Courtney Butner€¦ · Web viewAgency Preceptor: ... developed the Philadelphia Healthy Corner...

MPH Internship ProposalCourtney Butner

Forsyth County Department of Public Health: Health Policy Unit

799 Highland Avenue, Winston-Salem, NC 27101Ashley Curtice, MS

Student: Date: .

Agency Preceptor: Date: .

Internship Coordinator: Date: .


Part 1: PROBLEM DEFINITION

Health Problem

Food security is defined by the World Health Organization (WHO) as existing

“when all people at all times have access to sufficient, safe, nutritious food to maintain a

healthy and active life”. WHO also notes that food insecurity is built on three pillars:

food availability, food access, and food use (WHO, 2014). The State of Food Insecurity

in the World (SOFI 2014) confirmed that they have seen the number of hungry people

decline globally by more than 100 million over the last decade and by 209 million since

1990-92 (FAO, 2014). However, one in nine or approximately 805 million people in the

world still suffer from hunger, according to a recent report made by the UN (FAO, 2014).

According to hunger statistics from 2013 in the U.S., 49.1 million Americans lived in

food insecure households, including 33.3 million adults and 15.8 million children, this

equates to 14 percent of households (17.5 million households) being food insecure

(Feeding America, 2014). Households in 2013, that had higher rates of food insecurity

compared with the national average included households with children (20%), especially

households with children headed by single women (34%) or single men (23%), Black

non-Hispanic households (26%) and Hispanic households (24%) (Feeding America,

2014).

Food insecurity is a problem in North Carolina, at 17.3%, our state was among

eight states that exhibited statistically significantly higher household food insecurity

rates compared with the national average from 2011-2013 (Feeding America, 2014).

According to Healthy Food Resources Guide in North Carolina for 2014, about one in

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every five North Carolinians is “food insecure” and will not have access to enough food

this year, which includes one in every four children (The Support Center, 2014).

Certain populations are at a higher risk for food insecurity. For example women

and children are among those groups at higher risk for food insecurity and as a result

negative nutrition and health outcomes (Olson, 1999). In households with migrant and

seasonal Latino farmworkers are at a higher risk for food insecurity especially in those

with children (Quandt, 2004). A large part of the problem is that too many people live in

“food deserts” and therefore are unable to access the healthy foods they need. “Food

deserts” refer to communities that do not contain healthy food retailers. Therefore,

individuals living in food deserts must travel outside of their community in order to

purchase foods to feed their families a healthy diet (The Support Center, 2014).

Currently, North Carolina has 349 food deserts in 80 counties across the state,

including Forsyth County. This data is based on census tracts that do not have a

supermarket within one mile in urban areas or 10 miles in rural areas (The Support

Center, 2014). The high presence of food deserts in North Carolina is a major

contributing factor to food insecurity.

Another important thing to note is that the healthy food retailers in North Carolina

are greatly outnumbered by less healthy, more convenient food options. The lack of

healthy food is a leading cause of obesity, which is the second leading cause of

preventable death in the U.S. (The Support Center, 2014). Obesity leads to the

increased health risk of many conditions, including heart disease, diabetes, gallbladder

disease, and even certain forms of cancer. North Carolina’s rate of obesity is nearly 30

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percent with a ranking of 18th most obese state in the U.S. (The Support Center, 2014).

Limited access to healthy foods is a growing problem in Forsyth County. According to

the 2013 State of the County Health Report for Forsyth County, the percentage of the

population who are low-income and do not live close to the grocery store went up from

11% in 2012 to 12% in 2013. This report also noted a high percentage of restaurants

that are classified as fast-food establishments at 47%. (State of the County Health

Report, 2013). Food insecurity is a major problem in Forsyth County and a big factor

contributing to this is the lack of healthy options and the existence of food deserts.

