Michigan Farmers Market Association Prescription for Health Evaluation Tools: Pre and Post-Program Surveys

Transcription

1 Michigan Farmers Market Association Prescription for Health Evaluation Tools: Pre and Post-Program Surveys The following survey tools are intended to streamline and standardize data collection among Prescription for Health partners across Michigan. These tools were developed by the Michigan Farmers Market Association (MIFMA) and Public Sector Consultants following an in-depth review of evaluation tools being used in programs during and prior to 2017, and several state and national resources and data collection tools. The tools were reviewed by statewide network partners in October 2017 and revised based on partner feedback. Partners who utilize these survey tools and share results with the statewide network will help MIFMA analyze the progress and outcomes of Prescription for Health programs across the state. The survey questions below are organized into two sections, each representing a different evaluation tool: (1) a pre-program survey and (2) a post-program survey. These surveys were designed to be selfadministered by the program participant and could be distributed in paper format or electronically. When administering these surveys, it is important that the method remains consistent for all participants before and after the program, and that both questions and response options are not altered. Questions specific to your program may be added, but we request that these questions remain unaltered. Prescription for Health Evaluation Tools 1

2 Pre-Program Survey The following questions should be completed when patients/clients receive their first prescription. Questions that appear with a (*) are required questions and the rest are optional but recommended. Terms that appear with a number ( 1,2,3 ) are defined in the glossary. Note: Given the content of some questions, we suggest letting the participant know that answers will be anonymous, will be kept private, and will not affect a family s access to food assistance benefits in any way. A) What is your gender? * Female Male Other: B) What is your age? * C) What are the ages of each member in your household? * Please list each person s age, not including you. Please separate each person s age with a comma. For example: List 58, 37, 12, 8 for a household with a 58-year-old, a 37-year-old, a 12-year-old, and an 8-yearold. D) What is the highest level of education you have completed? Some high school High school/ged Some college Associate degree Bachelor s degree Graduate or professional degree Other: E) Are you of Hispanic, Latino/a, or Spanish origin? * Yes Prefer to not answer Prescription for Health Evaluation Tools 2

3 F) How do you identify in terms of race? * Check all that apply. American Indian or Alaska Native Asian or Asian American Black or African American Middle Eastern or Arab American Native Hawaiian or other Pacific Islander White Multiple races Other: Prefer to not answer G) Do you or anyone who lives with you participate in any of the following programs? * Check all that apply. EBT 8 /Bridge Card 1 /SNAP 29 (Supplemental Nutrition Assistance Program) Free/reduced School Lunch 13 Head Start 19 /Great Start Readiness Program 17 FDPIR 11 (Food Distribution Program on Indian Reservations) WIC 32 (Women, Infants and Children) WIC Project FRESH 33 Senior/Market FRESH 28 Double Up Food Bucks 7 Hoophouses for Health 24 CSFP (Commodity Supplemental Food Program) 2 TANF (Temporary Assistance for Needy Families) 31 Disability 6 /Medicaid 26 Meals on Wheels 25 Other: H) Before today, did you know that people can use their EBT 8 /Bridge Card 1 /SNAP 28 (food stamps) at many local farmers markets 10? * Select one. Yes Prescription for Health Evaluation Tools 3

4 I) If you answered yes to the question above, what prevented you from using your EBT 8 /Bridge Card 1 /SNAP 29 (food stamps) at a local farmers market 10? * I am not eligible for these benefits I am eligible for these benefits but do not receive them I am not available during the day(s) and/or time(s) the farmers market is open I do not have reliable transportation to get to the farmers market The items at the farmers market are too expensive The farmers market does not have the items I want to buy Other: J) Where do you, or someone you live with, get fresh fruits and vegetables 14? Check all that apply. Farmers market 10 Other farmer-direct market (such as on-farm market, roadside stand, community supported agriculture 5 (CSA)) Grocery store 18 (such as Kroger, IGA, etc.) Supercenter 30 (such as Walmart, Meijer, etc.) Gas station 16 Corner store/party store 4 My garden/community garden 3 Food pantry 12 Home delivery 23 service (Blue Apron, etc) Meals on Wheels Mobile market 27 A food box or vegetable box program Other: K) In the past year, did you or someone you live with buy directly from a farmer at a farmers market 10 or farm stand (such as )? * Select one. Never Less than once a month About once a month 2-3 times a month Weekly or more Prescription for Health Evaluation Tools 4

5 L) About how many cups of FRUIT do you eat each day? * (Image provided by MSU Extension) For example, 1 cup is the size of a baseball; 1 cup of fruit could be 1 small apple, 8 strawberries, 1 large peach. Include fresh, frozen, and canned fruits. DO NOT include fruit juice. less than ½ cup more than ½ cup up to 1 cup more than 1 cup up to 1 ½ cups more than 1 ½ cups up to 2 cups more than 2 cups M) About how many cups of VEGETABLES do you eat each day? * (Image provided by MSU Extension) For example, 1 cup is the size of a baseball; 1 cup of vegetables could be: 2 medium carrots, 1 large raw tomato, 1 small sweet potato, 2 handfuls of fresh greens. Please include fresh, frozen, and canned vegetables. DO NOT include French fries, fried potatoes, potato chips, or vegetable juice. (Image provided by MSU Extension) less than ½ cup more than ½ cup up to 1 cup more than 1 cup up to 1 ½ cups more than 1 ½ cups up to 2 cups more than 2 cups up to 2 ½ cups more than 2 ½ cups up to 3 cups more than 3 cups Prescription for Health Evaluation Tools 5

