more expensive.

• Servings of vegetables consumed are higher for respondents in the 25-34 age group than the 35-44 and 45-54 age groups.

• Internet use and age were significantly related. Respondents between the ages of 25 and 34 (about 44% of the sample) were more likely to mention the internet for finding information about healthy food choices, while respondents over the age of 45 (about 16% of the sample) were less likely to mention the internet.

In FFY2010-11, OSU Extension conducted more focus groups and interpreted the transcripts as part of phase II of the Food Hero campaign. Additionally, the team designed the updated website using results from Food Hero Phase I and the recently released Health Literacy Online US Department of Health and Human Services research-based guide to designing easy to use websites. The goals of Phase II were to update the campaign website, which acts as the educational centerpiece, to make it even more useful to SNAP eligible participants, to make a companion Spanish site, and also to expand the campaign from 4 counties to 14 counties. Focus groups. A total of two focus groups were organized and conducted in one metro county. One was conducted in English and the other in Spanish. Specifically, the team examined:

• What makes a great website • Reactions to membership options • Reactions to a prototype of a new Food Hero homepage • Reactions to a prototype of a new Food Hero recipe page • Reactions to a prototype of a new Food Hero tips A to Z page • Factors in choosing and preparing meals

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Key findings included the following:

• Homepage photos should feature entire families, and emphasize the whole family in the cooking process.

• Introduction and main message should stand out. • Homepage is attractive, easy to read, seems easy to navigate, and not

cluttered. • Impressed the content is available in Spanish. • High interest in membership if it is free. • Most useful membership features: creating a grocery list, saving favorite

recipes, sending recipes to your phone. • Would like to have menus included: include cost information for weekly menus

and overlap ingredients for the week. • Like the recipe page design: seems easy to navigate, step-by-step instructions

are helpful, like information about health benefits. The Spanish group additionally liked the ability to rate recipes.

• Suggestions for recipe page design: include pictures for multiple stages of preparation, add shopping tips, include total cost of meal, and offer more options by serving size. The Spanish group additionally would like the nutrition facts in Spanish.

• Like the tips page in that the design is not cluttered. • Suggestions for page design of tips: Readers should not be redirected to other

websites or told to search for information elsewhere; should be easily searchable; and English group wanted focus on nutrition and food preparation and Spanish group on family, food and health. Both groups gave a list of suggested tip categories.

• Factors in choosing meals: nutrition, cost, time, picky eaters. • How participants find recipes: word-of-mouth, cookbooks, internet searches,

and additionally Spanish group noted family (mom, grandmother) and WIC programs.

• Spanish group values preparing meals from their native countries and using recipes passed down from mothers or grandmothers.

The Food Hero needs assessment results are being used to improve Food Hero. Also, the focus group and survey results have been used in many other SNAP-Ed projects to inform decisions. OFNP has shared results with state partners for use on their projects. The choice of a website as a primary method of reaching the audience for the Food Hero campaign was based on an in-depth needs assessment in 2009 which included focus groups and a pre-campaign phone survey. The results of the phone survey (conducted in 5 counties, n=1,498 ) showed that when actively seeking information about healthy food choices, the internet was by far the most often cited resource the respondents would use (n=658) with grocery stores (n=193) and magazines (n=147) a distant second and third. When respondents were asked

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where they find the most useful cooking tips, the internet again led the way (n=372), with family and friends a close second (n=349). In general, differences between the counties in the Food Hero phone survey needs assessment were not statistically significant, with one notable exception: internet usage varied by county; however it did not appear to vary in an urban/rural pattern. When asked where they would want to find information on healthy food choices, Lane county respondents mentioned the internet more often than respondents from two other counties. The internet was mentioned by 57.6% of Lane (urban county) respondents and this was significantly higher than Marion (urban - 49.6%) and Klamath (rural - 47.7%). Josephine (rural) was in between, with 54.6%. Highlights from Oregon WIC focus groups include: • The most common barriers to eating vegetables and fruit were 1) feeding

relationship issues (i.e., children are picky eaters or parents don’t trust that children are capable of choosing what to eat) and 2) support issues (i.e., If Dad won’t eat produce, how can we get kids to eat produce?)

• The least common barriers were 1) access to fruits and veggies (not having enough money to purchase them), and 2) knowledge of the benefits of eating vegetables and fruits.

• Another barrier was that fresh produce is perishable and doesn’t last long. • Both Spanish and English speaking participants felt fresh vegetables and fruits

were the best. Overall, this response was attributed to taste, poor memories of other forms of produce, and the idea of nutrition content.

• WIC recommended that OFNP focus on emotional issues and family dynamics, and have photos of real mothers give the message as opposed to cartoon images.

• For the Spanish population different results were reported: o Spanish-speakers like the terms nutrition, vitamins, and healthy, while

English-speakers did not. o This population believed they ate less vegetables and fruits than actual

amounts because they were not always counting salsas and soups and chilies into the daily count.

In the summer of 2010, the US Department of Health and Human Services (US DHHS) published the Health Literacy Online Guide. This Guide has become a major resource for OFNP in the updating of FoodHero.org that occurred for Phase II and III of the Food Hero campaign. Some important research cited in the Guide is that 80% of Internet users have looked for health information online, as many as 50% of US citizens have limited literacy skills, and 90% limited health literacy skills (Fox 2006, Kutner et al. 2006). The Guide instructs web developers and health professionals developing web content in how to best design a health related website. The Oregon team used all the information relevant to Food Hero in the FoodHero.org update and tested many of the proposed design concepts in English and Spanish language

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focus groups (2 focus groups, n=14). The major themes and findings from the Guide and the focus groups include: • Emphasize low-cost

o Make tagline & logo more prominent, and emphasize “low-cost” o Provide more options to adjust recipe portions o Develop menus associated with recipes o Include local, seasonal, and substitution ingredient lists

• Emphasize health and nutrition o Keep fresh content on the homepage through a featured eats section and

rotating photos o Nutrition facts label for recipes should be provided in Spanish o All written content written in an actionable tone

• Emphasize family and friends o Rotate homepage picture to include more families o Include creative ways to win over picky eaters o Content written more in a conversational tone o Enhance the opportunities for participants to interact with each other and

their family and friends o Train OFNP educators to begin actively and regularly using Food Hero

with an active login to connect with target audience in a friendly tone • Simplify concepts/use conversational tone

o Include drop-down menus on main navigation tabs o Make absolutely clear membership is free

• Focus on ease of use o Avoid redirecting visitors to other sites o Recipes and tips will be tagged to search and organize in multiple

configurations o Provide A-Z indexing for Recipes and Tips o Retain the recipe rating system o List of “Share” a recipe or tip options will be limited to only most popular

sites

Preliminary 2013 Campaign Results Pre/Post survey Food Hero Results, online and paper collection The pre-campaign survey for FFY2013 is closed, (n=510) and the post-campaign (n=44) is still open, but a preliminary data analysis was done for this Plan. In the pre-survey, only 8.63% of participants had heard or seen the phrase Food Hero recently. In the post-survey the preliminary results show that 33.33% had heard or seen the phrase Food Hero recently. When shown the Food Hero logo, 58.14% of post campaign respondents had seen it before. Of the post campaign respondents 28% reported visiting FodoHero.org at least once in the past year; 41% reported seeing Food Hero messages via their child’s school and 24% from family or friends.

