Working to improve program delivery of the Good Food Box with the First Nations, Inuit and Métis communities and other community groups

by Emily Lecompte (University of Ottawa) & Natasha Beaudin (Centrtown CHC)

Presentation Overview

What is food security?

Food security in Canada

Living in Ottawa, ON

Choosing and eating fruits and vegetables

Canada’s response to food insecurity

Community health and research

Healthy People, Healthy Communities Project

CFPC Conflict of Interest

Presenter Disclosure

Presenters: Emily Lecompte & Natasha Beaudin

Relationships to commercial interests: None

Grants/Research Support: Community Information and Epidemiological

Technologies (source of research funding); Ms. Lecompte is a CIHR

Vanier Canada Graduate Scholarship recipient

Speakers Bureau/Honoraria: None

Consulting Fees: None

Other: None

Project Funders

What is Food Security?

“The necessary conditions for human beings to have physical and economic access, in socially acceptable ways, to food that is safe, nutritious and in keeping with their cultural preferences, so as to meet their dietary needs and live productive and healthy lives.”

What is Food Security?

Food quality, quantity, affordability, availability and accessibility

Food safety

Individual food skills and capacity

Cultural diversity of eating habits and behaviours

Environmental, economic and social sustainability of safe and healthy food systems

Living in Ottawa, Ontario

• Food insecure = 10.29%

• Unemployment = 7%

• Low-income = 12%

– $38,920 for a household of 4 people (after tax)

– $19,460.13 for single people

• Cost to feed a family of four = $789 per month

Ottawa Public Health 2012 & 2014

Tarasuk, Mitchell & Dachner, 2014

Choosing and eating fruits & veggies

Sensory

appeal

Price

Time

constraints Familiarity

& Habit

Media Social

interactions

Health

Availability

Personal

ideology

Advertising

Food retail

access

Canada’s response to food security

a)Establish food initiatives that follow a charitable model

b)Invest in community-based alternative food programs that provide income-relief.

Responses to improve food access and the affordability of healthful food options

Community Health & Research

A capacity building, community strengthening and food-related strategy: The Good Food Box

Program that provides fresh fruits and vegetables to households in cities across Canada at a lower cost

Benefits of program participation:

Increased access to and consumption of fruits and vegetables

Reduced economic burden of buying produce

Healthy People, Healthy Communities Project (2008 – 2016)

Thinking inside the [food box]

Research questions

1. What makes it easy or hard to participate in the Good Food Box?

2. Do Good Food Box customers eat fruits and vegetables more often than people who don’t use the program?

3. Does program participation relate to household food security compared to households who do not participate?

4. What may support program expansion, improve service delivery and enhance program participation?

• CIHR Guidelines for Health Research Involving Aboriginal People;

• Ownership, Control, Access, Possession (OCAP) Principles;

• Principles of Research Collaboration agreement signed by project partners;

• Privacy, confidentiality and community protocols;

• Digital voice recorder

• Recruitment posters in ENG and FR

• Participant survey package: questionnaires (3)

• Semi-structured interview protocol;

• Honoraria: $20 gift certificate, bus tickets, tobacco, tea, ‘Eating Well in Ottawa’ Pamphlet;

• Talking Stick (used for Talking Circle sessions).

How did we do it?

Who participated in the interviews?

GFB Customers

1-time Customers

Non-users

TOTAL

FNIM Peoples 3 6 11 20

Non-Aboriginal 10 10 9 29

TOTAL 13 16 20 49

Site Coordinators

HQ Staff

Steering Committee

TOTAL

MALE 2 1 0 3

FEMALE 4 4 3 11

TOTAL 6 5 3 14

Who participated in the Talking Circles/ Focus Groups?

What did we find?

68% of people not who didn’t take part in the Good Food Box knew about the program but may not have known where the nearest food distribution site was located.

No households with children were food secure.

95% of FNIM and 62% of non-Aboriginal participants were food insecure.

Medium to large relationship between Good Food Box participation and food security (φ = 0.476)

Odds of being food secure are 9.9 X greater if you are a current Good Food Box customer compared to 0.1 times smaller if you’re not.

What did we find?

