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FOOD BANK OF SOUTH JERSEY: Evaluation Report

Beth A. Uzwiak, Ph.D. 7/15/2015

CREATIVE RESEARCH AND EVALUATION, LLC

Creative Research & Evaluation, LLC 2

This report was made possible thanks to a grant from Campbell Soup Company.


TABLE OF CONTENTS REPORT OVERVIEW…………………………………………………………………….4

CHAPTER ONE: BACKGROUND………………………………………………………5

Project Background and Context…………………………………………………….5

Evaluation Methodology……………………………………………………………..8

Table 1: Overview of Focus Groups………………………………………………...9

Research Questions…………………………………………………………………10

CHAPTER TWO: FINDINGS…………………………………………………………11

Section One: Participant Perceptions of HLI Courses and Demonstrations……11

Finding 1: Participants report that they learned how to identify and prepare healthy foods……………………………………………………………………11

Finding 2: Participants report trying and enjoying new foods and recipes...13

Finding 3: Participants report changes in eating, shopping, and cooking habits after completing HLI courses. ………...……………………………….14

Finding 4: Adult participants report changes in food resource management after completing HLI courses..………………………………………………...16

Finding 5: Adult participants report that one-time demonstrations can be a catalyst to change nutritional habits. …………………………………………17

Finding 6: Participants report that they enjoy the structure of the courses and appreciate the instructors..…………………………………………………….18

Section Two: Participant Perceptions of Challenges.……………………………..20

Finding 7: Participants cite “habit,” “family,” and “taste” as factors that impact the choices they make about nutrition……………………………….20

Finding 8: Participants report that access to healthy food and transportation impact their nutritional choices. ……………………………………………...21

Finding 9: Participants report that financial cost and time to prepare home-cooked meals impacts their nutritional choices. ……………………………22


CHAPTER THREE: RECOMMENDATIONS AND CONCLUSIONS

Participant Recommendations……………………………………………………...23

Concluding Comments……………………………………………………………...25

Appendix 1: Short Questionnaire Template.…………………………………………27

Appendix 2: Focus Group Template …………………………………………………29


REPORT OVERVIEW During the spring of 2015, Creative Research & Evaluation, LLC was engaged to conduct a qualitative evaluation of nutritional classes and demonstrations provided by the Food Bank of South Jersey (FBSJ) at five sites in Camden, New Jersey. This evaluation analyzes the effectiveness, impact, and retention of the information contained in Healthy Living Initiative (HLI) courses. These programs include Share Our Strength’s Cooking Matters® courses and FBSJ signature classes including one-time demonstrations.

The evaluation draws on an evaluation approach known as Utilization Focused Evaluation. This approach is designed to maximize cooperation between the evaluator and evaluation stakeholders in order to ensure that the evaluation is focused on the actual needs of stakeholders and that data and findings generated by the evaluation will provide information and insights that are useable and relevant to stakeholders.1 Qualitative tools were developed in consultation with FBSJ staff and volunteers assisted with focus group administration and relationships with participants.

Chapter One provides background information about the program, about nutrition generally in Camden, New Jersey and about the methodology utilized. FBSJ provides food assistance to low-income individuals and families living in Burlington, Camden, Gloucester, and Salem counties. In addition to food distribution, the FBSJ’s Healthy Living Initiative (HLI) provides nutrition education to ensure that people are provided access to knowledge about healthy eating and cooking.2 This qualitative evaluation primarily utilized focus groups with children, teens, and adults to ascertain participants’ perceptions of HLI initiatives.

Chapter Two provides an analysis of the findings. Evaluation findings reveal that participants appreciate the HLI courses, that participants retain nutritional information and skills taught during the courses and demonstrations, and that participants continue to practice what they have learned such as trying new foods, reading labels, cooking with new ingredients, and food resource management skills including stretching ingredients.

1 Patton, M.Q. (2008) Utilization-Focused Evaluation, 4th Ed. Thousand Oaks, CA: Sage

Publications.

2 Food Bank of South Jersey. Healthy Living Initiative. http://www.foodbanksj.org/HealthyLivingInitiative.html. Last accessed June 18, 2015.


The majority of focus group participants, regardless of the class or program they attended, describe their experiences with FBSJ as positive. Participants enjoy the content of the courses as well as the food prepared. As one participant summarizes: “I thought the class was really useful. I really love the interaction with the kids when you come in and teach appetizers and healthy snacks. It really tuned them in, the students and the parents, to different ways of eating. And it introduced them to different habits, good habits, what you can do for snacks and other things. I think it's awesome. I hope you guys come back.” More details about the evaluation’s findings are presented in Chapter 2.

Finally, Chapter Three provides recommendations from participants about improving or modifying HLI classes and concluding comments by the evaluator. Appendices of assessment tools used during the evaluation follow this chapter.

CHAPTER ONE: Project Background and Context

Overview of the Food Bank of South Jersey

According to its website, FBSJ operates on one simple premise: food should not be wasted when hungry people are in our midst. Their food distribution program links over 10 million pounds of food with more than 200 charitable food providers, such as food pantries, community kitchens and shelters.3 In addition, every year, FBSJ provides a variety of courses for children, teens, adults (caregivers and teachers) and families, ranging from one-time demonstrations for parents and signature courses for teens, to six-week courses for families based on Share Our Strength’s Cooking Matters® curriculum.

Share Our Strength’s Cooking Matters®

Cooking Matters® aims to provide low-income families with the skills to stretch their food budgets so children can eat healthy meals at home. Along with six-week hands-on cooking courses, Cooking Matters® provides interactive grocery store tours and online educational tools. Class participants are taught to use nutritional information to make healthier choices, and to purchase and prepare affordable meals.4 Different curricula are geared to reach adults, child-care professionals, families, children, and teens.