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Google Analytics During the FFY2013 campaign, January 21 through May 26 (126 days), the following results were recorded on FoodHero.org as compared to the 126 days before the campaign began (September 17th, 2012 through January 20th):

Google Analytic Results Pre Campaign Campaign Visits 36,477 88,138 Unique visitors 29,498 68,283 Page views 137,894 237,515 Return visitors 20.9% 24.1% Pages per visit 3.78 2.69 Average visit duration 00:02:24 00:01:42 Visits via social referral 8,080 27,688

Media Buy Per industry average the online media buy which included both banners and pre-roll video was a great success. There were other media sources purchased but this is the medium which provides specific results. The following are some highlights:

• Campaign delivered in full with minor over delivery—overall click through rate (CTR) of .22%

• Banners performed on average .06% CTR, with Hispanic creative leading the two display lines (English and Spanish) in terms of performance. This is above the industry average for online display banners which is .02-.05 CTR.

• The Half Page (300x600) led performance for the banner portion, coming in a .10% CTR

• Pre Roll ended at 75% Completion Rate, which is 11% higher than industry Benchmarks for Pre Roll Completion Rate

f. Modification of Project Methods/Strategies. No modification of project methods or strategies is proposed. g. Use of Existing Educational Materials. Existing Food Hero materials will be used for the campaign. h. Development of New Educational Materials. Development of materials as part of a Recipe Tip Enhancement (RTE) project is proposed which will be highlighted in all campaign channels, including being featured on each recipe of foodhero.org. The FFY2013 Oregon SNAP-Ed focus groups, previous original research and in depth literature review will be used to inform development. As was determined in pre-campaign research and has held true throughout the campaign the target audience primarily visits Food Hero to get recipes. However, campaign focus group and survey data shows they are interested in other tips, which is why a tips section was created for Food Hero. People are visiting the tips section but to a much lesser extent. Food Hero literature reviews and focus group data shows that having all the tips and recipe info in one place should be the most effective. The RTE project intends to do this by embedding related tips into each recipe in a visually appealing

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format which is easy to use and includes some interactive tools (such as a check-off grocery list which the target audience has requested via focus groups). The project would take snippets of content from already existing Food Hero tips and put them into buttons on each recipe, but then provide links to get the full Food Hero-related tip. Decisions on what categories of tips to choose and what to name them will be determined from focus groups being conducted in the end of FFY2013 combined with previous results from Food Hero original research. Some ideas for these categories, based on focus group and survey data results, include an interactive tool to determine what ingredients for the recipe need to be added to the users pen and paper based grocery list, a list of what can be prepped ahead, food safety and storage tips, ideas for what to serve with the recipe, tips for how to prep ingredients, and ideas for how kids can help. The categories would be visible via color-coded and named “buttons” under each recipe name and when clicked they would open a window on top of the current window that would allow the user to interact with the recipe and the tip window. Google analytics would allow the Food Hero team to gauge which categories were most successful and where to put future efforts or edit or change categories that were less popular. FFY2013 focus group research will also explore the possibility of creating a pilot online class or series of classes to target SNAP participants. If the results indicate that online classes appeal to SNAP participants, more details about the design and feasibility of this project will be explored, and approval from FNS will be sought prior to development. i. Key Performance Measures/Indicators. The impact assessment for Food Hero consists of an online and hardcopy survey administered in English and Spanish. The survey is composed primarily of the same content as the phone survey completed in Phase I. This was intentional to provide assessment of impact over time, or phases, of the campaign. This survey seeks to determine the attitudes and behaviors of this audience as they relate to the Food Hero campaign and measure fruit and vegetable consumption. With these surveys, OSU seeks to determine whether the target audience has been exposed to the Food Hero brand and its campaign elements, including the website. Additionally, the survey intends to determine basic attitudes and behaviors as they relate to FoodHero.org, the campaign website, and the campaign marketing strategy. The results of these surveys have been and will continue to be used as a benchmark to test the effectiveness of the phases of the Food Hero campaign. The survey is available for review by FNS if desired. Additionally, because all OFNP recipes are now on Food Hero every recipe handout sent home to parents has Food Hero messaging. Thus, the Parent Recipe Survey that has been used successfully for a number of years will be edited to include two questions pertaining to Food Hero. A key measure will be to see if parents used the recipes sent home with the children.

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Key Impact Indicators: • Frequency of planning meals and snacks that include (a) fruits and (b)

vegetables • Frequency of preparing meals and snacks that include (a) fruits and (b)

vegetables • Consumption of fruits in meals and snacks [MT1-iid; LT2-a] • Consumption of vegetables in meals and snacks [MT1-iie; LT2-b] • Frequency of planning meals • Frequency of comparing prices when shopping • Frequency of using a grocery list when shopping [ST2-a; MT2-a] • Frequency of cooking and preparing foods at home

Project D – Walk with Ease (in conjunction with nutrition education) a. Related State Objectives:

Objective 1(b): Physical activity and calorie balance. The adults and children who participate in a SNAP-Ed class series will increase their levels of physical activity, reduce levels of sedentary behavior, and/or increase their utilization of recommended strategies for achieving calorie balance, by 10%, on average, from baseline levels at the start of their classes. Objective 2(b): Organizational collaboration. All SNAP-Ed Program units will collaborate with partner organizations on joint efforts aimed at improving dietary quality and/or increasing physical activity.

b. Audience: Adults with an emphasis on reaching older adults c. Focus on SNAP Target Audience. SNAP Eligible adults will be targeted, especially older adults.

d. Project Description. OSU has a five-year contract with the Oregon Health Authority to deliver Walk with Ease in counties in Oregon. The Walk with Ease program has four key components including health information, walking, exercises, and motivational strategies. This is a 6 week program conducted 3 times per week. Counties will incorporate Walk with Ease classes in conjunction with SNAP-Ed nutrition education, as appropriate. This is a pilot program to investigate the feasibility of piggybacking the two types of classes. Clatsop and Washington counties have indicated their interest in this. OSU particularly wants to target low income populations, rural residents, and minority groups. e. Summary of Research. There is clear evidence that walking as a form of physical activity benefits health (Lee & Buchner, 2008). Walking has the potential to have a large impact on population health because it is easily accessible and it is free. It is a low impact activity and appropriate for all ages. It is particularly suitable for sedentary populations. Research has shown a positive relationship between walking and