Non-health Problem

Corner stores have been found to be an important source of food for rural and

low-income residents and thus a good place in which to intervene (Pitts, 2013). The

FCDPH has found that corner stores within Forsyth County are willing to stock more

healthful foods if there is a customer demand for these foods. In order to increase the

demand for these foods the FCDPH developed the Healthy Corner Stores network,

which now includes five stores. The Health Policy Unit at FCDPH promotes the program

in a variety of ways which include; conducting taste testing blasts of healthy local and

seasonal produce for corner store customers, development of seasonal recipe

pamphlets, creation of an incentive program, and by organizing cooking lessons to be

taught in the community to promote cooking with fresh healthier foods. The Health

Policy Unit assists with the development, distribution, and displaying of healthier choice

options, seasonal recipe pamphlets, incentives for the purchase of healthier options and

advertisements for Healthy Corner Stores project, in the corner stores. They also

provide technical assistance and support the idea of a network where corner store

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owners can meet regularly and discuss logistics of selling healthier options to customers

to reduce the impact of food deserts in their neighborhoods. Recruitment of additional

corner stores to join the Healthy Corner Stores Network is needed. In addition to

recruitment there is also a need for assistance with program implementation and

promotion. The Health Policy Unit needs to collect data on the program during

implementation for evaluation. This will require communication with store owners and

customers to gage impact and needs of the program. Healthy Corner Stores Project is

being conducted in the hopes of accessing and addressing the issue of food insecurity

and food deserts in Forsyth County.

Forsyth County Department of Public Health (FCDPH): Health Policy Unit

The mission statement of FCDPH is, “to prevent disease and promote a healthy

community through regulation, education and partnerships.” The Forsyth County Health

Policy Unit’s mission “engages in efforts to positively affect behavioral and

environmental change in the areas of women’s health, infant mortality, tobacco

awareness and food security.” The Health Policy Unit’s Healthy Corner Store project

specifically targets the issue of food insecurity in Forsyth County.

SWOT analysis

In a SWOT analysis performed using organization and study-specific resources,

the strengths of the Health Policy Unit at FCDPH identified for the Healthy Corner Store

project include cooperation of corner stores, resources, and support from partnerships

with local universities. The Healthy Corner Stores Network already has the support of 4

corner stores in Forsyth County. Store owners from each of attend monthly meetings

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where they provide helpful insight and feedback, agree to post advertisements and

resources for the project in their stores, and allow taste testing at their stores to promote

the project. Storeowners seemed enthusiastic about the plans for taste testing at their

stores in order to promote the Healthy Corner Stores initiative. The Healthy Policy Unit

has resources through the FCDPH to use for the Healthy Corner Stores project.

Advertisements are the most important of those resources used by FCDPH for the

Healthy Corner Stores project. The FCDPH has partnerships with local universities like

UNCG and WSSU, which help provide the health department with assistance via

interns.

These strengths will assist the Health Policy Unit in tackling their weaknesses

that include staffing, corner store storage issues, costs of healthier options for corner

stores, and the selling of those healthier options. The Health Policy Unit is made up of

only 3 individuals and only one is focused on the Healthy Corner Stores project. Lack of

sufficient staffing may limit their reach and impact in Forsyth County with this project.

Healthier options tend to be more expensive and can be harder to sell, which would

result in a loss of profit. Corner store owners also have limited or the complete lack of

storage space for food items needing refrigeration.

An opportunity for improvement with the Healthy Corner Stores might be to

increase their partnership in the community in order to spread awareness of the Healthy

Corner Stores project. Forsyth County has many areas that are deemed food deserts so

this leaves a lot of opportunity for expanding the Healthy Corner Stores network. The

prevalence of food insecurity is also high, which should justify the need and hopefully

increase the support for the project. Corner store owners have agreed to split the

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purchase of produce from local farmers. This supports both the farmers; the corner

stores, and keeps money within the community.

Threats to the community with regard to the Healthy Corner Stores project

include lack of awareness in Forsyth County of the problem of food insecurity, lack of

knowledge of the benefits of eating a healthy diet with regards to chronic disease

prevention, and the importance of bigger threats to safety and overall welfare in the

community. The targeted population is at risk for many other health problems that may

take precedent over concerns of nutrition.

