Indiana Family Nutrition Program Fiscal Year Final Report

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1 Indiana Family Nutrition Program Fiscal Year Final Report Submitted to: United States Department of Agriculture Food and Nutrition Service Chicago, Illinois Indiana Family and Social Services Administration Supplemental Nutrition Assistance Program (SNAP) Indianapolis, Indiana Prepared by: Melissa Maulding, MS, RD Nutrition Education Program Director Purdue University Cooperative Extension Service West Lafayette, Indiana The Family Nutrition Program operates through Purdue University Cooperative Extension Service in partnership with Indiana Family & Social Services Administration (FSSA) and the United States Department of Agriculture (USDA). Purdue University Cooperative Extension Service, FSSA and USDA are equal opportunity/equal access/affirmative action institutions. This material was funded by USDA s Supplemental Nutrition Assistance Program. The Supplemental Nutrition Assistance Program helps end hunger and provides healthy foods for low-income families. To find out more about SNAP benefits contact your local office of Family Resources.

2 Impact 2012 Title: Indiana Family Nutrition Program (FNP) helping Hoosiers Eat Better for Less. Issue: According to the US Bureau of Labor STATS 8.2% of Hoosiers were unemployed in September 2012, with individual counties as high as 9% unemployment. In 2010, STATS IN reports IN ranked 22 nd in the nation with 15.31% of Hoosiers living in poverty. According to Indiana Family and Social Service Administration, as of October 2012, 923,253 individuals in Indiana receive food assistance (SNAP). Indiana, like the rest of the nation, has seen an increase in poverty and joblessness again this year. What has been done: The Family Nutrition Program (FNP), in partnership with Purdue University Cooperative Extension Service, Indiana Family Social Service Administration, and the U.S. Department of Agriculture provide education to low-income participants on food safety, diet quality, and economizing food dollars to help bring about nutrition-related lifestyle changes and reduce food security. The FNP goal is to improve the likelihood of SNAP eligible individuals making healthy food choices within a limited budget. In 2012 Purdue Extension requested $4,949,271 and received federal funds in the amount of $5,050,203 to fund the program. Impact: The impact of FNP is maximized through its partnerships in education with community agencies and organizations such as the Division of Family resources, schools, learning centers, libraries, WIC, health departments, senior centers, congregate meal sites, shelters and crisis centers. In 2012 the program was provided in 91 Indiana counties. A total of 231,614 clients were reached with direct education and an additional 105,228 clients were reached through indirect contact. A total of 27,797 participants completed the short term evaluation with 568 participants completing the medium term evaluation.

3 Paired t-tests were conducted to compare the 37 pre-post test answers for the 14 nutrition education lessons. Each client served as their own control. When comparing the retrospective post-test to pre-test results, all questions from all lessons showed improvement and were all statistically significant (p<0.05) (Appendix F -short term summary report ). Similarly, Paired t-tests were conducted to compare the 17 pre-post test answers. When comparing the post-test to pre-test results, all questions from all lessons showed improvement and were all statistically significant (p<0.05) (Appendix G -medium term summary report ). Contact Person: Melissa Maulding, MS, RD, FNP Director mmaulding@purdue.edu Impact Type: Extension Funding: USDA Food and Nutrition Services Partners: USDA Food and Nutrition Services Indiana Family and Social Services Administration Purdue Cooperative Extension Service