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration reductions in deaths from all causes. Even as little as 2.5 hours per week of walking resulted in a 19% reduction of deaths from all causes (Lee & Skerrett, 2001; Woodcock et al., 2011). Even 15 minutes a day makes a large difference in longevity patterns (Wen et al, 2011). Walking has preventative effects on the onset and management of chronic diseases, including Type 2 diabetes, heart disease and stroke, and back pain (C3 Collaborating for Health, 2012). f. Modification of Projects Methods/Strategies: None planned at this time.

g. Use of Existing Ed Materials. The Walk with Ease curriculum will be used.

h. Development of New Education Materials: None

i. Key Performance Measures/Indicators

• Time spent in moderate to vigorous physical activity [MT3-ii; LT7] • Number of community sites that have improved access or infrastructure to

promote physical activity, generally as the result of joint community efforts. [MT5; LT11]

3. Evaluation Plans Project: A - Individual- and group-based nutrition and physical activity education (Goal 1). Type of Evaluation: Outcome evaluation: Focused on educational outcomes using a pre-post design (but no comparison group) Evaluation Questions that will be addressed: • Do adults and children who participate in a SNAP-Ed class series increase their

consumption of fruits and vegetables by at least 10%, on average, from baseline levels?

• Do adults and children who participate in a SNAP-Ed class series increase their levels of physical activity, reduce levels of sedentary behavior, and/or increase their utilization of recommended strategies for achieving calorie balance by at least 10%, on average, from baseline levels?

• Do adults who participate in a SNAP-Ed class series increase their utilization of recommended food resource management strategies by at least 10%, on average, from baseline levels?

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration Approach to Conducting the Evaluation: • Scope: All units, with multiple sites per unit, will be involved in evaluating this

project. Design: The design will be pre-post, with the data analysis focusing on potential gains in targeted outcomes over the time period of the class series, as measured by the questionnaires.

• Measures: To the extent appropriate, there are several evaluation questions and/or scales that will be used broadly, across curricula, to measure outcome change. In other cases, the evaluation measures will be specifically geared to the lessons that are delivered to the participants in the local setting.

• Data collection process: In most cases, data will be collected through administering group questionnaires at the start of the series (pretests) and at the end of the series (posttests). In some cases, based on timing and logistics in the local setting, a retrospective pretest design may be used. The analysis and interpretation of data will be conducted at the campus level.

Plans for Using the Results: • The results of the evaluation of the targeted program outcomes, as well as

information on program outputs, will be shared with the funder in the SNAP-Ed annual report.

• The results will be analyzed to determine whether the program has achieved its targeted objectives. They will also be used to determine if the overall program is more effective in some regions than others, and for some objectives more than others.

• Results will also be used to determine whether program effectiveness is even or uneven across the units, and how some areas of the program can potentially be improved.

Most recent year of previous evaluation: FFY2013

Project: Evaluation of Growing Healthy Kids, a garden-based curriculum developed at Oregon State University Type of Evaluation: Outcome evaluation, focused on the effectiveness of the Growing Healthy Kids (GHK) curriculum in changing knowledge, intentions, and behaviors relating to healthy diets in students grades 2-3. Evaluation Questions that will be addressed: • Does participation in the GHK curriculum result in changes in elementary school

children’s (a) understanding of food and nutrition, (b) intentions to engage in healthy eating behaviors, and (c) consumption of vegetables and fruits?

• Does participation in the GHK curriculum increase children’s understanding of the biology of food and nutrition?

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration • How does the use of a garden setting for delivering nutrition education affect the

motivation of students to learn about foods and try new foods? Approach to Conducting the Evaluation: • Scope: With the curriculum’s focus on gardening, this evaluation will be conducted

in spring or summer 2014 at a limited number of sites, e.g., 4-8 schools (including both program and comparison groups).

• Design: We anticipate using a comparison group pretest-posttest design, with approximately half of the school sites receiving the GHK program and the remaining sites serving as control sites. The decision as to whether to assign sites to condition at random or, alternatively, to use a matching procedure will be based on feasibility and discussions with the site personnel, after the sites have been selected for participation in the evaluation. The evaluation measures will be administered at the start and the completion of the GHK program.

• Measures: The questionnaires will be developed in fall and winter, prior to beginning the delivery of the curriculum in spring 2014.

• Data collection process: Data collection will take place on-site in a group administration format, conducted by SNAP-Ed staff.

Plans for Using the Results: • Results will be shared with the funder in the SNAP-Ed annual report. • Results will be used to revise and improve the Growing Healthy Kids curriculum, in

ways indicated by the findings. • Results on curriculum effectiveness will be shared with other nutrition educators,

including other SNAP-Ed programs, as part of the dissemination effort for the GHK curriculum.

• Results will be shared through scholarly channels, as appropriate for the significance of the findings, in order to contribute to the field’s overall understanding of the use of garden-based programs as a strategy for delivering nutrition education for elementary school students.

• Results will be used to inform decisions about using this curriculum vs. other curricula in specific SNAP-Ed settings in future years.

Most recent year of previous evaluation: This evaluation has not previously been conducted.

Project: Evaluation of the Balanced Energy Physical Activity Toolkit (BEPAT) developed at Oregon State University Type of Evaluation: (1) Outcome evaluation, focused on the effects of using the toolkit on levels of physical activity behaviors in target audience using a quasi-experimental or randomized control/comparison group design in classes targeting children grades K-6.

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration (2) Process evaluation, focused on understanding the implementation of the BEPAT, the most appealing activities in the BEPAT, and other factors that can improve the effectiveness of the BEPAT as an educational strategy for the SNAP-Ed target audience. Evaluation Questions that will be addressed: Outcome Questions: • Do children who participate in SNAP-Ed classes that utilize the BEPAT spend more

time in light, moderate and vigorous activity and less time in sedentary activity than children who participate in SNAP-Ed classes that do not utilize the BEPAT?

• Do children who participate in SNAP-Ed classes that utilize the BEPAT increase their understanding of energy-balance more than children who participate in SNAP-Ed classes that do not utilize the BEPAT?

