Abstract
Improving WIC retention through targeted text-based communication: An evaluation of Colorado's pilot "Texting for Retention Program"
Gabrielle Elzinga-Marshall, MPA, Kristin McDermott, MA, Natalie Schroder and Erin Ulric, MPH
Colorado Department of Public Health and Environment, Denver, CO
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Introduction: Retention of children over the age of one has been identified as a significant concern to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the state of Colorado. In order to address retention concerns, the Colorado WIC Program has been piloting the Texting for Retention Program (TFRP) since early 2015. Approach: The TFRP is an innovative, research-driven approach aimed at “Millennial Moms,” women aged 18-34, who are technologically savvy and rely substantially on mobile devices. These women made up 85.5% of WIC participant mothers in 2014. The TFRP addresses a primary barrier to child retention in the WIC program, specifically remembering to schedule and attend appointments, and encourages retention by delivering information about the benefits of WIC participation through text message. This pilot was evaluated using a matched groups design. Pre- and post-TFRP retention outcomes were compared among a sample of WIC clinics receiving the basic texting innovation, an augmented texting innovation, and a matched control group. Results: Over the first three months of the pilot, 553 participants that otherwise would have left the program were retained, and clinics receiving the innovation had a 40.6% increase in reinstatements. Discussion: The TFRP has effectively utilized communications technology to improve public service provision. Initial results suggest that the program has had an overall positive impact on WIC retention, and could significantly improve Colorado WIC retention in the long term. The TFRP could be considered in other states where retention in WIC remains a concern.
Communication and informatics Conduct evaluation related to programs, research, and other areas of practice
Abstract
Barriers and Facilitators to Use of a Supplemental Nutrition Assistance Program (SNAP) Incentive Among Low-Income Health Center Patients
Alicia Cohen, MD, MSc1, Kelsie Oatmen2, Caroline Richardson, MD1, Oran Hesterman, PhD3 and Suzanna Zick, ND, MPH1
(1)University of Michigan, Ann Arbor, MI, (2)University of Michigan Medical School, Ann Arbor, MI, (3)Fair Food Network, Ann Arbor, MI
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Introduction: SNAP incentive programs—which match SNAP benefits spent on fruits and vegetables—facilitate increased produce consumption. Yet many eligible participants do not take advantage of these incentives, in part due to lack of program awareness. We examined the impact of a waiting room educational intervention about the farmers market-based SNAP incentive program Double Up Food Bucks (DUFB) on barriers and facilitators to program use.
Methods: We conducted five focus groups among a purposive sample (n=27) of 177 SNAP-enrolled adults from a health center in Southeast Michigan who participated in an educational intervention about DUFB. Focus groups examined barriers and facilitators to use of the incentive program. Groups were stratified by use/non-use of DUFB during the 6 month study period.
Results: DUFB use increased across all trial participants from 18% at baseline to 69% post-intervention. Focus group participants cited increased awareness of DUFB as an essential facilitator of first-time use. Additional facilitators to using DUFB included: 1) produce affordability, 2) higher quality produce, and 3) appreciation of the farmers markets environment. Reported barriers included: 1) lack of transportation, 2) persistent confusion related to program use, 3) limited market locations/hours, and 4) limited DUFB season (June-October).
Discussion: A brief educational intervention increased awareness of a SNAP incentive program among low-income health center patients, resulting in an almost 4-fold increase in program use. However, for a subset of patients barriers to incentive use remained. Interventions focused on better understanding and addressing remaining barriers may further improve fruit and vegetable access among vulnerable populations.
Clinical medicine applied in public health Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Public health or related research
Abstract
From the family table, to the lunch table: A photovoice study of minority youths' food experiences in home and school-based settings
Tara Entwistle, MPH1, Alen Agaronov, MS, RDN2, Lorene Harry and May May Leung, PhD, RD4
(1)School of Urban Public Health, Hunter College, CUNY School of Public Health, New York, NY, (2)Harvard T.H. Chan School of Public Health, Boston, MA, (3)City University of New York, Hunter College, New York, NY
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Introduction: Few studies have examined minority youths' perceptions of their food environments and how altering food environments can differentially impact children's dietary choices. This study used photovoice methods to explore home and school-based influences on food choices of youth residing in low-income urban neighborhoods.
Methods: 32 youth (mean age=11.81 years; 87.5% Latino, 12.5% African American) attending after-school Food Justice programming in three low-income New York City neighborhoods participated in a community food assessment using photovoice according to the prompt, “Who and what influence my food choices?” Photos guided in-depth interviews; two coders performed independent analysis of interview transcripts using principles of grounded theory.
Results: Analyses revealed a difference in attitudes related to youths' food environments at home and in school. Youth described loving motivations behind their families' cooking, compared to cafeteria staff that, “don't care,” and raise concerns about food poisoning. Latino youth expressed disappointment that school foods (like tacos) do not taste like ethnic foods from their country of origin, and compared homemade meals prepared by their grandmothers to less healthy foods served at school. Some participants reported feelings of guilt associated with eating too little or too much of their family's cooking. Peer pressure during lunchtime persuaded youth to eat “junk” foods, whereas family members across generations encouraged healthy food consumption at home.
Discussion: Further research is needed to understand differences between home and school food environments in youth living in low-income urban areas. Photovoice can be a useful tool for exploring place-based disparities in youths' dietary behaviors.
Environmental health sciences Planning of health education strategies, interventions, and programs Program planning Social and behavioral sciences
Abstract
Lunch at the Library: Stakeholder Perceptions about a Community-based Approach to Addressing Food Insecurity
Monica De La Cruz, MPH and Janine Bruce, DrPH, MPH
Stanford School of Medicine, Stanford, CA
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Introduction. Child hunger increases during summer when low-income children no longer receive free and reduced-price school meals. Libraries offer children a safe place to participate in summer programs, access resources, and at some locations, receive a healthy free meal. The "Lunch at the Library" program has been implemented across select California libraries in response to heightened summer food insecurity.
Methods. Twenty-four key stakeholders affiliated with public libraries across California participated in semi-structured phone interviews. Participants discussed the motivations behind implementing "Lunch at the Library" at their sites and the numerous facilitators and barriers to program implementation. Interview data were analyzed using transcript-based coding and theme analysis.
Results. Interview findings demonstrated that library staff recognized the need for library-based summer meal programs for low-income children in their communities. Interagency partnerships (i.e. government, health professionals, community non-profits, businesses) were deemed critical for facilitating and enhancing meal programs. Library staff described strategies for overcoming logistical and financial barriers of implementation. Participants noted that meal programs were associated with attracting new library patrons, increasing participation in existing library programs, and linking families to other community resources. Library staff discussed a shift in the library's mission within society to address the social needs of the communities that they serve.
Discussion. Library-based meal programs provide an innovative approach to addressing food insecurity in low-income communities. With the help of interagency partnerships, libraries have the potential to increase children's access to healthy meals and facilitate critical linkages to necessary social services.
Other professions or practice related to public health Program planning Public health or related research