4 Indiana Family Nutrition Program Final Report of Fiscal Year Project Summary Purdue University Cooperative Extension Service, in collaboration with the Indiana Family and Social Services Administration, received federal funds in the amount of $5,040,203 to fund the Supplemental Nutrition Assistance Program Education (SNAP-Ed) in Indiana, the Family Nutrition Program (FNP). The Family Nutrition Program provides food and nutrition education exclusively for SNAP recipients and SNAP eligible persons in 91 counties in Indiana (Appendix A). The Family Nutrition Program does not duplicate the USDA Expanded Food and Nutrition Education Program (EFNEP), which currently exists in 2 counties. SNAP recipients and SNAP eligible persons, such as singles, homeless, migrants, single mothers, families with and without children, and the elderly, who are ineligible to participate in EFNEP, along with our growing Hispanic population, are targeted for food and nutrition education programs through FNP. USDA and Purdue University Cooperative Extension Service are equal opportunity/equal access institutions. The Family Nutrition Program provides a means for the Purdue University Cooperative Extension Service to partner with the Indiana Family and Social Services Administration to provide educational programs that increase the likelihood of SNAP participants making healthy food choices and choosing active lifestyles consistent with the most recent advice reflected in the Dietary Guidelines for Americans and MyPyramid/MyPlate.

5 Part 1. SNAP-Ed Program Overview: The Indiana Family Nutrition Program provides nutrition interventions on a variety of nutrition subjects including diet quality, food safety, physical activity, food security, lowering fat and increasing fruit and vegetable consumption. These interventions are conducted statewide as presented in the SNAP-Ed Plan. In fiscal year 2012 Indiana Family Nutrition Program provided nutrition education programming targeting limited resource audiences in 91 counties statewide. The FNP Assistants organize community and home interventions to bring about nutrition and physical activity related lifestyle changes. Our mission is to increase the ability of individuals and families with limited resources to utilize their food dollars and stamps appropriately and to provide a safe meal environment. This mission is accomplished by providing informal and easily accessible educational programs in the home and community. Programs focus on developing knowledge and skill related to nutrition and meal planning; food purchasing; preparation and safety; resource management; and physical activity.

6 Contract Summary Data Through September 2012, 129 FNP Assistants reached 232,452 total clients through direct contacts: 19,495 adult males, 69,277 adult females, 70,237 youth males, and 73,443 youth females. Seniors, families with children, youth, single adults, teens, pregnant teens, clients with disabilities, homeless, and migrants are the categories included in these totals. By race, the total numbers of clients seen were Individuals Reporting Only One Race Hispanic/Latino, 607 American Indian or Alaska Native (.26%), 36 Asian (.01%), 958 Black or African American (.41%), 58 Native Hawaiian or Other Pacific Islander (.02%), 22,329 White or Caucasian (9.60%). Individuals Reporting Only One Race Non-Hispanic/Non-Latino, 779 American Indian or Alaska Native (.33%), 1210 Asian (.52%), 24,020 Black or African American (10.33%), 489 Native Hawaiian or Other Pacific Islander (.21%), White or Caucasian (74.45%). Individuals Reporting Multiple Races Hispanic/Latino, 124 American Indian or Alaska Native and White (.05%), 64 Asian and White (.03%), 981 Black or African American and White (.42%), 71 American Indian or Alaska Native and Black or African American (.03%), 879 All Others Reporting More Than One Race (.38%). Individuals Reporting Multiple Races Non-Hispanic/Non-Latino, 969 American Indian or Alaska Native and White (.41%), 99 Asian and White (.04%), 3443 Black or African American and White (1.48%), 168 American Indian or Alaska Native and Black or African American (.07%), 2105 All Others Reporting More Than One Race (.90%). (Appendix B). Indiana's population totals include the following: Reporting one race 86.9% White, 9.3% Black or African American, American India and Alaska Native.4% Native Hawaiian and Other Pacific Islander.01% Some Other race alone 1.6% and Two or more races 1.7%. Also