Process Questions: • How effectively are SNAP-Ed educators able to utilize the BEPAT with SNAP-Ed

approved curricula? • What is the level of engagement in the BEPAT activities among members of the

target audience? Approach to Conducting the Evaluation: • Scope: Select units across the state will be included in the evaluation to be

conducted in winter 2014. • Design: We anticipate using a group-randomized, controlled trial. Education

program assistants (EPAs) in selected, participating units will deliver similar curricula to intact classrooms. Ideally, classrooms within each school, matched by grade will be randomized to receive either SNAP-Ed approved curricula or SNAP-Ed approved curricula plus BEPAT (SNAP-Ed+). The evaluation measures will be collected at the start and the completion of each SNAP-Ed or SNAP-Ed+ lesson.

• Measures: Questionnaires concerning the process evaluation and the child-level energy-balance assessment will be developed in fall 2013, prior to evaluation onset in winter 2014. Physical activity monitors, validated for use with a pediatric population, will be used to collect child-level activity data during SNAP-Ed and SNAP-Ed+ lessons.

• Data collection process: SNAP-Ed educators will be trained and provided assistance in ensuring that each child has a monitor affixed to their hip at the start of each lesson being evaluated, and that all monitors are removed at the completion of each evaluated lesson. Children will complete a brief survey (1-3 questions) about energy-balance at the end of each evaluated lesson. Educators will fill out process evaluation questionnaires at the end of winter 2014. These may be completed online or via paper format.

Plans for Using the Results: • Results will be shared with the funder in the SNAP-Ed annual report. • Results will be used to revise and improve the BEPAT, in ways indicated by the

findings.

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration • Results on BEPAT effectiveness will be shared with nutrition educators broadly as

part of the dissemination effort for the BEPAT. • Results will be shared through scholarly channels, as appropriate for the significance

of the findings, in order to contribute to the field’s understanding of physical activity promotion strategies and the integration of physical activity and nutrition education via direct education delivery mechanisms.

• Results will be used to inform decisions about using BEPAT vs. other physical activity promotion strategies in specific SNAP-Ed settings in future years.

Project: B - Comprehensive and multi-level approaches (Goal 2). Type of Evaluation: Goal-oriented outcome evaluation: Focused on assessing the achievement of specific changes at the social, policy, or environmental level that has resulted from the participation of SNAP-Ed and other partners. Evaluation Questions that will be addressed: • What changes have been made to practices or capacities of community-level

organizations, institutions, or businesses to promote healthy food choices? • What changes have been made to policies or capacities at school sites to promote

healthy food choices and/or increased physical activity? • What changes have been made in community sites resulting in improved access or

infrastructure to promote physical activity? • What community-level partnerships, collaborations, or coalitions have operated, with

SNAP-Ed participation, to implement initiatives aimed at improving dietary quality or physical activity?

Approach to Conducting the Evaluation: • Scope: Information will be gathered at the unit level, including all units in the state. • Design: A survey design will be used, contacting units to ascertain their progress on

achieving environmental level changes in their communities. • Measures: A questionnaire will be developed, for distribution to SNAP-Ed units.

This measure will gather information about community-level changes that have occurred, as well as background information on the organizations and processes, so that successful strategies can be replicated in other localities and shared with peers.

• Data collection process: The questionnaire will be delivered online. Plans for Using the Results: • Results will be shared with the funder in the SNAP-Ed annual report. • Results will be analyzed to better understand the basis and strategies for successful

partnerships and community-level change. That knowledge will be shared program-wide, to build our organizational capacity to create productive partnerships and achieve meaningful environmental changes.

• Results will be shared, as appropriate, with SNAP-Ed programs in other states.

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration Most recent year of previous evaluation: FFY2013 (in more limited form)

Project: C - Community and Public Health Approaches - Food Hero, a social marketing campaign developed at Oregon State University. Type of Evaluation: Process evaluation, focused on understanding the implementation of the Food Hero campaign, the most appealing ways to frame the messages, the highest-visibility communications channels, and other factors that can make the campaign an effective educational strategy for the SNAP-Ed target audience. Evaluation Questions that will be addressed: • What are the best ways to deliver the Food Hero campaign in a local community? • How effective is the use of elementary schools as the central focal points for the

campaign? • What is the awareness level of target audience members regarding the campaign

during and after its delivery? • What do target audience members learn from the campaign? How much do they

pay attention to the campaign messages? • Which components of the campaign are most successful in reaching the target

audience (e.g., community billboards, public events, the school website, school newsletter, school banners, SNAP-Ed educator gear, the Food Hero monthly newsletter, links to the Food Hero website on school menus, etc.)?

Approach to Conducting the Evaluation: • Scope: The evaluation will be conducted using school communities as the units of

program delivery. Based on factors such as funding, staff resources and unit availability, the evaluation will probably be implemented at somewhere between 15 and 60 school sites. It is expected that the evaluation will take place during a campaign period of January-June 2014.

• Design: The design includes two components for two different groups. First, for the Food Hero target audience, a survey will be administered in a pre-post format, to determine audience members’ awareness levels and opinions about the campaign, and their changes in awareness between the launch of the campaign and its completion. Second, SNAP-Ed units will be surveyed periodically during the campaign, to determine their use of various communication channels and to track how the campaign is being delivered locally.

• Measures: The measures for the target audience will include pre- and post-campaign survey questionnaires, to be administered both online and in hard copy, depending on the venue and the preference of the individual participant (see next paragraph). The measure for the SNAP-Ed units will be an online survey.

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration Data collection process: For the target audience survey, there will be pretest and posttest data collection periods during which opportunities to complete the survey will be available, in accord with the venue being used. For example, hard copy questionnaires will be distributed at Food Hero parent sessions and public events, while links to the online survey will be listed on the Food Hero newsletter, school newsletter, and school lunch menu (which gets sent home to parents), as well as posted on the school website. Invitations to complete the survey online will also be sent to SNAP-Ed parents who are on program email lists. For the SNAP-Ed unit data, the questionnaires will be administered using Oregon State University’s Qualtrics survey system, through email contacts that provide links to the survey. Plans for Using the Results: • The results of the process evaluation will be shared with the funder in the SNAP-Ed

annual report. • Results will be used for formative purposes, to analyze the effectiveness of

individual campaign components and to help the Food Hero campaign evolve and maximize its effectiveness.

• Results will be used for to inform decisions about whether to continue using elementary schools as the focal points for Food Hero campaign activities, or whether additional options should be explored as well.

• Results will be used to plan an outcome evaluation for the Food Hero campaign in the FY 2015 SNAP-Ed plan.

Most recent year of previous evaluation: FFY2013 4. Coordination Efforts State-level coordination: A. DHS and OSU – Joint Perspective. Oregon DHS continues to work closely with

OSU Extension Service to develop strategies to assist SNAP eligible audiences. The partnership collaborates on other funded grant and contract programs to increase SNAP participation and promote SNAP-Ed healthy eating and obesity prevention strategies.