3 See: http://www.foodbanksj.org. Last accessed June 18, 2015.

4 Share Our Strength (2013) Cooking Matters In Your Community: Facilitators Guide. Washington, DC.


Cooking Matters for Adults® teaches low-income adults how to prepare and shop for healthy meals on a limited budget. Cooking Matters for Families® brings school-aged children and their families together to learn about healthy eating, planning meals as a family, and working together in the kitchen. Cooking Matters for Kids® teaches children in third grade through fifth grade how to prepare healthy meals and snacks and make smart choices wherever they are. Cooking Matters for Teens® teaches adolescents in sixth grade and above how to make healthy food choices and prepare healthy meals and snacks for themselves, their families, and friends.5

Each Cooking Matters® class uses interactive lessons to teach cooking, food safety and food resource management using the USDA’s MyPlate guidelines and the Dietary Guideline for Americans as the foundation for basic nutrition. Cooking Matters® curriculum is based on the premise that food is to be enjoyed. Recipes emphasize food that is delicious, satisfying, and healthy. By teaching families to shop for and prepare healthy, low-cost meals, the negative health and economic effects of hunger and poor diet can be avoided.

United States Department of Agriculture (USDA) MyPlate Guidelines

The USDA first published MyPlate guidelines in 2011 as a replacement to the food pyramid schema. MyPlate is visualized as a round plate divided into 5 food groups: 40% vegetables, 30% grains, 20% protein, 10% fruits, with a small circle meant to represent a dairy serving. MyPlate guidelines include recommendations such as “make half your grains whole,” “make half your plate fruits and vegetables,” and “vary your protein food choices.” Guidelines also promote portion control and reductions in sugar and sodium intakes. Like Cooking Matters®, MyPlate also asserts that food is to be enjoyed.

5 Share Our Strength (2012) Cooking Matters Annual Review. Washington, DC.


FBSJ Signature Courses

In addition to the Cooking Matters® courses mentioned above, the FBSJ has developed signature courses based on MyPlate guidelines, including Youth Nutritional Outreach Training (YNOT), a course for 15 high school students ages 16-19 that teaches healthy cooking and public speaking. In this course, participants learn general nutritional concepts, safe food handing, and how to conduct a successful public cooking demonstration.

FBSJ has also developed what they call “Healthy Home and School” workshops for parents and students and a series of demonstrations that couple skills training (such as reading a food label) with games and the preparation and tasting of a recipe. All of these signature courses utilize the nutritional guides set forth by MyPlate in an interactive hands-on way that stresses that food preparation and consumption can be fun.

Nutrition in Camden, New Jersey

Nationwide we are experiencing a historically high demand for food assistance. Unemployment and poverty rates have remained high since the 2008 economic recession. The number of households receiving nutrition assistance from the federal government’s Supplemental Nutrition Assistance Program increased by approximately 50 percent between 2009 and 2013.6 A city of 8 square miles, Camden has a population of 78,000 with 23,000 children and a child obesity rate of 42%, 10% higher than the national average. Camden has a Food Insecurity rate of 35%. Food insecure households are those that are uncertain of having, or are unable to acquire, adequate food to meet the needs of all of their members because they have insufficient money or other resources for food.7 In addition, in the fall of 2013, Camden lost its only full-service grocery store. The food system in Camden is now primarily comprised of a network of 150+ corner stores.8

6 Feeding America (2014) Hunger in America National Report. Chicago, IL.

7 Delaware Valley Regional Planning Commission (2010) Greater Philadelphia Food System Study. Philadelphia, PA.

8 Campbell Soup Company and The Food Trust (2014) Campbell Healthy Communities Annual Report. Camden, NJ.


Campbell Healthy Communities

In 2011, Campbell Soup Company started the Campbell Healthy Communities, a collaborative effort to “measurably improve the health of the young people in our hometown of Camden, New Jersey by reducing childhood obesity and hunger by 50 percent.”9

Campbell Healthy Communities collaborates with local partners including FBSJ, the Food Trust, Center for Environmental Transformation, and the FoodCorps on programs in four strategic areas: ensuring access to affordable and fresh foods, increasing physical activity in a safe environment, supporting healthy lifestyles through nutrition education and partnering with the community to advance positive social change.10

Programs include increasing fresh food options at corner stores through the Healthy Corner Store Network. In addition, FBSJ collaborated with the Food Trust, Center for Environmental Transformation, and FoodCorps to support nutrition education activities at six sites: four schools and two community-based organizations. In this report, we examine FBSJ activities at 4 of these 6 sites: 1) ECO Charter School; 2) Center for Family Services Head Start at Pine Street; 3) KIPP Norcross Academy; and 4) Cooper's Poynt School.

In addition, gardens were built and maintained at all six sites and teachers incorporated gardening into their educational curriculum. Farm-to-school lessons highlighted benefits of local produce and taste tests with produce donated from local farms. The Cooking Matters® course at ECO Charter School took place in the Campbell Consumer Test Kitchen with Campbell chefs and volunteers.11

EVALUATION METHODOLOGY

Data sources for the evaluation of HLI courses consisted of qualitative data collected from 6 focus groups conducted at 5 sites in Camden, New Jersey over the course of 3 months from April to June 2015. Focus groups were conducted with parents and teachers, high school students, and middle school students who participated in a variety of HLI courses between August 2014 and February 2015. 9 See http://www.campbellsoupcompany.com. Last accessed June 18, 2015.

10 Campbell Soup Company and The Food Trust (2014) Campbell Healthy Communities Annual Report. Camden, New Jersey: Campbell Healthy Communities.

