Voices for food: methodologies for implementing a multi-state community-based intervention in rural, high poverty communities

Abstract

BackgroundRural communities experience unique barriers to food access when compared to urban areas and food security is a public health issue in rural, high poverty communities. A multi-leveled socio-ecological intervention to develop food policy councils (FPCs), and improve food security in rural communities was created. Methods to carry out such an intervention were developed and are described.MethodsA longitudinal, matched treatment and comparison study was conducted in 24 rural, high poverty counties in South Dakota, Indiana, Missouri, Michigan, Nebraska and Ohio. Counties were assigned to a treatment (n = 12) or comparison (n = 12) group. Intervention activities focus on three key components that impact food security: 1) community coaching by Extension Educators/field staff, 2) FPC development, and 3) development of a MyChoice food pantry. Community coaching was only provided to intervention counties. Evaluation components focus on three levels of the intervention: 1) Community (FPCs), 2) Food Pantry Organization, and 3) Pantry Client & Families. Participants in this study were community stakeholders, food pantry directors, staff/volunteers and food pantry clients. Pantry food access/availability including pantry food quality and quantity, household food security and pantry client dietary intake are dependent variables.DiscussionThe results of this study will provide a framework for utilizing a multi-leveled socio-ecological intervention with the purpose of improving food security in rural, high poverty communities. Additionally, the results of this study will yield evidence-based best practices and tools for both FPC development and the transition to a guided-client choice model of distribution in food pantries.Trial registrationClinicalTrials.gov; NCT03566095. Retrospectively registered on June, 21, 2018.

Food Insecurity and Cardiovascular Disease Risk

“…Programs that link patients to emergency food pantries and other community resources to help support unmet need for food assistance may also be helpful [ 73 ]. Lastly, supporting access to healthful foods and beverages in food environments such as federal food assistance programs and emergency food assistance network may be particularly relevant for disadvantaged subgroups to improve diet, health, and wellness [ 74 ].…”

Needs and Preferences Among Food Pantry Clients

“…Small-scale and localized research studies have also suggested that clients rely on food pantries for large portions of their food ( 14 , 15 ) over long periods of time ( 1 , 14 , 16 ). The persistent nature of food insecurity and the chronic food needs of clients have been identified by hunger relief agencies in their recent move away from the term “emergency food system,” prompting food pantries to adopt new policies and interventions to improve the healthfulness and client-centeredness of their services ( 4 , 14 , 17 – 21 ).…”

A Mentor-Led Text-Messaging Intervention Increases Intake of Fruits and Vegetables and Goal Setting for Healthier Dietary Consumption among Rural Adolescents in Kentucky and North Carolina, 2017

“…While not statistically significant relative to controls, these findings hold promise for future interventions aiming to improve shopping behaviors among adolescents, a critical priority population for behavior change as adolescents are transitioning into adulthood. To facilitate healthier purchases in future studies, intervention content could use ecological momentary assessment (prompts that are capturing where the individual is shopping at the given moment [33]) techniques to send messages when adolescents are “in the moment” of purchasing food at various food venues.…”