B. Oregon Food Bank. Because Oregon has one of the highest rates of child hunger in the U.S. (Feeding America, 2011), emergency foods are a critical resource for food insecure Oregonians. Although food boxes are meant to assist in emergencies, a large number of households rely on them at least once a month. The seemingly paradoxical co-incidence of food insecurity and overweight/obesity has led to partnerships focused not just on improving food security (by reducing reliance on emergency foods), but also developing strategies and resources to help improve the nutritional quality of emergency foods for those that need them.

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Oregon State University has a strong history of collaborating with Oregon Food Bank (OFB), a statewide network of almost 1,000 agencies strengthening food security of some of our most vulnerable Oregonians: families, children, immigrants, and seniors living in poverty. OFB recovers, processes, stores and delivers over 81 million pounds of food each year, an increase of about 41% since 2008 (Oregon Food Bank, 2012). Based in part on a study of nutritional quality of emergency foods conducted jointly by OFB and OSU Extension (Hoisington et al., 2011), OFB has developed policies to guide the acquisition of nutrient-dense foods when appropriate and practical, including increasing the proportion of fruits and vegetables, whole grains, and low-fat dairy acquired and distributed.

Utilizing another common food banking strategy, an increasing number of food pantries within the OFB network are incorporating a ‘shopping style’ approach, where recipients choose the contents of their food box. According to the principles of behavior economics (Just, 2007) external cues can have a major effect on the food selected. OFB will be encouraging their member agencies to re-design their pantries with supports that encourage healthier eating patterns.

For FFY2014, OSU’s SNAP-Ed partnership with OFB will expand to incorporate strategies from our 3 Projects:

a) Individual/group-based nutrition education, health promotion intervention

strategies:

• Direct education for adults and families using Cooking Matters™ with OFB partners agencies.

• Indirect: posters, displays, bulletin boards, and food demonstrations using gleaned and commodity foods, “Plant a Row” donated garden produce, and low-cost staples.

• Train-the-trainer: training volunteers to expand our direct and indirect reach.

b) Comprehensive, multi-level approaches: OSU will align our SNAP-Ed interventions with OFB’s efforts through developing intentional relationships with regional and local agencies that are changing or considering changing the emergency food environment, using the following strategies:

• Healthy Pantry Committee participation: roles include conducting “Healthy

Pantry Assessments” (appendix B) and generating related report(s), recommending intervention strategies, and working with committee on pre-post intervention assessments.

• Provision of training for network staff on importance of vegetables and fruits to increase awareness of/support for implementing strategies to improve quality of emergency foods provided.

• Co-application for grants and awards • Joint health promotion events with other stakeholders

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c) Community and public health approaches: OSU will pilot conducting “Food Hero Healthy Pantry Makeovers” in 8-10 food pantries, incorporating the results of Healthy Pantry Assessments (see 2, above) – with a special emphasis on external cues and other marketing strategies to encourage selection of healthy foods.

C. Child Nutrition Programs. For FFY2014, OSU’s SNAP-Ed partnership with Oregon

Department of Education (Child Nutrition Programs, School Food Service, and the broader school environment) will incorporate strategies from our 3 Projects: a) Individual/group-based nutrition education, health promotion intervention

strategies: All SNAP-Ed units plan to provide school-based, after school, and summer nutrition education at public schools and USDA Summer Feeding sites. The types of nutrition education activities conducted in these programs include series of classes, and single events, and may include posters/displays, handouts, and nutrition take-home messages for parents. Very strong relationships with schools are enjoyed at the local level. OSU will continue tracking and reporting on the delivery of nutrition education information and messages sent to adults in the home. Most take home nutrition messages are given to students in the classroom or after school programs and sent home to parents/guardians. Nutrition messages will be delivered to parents or guardians of youth in the following ways: • Recipes sent home to family members with youth participating in SNAP-Ed

youth groups • Youth verbally sharing nutrition information learned in SNAP-Ed classes with

family members • Parent newsletters with nutrition information and nutrition-related family

activity suggestions • SNAP-Ed information brochures

Additionally, in an attempt to reinforce nutrition messages throughout the school and in the home, Unit faculty are involved in such activities as hosting activities at back to school nights, writing articles in school parent newsletters, creating prominent bulletin boards in school hallways, and offering classes to parents and their children. Several Units do this through coordinated messages that are sent through many school channels.

b) Comprehensive, multi-level approaches: OSU will align SNAP-Ed

interventions with Oregon Department of Education Child Nutrition Programs through developing intentional relationships with schools (and in some cases, school districts) that are changing or considering changing the food/physical activity environment, using the following strategies:

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• School Nutrition and Physical Activity (SNPA) environmental assessments: co-conducting assessments and generating related report(s); working with school partners to identify assessment-informed intervention strategies; co-establishment of physical, social, and/or policy supports for healthy eating and physical activity, and supporting post-intervention evaluation (appendix B).

• Wellness Committee participation: in partnership with wellness committee, OSU’s role may include co-development of a school-level policy based on guidelines (e.g. recess before lunch).

• Nutrition Services: joint identification of opportunities for interacting with

school food service director and other school-environment stakeholders to strategically align nutrition education with the menu: e.g. nutrition messaging and activities linked to the new Healthy Hunger-Free Kids school lunch meal pattern specifications regarding vegetables and fruit, vegetable subgroups, and grains.

• Coaching school staff on importance of championing healthy eating and

physical activity and to increase awareness of strategies to change dietary and physical patterns in school.

• Co-application for grants and awards, including Fresh Fruit and Vegetable

Snack Program and for other grants and awards, such as Healthy, Active Schools and Healthier School and Healthier US School Challenge Awards.

• Joint health promotion events with other stakeholders within a Coordinated

School Health model.

c) Community and public health approaches: Units will partner with schools to deliver the Food Hero campaign as described in detail in project C.

D. Women, Infants and Children (WIC). WIC’s vision in Oregon is for families to have

the resources and knowledge to achieve optimal nutrition and lifelong health. This vision aligns with SNAP-Ed’s ultimate goal of promoting good health and preventing or postponing the onset of diet-related chronic diseases by empowering participants to establish healthier eating habits and be more physically active.

Oregon State University SNAP-Ed has a long history of collaborating with state and local WIC Program coordinators. Both programs refer participants to each other’s services and educational programs through links on statewide websites and educators in the community. In addition, SNAP-Ed educators extend the nutrition counseling/classes provided to WIC clients with follow-up classes on topics such as meal planning/preparation using WIC foods, shopping, budgeting, and feeding young children.