Strengths

Cooperation of corner stores in Forsyth County

Office space and equipment for data collection, data analysis, and the preparation of tools

Support and partnerships with universities and local community organizations

Weaknesses

Number of staff working on Healthy Corner Stores Project

Refrigerated storage space in corner stores

Costs of healthier options Sale of healthier options

Opportunities

Prevalence of food deserts in Forsyth County

Good rapport with community Connection with local farmer(s)

Threats

Awareness of food insecurity in Forsyth County

Knowledge on the benefits of eating a nutritious diet

Importance in the community of other issues

Ethical Dilemmas

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Some ethical dilemmas that may arise throughout the development and implementation

of the Healthy Corner Stores project include the following:

Unintentional lack of cultural sensitivity

Overgeneralization of the needs of corner stores for the purposes of the Healthy

Corner Store project

Unintentional lack of knowledge on the perceived needs related to food and

nutrition among those living in food deserts in Forsyth County

Large portions of the population in Forsyth County that use the corner stores are from

minority groups. These minority groups are mostly made up of either Hispanic or African

American populations. While the Healthy Corner Stores project has resources and tools

available to reach this population (signs present in both English and Spanish, good

communication with at least one Hispanic store owner, access to translators through the

health department), there may also be cultural barriers that are not or will not be

considered based on the fact that there is currently no representative on the project who

is Hispanic. Another ethical issue that may need to be considered is do the goals of the

Healthy Corner Stores project match those of the customers and targeted population.

The Health Policy Unit conducts meetings with store owners in gain further insight into

the community and get feedback on what about the Healthy Corner Stores project is

working and what needs improvement. While an evaluation of the program has not been

established, the Health Policy Unit does have experience with surveys and focus

groups. The Healthy Corner Stores’ project does conduct free taste testing’s at stores to

promote the sale and consumption of the “healthier” corner store options.

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Part 2: Problem Analysis

Conceptual Model

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“Food security exists when all people, at all times, have physical, social and

economic access to sufficient, safe and nutritious food, which means their dietary needs

and food preferences for an active and healthy life.” (The State of Food Insecurity in the

World, 2013). This definition indicates that the problem of food insecurity is

multidimensional and influenced by several factors. In order to decrease the problem of

food insecurity in Forsyth County the FCDPH developed their Healthy Corner Stores

program. This program focuses on the presence of food deserts in Forsyth County.

Food deserts are defined as urban neighborhoods, rural towns, or communities lacking

access to fresh, healthy, and affordable food. These communities are primarily served

by convenience stores or fast-food restaurants due to the lack of grocery stores or

supermarkets in the area. Convenience stores and fast-food restaurants often fail to

offer healthy affordable options. The lack of access to healthy foods contributes to a

poor diet and lead to higher levels of diet-related diseases like obesity, diabetes, and

heart disease. (USDA, 2014). We may not be able to change factors that contribute to

food insecurity in Forsyth County like poverty and low socioeconomic status, but we can

have an impact on other contributing factors for example access and availability of

healthy food options in corner stores.

Figure 1 illustrates some of the contributing factors to food insecurity. In Forsyth

County the role of food deserts exacerbate the problem of food insecurity, which

ultimately leads to health disparities among people living in these communities. The

socio-ecological model was used to identify the multi-level factors that play a role in

food insecurity outlined in the following section, along with how food deserts significantly

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contribute to the problem of food insecurity. Poverty and socioeconomic status (SES) is

a factor that affects food insecurity at every level of the socioecological model.

Figure 1

Intrapersonal Level

Food insecurity at the intrapersonal level would include the individual’s

knowledge, attitudes, and beliefs about food in general. A formative evaluation for a

Healthy Corner Store Initiative in Pitt County, North Carolina reported on customer

surveys and found that 92% of customers said they would be very to somewhat likely to

purchase fresh fruits and 79% reported being very to somewhat likely to purchase fresh

vegetables. (Pitts et. al, 2013). This study reported that some customers were willing to

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buy fruits and vegetables if they were available while others reported not eating more

fruits and vegetables because they liked to eat other foods more. Another study looked

at intrapersonal factors and found that a barrier to accessing food was related to lack of

motivation and energy to cook. (Radermacher et al, 2010). The study also mentioned

that food preferences and availability affected food choice among different cultural

groups based on ethnic heritage and traditional cuisine. (Radermacher et al, 2010).

Both their social and physical environments often influence individual preference

heavily.