11 Ibid.


Each focus group was designed to gain the insight of a different constituency in order to provide a broad assessment of the impact of HLI curriculum.

Table 1 below provides an overview of the location, demographics, and courses discussed in each focus group.

Table 1: Overview of Focus Groups

LOCATION COURSE DATES COURSE PARTICIPANTS

CURRICULUM FOCUS GROUP

PARTICPANTS

Center for Environmental Transformation (CFET)

Youth Nutrition Outreach Training (YNOT)

8/2014

15 high school students ages 16-19

FBSJ signature course utilizing MyPlate

5 YNOT graduates (Ages 16-19)

Center for Family Services (CFS) Pine Street Head Start

Healthy Home and School workshops (Lunch and Learn) for teachers and staff

Fall 2014

15 teachers and staff

FBSJ signature course (workshops) utilizing MyPlate

13 teachers and staff

Center for Family Services (CFS) Pine Street Head Start

Healthy Home and School demonstrations for caregivers and children

Fall 2014

10 parents FBSJ signature course (demonstrations)

utilizing MyPlate

1 parent

Cooper’s Poynt School

Cooking Matters for

Parents®

1/2014- 2/2014

Parents and teachers (attendance varied; average 9 participants)

Cooking Matters for

Parents®

7 graduates (teachers)

Eco Charter School

Healthy Cooking for Children

2/2014 13 children ages 9-10

FBSJ signature course utilizing MyPlate

12 course graduates (10 and 11 year-olds)

Kipp Norcress Academy

Several demonstrations for children and caregivers

Fall 2014; Winter 2015

Adult caregivers of students in Kipp’s Saturday school (attendance varied)

FBSJ signature course (demonstrations)

utilizing MyPlate

18 adult caregivers of students


Each focus group was modified to ask participants questions specific to the program under discussion. Qualitative data reveals the perspectives of HLI participants in their own words, their thoughts about the courses, opinions about the challenges of making changes to healthy cooking and eating, and recommendations on how to improve the courses. Because multiple activities were held at each site over a long period of time, some focus group participant’s responses also included comments about other programs than the ones under discussion.

In addition, the evaluation includes a review of relevant background documents and prior evaluations. To supplement the qualitative data, 3 out of 6 focus groups (those with parents) included a short questionnaire to provide supplemental data such as favorite recipes and behaviors that have changed since attending a demonstration or completing a course. Like the focus group questions, each questionnaire was modified to reflect the course or demonstration.

Research Questions The evaluation was organized to ascertain two basic things: 1) knowledge – what do participants remember learning from HLI courses and demonstrations? And 2) behavior – in what areas do participants report change after experiencing these programs? As a result, evaluation tools were designed to answer the following questions:

1) What nutritional concepts do participants of different courses report

retaining 1 to 12 months after completing HLI programs? 2) What nutritional behaviors do participants report changing 1 to 12

months after completing HLI programs? These behaviors include food resource management (planning meals, stretching food), healthy food (buying, preparing, and consuming nutritious food), and daily eating habits.

3) What are participants’ perceptions of the format, style and content of the classes offered and the recipes practiced or sampled during classes?

4) What are participants’ recommendations for improvements/modifications?


CHAPTER TWO: FINDINGS

Findings are divided into two sections: 1) Participant perceptions of FBSJ HLI courses and 2) Participant perceptions of challenges to making healthy changes to nutritional habits.

Section One: Participant Perceptions of HLI Courses and Demonstrations

Data reveal that participants enjoyed the courses and demonstrations. Participants learned new nutritional information based on MyPlate and new skills including label reading and stretching ingredients. Many participants reported changes in how they purchase, prepare, and consume healthy food after completing a course. Participants describe both the courses and the one-lesson demonstrations as “inspiring” and report that they shared what they learned with other family members, friends and co-workers.

Adult, child, and teenage participants who completed HLI courses and demonstrations were able to identify specific nutritional skills that they learned, from selecting healthy foods to preparing new recipes. Some participants remember these skills because they helped them make a nutritional change. A Cooking Matters for Parents® graduate recalled:

The labels. I remember learning how to read different labels, learning what is in the different foods. That was good for me because I wanted to start eating healthy so it would help me with my diet.

Two other Cooking Matters for Parents® participants recalled that they were taught skills that they did not know previously.

They taught us when we cut something not to put our finger like this, they taught us to cut with our fingers folded.

I remember learning how to cut up that chicken, bam bam bam, in 5 exact pieces in about 30 seconds.

FINDING 1: Participants report that they learned how to identify and prepare healthy foods.


Participants in Cooking Matters for Parents® reported that they remember learning about MyPlate.

That is the one with the different components, the grains et cetera. You want at least 3 out of the 5 components. If you can have all 5, they want you to have it. But they want to you get at least 3.

A teacher explained that after several Healthy Home and School workshops, her students “can do the MyPlate on a Smartboard” and can “tell you that fried chicken and ice cream are not healthy.”

A teacher from this school who completed several Healthy Home and School workshops for staff, reported that learning MyPlate has influenced the way that they teach nutrition in the classroom:

It’s more intentional. Before we used to talk about meal times, during our meals we would talk about what we were eating, but now we specifically talk about what food groups we are eating and where the food comes from. Before we would say we are eating greens, simple stuff, but now we are more intentional, we try to get the kids to think more about the things they are putting in their bodies.

After completing the Healthy Home and School workshops, teachers utilized the MyPlate framework and cards that FBSJ provided about food groups to reinforce what the children learned.

We have these cards, they passed out cards for all of the food groups; they gave us a big model. So during lunch time we are able to share with the kids, put up certain food groups and say green is vegetables... the MyPlate handouts that was pretty good.