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http://www.ode.state.or.us/search/page/?id=3016

http://www.fns.usda.gov/cnd/governance/legislation/cnr_2010.htm



http://www.fns.usda.gov/tn/healthierus/

http://www.cdc.gov/healthyyouth/cshp/components.htm

http://www.cdc.gov/healthyyouth/cshp/components.htm


In the past, Oregon WIC and OSU SNAP-Ed have worked to provide consistent nutrition messaging to families, based on the current USDA food guidance system. For FY2014, OSU’s SNAP-Ed partnership with WIC will expand to include targeted messaging across both programs to encourage and support family mealtime, using the USDA/FNS family meals messaging, “Cook together. Eat together. Talk together. Make meal time a family time.” These child feeding messages provide mothers with actionable tips and help build their skills and self‐efficacy in teaching their children healthy eating habits. Formative research on this messaging indicated that moms are motivated by information that is new or unique to them and that they found these messages and tips both relevant and realistic (FNS 2010).

a) Individual/group-based nutrition education, health promotion

intervention strategies: • Direct education: Four classes will be co-developed, focusing on the

concepts of “Cook,” “Eat,” “Talk,” and “Family Meal Time.” Classes will be taught by SNAP-Ed educators at a variety of community sites that reach both WIC and SNAP-Ed mothers (will not supplant WIC nutrition education).

• Indirect: Food demonstrations promoting the use of Food Hero family meal recipes that are quick, low-cost and easy to prepare, to encourage family meal time experiences.

b) Comprehensive, multi-level approaches:

• Training of WIC agency (county) coordinators: develop a simplified informational brochure to train WIC agency staff on the nutrition educational opportunities available through SNAP-Ed and EFNEP. This resource will clarify allowable SNAP-Ed and EFNEP activities/ interventions and promote coordinated efforts between OSU and WIC. Production costs will be shared/pro-rated with EFNEP.

• Further investigate collaborative efforts to promote and support WIC breastfeeding activities.

c) Community and public health approaches:

• Promote the Food Hero website at SNAP-Ed family meal classes and WIC agency sites as the “go to” resource for more tips and tools to make family meal time possible.

E. Nutrition Council of Oregon (NCO). An OSU Nutrition Specialist and DHS program

representative continue to represent SNAP-Ed as active participants of this statewide council, which is comprised of other FNS program representatives (WIC and Child Nutrition Programs), the Department of Public Health, and other stakeholders. NCO members focus on collaborative messaging regarding increasing fruit and vegetable consumption, physical activity, and family meals. In FFY2014, NCO has chosen Food Hero (OSU SNAP-Ed) as a vehicle for promoting a “shared mealtime” campaign, which will draw SNAP-Ed audiences to foodhero.org for tips on making help family meals more achievable. In addition, NCO engages

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with school districts in the encouragement of wellness policies and other strategies to address rates of obesity in Oregon adults and youth, with SNAP-Ed a partner in half (18) of Oregon’s counties.

F. EFNEP. EFNEP (Expanded Food and Nutrition Education Program) is designed to

assist limited resource audiences in acquiring the knowledge, skills, attitudes, and behavior change necessary for selecting nutritionally sound diets, and to contribute to their personal development and the improvement of the total family diet and nutritional well-being. In Oregon, OSU Extension has both SNAP-Ed and EFNEP funding. Although the programs are administered separately in counties where EFNEP programming is occurring (Lane, Washington, Multnomah, Marion, Polk, Linn, Clackamas, Yamhill, Benton), the target population receives very similar educational opportunities. Leveraging funds from both programs is done on any cross-program projects.

EFNEP and SNAP-Ed are coordinated carefully in these counties. All reporting of EFNEP education delivery is done separately and distinctly from SNAP-Ed delivery. All OSUES Staff are trained to understand that these are two different programs with different sets of guidelines. SNAP-Ed has more opportunity to serve all ages of adults, including seniors, and youth, whereas EFNEP targets families with young children and youth. EFNEP also works more closely with WIC, due to fewer restrictions.

Oregon EFNEP targets adults with young children who have time to attend a series of classes, ideally 6 to 12 lessons. The Hispanic, Russian, and Somali populations are examples of communities that participate regularly in a longer series of EFNEP lessons. SNAP-Ed offers a shorter (3-4 lessons) series of classes, targeting eligible adults, youth and families who do not have time to attend a longer series of classes.

G. Oregon Hunger Task Force. The Oregon Hunger Task Force was created by the

State Legislature in 1989 to collaborate with state agencies, businesses, non-profits, public officials and local communities to end hunger in Oregon. Working with partners throughout Oregon, the Task Force promotes community awareness, compiles research, develops proposals for government action and conducts outreach to expand participation in Federal Nutrition Programs. An OSU Extension Service representative participates in monthly meetings and shares information about SNAP-Ed programming. OSU SNAP-Ed programs have linked strategically with agencies serving SNAP audiences through participation in the Task Force – for example, USDA Summer Feeding Program sites and other Child Nutrition Programs, Oregon Child Development Coalition/Migrant Head Start, and WIC.

H. Local Coalitions. Baker County Community Food Systems Collaborative (partner and member): Promotes access to healthy local foods. Meets quarterly.

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration Benton County Hispanic Advisory Committee (member and secretary): Increases services to the Latino audience. Meets once a month. Lincoln Wellness Committee (member): Comprised of community organizations, food service, and parents; enhances the health of families of the Lincoln School. Meets once a month. Health Equity Alliance (member): Decreases health disparities that exist in the community. Meets once a month. Community Health Improvement Plan (member): Implements strategic plans to improve the health of Benton County. Meets quarterly. Clackamas County Milwaukie High School Healthy School (partner): Creates a healthy students/healthy school environment. Meets twice a year. Welches School District Wellness Committee (partner): Creates a healthy students/healthy school environment. Meets twice a year. Clatsop County North Coast Food Web (NCFW founder/director): Cultivates a thriving regional economy and healthy communities through food and agriculture. Activities include supporting expansion and diversification of regional food production and access, in both public and private sectors. Additionally, NCFW connects, collaborates, creates networks and builds capacity through development of community assets, including food system infrastructure, financial resources, social capital resources, knowledge and the next generation of food system leadership. For example, we will investigate the feasibility of Community Supported Agriculture (CSA) taking EBT cards in our county. Meets monthly.

• Mobile Garden Project: The successful Mobile Garden project will continue as a way to support and strengthen food production skills and accessibility to fresh fruits and vegetables. In this project, mobile gardens are created in donated used/discarded shopping carts. Carts are organized in a “mobile garden library,” and loaned out to SNAP-eligible participants through school and/or community venues. SNAP-Ed nutrition education and physical activity lessons accompany instruction, materials, and support to grow food.