7 Not Hispanic or Latino 94.0% and Hispanic or Latino 6.0%. (Appendix C). From October 1, 2011 September 30, 2012, FNP Assistants presented 17,339 group presentations and 14,243 individual presentations (direct contacts) around the state. Other indirect contacts include the following: 411,735 informational brochures distributed, 116,854 FNP newsletters distributed, and 60,029 clients recruited for programs. (Appendix B). 2. SNAP-Ed Administrative Expenditures: Type of Administrative Expense: Name of IA: % of Total Administrative Expenditures for each Implementing Agency by Type of Expense Purdue University % values $ values Administrative Salary 68% 315,563 Administrative Training 10% 44,307 Functions Reporting Costs ( identify % 10% 48,316 related to EARS, if possible) Equipment/Office Supplies 4% 16,456 Operating Costs 3% 12,820 Indirect Costs 5% 21,348 Name of IA: % values 3. SNAP-Ed Evaluation Reports Completed for this Reporting Year: Project Name: Indiana Family Nutrition Program $ values % values Key Project Objectives specific objectives are located in each major program goal below. Name of IA: Goal 1: (Dietary Quality) To adopt healthy eating and active lifestyles that are consistent with the current Dietary Guidelines for Americans and USDA MyPyramid/MyPlate. Objective 1a. Participants will know the recommended amounts to eat from the food groups on MyPyramid/MyPlate. Objective 1b. Participants will eat more than one kind of fruit each day postprogram compared with pre-program. $ values

8 Objective 1c. Participants will increase the number of times they eat low-fat or nonfat milk products per day post-program compared with pre-program. Objective 1d. Participants will increase the amount of 100% fruit juice they drink each day post-program compared with pre-program. Objective 1e. Participants will eat more than one kind of vegetable each day. Objective 1f. Participants will know the number of vegetables they eat or drink each day. Objective 1g. Participants will increase the frequency of eating breakfast postprogram compared with pre-program. Objective 1h. Participants will increase the amount of whole grain foods they eat each day post-program compared with pre-program. Goal 2: (Shopping Behavior/Food Resource Management) To enhance practices related to thrifty shopping and preparation of nutritious foods. Objective 2a. Participants will improve knowledge and behavior post-program compared with pre-program by planning their meals ahead of time for the week. Objective 2b. Participants will improve food selection awareness and selection behavior post-program compared with pre-program by shopping from a list. Objective 2c. Participants will improve nutrition knowledge and selection behavior post-program compared with pre-program by reading the nutrition facts labels to help them select their foods. Goal 3: (Food Safety) To improve food safety behaviors including handling, preparing, and storing foods to reduce risk to food borne illnesses. Objective 3a. Participants will be able to put into practice the four fundamental elements of food safety. Objective 3b. Participants will understand the health benefits of providing a food safe environment for their family. Goal 4: (Physical Activity) Participants will balance the food they eat with physical activity. Objective 4a. Participants will increase the number of minutes they exercise each day post-program compared with pre-program.

9 Goal 5: (Food Security) Participants will be able to acquire sufficient food to feed themselves and their families. Objective 5a. Participants will use community programs and resources, such as the SNAP Program, to improve their food security. Objective 5b. Participants will have access to SNAP applications and local Division of Family Resources addresses and phone numbers. Target Audience: adult SNAP or SNAP eligible participants in Indiana Evaluation Type: process (PE) and impact (IE) SNAP-Ed Planned Improvements: In , the Indiana Family Nutrition Program plans to continue our existing internal county review system. This system is intended to ensure consistent and quality programming across the state. Logistically this program improvement/maintenance program will have at least one member of the Indiana SNAP- Ed Administrative team performing a county site visit every three years to investigate program efficiency and compliance with state and federal obligations and recommendations. In addition to the continuation of these administrative improvements, we plan to update complete our curricula update, reflecting the most current dietary guidance as set forth by the USDA. In addition our survey tools will be updated to reflect curricular changes. We also hope to have our evaluation tools translated into Spanish to better serve this audience and enable the collection of program impact on this important sect of our clientele.