During a focus group, staff members also talked about nutritional information they saw retained in both parents and children who participated in Healthy Home and School workshops which included “a real deep understanding of what is good for them and what is not good for them, which is really really very important.”

Teenage graduates of the YNOT program also recalled learning how to avoid contamination and prepare food safely. The transcript below demonstrates these points:

Focus Group Facilitator: What do you remember the most? What is the most important thing you remember about the program?


Teenager #1: I think I remember a lot of washing our hands, and making sure that everything is clean and you shouldn’t touch things when you know you just touched a counter.

Focus Group Facilitator: What else do you remember learning?

Teenager #2: She taught us knife skills. Teenager #1: How to cut without cutting our fingers.

Teenager: #3: I remember the food borne illnesses.

Teenager #2: How to not cause contamination. So when you use a cutting board for one thing, either wash it off or use another one when you are going to cut another thing.

Both MyPlate guidelines and Cooking Matters® curriculum put forth that food is to be enjoyed. Changing nutritional habits, while challenging, can also be fun and can introduce people to new taste experiences. Recipe demonstrations aim to have participants try foods that they may not have tasted before. One participant of a Cooking Matters for Parents® course exclaimed that the most important result of her taking a HLI course is that, “I will try new things now. Before I would eat nothing!” Students and teachers who completed Healthy Home and School workshops at one site started the “Two-Bite Club” which encourages kids to try new foods by committing them to try at least two bites. A teacher at this school shared:

The best part I like is the Two-Bite Club because if the kids say that they don't like something, that they used to say, ewww I don't like it. We were taught to tell them, put it on your plate and just try it, just try two bites. And they try the two bites, and some of them like it, some of them don't but at least it encourages them to try foods. They say I am part of the Two-Bite Club! It's a fun activity.

FINDING 2: Participants report trying and enjoying new foods and recipes.


Participants of courses and demonstrations report really enjoying at least one new recipe. Favorite recipes include:

Salmon cakes

Healthy mac-n-cheese

Healthy grilled cheese

Healthy hoagies

Salsa

Soup with kale

Participants also report trying these recipes at home, especially if a course provided them with ingredients, ingredient lists, or money cards to purchase ingredients. One parent who participated in two demonstrations shared that her family loved the salmon cakes she made and that they have become part of what she cooks on a regular basis. A parent who participated in Cooking Matters for Parents® shared that she cooked healthy French toast for her son, and now he prepares it for her. A child (5th grade student) shared that he loved the salsa that he tried during a course so much that he “begged” his mom to buy it. Once she agreed to buy it, he “ate it all, like, in one day.”

When asked in a questionnaire what they thought their child or children have learned during one-time demonstrations, one mother replied: “How to be open-minded about food.” Another replied “that some healthy food taste good.”

MyPlate guidelines emphasize portion control, reductions in salt and sugar intake, and increases in fresh fruits, vegetables, and whole grains. HLI courses present alternatives to common foods and demonstrate recipes that meet MyPlate guidelines. Participants of Cooking Matters for Parents® report that this curricular strategy has had a lasting impact on their nutritional habits:

I don’t drink sodas at all after this class. I just drink different juices and mix it with seltzer water.

FINDING 3: Participants report changes in eating, shopping, and cooking habits after completing HLI courses.


HLI curriculum introduces ways that participants can meet MyPlate guidelines, including switching one ingredient for a healthier alternative. One Cooking Matters for Parents® participant shared: “I switched instead of the white rice or the regular pasta to the brown.”

Participants of Cooking Matters for Parents® also report changes in cooking practices.

I am using cayenne to season instead of other stuff like salt.

I am not frying chicken anymore. I will bake it.

I am cooking more chicken instead of fatty stuff, more lean meats. Since he [the instructor] taught us how to cook chicken.

Changes in cooking practices, in turn, means changes in what these participants are purchasing:

When I go shopping I buy more vegetables and fruit now because that will help me and help them (my children) too. My older son never liked vegetables and now he likes vegetables.

I have been buying more bagged vegetables instead of the canned vegetables.

We eat healthier food rather than purchase fast food.

Parents report that what their children learn has an impact on what they buy at the store:

I am a Head Start parent and my son will tell me, “Mom you are giving me chips and that is not healthy!” Like, “Mom, my teacher said that chips are not healthy!” Well, I guess I won't be giving you any chips!

Children who participated in a Healthy Cooking for Children course report that they ask their families to buy different foods now, and will eat salad with dinner, which they didn’t do before.


Cooking Matters® courses teach participants how to shop and plan meals ahead of time. Participants of Cooking Matters for Parents® stated that budgeting information was helpful to them.

[The instructor] was just saying that when you go out you have to budget your food, plan it for the whole week. If you plan for the whole week, you can look in your cabinet or your freezer and see that you have chicken, you got this or you got that, what can I go make to go with this for the rest of the week.

If you plan ahead, that is going to cut back your budget. So instead of being like “I have to go out to the store and get this,” no you don't, you already have this in your cabinet.

One parent who participated in several Healthy Home and School workshops noted that learning how to “stretch” ingredients in the kitchen has saved her both money and time. She commented:

I thought a lot about stretching ingredients, especially about the chicken, about how I could stretch chicken all over the place, in salad too. I also never thought about using wheat tortillas before and how you could stretch that out with a little cheese.

A few parents who completed a Cooking Matters for Parents® course shared that the courses made them think about how much money they spend on quick and easy meals, such as fast food. When added up, they realized that what they spend on these meals is more than buying food at the grocery store. As a result, one parent shared:

I cut down on his [participant’s son] eating out. I bring his lunch, I go to the store for it, and then after school because I don't cook, I had to buy him something again. So we made a choice: which one [would be cut]?