Good Food Box customers eat fruit more often on in an average week than people who don’t participate in the program

30% of the change in frequency of average fruit consumption in an average week is because of participation in the Good Food Box Program

What did we find?

0

0.5

1

1.5

2

2.5

3

GFB Customer Former GFB customer

Comparison group (non-

customer)

Mea

n w

eek

ly f

ruit

con

sum

pti

on

(log(F

FQ

_F

ru

it +

1)

Study groups

Mean weekly frequency of fruit consumption

Figure 1. GFB = Good Food Box. Reported weekly mean intake of fruits for each participant group. Results demonstrate a significant positive

effect for mean frequency of fruit consumption between Ottawa Good Food Box customers compared to non-customers; meaning Ottawa Good

Food Box customers ate reported eating significantly more fruits than individuals who did not take part in the program.

What did we find? Reasons people join the Good Food Box

Physical factors Access to GFB site

Economic factors Financial need

Save money

Social factors Family, friends, significant others

Individual factors Curiosity

Maintain healthy lifestyle

Program volunteer

What did we find? Reasons people drop out of the Good Food Box Physical factors Access to GFB site

Economic factors Incurred parking costs

No money

Participation in alternate food program

Social factors Altruism

Individual factors Wasted more than consumed

Program-specific factors Ordering process

Poor fruit and vegetable quality

Previous less positive experience in the program

What did we find? Barriers to Good Food Box participation

• Physical factors o Access to GFB site

• Economic factors o Competition for savings o Money o Product cost

• Program-specific issues o Ordering process o Content o Inability to select produce o Previous less positive experiences in the program o No delivery o Unaware of the GFB Program

• Social factors o Stigma

• Individual factors o Health issues

What did we find?

Perceived program/ site management strengths

Affordable /Good value Available Dependability Convenient program and location (e.g. Close to home)

Staff Swap Box option Advance payment Content: Element of surprise Food quality, quantity, variety Locally grown produce Product options Recipe cards Newsletter

What did we find?

Perceived benefits for participants Food buying alternative Builds sense of community Provides food security Enables financial management Enables time management Increase access to new foods Increases access to fruit and vegetables

Perceived benefits for the community

Supports local farms

What did we find? Opportunities for improvement

Content: Food quality (e.g. Bruised or expired produce) Food quantity (e.g. Not enough of certain fruits/ vegetables Food variety (e.g. Not enough seasonal produce)

Inability to select produce Element of surprise Value: Little quantity of food for cost of food box Food packaging Hours of operation Communication with clients Limited program capacity Monthly ordering frequency not enough Ordering process Transportation of food from Good Food Box site

Challenges for the Good Food Box Program:

Branding and marketing: Differentiating program from charities

Visibility

Human resources: Recruitment and retention of site coordinators/ volunteers, steering

Committee members

Financial/ Funding resources: Customer recruitment and retention: FNIM peoples,

Competing with food retailers: Convenience,

Seasonal fluctuation of food prices

Sustainable funding, Food truck

What did we find?

Challenges for the Good Food Box Program (cont’d):

Material resources:

Choice of food distribution locations

Delivery option

Food delivery

Food storage

Partnerships/ Relationship development

Future directions and priorities

What did we find?

Content:

Food quantity

More food varieties and locally grown produce

Quality control

Increase visibility:

Advertisement options

Perspectives from Ottawa residents

Recommendations to improve the Good Food Box Program

Ordering process

New products and options

Selection box

Swap box

Delivery option

Information/ Education aspects

Opportunities for community outreach and engagement

Perspectives from Ottawa residents

Recommendations to improve the Good Food Box Program

Recommendations to improve the Good Food Box Program

Data collection

Marketing strategy

Program administration

Program components

Funding

Product improvement

Communication with customer

Perspectives from site coordinators

Expansion?

Concluding remarks Health, poverty, food and hunger, human rights and the

environment are issues we need to tackle in the 21st century The face of poverty and hunger in Canada has changed and

further inaction is no longer an option.

Coordinated and deliberate effort by all levels of government and community inclusion is needed to raise the profile of health research and culture in relation to healing and well-being;

THANK YOU! MIIGWETCH! MERCI! ᖁᔭᓐᓇᒦᒃ MARSEE!