VeggieRx Program Details
History of Fresh Approach and PCFMA
Fresh Approach, a 501c3 nonprofit organization, is a leader in the San Francisco Bay Area in developing innovative programs that increase community access to fresh, healthy foods and educate the community about how to incorporate these foods into a healthy diet. Fresh Approach was founded in 2008 by the Pacific Coast Farmers’ Market Association (PCFMA) to pursue community-based nutrition education and food access projects that PCFMA was not able to fund or operate as a 501c5 organization. The mission of Fresh Approach is to encourage healthier children, families and communities through community education, innovative programming and novel partnerships that promote a stronger local food system and better-informed choices about food and nutrition.
Fresh Approach currently operates four programs: Cookin’ the Market which performs cooking demonstrations at community events, VeggieRx which partners with community-based clinics to provide fruit and vegetable vouchers to families in anti-obesity and diabetes management programs to spend at the farmers’ market, Healthy Food/Healthy You which targets nutrition education to recipients of WIC and CalFresh (the state’s food stamp program, known as SNAP in other states) benefits, and Market Match which provides $5 financial incentives to CalFresh recipients when they shop farmers’ markets using their CalFresh benefits.
Fresh Approach is able to tactfully implement its projects by having a staff with complementary backgrounds and skills. Allen Moy, Executive Director, effectively develops and manages projects due to his experience as Assistant Director at PCFMA and extensive nonprofit experience related to poverty and social justice. Katie Gronsky, Community Outreach Coordinator for nutrition and health-related projects, is a Certified Health Education Specialist with experience teaching nutrition to low-income populations. And Laura Salcido, Community Outreach Coordinator in school-based education and sustainable agriculture education programs, has experience organizing farm-to-school activities and farm-to-school workshops.
Program Operations
VeggieRx gives low-income families in weight management and diabetes clinics “prescription” vouchers for fruits and vegetables at local farmers’ markets. During at least 8 visits over 4 months, clinic staff conduct nutrition education and measure health indicators such as Body Mass Index. Fresh Approach collects health data from the clinics and voucher redemption data from the farmers’ markets to measure the correlation between produce consumption and health improvements. VeggieRx encourages the development of healthy shopping and eating patterns and the long-term purchase and consumption of fruits and vegetables.
VeggieRx will ensure sustained changes with shopping, cooking, and eating habits among participants by utilizing a multifaceted educational approach such as educational sessions and tracking health indicators. Participants will actively learn by being involved in hands-on cooking and nutrition classes with their families. Barriers such as uneasiness associated with trying a new shopping method, misconceptions of the costs associated with fresh produce, and the lack of cooking skills will be addressed. All of these program elements will lead to increased skills, support, and self-efficacy needed to sustain behaviors beyond the completion of the program.
Promotional materials will primarily be used during the recruitment process for both community-based clinics and program participants. Once a clinic partner is secured, Fresh Approach will encourage allied health professionals and nurse practitioners to recruit at-risk participants by word of mouth. Fresh Approach will provide brochures in the clinics to provide program details to those that use the clinic. Fresh Approach will publicize the program utilizing PCFMA’s newsletter, Fresh Approach’s website, a radio PSA, and through relevant conferences to disseminate program results.
Program Evaluation
Fresh Approach and an independent evaluator will oversee program evaluation and consolidate health outcome data with voucher utilization data. The program will be evaluated on four factors: The rate of voucher utilization (goal of 65%), the change in health outcomes (goal of 70% showing improvement), the rate of behavioral change (goal of 70% reporting improvement), and the correlation of these three individual factors. The behavioral changes will be measured through pre- and post-surveys and focus groups measuring changes in shopping, cooking, and eating habits.
A process evaluation will be conducted throughout the program to ensure that the program is being carried out in a timely, culturally competent, and appropriate manner. A check-off and participant list will be used to coordinate clinic partners to keep track of participant attendance, physiological changes, and participant feedback. If a problem were to occur, the project manager would adjust the program accordingly.
Program Partners
Community partners are critical to the success of VeggieRx. Community-based clinics are responsible for recruiting participants in diabetes and weight management programs, measuring and recording participants’ health indicators at each site visit, and conducting nutrition education classes. In addition, PCFMA is responsible for the VeggieRx coupons both administratively and at the farmers’ markets.
Nurses and allied health professionals will deliver VeggieRx classes and measure and record health indicators. As health professionals, they are knowledgeable in communicating the importance creating behavioral changes necessary to decrease the prevalence of obesity and are experienced in measuring health indicators.
Fresh Approach’s secured grant dollars will serve as a tool to support community-based clinics to implement VeggieRx by giving a financial stipend to each clinic, assist in the development of curriculum and promotional and outreach materials, and develop and implement the majority of the evaluation component for the program. PCFMA will also benefit from the grant by paying for the VeggieRx coupon incentives thereby bringing more customers to their markets and achieving their mission to provide viable economic opportunities for California farmers and local access to farm fresh products and to support local businesses and community organizations.
- Community-based clinics stipends: $2,000-$3,000 for the implementation of this program
- Fresh Approach incentives for participants: Each individual receives $7 per week for a 16-week span. An estimated 35 families per clinic partner.
- Pacific Coast Farmers’ Market Association: $1,500 reimbursement for time processing and training related to the VeggieRx coupons.
Pilot Program Results
In 2011, Fresh Approach piloted VeggieRx with 234 individuals at the Indian Health Center in San Jose. Preliminary results show positive physiological program effects as 56% of survey participants reported that their weight decreased during the months that they were involved in the program and those that redeemed over 85% of their checks averaged a 1.5% decrease in their BMI. In addition, participant feedback was consistently positive, one participant stated, “This program helped me change my way of cooking, helped me lose 10 pounds, also helped my 4 year old try new veggies and fruit that she now likes”.
Program Funding
Fresh Approach has funding from The Health Trust to operate Veggie Rx in San Jose in 2012. Fresh Approach is also actively recruiting additional funding to be able to expand the program to additional locations.
Information about Wholesome Wave
The VeggieRx program model is based on Wholesome Wave’s Fruit and Vegetable Prescription Program. Fresh Approach operates VeggieRx independently, fine-tuning aspects of the original model to fit the unique challenges facing community-based clinics. Wholesome Wave allows vouchers to be dispersed only by a physician, nurse practitioner or physician’s assistant; this requirement may be cost-prohibitive for community-based clinics, so Veggie Rx allows disbursement to be carried out allied health professionals or nurse practitioners.