In addition, some courses provide participants with recipes and ingredients after each class. Staff at a school that hosted Healthy Home and School demonstrations explained that this practice made it easy for a parent to make a new meal at home:

FINDING 4: Adult participants report changes in food resource management after completing HLI courses.


I know one of the parents said that she appreciated that they actually gave her the ingredients. So she came to the training and was able to go home and make the food, she was able to follow the recipe without having to go out and purchase anything.

Data from focus groups as well as supplemental questionnaires indicate that one-time demonstrations and workshops can have a great impact on parents and children. For example, one caregiver who attended several cooking demonstrations with her daughter explained: “I never ate a salad with dinner. I just cooked one dish. Now my daughter is requesting a salad with her dish.” Another participant corroborated: “That’s what she (my child) says! Eat your vegetables every time we sit to eat something.” Other adults who attended at least one demonstration with their child or children reported changes such as:

I am eating less processed food.

I get more fruits and vegetables now because of the classes.

Fish. We didn't eat fish at my house. Now the kids ask for it.

When asked on a questionnaire (see Appendix 1) if they have changed any shopping habits because of a demonstration, 9 out of 18 respondents answered yes. When asked what they have changed, replies included:

I don’t choose too many processed foods

Buy more veggies

Looking for different tastes

I buy more veggies now that I know how to make them so my children will eat them all

I get less stuff with sugars and buy more vegs and fruits

Buying more healthier foods

FINDING 5: Adult participants report that one-time demonstrations can be a catalyst for changing nutritional habits.


When asked on a questionnaire (see Appendix 1) if they have changed any cooking habits because of a demonstration, 7 out of 18 respondents answered yes. When asked what they have changed, replies included:

I cook more rather than microwave

Try to bake more instead of frying foods

Less salt and oil

When asked on a questionnaire (see Appendix 1) if they have changed any eating habits because of a demonstration, 9 out of 18 respondents answered yes. When asked what they have changed, replies included:

Not eating out as much

Trying to get rids of fats

Lite on salt

Try to eat lite portions

Eating smaller portion

Similarly, parents of children who have completed Healthy Home and School workshops shared that what their children have learned about healthy food has impacted what food they buy and prepare. A parent shared that if she prepares a meal that is unhealthy, her child will say: “This is not healthy, I know what is healthy!” Sometimes this child will “go into the store and he will pick out granola bars instead of chips.”

Cooking Matters® participants report that HLI courses are fun: they engage students in the process of learning nutritional information. A graduate of the Cooking Matters for Parents® shared:

It was engaging because I am very easily distracted and they had my attention all the time. And they made the class fun. We would play games. That was fun; the games were very interactive. And the games were

FINDING 6: Participants report that they enjoy the structure of the courses and appreciate the instructors.


learning games on different topics like salt intake, how to read labels, that made me want to actually go out and do these things so that is what made it fun and engaging for me.

Likewise, FBSJ signature courses are fun. When asked why he enjoyed the YNOT course, one participant shared, “It was just all around fun to work with everyone and to see how everyone else was interacting to make this one thing (a grilled cheese sandwich).”

The structure of HLI courses, their use of hands-on facilitation techniques means that participants are “doing” rather than simply observing. The classes are interactive and engaging. A YNOT graduate expressed the following:

It was really hands-on, I liked that it wasn't someone just telling you what you had to do, but showing you.

A teacher explained:

To have them come into the classroom and do hands-on with the children, that is very helpful, it is helpful with the curriculum that we have here, with the MyPlate and the other things and it helps the children get a better grasp of what they are eating and why.

Participants also enjoyed instructors as facilitators:

I liked that the teacher didn't just sit there and talk and talk and talk. She showed us, wash your hands, now you are going to put on your gloves, she did it, she didn't just tell us, she made sure we did it. She wasn't just talking down at us like we didn't know anything. They were good; they were very informative all the different ones that presented were very informative.

Others participants noted that facilitators, especially those who taught longer courses, went above and beyond their roles as educators. A YNOT graduate shared that a teacher helped her when she was going through a personal issue. “She really cared not just about the class but about me.” Participants of one-time workshops at a Saturday program were impressed that FBSJ staff and volunteers showed up on the weekends to help, which made them feel like “we matter, our kids matter,” and that the Food Bank “really cares.”


Section Two: Participant Perceptions of Challenges to Making Changes to Nutritional Habits

In discussing the ways that HLI courses inspired them to make nutritional changes, participants also articulated the challenges that they face when attempting to make these changes. Some of these challenges are ones that many people face, such as breaking individual eating habits and making healthy choices even when other family members do not make the same choices. Other challenges are more specific to people who live in an area where there are less healthy food options. As one teacher opined: “You can't keep healthy food choices separate from their [caregivers] whole life.” We discuss these challenges in this evaluation as an ongoing source of data to inform FBSJ curriculum. These challenges are ones that FBSJ already strives to address in its programming, such as providing food samples to taste, ingredient lists, and money cards.

As one participant stressed, when it comes to creating healthy eating habits “change is gradual, change takes time,” especially when one family member tries to introduce change to other family members. “I stopped buying sodas,” one focus group participant who attended the Cooking Matters for Parents® course shared, “but it made my sons mad. I told them it was for their health, but they still don’t want to drink fruit water instead.”

Another mother shared during a focus group that it is not easy for her to get other people in her family to eat healthy. When she tried to introduce new foods, especially vegetables, her husband would say: “No, make me something else I am not going to eat that.” As she continued to take HLI courses, she convinced him that he needed to set an example for their son, and he has started to eat vegetables occasionally.