Interpersonal Level

At the interpersonal level food insecurity is affected by factors that relate to how

the individual is influenced by their family, friends, and peers. A study looking to

understand the interactions with the food environment noted that a family group

shopping in a corner store engaged in constant negotiations and compromises over

what products to buy. (Thompson et al., 2013). The child in this family unit kept asking

his mother if she would purchase certain food products. In this situation the mother was

influencing her son’s food choices by limiting her purchase to certain items based on a

variety of factors (cost, her taste preferences, perceived needs of son, etc.) that were

out of his control. Our family, friends, colleagues and our environment heavily influence

food choices.

Community Level

Food insecurity is greatly influenced by one’s environment. The 2014 Healthy

Food Resources in North Carolina resource guide reported that one in every five North

Carolinians is food insecure and will not have access to enough food this year. (The

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Support Center, 2014). This resource guide also noted that one-third of North

Carolinians living with food insecurity currently earn incomes that are 200 percent above

the poverty level. (The Support Center, 2014). So while poverty and SES are certainly

factors that affect food insecurity they are not the only ones. A large part of the food

insecurity problem is that too many people live in food deserts and cannot access the

healthy foods they need. (The Support Center, 2014). According to the Center of

Disease Control, only 11 of every 100 food retailers have healthy food options available

in their restaurant and store. (CDC, 2014). One study found 6 major community-level

barriers affecting access to fruit and vegetables: cost, transportation, quality, variety,

changing food environment, and changing societal norms. (Haynes-Maslow et al.,

2011). Cost was the most commonly and extensively described barrier to purchasing

fresh fruits and vegetables. (Haynes-Maslow et al, 2011). Food choice is influenced by

price and larger food stores in urban centers are understood to have better food prices.

(Dean & Sharkey, 2011). Transportation was another common barrier especially for

elderly or those who did not own a vehicle. (Haynes-Maslow et al., 2011). Better food

quality is a strong predictor of food choice. A focus group research identified that poor

food quality, including spoiled fruits and vegetables, as a factor that limited food choices

for rural populations. (Dean & Sharkey, 2011). Limited variety at corner stores

decreased participants’ willingness to shop there, but participants with limited

transportation found it difficult to search for produce elsewhere. (Dean & Sharkey,

2011). The food environment has changed in the last few decades especially in low-

income neighborhoods. Fast food restaurants are now recognized as being apart of the

current food environment and despite being viewed as unhealthy and linked with

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obesity, many participants still purchased it because of it’s proximity to home and

therefore convenience. (Haynes-Maslow et al., 2011). This study also noted the change

societal norms on foods in the United States: the social shifts of the role of women in

the family, children having more choice, and the overall shift from less emphasis on

cooking and more emphasis on convenience. (Haynes-Maslow et al., 2011). Food

preparation time and convenience of prepared food were both noted barriers to eating

fruits and vegetables.

Community level factors are not limited to the environment including the corner

stores availability of fresh produce; we also must consider public policy. Policy makers

could help by supporting programs like the healthy corner stores initiatives aimed at

addressing the barriers in low-income communities. This could be done by encouraging

grocery stores to locate in these communities, creating incentives for convenience

stores to carry more produce, and restricting the number of fast food restaurants that

locate in these communities. Policy makers can also consider decreasing fruits and

vegetable prices, either through subsidies or vouchers, to address cost barriers.

(Haynes-Maslow et al., 2011). Another issue that could be addressed at the policy level

is the concern for safety from crime in and around corner stores. The CPPW Nashville

corner store initiative noted this as one of the greatest challenge for communities. The

public policy they discussed related to incorporating police department representatives

in strategy development to solve this problem. (Larson et al., 2012). Another challenge

discussed was the lack of trust between corner store owners and community members.

The development of partnerships between stores and community organizations was

suggested to help sustain the viability and availability of healthful foods in corner stores

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by engaging organizations to promote the purchase of certain items. (Larson et al.,

2012).

Changeability Matrix

High Changeability Low Changeability

High Importance

Increased number of Healthy Corner Stores in networkAwareness of food desertsAvailability of healthy foodsKnowledge about benefits of healthy foods

Access to healthy foodPoverty/SESCultureHealthy food choicesCost (healthy foods, storage equipment, etc.)