10 5. EARS Feedback: In 2012, Indiana FNP collected age, SNAP status, gender, race and ethnicity for participants and contacts. Number of SNAP-Ed delivery sites by type of setting and programming format was collected but was not directly connected to participant and contacts. Educational topic areas of emphasis were also collected on direct contacts. All indirect education EARS data was also collected. Expenditures by source of funding and by category of spending were also collected. Section B: Final Report Summary for Evaluations 1. Name of Project or Social Marketing Campaign If multiple projects or campaigns were part of a single impact evaluation, please list them all. Indiana Family Nutrition Program and Indiana Family Nutrition Senior Program a. Short-term survey (Appendix D ) used to assess short term changes such as knowledge, attitudes, confidence and intentions related to nutrition education lessons in the FNP curriculum. b. Medium-term survey (Appendix E ) used to assess medium term changes such as behaviors related to nutrition education lessons in the FNP curriculum. 2. Key Evaluation Impact(s) Identify each impact being assessed by the evaluations. For example are SNAP-Ed participants more likely than non-participants to report they intend to increase their fruit and vegetable intake? Or do a greater proportion of SNAP-Ed participants choose lowfat (1% or fat-free) milk in the school cafeteria compared to non-participants? a. Short-term survey (Appendix D): Each client is asked to complete a retrospective prepost test to determine knowledge, attitude, confidence and intentions changes immediately after each lesson provided. Three questions correspond to each educational lesson. There are fourteen lessons total and they are provided at different times. The

11 questions are listed below. Five answer choices ranging from agree to disagree are presented for participant response to each question. A. MyPyramid/MyPlate 1. I know at least one reason why I should eat different foods in each food group. 2. I know at least one way to cut down on high-fat and high-sugar foods in my diet. 3. I know at least one reason for being physically active. B. Label Reading 4. I know at least one reason why it is important to read a nutrition label. 5. I know how to read a nutrition label to tell if a food is nutritious. 6. I plan on reading nutrition labels to decide what food to buy. C. Fruits & Vegetables 7. I know why eating a variety of fruits and vegetables is good for my health. 8. I plan to choose more fruit (fresh, frozen, canned or dried) instead of fruit juice. 9. I plan on eating more dark green (such as spinach) and orange (such as carrots) vegetables. D. Grains 10. I know how to spot a whole grain food. 11. I know at least one reason why I should eat breakfast every day. 12. I feel confident in eating more whole grain foods each day. E. Milk 13. I know how to identify low-fat (1%) or nonfat (skim) milk, yogurt or cheese. 14. I plan on drinking or using low-fat (1%) or nonfat (skim) milk instead of 2% or whole (vitamin D) milk.

12 15. I know examples of foods or drinks that are high in calcium besides milk, cheese and yogurt. F. Fats 16. I know examples of foods that contain liquid fats. 17. I know why using liquid fats instead of solid fats is healthier for me. 18. I plan on using liquid fats instead of solid fats when I cook. G. Food Safety 19. I know the 4 main steps to keeping food safe. 20. I know the health benefits of using the 4 main food safety steps at home. 21. I feel confident about preventing food poisoning/illness at home. H. Meat & Beans 22. I know examples of high-protein foods that are lean (lower in fat). 23. I know the health benefits of eating lean (lower fat) sources of protein. 24. I feel confident in using a meat thermometer to test for doneness of meat. I. Meal Planning 25. I feel confident that I can prepare easy meals at home. 26. I plan on eating together as a family at least 4 days of the week. 27. I plan to eat out less often. J. Physical Activity 28. I know how many minutes of physical activity I need each day. 29. I plan to increase my physical activity. 30. I know how to start a walking program for myself.

13 K. A Trip to the Store 31. I plan to compare prices of food items at the store before buying them. 32. I plan to use coupons on items that I buy on a regular basis. L. Menu Planning 33. I know how to plan menus before going shopping. 34. I know how to plan meals using what I already have on hand. M. The Ins and Outs 35. I can describe where my money goes during the month. 36. I know at least one example of a flexible expense. N. It All Adds Up 37. I know how to figure out how much money I spend on frequently purchased items. b. Medium-term survey (Appendix E): Each client is asked to complete a pre-post test to determine behavior changes including the questions below. Multiple choice answers are provided for each question. Each client serves as their own control before and after they receive at least four core educational lessons including MyPyramid/MyPlate, Label Reading, Grains and Fruits & Vegetables. 1. Do you know the recommended amounts to eat from the food groups on MyPyramid/MyPlate? 2. Do you eat more than one kind of fruit each day? 3. How much fruit do you eat each day? (do NOT count juice) 4. How much 100% fruit juice do you drink each day? 5. Do you eat more than one kind of vegetable each day? 6. How many vegetables do you eat or drink each day? (include vegetable juice)