One demonstration participant declared that “fear of the unknown” could prevent people from changing their food habits. Another focus group participant who attended several demonstrations expounded:

Sometimes it is hard to buy more healthier stuff because you are afraid it is not going to taste right. You normally just go to the stuff that you are used to

FINDING 7: Participants cite “habit,” “family,” and “taste” as factors that impact the choices they make about nutrition.


because you are like “Oh I know how that tastes.” We will get the Doritos instead of the tortilla chips.

This statement underscores the importance of HLI classes that showcase diverse recipes and allow participants to try new foods. This practice, in turn, gives participants the confidence to purchase previously unfamiliar ingredients at the store. For many, trying new foods is also a budgeting concern: people do not want to spend money on food if they are uncertain they or their family will like it. A teacher explained that when students are given an opportunity to try new foods in the classroom during HLI classes, parents then learn what foods their children like: “Every time they do an activity the kids use so many vegetables and fruit and the parents are like, oh, okay, so you eat spinach, oh, okay now I can buy the spinach. Maybe before they wouldn't buy it because they felt that the kids wouldn't eat it.”

Similarly, a parent shared that buying new foods is a challenge if “you don’t know how to prepare whatever it is.” Learning how to prepare as well as taste new foods is crucial to adult participants buying healthy ingredients for themselves and their families.

As mentioned above, Camden lacks a full-service grocery store. Many residents rely on corner stores for groceries and quick meals. While some corner stores have fresh fruits and vegetables, many do not. When asked his biggest challenge in making nutritional changes, one participant who attended several demonstrations responded: “Transportation. If you don't have a car, you can't shop certain places. You are stuck shopping at other places.”

During a focus group discussion, one participant suggested that while money cards and food donations help, people also need “permanent access. Bringing a truck once a week does not solve the problem. You are just putting a Band Aid on it. You want to really incorporate something that is really going to be there, that they know is going to be there, that they can look forward to going to.”

In response, a teacher whose students participated in Healthy Home and School workshops mentioned the recent increase in “neighborhoods stores pairing up with fresh produce places” (due to Campbell Healthy Communities discussed in Chapter 1). She believes that if corner stores carry small things like fruits and “if they sold it

FINDING 8: Participants report that access to healthy food and transportation impact their nutritional choices.


at the right price families would buy it. It's just that there aren't many options now.”

Finances impact nutritional choices for the majority of participants. A parent who completed several Healthy Home and School workshops shared, “It is is so hard sometimes to find food. The fruits are so expensive; the vegetables are so expensive, so where are you going to go? Toward the cheap things. Toward what you can afford.”

Even armed with nutritional information, finances play a part in decision-making. One teacher explained that she thought caregivers who completed Healthy Home and School demonstrations “got the understanding that, you know, if we can make a vegetable choice, let's make a vegetable choice instead of another box of cereal. Where we can, let's make a healthy, lean meat choice instead of something high in salt.” However, while caregivers understand the importance of nutrition, she believes that they “still pretty much go and buy what one can afford to shop with.”

A parent who completed Cooking Matters for Parents® shared: “You know what else helps? When we got those money cards to Buy Rite and to ALDI. And then if you say this is what you need to go get, give a list of what you can buy with those cards.”

Participants commented that they are willing to replace a less healthy food option with a more healthy food option as long as the prices are similar. Several parents revealed that the classes impacted what they purchased when they were shown that healthy food could be inexpensive. One shared a specific example she learned, that to make a healthy snack (ants on a log) you need only three ingredients: “celery, peanut butter, soy butter, or sun butter, whatever they want, and raisins. It’s just three simple ingredients, it's not anything special or expensive.”

Many participants cited time as a major factor in their decisions around purchasing and preparing food. A teacher shared her opinion that, “One of the things is that parents are working till 5, 6, and 7 o’clock at night. If they can buy something on the way home, that is easier.”

FINDING 9: Participants report that financial cost and time to prepare home-cooked meals impacts their nutritional choices.


A teenage graduate of the YNOT course explained that in her house, her mom is often too tired to cook. She grew up eating McDonalds and even though she now knows that it is unhealthy compared to a home-cooked meal, sometimes there just isn’t the time or energy to prepare food.

I think for parents, fast food is an easier option. When they are out working and it’s in their minds to keep a roof over the kids heads, sometimes cooking isn't good for them after work, they want to go to sleep so the easy way out is to cook them some hotdogs which they probably don't want to go out to the store and buy them hotdogs, or they are going to be buying McDonalds. You might as well buy them McDonalds because then you don't have to cook anything. That is what my mom used to do.

When asked if knowing how to cook a quick healthy meal has changed choices at home, she replied: “Only once in a while.” Her peer corroborated when he shared that, “For me, a quick meal is a bowl of cereal.”

CHAPTER THREE: RECOMMENDATIONS AND CONCLUDING COMMENTS

PARTICIPANT RECOMMENDATIONS

Overall, participants had very little feedback to improve HLI courses. Some participants referenced recipes that they liked less than other recipes and offered suggestions for additional things they would appreciate, such as “Spanish foods” and instructors who speak Spanish. Most of the recommendations were for additional courses and demonstrations and ongoing support from FBSJ.

Participants’ recommendations tended to be specific to the course or courses that they experienced. Many of their suggestions are already part of the courses that FBSJ offers, for example Cooking Matters for Parents® participants said that they would like courses for their children as well. Teachers of students who participated in school-based courses suggested “workshops with parents.”

Participants of short-term demonstrations suggested more long-term courses. Participants of long-term courses suggested some short demos: “Maybe when you start the program up again, have more hands-on activities for parents to show them ways where they can create some really great dishes, quick. Which is really easy, it’s more filling, it’s more healthy.” Recommendations such as these suggest the desire for ongoing and comprehensive FBSJ programming at each site.