Low Importance

Quality of producePartnerships with community organizations (i.e. local farmers)

Societal normsTransportationPersonal taste preferencesDesire to support local businessesVariety of produce (seasonal/prices)

Factors addressed by FCDPH: Health Policy Unit

In connection with the FCDPH’s Health Policy Unit mission, the Health Policy

Unit is in the process of developing and implementing their Healthy Corner Stores

project to combat food insecurity in areas of Forsyth County where food deserts are

present. The Healthy Corner Store project is designed to bring healthier options to

convenience type corner stores in the form of fresh fruits and vegetables. So far the

Health Policy Unit has recruited 4 corner stores to be apart of this project. The Health

Policy Unit has planned healthy taste testing at corner stores in order to promote the

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sell and purchase of their healthier inventory. Corner store owners have agreed to meet

monthly to discuss the success and possible improvement of the project. The Health

Policy Unit has connected corner store owners with a local farmer in order to support

the process of developing community partnerships. In addition to hosting taste testing’s

at corner stores and connecting corner stores with a local farmer, the Health Policy Unit

has developed advertising for the Healthy Corner Store project. They have developed

ads for the local newspaper, signs for store owners to put out front, labeling for healthier

options in store, and are in the process of developing a seasonal recipe pamphlet to

distribute to customers. The goal of this project is to increase the access and availability

of healthier food options in food deserts for the purposes of decreasing food insecurity.

Previous Studies

Previous research has been conducted to address the problem of food insecurity

in areas with food deserts. The Food Trust, a nationally recognized nonprofit, developed

the Philadelphia Healthy Corner Stores Network, which is a citywide network of over

600 corner stores committed to the improvement of healthy food access in underserved

communities in Philadelphia. (Food Trust, 2012). This network is part of the Healthy

Corner Store Initiative that works in partnership with the Philadelphia Department of

Public Health (PDPH) and their Get Healthy Initiative. The Healthy Corner Store

Initiative works to increase the awareness and availability of healthy foods in corner

stores in Philadelphia. This initiative works through a multifaceted approach that

includes; increasing store capacity to sell and market healthy items in order to improve

healthy options in communities, training and technical assistance to store owners to

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provide the skills to make healthy changes profitable, marketing healthy messages to

youth and adults to encourage healthy eating choices, hosting in-store community

nutrition education lessons, educating youth in schools near targeted corner stores to

reinforce healthy messages and provide nutrition education through the Snackin’ Fresh

program, linking corner store owners to community partners (local farmers and fresh

food suppliers) to create and sustain healthy corner stores. (Food Trust, 2012). The

Healthy Corner Stores Initiative has found that corner store owners are willing to

introduce inventory, but need support and simple steps to follow. Over 480 hours of

training were provided to store owners and 80% of store owners accepted at least one

training session. (Food Trust, 2012). This demonstrates a strong interest in store

owners in learning how to profitably sell healthy products. Corner stores that made

small investments in equipment were able to significantly increase the stores’ capacity

to sell healthy products. Infrastructural changes such as the addition of refrigeration

units and shelving were completed as a part of the initiative to expand each store’s

inventory of healthy products. The average store conversion introduced 44 new healthy

products, about half of which were fresh fruits and vegetables. (Food Trust, 2012).

Another corner store project to mention is part of the Centers for Disease Control

and Prevention’s Communities Putting Prevention to Work (CPPW) initiative, aimed to

increase availability of healthful foods in food deserts in Nashville, Tennessee. (Larson

et al., 2012). This project identified 4 food deserts in which most residents were low-

income and racially and ethnically diverse. Their objective was to develop an approach

that would increase the availability of fresh fruits and vegetables, low-fat or non-fat milk,

and 100% whole-wheat bread in Nashville’s food deserts and to engage the community

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members in order to promote the strategy. (Larson et al., 2012). Few stores were able

to stock items in each of these categories. Major barriers were reported relating to the

retailing of healthful options that included; mistrust of store owners, history of poor-

quality produce, and limited familiarity with healthful options. (Larson et al., 2012). This

study interpreted these results to indicate the importance of engaging community

residents and understanding neighborhood context as a crucial part in the development

of strategies to increase access to healthful foods in corner stores. (Larson et al., 2012).