14 7. How often do you eat breakfast? 8. How much whole grain foods do you eat each day? 9. Do you plan meals ahead of time for the week? 10. Do you use a list when grocery shopping? 11. When shopping, do you use the Nutrition Facts on the food label to decide what food to buy? 12. Do you clean the surfaces used for preparing food before every meal? 13. Do you wash your hands before preparing food? 14. Do you wash your hands before eating food? 15. How much physical activity (exercise) do you get each day? 16. Do you run out of money for food before the end of the month? 17. Do you run out of food before the end of the month? 3. Evaluation participants. Describe the population being evaluated and its size. For example, all (1200) kindergarten students at public schools in one school district. Both surveys evaluate impact on adults (ages 18 and older) of various genders, ages, ethnicities etc. Data have been collected in Indiana for: (October 1, 2011 September 30, 2012) a. Short-term survey = 27,797 lessons b. Medium-term survey =568 adults 4. Assignment to intervention and control or comparison conditions a. Describe the unit of assignment to intervention and control groups. For example, an intervention focused on kindergarten students may assign school districts, individual schools, classrooms, or individual student to intervention and control groups.

15 All participants receive an intervention and have the option to complete an evaluation/survey. There are no control groups. A pre-post test design is used for both surveys so each participant serves as his/her own control. b. Describe how assignment to intervention and control groups was carried out. Be explicit about whether or not assignment was random. For example, ten kindergarten classrooms were randomly assigned to intervention and control groups. All participants receive an intervention and have the option to complete an evaluation/survey. There are no control groups. A pre-post test design is used for both surveys so each participant serves as his/her own control. c. Describe how many units and individuals were in the intervention and control groups at the start of the intervention. All clients are asked to volunteer to complete a survey before and/or after they receive nutrition education lessons. As of September 30, 2012, 568 medium-term and 27,797 short- term surveys have been completed. 5. Impact Measure(s) For each evaluation impact, describe the measure(s) used. Descriptions should indicate if the focus is on knowledge, skills, attitudes, intention to act, behavior or something else. Each measure should also be characterized in terms of its nutritional focus, e.g. low fat food preparation, number of whole grain servings consumed, ability to accurately read food labels. Finally indicate if impact data were collected through observation, selfreport, or another method. a. Short-term survey = used to assess short-term changes such as knowledge, awareness, attitudes, confidence and intentions related to nutrition education lessons in the FNP curriculum. Nutritional Focus: Three questions for each nutrition education lesson (14 total lessons) pertain to topics including: MyPyramid/MyPlate, Label Reading, Fruits & Vegetables,

16 Grains, Dairy, Fats, Meal Planning, Food Safety, Meat & Beans, Physical Activity and Money Management. Data are collected through self-administered and self-reported surveys. b. Medium-term survey = used to assess medium term changes such as behaviors related to nutrition education lessons in the FNP curriculum. Nutritional Focus: Questions pertain to four specific core lessons: MyPyramid/MyPlate (knowledge of tool and food groups), Label Reading (use of label), Fruits & Vegetables (consumption of each and variety) and Grains (whole grains and eating breakfast). These lessons are completed prior to the post test. Data are collected through self-administered and selfreported surveys. a. Describe the points at which data were collected from intervention and control group participants. For example, these points may include pre-test or baseline, midway through the intervention, post-test as intervention ends or follow-up some weeks or months after the intervention ends. a. Short-term survey = data are collected in a retrospective manner. A client completes three questions immediately after their nutrition education lesson and answers questions related to their knowledge, attitudes, intentions, etc., before and after they received the lesson. b. Medium-term survey = data are collected as a traditional pre-post test. There are 17 questions in the survey. A minimum of four core lessons are provided before the post test. Those lessons include the topics: MyPyramid/MyPlate, Label Reading, Fruits & Vegetables and Grains.