Some participants suggested additional courses at different times:

If they could have some day classes and night classes; they think people don't work but they really do. A lot of the classes were during job time.

Recommendations also encompass providing assistance with financial constraints. A teacher of children who completed Healthy Home and School workshops with parents suggested the following:

Give participants vegetable stipends. If you really want to tip it off, maybe 15-20 dollars a month to buy vegetables, which would be great […] it’s a good amount to buy some fresh fruits and fresh vegetables once a month and that is a way of training parents the young and the older ones how to keep the budget in hand, and how to keep those things inside the household.

A YNOT graduate suggested additional content/classes as part of the course:

I don't think one demo is enough because not everyone can be at that one demo. If you keep on doing them, more people will come.

This participant also thought that additional support from FBSJ would have helped them continue what they learned during the course. The following transcript reveals her thinking:

Teenager #1: When we did it [a public cooking demonstration] with the Food Bank, after the Food Bank left, we should have done it on our own. Because they left burners and things like that here at the center. We should have done it on our own so people know it is us and not the Food Bank that is trying to help. The Food Bank gave us these classes, they wanted us to start this but we should have continued instead of just stopping.

Focus Group Facilitator: Why do you think you stopped?

Teenager #1: We stopped because it was not a requirement of us anymore. I don't know if it should be a requirement but we should do it on our own. Focus Group Facilitator: What might have helped you continue to do the demos on your own?

Teenager #1: Maybe if the Food Bank left us other recipes to try that are easy, or something that demonstrates our weekly vegetable because we


have a lot of tomatoes at one point, or at another point we have a lot of corn.

EVALUATOR RECOMMENDATIONS One goal of this evaluation was to ascertain whether one-time HLI demonstrations have an impact on participants and, if so, what this impact is. Two out of the six focus groups were designed to pose questions to participants of one-time demonstrations. It was challenging, however, to disaggregate data about one-time demonstrations because participants in the focus groups had also attended other HLI courses and events. While some of their responses spoke specifically about the benefits of one-time demonstrations (see Finding 5), participants also spoke generally about their impressions of the Food Bank and all of the activities they had participated in. It was challenging, therefore, to distinguish the potentially different impact of different courses.

In order to better track the impact of one-time demonstrations and to have the capacity to disaggregate this data from generalized data about FBSJ, CR&E suggests that the Food Bank create a database that tracks participants, specifically the name and number of all the courses that participants attend. This strategy will require the Food Bank to collect names, along with basic demographic data from all participants at the start of all HLI courses, including one-time demonstrations, and to take systematic attendance. This way, participants can be better selected for qualitative focus groups (or interviews) that address the specific courses and topics they encountered. As well, tracking participation will reveal how many participants in one-time demonstrations return for more courses and which courses they select.

Keeping detailed attendance during longer-term courses (tracking how many classes that participants attend over time) will also assist in determining the impact of the classes on participants. It could be useful to clarify what percent of participants complete courses, whether this varies by course, by site, or by demographic characteristics of participants. In addition, having clearer information about who the participants are in each focus group will make generalizations and interpretations of impact and outcomes more meaningful. For example, in the report, we believe we can generalize that participants who attended more classes in a longer course tended to remember more details and retain more behavioral changes, but accurate participation data can confirm this generalization. Similarly, with more detailed information about participants in focus groups, it would be possible to better understand how HLI courses are meeting the needs of various subgroups.


In addition, CR&E suggests that the Food Bank continue to collect pre- and post- survey data to capture immediate impressions about HLI courses. With more systemic tracking of participants, survey data can be examined in relation to qualitative data from focus groups to determine the reasons why participants attended each type of course and the impact of these courses over time.

While CR&E recognizes that the Food Bank would like to better ascertain the impact that different courses have on participants in order to know what classes to promote and emphasize, we also suggest that the Food Bank, in making programmatic decisions, consider that each of the courses they offer appears to fill a different niche. As the data in this report reveals, participants appreciate the wide variety of courses that are available, and appreciate having a choice of classes to fit their schedule, available time, and level of investment. As well, participants stress the importance of trust and relationship-building that FBSJ courses engender. The very presence of FBSJ at the six sites under study was overwhelmingly positive, regardless of the type of course offered.

CONCLUDING COMMENTS

As documented in the findings presented above, participants have overwhelmingly positive perceptions of HLI classes and demonstrations provided by FBSJ. Participants of courses, one-time demonstrations, and workshops all report learning new nutritional information such as the importance of healthy eating, label reading, and portion control. Learning new information, in turn, has resulted in behavioral changes after the courses such as buying more vegetables, stretching ingredients to make more than one meal, or reducing salt intake. These behaviors have been proven to reduce food insecurity and improve overall health. These results indicate that FBSJ courses contribute to Campbell Health Communities’ goal of supporting healthy lifestyles through nutrition education. Regardless of the amount of time that passed since completing the courses, child graduates of Cooking Matters® courses and FBSJ signature courses that had multiple class meetings tended to have sharper and more detailed recall of course concepts than adults. For example, YNOT was held over a year ago, yet participants were able to recall in detail the content of each class, homework assignments, and how they prepared for the end-of-course public cooking demonstration. It is clear that this course had a profound impact on the participants; at least one remains involved FBSJ activities as a nutritional assistant. Likewise, 5th grade students who completed a Healthy Cooking course were overwhelmingly enthusiastic about the course. These groups, because they were comprised of children, were more consistent with attendance, which likely contributed to the participants’