Outcome Objectives

The objectives of FCDPH Health Policy Unit’s Healthy Corner Stores project are

to decrease food insecurity in Forsyth County in areas where food deserts are

prevalent. The Health Policy Unit plans to implement the Healthy Corner Stores project

with specific aims that include the increasing awareness of healthy food options at

corner stores through advertisements, food tastings, development and distribution of

seasonal recipe pamphlets, increasing availability of healthy options through

partnerships with local farmers, increasing the program’s reach by recruiting additional

corner stores to become part of the Healthy Corner Stores network, increasing

customer participation by incorporating an incentives plan, and providing store owners

with support (for example tips for purchasing storage, advertising for healthier options,

and connecting store owners with potential community partners).

I hope to learn more about the impact of food insecurity and food deserts in

Forsyth County by assisting in the implementation of the Healthy Corner Stores project.

I will promote the program through conducting taste testing of healthy food options sold

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at corner stores, development of seasonal healthy recipe pamphlets, recruitment of

additional corner stores, provide support to store owners, and the creation of incentive

program to promote the sell of healthy food options sold at corner stores. These tasks

will allow me to access the success and needs of the Healthy Corner Stores project in

the hopes of improving the program and problem of food insecurity in areas with food

deserts.

Part 3: Internship Plan

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The focus of this internship will be program implementation of the FCDPH Health

Policy Unit’s Healthy Corner Store project. This project was designed to decrease the

problem of food insecurity in Forsyth County among areas that are affected the most

and deemed food deserts. Implementation of this program will involve several tasks

including; developing a seasonal recipe pamphlet, hosting taste testing blasts,

organizing meetings with corner store owners, assisting with the development of an

incentive program, and organizing cooking lessons. This internship will also include a

recruitment component and an evaluation component. Recruiting 2 additional corner

stores to join the Healthy Corner Store Network is one of the goals of the internship.

The evaluation piece will involve distributing surveys at Healthy Corner Stores during

taste testing’s, cooking lessons, and other events in order to access the success of this

program. While this will involve compiling data from surveys, data analysis will not be

part of the responsibilities of this internship. Figure 2 below shows a detailed outline of

the resources needed, activities and outcomes of the Healthy Corner Store Project.

Figure 2

Logic Model

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INPUTS/RESOURCES

ACTIVITIES OUTPUTS OUTCOMES/ IMPACT

Working with corner store owners in Forsyth County

FCDPH staff Transportation Telephones Healthy Corner

Store advertisements (i.e. healthier option signs)

Computer Printer Foods for taste

testing Cooking tools for

food preparation Marketing

supplies

Developing seasonal recipe pamphlets & incentive program (punch card)

Hosting taste testing blasts at Healthy Corner Stores

Data collection & analysis on community’s level of exposure to program campaign

Organizing meetings with corner store owners

Organizing cooking lessons

Recruiting 2 additional corner stores to join Healthy Corner Store Network

Evaluation of program (developing, distributing & compiling surveys at taste testing, cooking classes, corner stores, etc.)

Data from observations of interactions at corner stores; taste testing blasts, cooking lessons, etc.

Feedback from corner store owners on success of healthy corner store program

Increased marketing about healthy options at corner stores

Program development

Implement Healthy Corner Stores program

Short-term Outcomes

Increased promotion Healthy Corner Stores program

Increased awareness of healthier options at corner stores

Recruit 2 additional corner stores

Evaluate program success through collection & interpretation of surveys

Long-term Outcomes

Improve Healthy Corner Store program to reduce food insecurity in Forsyth County food deserts

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Data Collection & Program Implementation

This is the second year the FCDPH has implemented the Healthy Corner Stores

Project. In order to implement the program there are a variety of activities they have

designed to use as tools. The activities that will be executed from January to April of

next year include; developing a seasonal recipe pamphlet for corner store owners that

they can make available to customers in order to promote healthier options, hosting

taste testing blasts at corner stores to endorse the program, organize meetings with

corner store owners to gather feedback and provide technical support for the program,

develop an incentive program in order to encourage customers to buy healthy corner

store items, and to organize cooking lessons in the community to sponsor the program

and stimulate the sale of healthier options at corner stores. Many of these activities will

allow for qualitative data collection based on observations of customer’s participation in

the activities/events and feedback from meetings with corner store owners. The

implementation of the program will also involve recruitment.