• Clatsop Community Action (CCA) Food Bank collaborated with OSU Extension

and other partners to set up a farmer’s market-targeting for limited-resource individuals. This year at the River People Farmers’ Market in Astoria, a pilot project will help fund the market’s innovative “SNAP MATCH” program. OSU Extension SNAP-Ed will partner to expand SNAP match at farmers’ markets in

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our region. SNAP participants are encouraged to visit the market information booth, where up to $10 on their Oregon Trail Cards (EBT cards) will be matched with $10 in market tokens. Our role is to help create and manage the project. The goal is for SNAP participants to eat more fruits and vegetables.

CHART (Community Health Action Resource Team) (team member): Create a Clatsop County comprehensive workplace wellness plan in order to create healthier workplaces, healthier communities, and healthier people. Additionally the group has a Vista volunteer helping to organize the coalition as it moves forward. Meets monthly. Friends of Clatsop Community Gardens Association (Garden manager of the Sunny Hunt Community Garden in Seaside & FCCGA Board member): building community resiliency through gardening. Meets monthly. School Wellness committees (member): Improved wellness in schools through the promotion of healthy food and activities for families. Meetings vary. Columbia County The Columbia Health Coalition (coalition member): Empower the community to increase opportunities for healthy lifestyles through initiatives for policy, systems, and environmental change. Meets monthly. Columbia Pacific Food Bank Board of Directors (Vice President): End hunger and its root causes in Columbia County. Provide governance and oversight of the operations of the Columbia Pacific Food Bank. Meets 6 to 8 times per year. Rainier School District Wellness Committee (committee member): Provide leadership in regards to wellness for the school community in Rainier. Coos County Chronic Disease Coalition (member): Purpose is to help health professionals and educators share resources, get events on calendars, and market programs. FEAST (Food, Education, Agriculture, Solutions Together) This outreach project is sponsored by the Oregon Food Bank in Coos and Curry counties (participant): FEAST is a community organizing process that allows participants to engage in an informed and facilitated discussion about food, education and agriculture in their community and begin to work toward solutions together to help build a healthier, more equitable and more resilient local food system. Community Health Education Coalition (member): Conducts Body Walk for 3rd graders and the elder resource fair each year.

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration Crook County Crook County Community Health Improvement Partnership (CHIP) (committee member): Community partners meeting to address needs and share ideas, strategies and form partnerships to improve the health of residents. Curry County Nutrition Coalitions (with Leightman Maxey Foundation) (member): Leightman Maxey is making efforts to bring nutrition education to southern Oregon. They are sponsoring a nutrition coalition that assesses the community and determines needs, then makes efforts to find the partners/programs to fill those needs. Deschutes County Head Start Health Services Advisory Committee (member): Provides guidance and advice on program policies in health, safety, nutrition and mental health in Deschutes County. Meets twice a year. School Wellness Policy Committees (member): Develop/Implement school wellness policy in the Bend-LaPine and Redmond school districts. Meets once a year. Housing Works/ Families Forward Program Coordinating Committee (PCC) (member): Manages section 8 housing units (HUD) and provides family support education including transition to home ownership education opportunities. We provide nutrition education & shopping behavior classes at sites. Meets 4 times per year. St. Charles Hospital Community Health Division (member): Regional health collaborative working to promote good health and wellness and reduce obesity in Central Oregon. Meets 1 to 4 times per year. Douglas County Live Well Douglas County (member/presenter): Create synergies to health in Douglas County: members from health related organizations are always asked to attend and give updates on programs in Douglas County. Meets 9 times per year. Gilliam County Local Community Advisory Committee for GOHBI (member): Local input on health services. Meets monthly. Grant County CHIP (Chairperson): Community Health. Goal for 2014 is to compile and distribute a health resource book. Meets monthly. Hood River County Healthy Active Hood River County (attendee, listserv keeper, rotating secretary, and convener): Making the healthy choice the easy choice for all in Hood River County. The coalition is actively pursuing outcomes in response to several needs assessments. The

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration focus of the group is policy, systems, and environmental changes to improve the health and well-being of our community. Meets every other month. School Health Advisory Committee (attendee/convener): Promote health in schools. Meets once a year. Better Health for Busytown (attendee): Busytown was convened by our local medical providers to identify high users of health care and encourage them to seek preventive measures by plugging them into local resources to gain skills in healthy eating and active living. The providers are interested in developing a referral system for their low-income patients to seek nutrition education and physical activity programs in the community to decrease overall health care costs in the long run. They work primarily with Medicaid patients in the community. Meets monthly. Jackson County Southern Oregon Head Start Health Advisory Committee (committee member): Review policies, programs and education plans. Parents, Head Start staff, community partners and health care providers participate. Meets quarterly. Pioneering Healthy Communities Task Force (participant in task force groups): Includes representatives from Public Health, WIC, Coordinated Care Organization, healthcare, local Food Bank, farmers’ markets and educators. Review and evaluate strategies identified in Healthy Communities assessment of local status of population, services and community needs. Leightman Maxey Nutrition Coalition (participant/member): This foundation brings together individuals, agencies and groups with interest in nutrition education for the purpose of networking, developing programs and funding opportunities. Attendees include YMCA, school food service managers, school personnel, food pantry & Food Bank, regional Extension faculty, health providers and businesses to discuss programs, projects and develop strategies and funding for projects. Meets quarterly. ACCESS Food Systems Food Council Task Force (participant in task force projects): Increase food security through access to food and education. This coalition directed by ACCESS has completed Community Food Assessment for our two county regions. They have received a Meyer Memorial grant to develop education at food pantries and use the Cooking Matters program. We expect some cooperative programming will develop based on these resources over the next two years. Meets as needed. Jefferson County Community Health Improvement Partnership (CHIP) (committee member): Jefferson County CHIP is designed to bring together local residents and health care providers to find ways of improving the health of residents. They have developed workgroups targeting four focus areas: community and school-based obesity prevention initiatives, children's oral health, healthy brain and character supports for infants and children, and community-based participatory research. Meets once every 2 months.