comprehensive recall. In contrast, participants in the Cooking Matters for Parents® course had more variety in what they recalled from the classes because they each attended a different number of classes. Several participants only attended 2 out of the 6 classes, for example. Unsurprisingly, those that attended the most classes reported the most changes to eating, shopping and cooking behaviors. Likewise, parents who attended demonstrations with their children, and parents of children who attended workshops report that their children are most impacted by the course content. Parents report that after attending courses, children often insist on nutritional changes at home. This suggests that providing opportunities to try new food (such as the “Two-Bite Club”) leads to positive changes for children and, in turn, families. Children are often catalysts for nutritional change in the home. One-time demonstrations and workshops open the door for further nutritional changes. Most of the focus group participants who attended a one-time class came back for more. While this makes it difficult to ascertain the impact of a stand-alone class, it does suggest that these classes are welcome opportunities for participants to learn about basic nutrition in an accessible way. Focus group participants of these demonstrations recommended that FBSJ provide additional classes. They also identified the need for a choice of classes that can fit their available time, schedule, and level of commitment. In every instance – from Cooking Matter for Parents® to one-time demonstrations, focus group participants request “more”: more class selections, more time for each class, and more offerings overall. As one staff member suggested: “Keep introducing, keep reinforcing, keep sending home different things, keep advertising, keep telling people about the classes.”


APPENDICES

Appendix #1: Short Questionnaire Template (modified slightly for 3 sites).

QUESTIONAIRE

WELCOME! Please answer the following questions. Each question is about Healthy Home and School workshops.

1) How many children live in your household?

2) How many adults live in your household?

3) What are the most helpful things you learned in this course?

4) How many times each week do young children help in your home while making a meal?

Never Once a week 2-3 times 4-6 times More than 6 times

5) What do young children help with?

6) Do young children help more in the kitchen since you took this course?

YES NO

7) How often do teenagers help in your home while making a meal?

Never Once a week 2-3 times 4-6 times More than 6 times

8) What do teenagers help with?

9) Do teenagers help more in the kitchen since you took this course?

YES NO


10) Have you tried any new foods at home since taking these classes?

YES NO

If yes, what have you tried?

11) Have you changed any shopping habits because of these classes?

YES NO

If yes, what are you doing differently?

12) Have you changed any cooking habits because of these classes??

YES NO


13) Have you changed any eating habits because of these classes??

YES NO


14) How easy is it for you to make changes in your shopping, cooking, or eating?

Very Easy Somewhat Easy In the middle Somewhat Difficult Very Difficult

15) Did you share what you learned in these classes with other people in your life?

YES NO

16) Do you like the format of classes?

YES NO

17) Do you have any other comments?


Appendix #2: Basic Focus Group Template (modified significantly for each focus group based on curriculum.)

General retention

What do you remember the best from the course? What really stands out?

What did you enjoy the most?

What do you remember learning about MyPlate?

Recipes

What recipes do you remember?

What recipe/s did you like the most? Why?

Have you made the recipe again or used it in your teaching? Why or why not?

Label reading

What do you remember learning about label reading? Why is it important?

Did you read labels before the course? Do you read labels now? When and how often?

Healthy shopping, cooking, eating

Do you think that you shop healthier since taking this course?

In what ways? If no, why not?

Do you buy different foods since taking this course?

If yes, what is different? If no, why not?

Do you think that you cook healthier since taking this course?


Do you cook different meals since taking this course?

If yes, what is different?

Do you think that you eat healthier since taking this course?



Do you eat different foods since taking this course?

Do you buy, cook or eat different snacks or beverages since taking this course? If yes, what is different?

Do you swap out foods that are less healthy for healthier options? Like what?

What about portion control? Has this changed?

Has anything else changed about how you buy, cook, or eat food?

Food resource management

Before taking this course, did you plan your meals ahead of time or make shopping lists?

Has this changed since taking this course?

What do you remember learning about choosing best-priced forms of fruits and vegetables?

Do you feel more confident that you can cook and buy healthier food on a budget since taking this course?

What about “stretching” ingredients?

Family

Do you think what you learned during the course has impacted your family in any way?

How do you think your children have been impacted by you taking this course? How do you think your family has been impacted by your child taking this course?

Shopping? Do you involve kids or other family members?

Cooking?

Eating?

What happens when you eat away from home?

Did you share what you learned in the course with others?


Course format and style

What did you think about the form and style of the course?

What worked well for you?

What would you change?

Would you recommend this class to someone else?

Do you have any other comments?

Behavior change based on MyPlate

Have you increased your fruit and vegetable consumption?

Have you increased your whole grains consumption?

Have you reduced your sugars consumption?

How confident are you that you can discuss the difference between healthy and unhealthy fats?

Do you prepare recipes using herbs and spices instead of salt?

Do you prepare recipes with foods from multiple food groups?

Do you prepare recipes with different forms of fruits and vegetables?

Pros and cons of fresh, frozen, and canned?

How confident are you that you can identify healthy beverages?

How often do you practice proper hand washing?

How often do you practice basic knife safety?

Challenges

What do you think are the biggest nutritional challenges for local families in general? What do you think families do well in meeting these nutritional challenges? Where do you think most people shop? What is it like to try and get healthy foods in local neighborhoods? What do you think are the biggest challenges to buying nutritious food?


What do you think are the biggest challenges to preparing nutritious food? What do you think are the biggest challenges to changing the way that we shop and eat? What changes do you think would help kids be healthier? How could this happen? What do you think about nutrition at the school? What would make it better?

What gets parents involved?

In what way do you teach nutrition in the classroom?

How often do you teach nutrition in the classroom?

What topics have you covered?

How do students respond to nutrition activities in the classroom?

Did this course help you think about how to teach nutrition in the classroom? If yes, in what ways? If no, why not?

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