Recruitment

Forsyth County has many areas that are classified as food deserts. These food

deserts lack grocery stores or supermarkets therefore residents must either travel

outside of their neighborhood in order to purchase food items or buy food from local

fast-food restaurants or corner stores. The corner stores typically contain very little if

any fresh fruits and vegetables. The Healthy Corner Stores Project developed by

FCDPH hopes to recruit 2 additional corner stores to join the network. This will involve

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going into corner stores and talking to owners about the project. Corner store owners

who are interested will receive a letter with additional information about the program and

what they must do in order to be apart of the program. The more stores that join the

network, the greater the reach and impact the Healthy Corner Stores Project can have

on food insecurity in Forsyth County.

Evaluation

In order to gather information about the success of the program within the

community, data will be collected and compiled from surveys given during taste

testing’s, cooking lessons, and at Healthy Corner Stores. Qualitative data will be

accessed through site visits and feedback from storeowners during meetings about

Healthy Corner Store Project. The data collected from observations and surveys will be

prepared for evaluation of the program.

Internship activities will commence the week of January 5, 2015 and end during

the week of April 20, 2015. Figure 3 shows a breakdown of the activities that will be

completed during the internship and a prediction of the timeline.

Figure 3

Project Timeline

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Resources

1. Feeding America. (2014). Hunger Statistics, Hunger Facts & Poverty Facts. Retrieved October 14, 2014, from http://feedingamerica.org/hunger-in- america/hunger-facts/hunger-and-poverty-statistics.aspx.2. Food and Agriculture Organization of the United Nations. (2014). World hunger falls, but 805 million still chronically undernourished. Retrieved October 14, 2014, from http://www.fao.org/news/story/en/item/243839/icode/.3. Forsyth County Department of Public Health. (2013). 2013 State of the County Health Report: Forsyth County. Retrieved from http://www.co.forsyth.nc.us/publichealth/Documents/2013%20FC%20SOTCH_F inal.pdf.

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Internship Activities Jan.2014

Feb.2014

Mar.2014

April2014

Data Collection & Program Implementation Part 1

Developing seasonal recipe pamphlets for Healthy Corner Stores to distribute

X X

Assisting with Health Policy Unit’s development of small business classes to support Healthy Corner Stores Project (preparing, organizing, & attending owner’s meetings)

X X

Taste testing blast at Healthy Corner Stores

X

Data Collection & Program Implementation Part 2

Assisting with the development of an incentive program for Healthy Corner Store Owners to provide to their customers (punch cards)

X X X

Cooking Lessons (find locations, promote lessons, host event or find chef to host)

X

Recruitment Recruiting 2 additional corner stores to join the Healthy Corner Stores Network

X X X X

Evaluation Evaluation of Healthy Corner Stores Program (compiling data from surveys distributed at events- taste testing’s, cooking classes, etc.)

X X X


4. Haynes-Maslow, L., Parsons, SE, Wheeler, SB, Leone, LA. (2013). A Qualitative Study of Perceived Barriers to Fruit and Vegetable Consumption Among Low-Income Populations, North Carolina, 2011. Preventing Chronic Disease: Public Health Research, Practice, and Policy, 10, 1-10. DOI: http://dx.doi.org/105888/pcd10.120206.5. North Carolina Association of Feeding America Food Banks. (2014). Hunger in North Carolina. Retrieved October 14, 2014, from http://ncfoodbanks.org/hunger-in-north-carolina/.6. Olson, CM. (1999). Nutrition and Health Outcomes Associated with Food Insecurity and Hunger. Journal of Nutrition, 521S-524S. Downloaded October 14, 2014, from jn.nutrition.org.7. Pitts SB, Bringolf KR, Lloyd CL, McGuirt JT, Lawton KK, Morgan J. (2013). Formative Evaluation for a Healthy Corner Stores Initiative, Part 2. Preventing Chronic Disease, 10, 1-9. DOI: http://dx.doi.org/10.5888/pcd10.120319.8. Quandt, SA, Arcury TA, Early, J., Tapia, J., & Davis JD. (2004). Household Food Security Among Migrant and Seasonal Latino Farmworkers in North Carolina. Public Health Reports, 119, 568-576.9. Quandt SA, Shoaf JI, & Arcury TA. (2006). Experiences of Latino Immigrant Families in North Carolina Help Explain Elevated Levels of Food Insecurity and Hunger. Journal of Nutrition, 136(10): 2638-2644.10. The Support Center. (2014). Healthy Food Resources in North Carolina. [Resource Guide]. 11. World Health Organization. (2014). Trade, foreign policy, diplomacy and health: Food Security. Retrieved October 14, 2014, from http://www.who.int/trade/glossary/story028/en/. 12. Haynes-Maslow L, Parsons SE, Wheeler SB, Leone LA. A Qualitative Study of Perceived Barriers to Fruit and Vegetable Consumption Among Low-Income Populations, North Carolina, 2011. Prev Chronic Dis 2013;10;120206. DOI: http://dx.doi.org/10.5888/pcd10.120206. 13. Pitts SB, Bringolf KR, Lloyd CL, McGuirt JT, Lawton KK, Morgan J. Formative Evaluation for a Healthy Corner Store Initiative in Pitt County, North Carolina: Engaging Stakeholders for a Healthy Corner Store Initiative, Part 2. Prev Chronic Dis 2013;10:120319. DOI: http://dx.doi.org/10.5888/pcd10.120319.

