Gaining Consensus on Factors In Infl fluencing Farm to School Im Implementation Eunlye Lee PhD, Carol Smathers, MS, Pat Bebo, MS, Jarrod Dalton, PhD, and Darcy Freedman, PhD
Acknowledgements This study is supported by the Centers for Disease Control and Prevention Preventive Health and Health Services Block Grant (2B01OT009042-15) and by the U.S. Department of Agriculture Nutrition Education and Obesity Grant Program (G-1415- 17-0847 and G-1617-0452).
Presentation Overview • Background • Introduction to Building Capacity for Obesity Prevention (BCOP) Study • Multi-phase Consensus Modeling • Summary of Theme and Indicator Refinement • Factors Influencing Farm to School Interventions • Supporting Resources • Contributions and Implications
Background Prevalence of Self-reported Obesity among US Adults by State and Territory, BRFSS, 2015 BRFSS = Behavioral Risk Factor Surveillance System, Obesity = Body Mass Index (BMI) of 30 or higher
Background (c (cont.) Prevalence of Self-reported Obesity among US Adults by Race/Ethnicity, State and Territory, BRFSS, 2013-2015 Non-Hispanic Whites Hispanics Non-Hispanic Blacks BRFSS = Behavioral Risk Factor Surveillance System, Obesity = Body Mass Index (BMI) of 30 or higher
Polic licy, Systems, and Envir ironmental (PSE) In Interventions A policy change includes laws, ordinances, rules and/or regulations. Policy change P may target government entities at national, state, or local levels or organizations such as schools, childcare centers, or churches. A system change seeks to shift the way that a community makes decisions about S policies, programs, and the allocation of its resources and, ultimately, in the way it delivers services to its residents. Systems change such as increasing more locally grown foods into food distribution systems often involves collaboration between diverse sectors and stakeholders. An environmental change is a change to the physical or social environment where E people live, work, learn, play, and pray. This may involve developing or enhancing infrastructure or promoting social norms to shift behaviors within environments.
Nutrit ition-rela lated PSE Recommendations Example Recommendations Recommended by Encourage small store owners to offer fresh produce and healthier foods through CDC financial or other incentives. IOM Increase access to farmers’ markets in low-income communities CDC Encourage farmers’ markets and small store owners to accept SNAP and WIC electronic CDC benefit cards. Increase farm-to-school and farm-to-institution programs. CDC Promote community gardens through zoning policy and grants or other financial IOM support. Establish strong nutrition standards and healthy food policies for foods served at public IOM facilities and government buildings . CDC = Centers for Disease Control and Prevention, IOM = Institute of Medicine
Building Capacity for Obesity Prevention (B (BCOP) • A partnership between researchers and practitioners • To identify key aspects of community readiness and practitioner capacity for obesity prevention • To develop web-based tools to be used by community nutrition and public health practitioners in their planning of nutrition-related PSE interventions • Consensus-based modeling approach: Active stakeholder engagement (> 200) PSE Interventions = Policy, System, and Environmental Interventions
Building Capacity for Obesity Prevention (B (BCOP) Nutrition-related Policy, System, Environmental (PSE) Interventions Farmers’ Market Healthy Food Retail Farm to School Healthy Eating in Childcare
Farm to School PSE Project Id Ideas • Promoting school gardens • Increasing salad bar activities at schools Produce from school gardens is used in cafeteria School gardens are incorporated into curriculum • Increasing locally grown foods purchase for school cafeteria
Multi-phase Consensus-based Modeling • 194 practitioners and • • 14 expert panelists/2 4 practitioners community residents • hours Face and content • 18 in-person and 23 • Ranking of indicators validity focus group interviews and weight for themes [Phase 1] [Phase 2] [Phase 3] [Phase 4] [Phase 5] Qualitative Indicator Consensus Indicator Pilot Testing Study Development Conference Refinement • • Iterative process Remapping among 4 researchers indicators/themes • • 6 themes and 23 Development of response options indicators
Summary of f Theme and In Indicator Refi finement # of themes and indicators before 6 themes and consensus 23 indicators conference # of themes and indicators after 4 Themes and 16 Indicators consensus conference 4 Themes and 17 Indicators PSE Readiness Assessment and Decision Instrument PSE Interventions = Policy, System, and Environmental Interventions
What In Infl fluences Readin iness to Im Imple lement Farm to Sc School l PSE SE Projec jects? • Resources of schools to support implementation of farm to school School Capacity PSE projects. [0.36) Networks and Relationships • Relationships and support systems that can help practitioners implement farm to school PSE projects. [0.30] Organizational and Practitioner • Skills, resources, and capacity for organizations and practitioners to Capacity support implementation of farm to school PSE projects [0.21] Community Resources and • Community factors such as community leadership investment and Motivations support systems that influence implementation of farm to school PSE projects [0.13] Standardized theme weights from the consensus conference are presented in brackets.
School Capacity • To what extent… do school food service guidelines in your service area support farm to school PSE projects? [0.28] are farm to school PSE projects in your service area integrated into school curriculum and activities (e.g., greenhouse integrated with science class)? [0.25] Standardized indicator weights from the consensus conference are presented in brackets.
Networks and Relationships • To what extent… are there champions for farm to school PSE projects in your service area? [0.28] are there sourcing and aggregation systems available in your service areas to support access to locally produced food items at schools? [0.26] Standardized indicator weights from the consensus conference are presented in brackets.
Organizational and Practitioner Capacity • To what extent… do you spend time each month seeking out or connecting with community stakeholders in your service area such as agricultural coordinators, school cafeteria managers, or school wellness committees to increase support for implementation of farm to school PSE projects? [0.30] does your organization have capacity and tools to evaluate implementation of farm to school PSE projects in your service area? [0.27] Standardized indicator weights from the consensus conference are presented in brackets.
Community Resources and Motivations • To what extent… are parents and students in your service area aware of farm to school PSE project opportunities such as school gardens and salad bars at school? [0.28] are community leaders in your service area aware of farm to school PSE project opportunities such as school gardens and salad bars at school? [0.28] Standardized indicator weights from the consensus conference are presented in brackets.
www.psereadi.org
Supporting Resources • A report with three tailored recommendations for action • Compendium of resources • Videos • Learning collaborative
Contributions & Im Implications • This is one of the first attempts to understand factors for successful implementation of Farm to School interventions and operationalize them into measureable indicators. • The assessment tools are developed through strong engagement and partnership among community stakeholders. • Implementation of Farm to School interventions guided by careful assessment of community readiness and practitioner capacity promotes the uptake and success of the interventions.
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