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration Healthy Eating Active Living (committee member): Working to improve opportunities for healthy eating and active living. Meets every couple of months. School Wellness Committees: Improve wellness and health in the school environment. Meets quarterly. Josephine County Nutrition & Wellness Committee (member): Review food service programs, wellness policies and classroom health education. District staff, teachers, parents and community members make up this group. Meets 1 to 2 times per year. Southern Oregon Head Start Health Advisory Committee (committee member): Review policies, programs and education related to health in Head Start program. Parents, HS staff, public health, school nursing staff, and other health care providers attend these meetings. Meets quarterly at a preschool site. Pioneering Healthy Communities Task Force (participant): Plan, review and evaluate strategies identified in Healthy Communities assessment of local health status of population, services and community. Develop interventions to address needs in the community. Includes representatives from Public health, school district, Coordinated Care Organization, other health providers and community partners like YMCA. Recently added Food Hero and OSU Food Safety and Preservation to their website. Leightman Maxey Nutrition Coalition (participant/member): This foundation brings together individuals, agencies and community groups with interest in nutrition education for purpose of networking, developing programs/projects and learning about funding opportunities. Attendees include school food service administrators, school administrators, teachers, college staff, food coop, ACCESS, and regional Extension faculty. Meets quarterly at a community site. Klamath County City and County School District Wellness Committees (member/advisor): Improve food and physical activity behaviors and access for students and staff. Meets monthly at the School District office. School-Site Wellness Committee (member/coordinator for food/activity efforts at school): Improve food and physical activity opportunities at school. Meets monthly. Healthy Klamath (member/leader): Coordinate efforts to support policies, education and systems to improve health and access to health in the community. Meets quarterly or as needed at the Health Department or Sky Lakes Medical Center. Youth Development Network (member): Network resources for health of youth in the community. Meets monthly.

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration Lake County Lakeview United Prevention/ Intervention Coalition (member): Network of service agencies that seek to collaborate on improving the health of youth in the region. Meets monthly. Lincoln County Lincoln County Childhood Obesity Partnership (chairperson): Work collaboratively to enhance health of children and families through the delivery of evidence-based community health promotion services targeting obesity. Focus is the community & family. Priorities are 1) Provide accessible, low cost, and affordable physical activity programs 2) Develop sustainable community/school gardens and other local food projects. Meets every other month. Linn County Health Equity Alliance (member): Increase health equity among priority populations. Meets once a month in Linn/Benton County. Hispanic Advisory Committee (member/secretary): Increase services to Latino population. Networking and sharing program information with other organizations that works with the Latino population. Meets once a month in Linn/Benton County. Community Health Improvement Plan (member): Form strategic plan for improving Linn County health. Working to expand theme areas to include social determinants of health. Meets quarterly. Malheur County Malheur County Wellness (member): Bringing agencies from the community together. Meets once a month. Marion County Pioneering Healthy Communities (coalition member): YMCA is lead on this project. Help put systems in place that increase access to healthy food options and opportunities for safe places to play. Meets 9 times per year. Marion Co. Community Health Improvement Taskforce (partner/coalition member): Conduct needs assessment, develop plans, and implement plans. Each agency has objectives in plan; NEP objectives are included in plan. Meets quarterly. Morrow County Community Health Improvement Partnership of Morrow County (member): Community health behavioral change. Meets monthly. Multnomah Hispanic Parish Health Promoter Advisory Board (committee member): Target is Latino families living in the Portland Metro Area. Focus is program guidance. Meets 3 times per year; Catholic Charities/Providence.

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration Multnomah- Portland Power Up! WISE (Wellness in School Environment) (member): To coordinate working with youth in the schools so other groups and agencies are aware of program outreach. Meets 4-6 times per year. PPS WAC (Portland Public Schools Wellness Advisory Committee) (community member): To work on improving nutrition/physical activity outreach in the schools. Meets monthly; PPS District Office/Other schools in District. NCO Share Mealtime Committee (SNAP-Ed member): To expand using "Share Mealtime" messaging in a cooperative way throughout the year. Meets monthly. Polk County Pioneering Healthy Communities (coalition member): Help put systems in place that increase access to fruit/vegetables and safe places to play. YMCA is lead on this coalition. Meets 9 times per year. Tillamook County Tillamook Co. Child Hunger Summit (speaker/participant): Inform community of need. Umatilla County Healthy Communities Coalition (member): Analyze community health needs; decide on approach to meet need. Meets monthly. Union County Union County Fit Kids (member): Improve availability of healthy foods and physical activity for elementary aged kids. Research based coalition linked with OHSU School of Nursing. Meets monthly. Community Food Systems Collaborative (member/partner): Strengthen access to affordable, healthy food. Funded by a Meyer Memorial Trust Grant for at least 3 years. Meets quarterly at the Eastern Oregon/Oregon Rural Action Office. SNACZ Project (nutrition education): Students advocate for healthy snacking zones in their communities. 4 year USDA funded project linked with 4-H afterschool nutrition clubs. Meets several times/month. Wallowa County School Wellness Committee (Liaison): Oversee school policy and review policy. Meets in Joseph and Wallowa Schools. Warm Springs County Head Start Advisory Committee (nutrition advisor): Evaluate early childhood needs of the Warm Springs community. This group meets to discuss emerging issues within the community regarding health and safety for children ages newborn to 5 years of age. Meets 6 times per year at the Early Childhood Center.

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FFY2014 Oregon SNAP-Ed Plan Section B: Goals, Objectives, Projects, Campaigns, Evaluation, and Collaboration CHIRP Community Health Improvement Research Partnerships (member): Work within the community to help prevent childhood obesity, dental caries in youth, and brain development. Seek grant funding for research within health and nutritional needs of the community. This coalition encompasses Jefferson, Deschutes, Crook, and Warm Springs counties. Meets monthly at the St. Charles Hospital in Madras. Wasco County School Health Advisory Committee (SHAC) (attendee): Improve health and wellbeing of students in school district. Meets quarterly. Physical Activity and Nutrition Committee (PANC) (attendee/mentor): Similar to HAHRC Coalition in Hood River; PANC was developed in response to the Healthy Communities Survey Process and is seeking to improve the Policy, Systems, and Environmental approaches to nutrition and physical activity. Convened by Health Department. Better Health for Busytown (attendee, advisor on nutrition): The goal of Busytown is to address the healthcare needs of the Gorge community and reduce healthcare use among top users of emergency room care. The approach of the coalition is Gorge-wide and will impact the health of individuals throughout Hood River and Wasco Counties. Meets monthly at Providence Hood River Memorial Hospital and Gorge Wide Approach. Wasco County Network on Aging (attendee/convener): WCNOA is a Network of local service providers that work with Aging Adults and Seniors to improve their health. OSU’s role in the WCNOA is to improve the healthy eating and active living behaviors of adults 65 and older. Meets monthly. Washington County HSAC, Health Services Advisory Committee (member): Inform health decisions. Meets quarterly. Somali & Somali Bantu Resource Group (member): Providing support and resources for the immigrant community. Meets 5 times per year. Childhood Care and Education (member): Coordinating efforts with providers in Washington County. Meets monthly. Metro Extension Outreach Group (member): Coordinate effort in SE Portland. Meets in Multnomah County four times a year. Yamhill County School wellness committee(s): will pursue membership in FFY2014.

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