14. The Food Trust. (2012). Philadelphia’s Healthy Corner Store Initiative. Retrieved November 1, 2014 from http://thefoodtrust.org/uploads/media_items/hcsi-y2report- final.original.pdf.15. The Support Center. (2014). Healthy Food Resources in North Carolina: January 2014. Retrieved November 2, 2014 from http://thesupportcenter-nc.org/cms/wp- content/uploads/2014/01/HF-Resource-Guide-1.14.pdf.16. Borradaile KE, Sherman S, Vander Veur SS, McCoy T, Sandoval B, Nachmani J, Karpyn A, Foster GD. (2009). Snacking in Children: The Role of Urban Corner Stores. Pediatrics 2009;124:5, 1293-1298. DOI: http://dx.doi.org/10.1542/peds.2009-0964. 17. Dean, WR, Sharkey JR. (2011). Rural and Urban Differences in the Associations between Characteristics of the Community Food Environment and Fruit and

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Vegetable Intake. J Nutr Educ Behav. 2011;23:426-433. DOI: http://dx.doi.org/10.1016/j.jneb.2010.07.001.18. Thompson C, Cummins S, Brown T, Kyle R. (2012). Understanding interactions with the food environment: An exploration of supermarket food shopping routines in deprived neighborhoods. Health & Place 2013;19:116-123. DOI: http://dx.doi.org/10.1016/j.healthplace.2012.10.003.19. Larson C, Haushalter A, Buck T, Campbell D, Henderson T, Schlundt D. (2013). Development of a Community-Sensitive Strategy to Increase Availability of Fresh Fruits and Vegetables in Nashville’s Urban Food Deserts, 2010-2012. Prev Chronic Dis 2013;10:E125-137. DOI: http://dx.doi.org/10.5888/pcd10.130008. 20. Munoz-Plaza CE, Morland KB, Pierre JA, Spark A, Filomena SE, Noyes P. (2013). Navigating the Urban Food Environment: Challenges and Resilience of Community-dwelling Older Adults. J Nutr Educ Behav. 2013;45:322-331. DOI: http://dx.doi.org/10.1016/j.jneb.2013.01.015. 21. Radermacher H, Feldman S, Bird S. (2010). Food Security in Older Australians from Different Cultural Backgrounds. J Nutr Educ Behav. 2010;42:328-336. DOI: http://dx.doi.org/10.1016/j.jneb.2009.10.004. 22. USDA. (2014). Definitions of Food Insecurity. Retrieved October 31, 2014 from http://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the- us/definitions-of-food-security.aspx.23. The State of Food Insecurity in the World. (2013). Measuring different dimensions of food insecurity. Retrieved November 1, 2014 from http://www.fao.org/docrep/018/i3434e/i3434e02.pdf24. USDA. (2014). Food Deserts. Retrieved November 2, 2014 from http://apps.ams.usda.gov/fooddeserts/fooddeserts.aspx

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Courtney Butner€¦ · Web viewAgency Preceptor: ... developed the Philadelphia Healthy Corner...

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