17 6. Results Compare intervention and control groups at each measurement point, by individual measure. Report the number of intervention and the number of control group participants measured at each point. Describe any tests of statistical significance and the results. a. Short-term survey = Paired t-tests were conducted to compare the 37 pre-post test answers for the 14 nutrition education lessons. Each client served as their own control. When comparing the retrospective post-test to pre-test results, all questions from all lessons showed improvement and were all statistically significant (p<0.05) (Appendix F -short term summary report ). 16. Medium-term survey = Paired t-tests were conducted to compare the 17 pre-post test answers. Each client served as their own control. When comparing the post-test to pre-test results, all questions from all lessons showed improvement and were all statistically significant (p<0.05) (Appendix G -medium term summary report ). 7. Reference Please contact Dr. Heather Eicher-Miller at heicherm@purdue.edu or if there are questions related to the impact evaluations. Indiana Family Nutrition Youth Program In 2012, the Family Nutrition Youth Program was conducted in 43 counties in Indiana. The program targeted youth in schools with 50% or more free and reduced lunch, after school programs, and summer youth programs that target SNAP eligible families. Forty-eight FNP Assistants provided educational programming in one-time groups and multi-session groups. The program focused on teaching kids about healthy food choices and being physically active everyday using the Professor Popcorn curriculum. A total of 48 FNP Assistants reached 143,680 total youth clients: 70,237

18 males and 73,443 females. By race, the total numbers of youth clients seen were Individuals Reporting Only One Race Hispanic/Latino, 385 American Indian or Alaska Native (.27%), 17 Asian (.01%), 590 Black or African American (.41%), 48 Native Hawaiian or Other Pacific Islander (.03%), 16,393 White or Caucasian (11.41%). Individuals Reporting Only One Race Non-Hispanic/Non-Latino, 497 American Indian or Alaska Native (.34%), 734 Asian (.51%), 17,050 Black or African American (11.87%), 314 Native Hawaiian or Other Pacific Islander (.22%), 101,014 White or Caucasian (70.30%). Individuals Reporting Multiple Races Hispanic/Latino, 62 American Indian or Alaska Native and White (.04%), 51 Asian and White (.03%), 857 Black or African American and White (.60%), 42 American Indian or Alaska Native and Black or African American (.03%), 721 All Others Reporting More Than One Race (.50%). Individuals Reporting Multiple Races Non-Hispanic/Non-Latino, 223 American Indian or Alaska Native and White (.15%), 72 Asian and White (.05%), 2800 Black or African American and White (1.95%), 76 American Indian or Alaska Native and Black or African American (.05%), 1734 All Others Reporting More Than One Race (1.21%). (Appendix B). Data for the nine counties on indicators related to healthy food selection, food safety and physical activity are included in Appendix H. Family Nutrition Programs Qualitative Data For qualitative data, all FNP Assistants also submit success stories and impact statements to document how the Family Nutrition Program intervention changes the target populations attitudes, awareness, and behavior. This impact data is written by agency representatives, and the FNP Assistants. Samples of these stories and impact statements can be found in Appendix I.

19 Appendices Index Appendix A: Appendix B: Appendix C: Appendix D: Appendix E: Appendix F: Appendix G: Appendix H: Appendix I: FNP Counties Map Monthly Activity Report Summary Profile of General Demographic Characteristics FNP Evaluation Survey Short Term FNP Evaluation Survey Medium Term Evaluation Study Results Short Term Evaluation Study Results Medium Term Youth Data FNP Success Stories

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