6 N) Do you eat fruits and vegetables as snacks? * Yes, sometimes Yes, often Yes, every day O) About how many cups of SUGARED BEVERAGES do you have each day? This includes beverages such as soda pop, sweetened ice tea, sports drinks, and energy drinks. For example, 1 cup is equal to 8 ounces; a standard can of soda pop is 12 ounces. (Image provided by MSU Extension) ½ a cup or less ½ cup to 1½ cups 1½ cups to 2½ cups 2½ to 3½ cups 3½ to 4½ cups 4½ cups or more P) In the last 30 days, did you or others in your home ever skip meals, cut the size of your meals, and/or buy fewer healthy foods 21 (such as fruits and vegetables) because there was not enough money for food? * Yes I do not know Q) If you answered yes to the question above, in the last 30 days, how many days did this happen? days Prescription for Health Evaluation Tools 6

7 R) Would you say in general that your health is? Excellent Very good Good Fair Poor I do not know S) In general, how healthy are your overall eating habits? * Excellent Very good Good Fair Poor I do not know T) How much do you agree with the following statements? * Strongly Agree Agree Neutral Disagree Strongly Disagree T1) I know where to buy locallygrown a, healthy foods 21. T2) I know how to select highquality fruits and vegetables 22. T3) I know how to store fresh fruits and vegetables 14 so they last longer. T4) I know how to prepare and cook fresh fruits and vegetables 14. T5) Eating fruits and vegetables helps me improve my health. (Optional). T6) I can count on the people around me to support me to eat a healthier diet 20. (Optional). a This term is not defined, as each person defines local differently Prescription for Health Evaluation Tools 7

8 Post-Program Survey: Adult Patients The following questions should be completed during the anticipated final point of contact with each patient/client. This may be when they receive their last fruit and vegetable prescription or after. Note: Given the content of some questions, we suggest letting the participant know that answers will be anonymous, will be kept private, and will not affect a family s access to food assistance benefits in any way. U) How often did you use your prescription this season? * Select one. Never Less than once a month About once a month 2-3 times a month Weekly or more V) Did you or anyone who lives with you use any of the following programs at the farmers market this year? * Check all that apply. EBT 8 /Bridge Card 1 /SNAP 29 (Supplemental Nutrition Assistance Program) WIC Project FRESH 33 Senior/Market FRESH 28 Double Up Food Bucks 7 Hoophouses for Health 24 Other: Prescription for Health Evaluation Tools 8

9 W) How much do you agree with the following statements? * Strongly Agree Agree Neutral Disagree Strongly Disagree V1) I know where to buy locallygrown a, healthy foods 21. V2) I know how to select highquality fruits and vegetables 22. V3) I know how to store fresh fruits and vegetables 14 so they last longer. V4) I know how to prepare and cook fresh fruits and vegetables 14. V5) Eating fruits and vegetables helps me improve my health. (Optional). V6) I can count on the people around me to support me to eat a healthier diet 20. (Optional). a This term is not defined, as each person defines local differently Prescription for Health Evaluation Tools 9

10 X) About how many cups of FRUIT do you eat each day? * For example, 1 cup is the size of a baseball; 1 cup of fruit could be: 1 small apple, 1 medium banana, 1 large orange. Include fresh, frozen, and canned fruits. DO NOT include fruit juice. (Image provided by MSU Extension) ½ a cup or less ½ cup to 1½ cups 1½ cups to 2½ cups 2½ to 3½ cups 3½ to 4½ cups 4½ cups or more Y) About how many cups of VEGETABLES do you eat each day? * For example, 1 cup is the size of a baseball; 1 cup of vegetables could be: 2 medium carrots, 1 large, raw tomato, 1 small sweet potato, 2 handfuls of fresh greens. Please include fresh, frozen, and canned vegetables. DO NOT include French fries, fried potatoes, potato chips, or vegetable juice. (Image provided by MSU Extension) ½ a cup or less ½ cup to 1½ cups 1½ cups to 2½ cups 2½ to 3½ cups 3½ to 4½ cups 4½ cups or more Prescription for Health Evaluation Tools 10

11 Z) Do you eat fruits and vegetables as snacks? * Yes, sometimes Yes, often Yes, every day AA) About how many cups of SUGARED BEVERAGES do you have each day? This includes beverages such as soda pop, sweetened ice tea, sports drinks, and energy drinks. For example, 1 cup is equal to 8 ounces; a standard can of soda pop is 12 ounces. (Image provided by MSU Extension) ½ a cup or less ½ cup to 1½ cups 1½ cups to 2½ cups 2½ to 3½ cups 3½ to 4½ cups 4½ cups or more AB) In the last 30 days, did you or others in your home ever skip meals, cut the size of your meals, and/or buy fewer healthy foods 20 (such as fruits and vegetables) because there was not enough money for food? * Yes I do not know AC) If you answered yes to the question above, in the last 30 days, how many days did this happen? days Prescription for Health Evaluation Tools 11

12 AD) After participating in this program, do you know that people can use their EBT 8 /Bridge Card 1 /SNAP 29 (food stamps) at many local farmers markets 10? Select one. Yes AE) What would help you buy more healthy food 21 at a local farmers market 10? Please select all that apply. More hours of operation at the farmers market More days of farmers market More vendors at the farmers market More fruits to buy More vegetables to buy Being able to do more of my shopping at the market Accept other forms of payment Other: AF) Would you say in general that your health is? Excellent Very good Good Fair Poor I don t know AG) In general, how healthy are your overall eating habits? * Excellent Very good Good Fair Poor I don t know Prescription for Health Evaluation Tools 12

13 AH) How much do you agree with the following statements? * Strongly Agree Agree Neutral Disagree Strongly Disagree X1) As a result of this program, I am able to manage my overall health better. X2) I would recommend this program to someone I know. Prescription for Health Evaluation Tools 13