Food Procurement Identifying Leverage Points for Disseminating - PowerPoint PPT Presentation

Mapping the Social Context of Food Procurement Identifying Leverage Points for Disseminating Healthy Eating Messages Among Low-income Populations

Co-Authors Madalena Monteban, PhD Darcy Freedman, PhD, MPH Kimberly Bess, PhD Colleen Walsh, PhD, Kristen Matlack, MPH Susan Flocke, PhD, Heather Baily, MA

Acknowledgements • This presentation is a product of the Prevention Research Center for Healthy Neighborhoods (PRCHN) at Case Western Reserve University, supported by Cooperative Agreement Number 1U48DP005030 awarded by CDC. FreshLink is the Core Research of the PRCHN. • Results and information presented are the views of the authors and do not necessarily represent the official position of the CDC.

Overview Research background Describe research design and methods Review findings Discuss D&I implications

Background

Importance of Physical and Social Food Environment

Diffusion and Social Network Theory • Diffusion theory (Rogers 2002) • Social capital theory (Lin 2001)

Nutritious • Household finances Food Access • Food costs • Store incentives • Perceived value of food Economic • Quality and variety of foods sold • Staff & service • Presentation of store and customer base Service Delivery • Boundaries of local food environment • Diversity of food stores available Spatial- • Travel time and transportation resources Temporal • Time costs • Relationships and social networks Social • Cultural foodways, traditions, and norms Personal • Health status • Food & nutrition knowledge • Food-related identities & preferences Freedman et al., 2013

Research Design and Methods

FreshLink Goals (2014-19) Work with community partners to employ a rapid-response system for evaluating and improving the reach, adoption, and impact of farmer's markets among SNAP recipients living in low-income neighborhoods in Greater Cleveland, Ohio. SNAP = Supplemental Nutrition Assistance Program, formerly Food Stamps

Planning Phase of FreshLink Summer 2015: Survey research with 320 people receiving SNAP • What are food shopping patterns, attitudes, and beliefs related to use of farmers’ markets and other places to access healthy foods? Winter 2015-16: Interview research with 30 people enrolled in survey • What is the role of social networks in shaping food-related habits? What are people's main food access points? Do people have connections at these core food procurement places? What is the nature of people's relationships at food procurement places? Can people’s relationships at food procurement places be leveraged to disseminate healthy eating messages?

Sample and Recruitment N = 30 parents/caregivers receiving SNAP in Cleveland, Ohio Purposive sampling: • Social network size • Farmer’s Market Shopping • Geography • Working outside home/student • Race/ethnicity • Education

Data collection • Semi-structured interviews • Participatory social network mapping Focused on people and places related to participant’s food habits (getting, making, and eating).

Data collection

Quantitative analysis: Two-mode network analysis • Data recorded ties between: • Participants and procurement places • Participants and staff at procurement places • Analysis: • Core-periphery analysis of participants and procurement places • Frequencies for characteristics of participants and staff at procurement places

Qualitative analysis • Team-based analysis of interview transcripts using Atlas.ti software focused on three types of social connections: • purely social • information exchange • material exchange

Participant Characteristics N=30 N (%) Female 29 (97%) Black/African American 24 (80%) Not currently employed for wages 22 (73%) Annual household income less than $10,000/year 15 (50%) Completed High School 21(70%) Mean (range) Number of children in household 3 (1-8) Age 36 (25-59)

Findings

People’s Connections in Food Procurement Places N= 30 people 21 know someone at procurement place (70%) N= 10 place types People know someone at 9 place types (90%) Unique Place Types N Food Pantry 35 Discount Store 22 Convenience Store 18 Supermarket 16 Dollar Store 15 Farmer’s Market 15 Specialty Store 10 Supercenter 5 Warehouse Store 7 Small Grocer 3 Total 145 Shape: Procurement Place People Color: Connection No Connection Size: larger = more connections LEGEND

People’s Connections in Food Procurement Places Food Pantry N = 21 people go connected at Food Pantry 10 (48%) Supermarket (e.g. Safeway, QFC) N = 29 people go connected at Supermarket 9 (31%) Discount Store (e.g. Save-a-Lot, Aldi) N = 29 people go connected at Discount Store 3 (13%) Farmers’ Market (e.g. Public Market, Farm Stand) N = 22 people go connected at Farmers’ Market 2 (10 %) Shape: Procurement Place People Color: Connection No Connection Size: larger = more connections LEGEND

Alters at food procurement places

Alter characteristics

Nature of connections: Purely Social “I grew up with and I went to school and we used to work together” -Alter: Friend works at Discount Store “ Boy I know them real well especially since I’ve been there eight, nine years now.” -Alter: Volunteers at Food Pantry

Nature of connections: Information Exchange “ she’s like “we have sales on ground beef”… I’m like okay ” -Alter: Manager at Discount Store “Oh yeah, they try to get you to eat squash at the [Food Pantry]. (Laughter) ...They tell you how to cook it and how to eat it .” -Alter: Volunteers at Food Pantry “[my cousin says] ‘you should come here 'cause we got a sale on this and we got a sale on that…and you can come get a case of chicken wings from here because it's cheaper over here than over there’” -Alter: Cousin who works at Supermarket

Nature of connections: Material Exchange [Farm owner] “ gives cuts of meat…like if he slaughters a cow um… he’ll give… cuts that he really don’t care too much for.” -Alter: Friend who owns a Farm “ …the [Food Pantry]…they know that I um…like I’ll share with the older lady that’s across the street and she’s old so um…she [Food Pantry volunteer] give me like a crate of each um…vegetable or whatever that they have [to share with others]… ” -Alter: Volunteers at a Food Pantry

Implications for D&I Research

• Social connections at food procurement places may be leveraged to disseminate healthy eating messages. • Complimentary interventions to create new or catalyze existing social capital within food procurement spaces.

Thank you to the parents/caregivers who participated in this study sharing their time and experiences. Our appreciation also goes to members of the FreshLink research team Elaine Borawski, Erika Trapl, and Emily Jennings.