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The Food Access Project. By: Kathryn Allard, Stephania Fenelon, Marlyn Frias , Emilie Rider, & Carla Salvadore. Background on SNAP. “Supplemental Nutrition Assistance Program”—Previously known as the Food Stamp Program Established to fight hunger and malnutrition
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The Food Access Project By: Kathryn Allard, Stephania Fenelon, MarlynFrias, Emilie Rider, & Carla Salvadore
Background on SNAP • “Supplemental Nutrition Assistance Program”—Previously known as the Food Stamp Program • Established to fight hunger and malnutrition • Eligibility for SNAP benefits depends on income • Less than 185% of the federal poverty level • Benefits are used for food to be purchased and prepared at home • Currently SNAP benefits cannot be used to purchase prepared meals
The Food Access Project • Problem: Individuals that cannot store and prepare their meals at home cannot make use of their SNAP benefits. • Homeless • Those without kitchens • Elderly • Disabled • Solution: Allow high risk populations to purchase prepared meals with their SNAP benefits.
Project Mission Statement • “To decrease hunger and food insecurity for homeless individuals and others who do not have a way to prepare food in Rhode Island.” • Short term goal: Access food for those without kitchens and cooking facilities • Long term goal: Improve nutrition and the health of the homeless population
Proposed Pilot Program • Two strategies to increase food access to high risk populations: • Strategy 1: Outreach • Understanding health and nutrition problems • Establish rapport between target population and nursing students • Key informant interviews • Focus group meetings • Health fairs • Strategy 2: Work with restaurants and markets to establish contracts for use of SNAP benefits
The Nursing Students • 5 URI senior nursing students • Diverse backgrounds • Caucasian • Native American • African American • Hispanic • Age range • 22-26 years old • All female
With Funding from Southern RI AHEC… • As a team we participated in focus groups, analyzed data, conducted a literature review, and organized health outreach events. • Agencies we worked with: • Warm Shelter • Rhode Island Center Assisting those in Need (RICAN) • Welcome House • McKinney Shelter • Lucy Hearth
Focus Groups • Common Themes: • Transportation is a problem • Primary source of food include soup kitchens and food pantries • Nutrition is important • Access to water is a concern • Salt intake was not a concern • SNAP benefits do not help homeless people because there is nowhere to prepare or store foods • Being able to get prepared food specifically at subway with food stamps would benefit people who are homeless
Health Promotion • Blood pressure screenings • Risk assessment quizzes • Hypertension risk • Skin cancer risk • Summer health tips • Hand hygiene • Blood glucose readings • Body mass index screenings • Dental hygiene • Nutrition education • Healthy eating on a budget • Provided nutritious snacks • SNAP outreach applications • Health related giveaways • Raffle
Blood Pressure Screenings • Assessment quiz to determine patient’s risk of developing hypertension • Exercise, diet, alcohol intake, smoking, weight, age, medications etc. • Prior history • Screened blood pressure • Education • Pamphlet • Explanation of their reading • Lifestyle modifications • Referral to primary care provider • Answered questions
Healthy Summer Tips • Skin cancer risk assessment • Sunscreen use • Skin tone and color • History of sunburns • Family/prior history of skin cancer • Skin self assessment education • Warning signs of skin cancer • Asymmetrical, irregular borders, color, diameter, elevation, family history • Sun safety • Prevention of vector-borne diseases
Hand Hygiene • Described the importance of adequate hand washing • The pathogens commonly found on hands • When hand washing is necessary • Adequate hand washing technique • Alternate washing techniques • Alcohol gel • Hand sanitizers • Gave out hand sanitizers for participation
Body Mass Index Measurements • Calculated BMI off of height and weight using a chart from clinical guidelines • Advised clients that BMI is a good measurement for overweight and obesity but has limitations • Abnormal BMI • Informed them of normal values • Obtained patient history • Strategies to change lifestyle
Nutrition Education • Nutrition pamphlet • Food pyramid guidelines • Health benefits • Tips to healthy snacking • Healthy eating on a budget • Advising clients on how to purchase nutritious foods in discount supermarkets and farmer markets • Gave out fruit for healthy snacks
Empowering the HomelessPopulation in RI • Education, education, education!!! • Helps enhance their quality of life and autonomy • Established rapport with vulnerable populations • Understanding nutritional opinions and practices of the population • Important for healthcare professionals to assess the needs of homeless “The best way to find yourself, is to lose yourself in the service of others” -Ghandi
References • Algert, S.J., Reibel, M., & Renvall, M.J. (2006). Barriers to participation in the food stamp program among food pantry clients in Los Angeles. American Journal of Public Health, 96(5), 807-809. • Baggett, T., O'Connell, J., Singer, D., & Rigotti, N. (2010). The unmet health care needs of homeless adults: a national study. American Journal of Public Health, 100(7), 1326-1333. • Centers for Disease Control and Prevention (2009). Clinical growth charts. Retrieved from http://www.cdc.gov/growthcharts/clinical_charts.htm. • Centers for Disease Control and Prevention (2010). Skin cancer. Retrieved from http://www.cdc.gov/cancer/skin/basic_info/prevention.htm. • Centers for Disease Control and Prevention (2009). Travelers health. Retrieved from http://wwwnc.cdc.gov/travel/content/mosquito tick.aspx. • Dammann, K.W., Smith, C. (2009). Factors affecting low-income women’s food choices and the perceived impact of dietary intake and socioeconomic status on their health and weight. Journal of Nutrition Education and Behavior, 31(4), 242-253. • Davis, L.R., Holleman, W.L., Weller, N.F., Jadhav, M. (2008). Dietary intake of homeless women residing at a transitional living center. Journal of Health Care for the Poor and Underserved, 19(3), 952-962. • Department of Health and Human Services (2010). Aim for a healthy weight. Retrieved from http://www.nhlbi.nih.gov/health/public /heart/ obesity/lose_wt/index.htm. • Fournier, M., Austin, S., Samples, C., Goodenow, C., Wylie, S., & Corliss, H. (2009). A Comparison of Weight-Related Behaviors Among High School Students Who Are Homeless and Non-Homeless. Journal of School Health, 79(10), 466-473.
References • Rank, M., & Hirschl, T. (2005). Likelihood of using food stamps during the adulthood years. Journal of Nutrition Education & Behavior , 37 (3), 137-146. • Rhode Island Coalition for the Homeless (2010). Street sheets. Retrieved from http://www.rihomeless.org/Resources/StreetSheets/tabid/172/Default.aspx. • Rhode Island Department of Health (2010). Community heath centers in Rhode Island. Retrieved from http://www.health.ri.gov/disease/primarycare/healthcenters.php. • Richards, R., Smith, C. (2006). The impact of homeless shelters on food access and choice among homeless families in Minnesota. Journal of Nutrition Education and Behavior, 38(2), 96-105. • Savage, C., Lindsell, C., Gillespie, G., Dempsey, A., Lee, R., & Corbin, A. (2006). Health care needs of homeless adults at a nurse-managed clinic. Journal of Community Health Nursing , 23 (4), 225-234. • Schwarz, K.B., Garrett, B., Hampsey, J., & Thompson, D. (2007). High prevalence of overweight and obesity in homeless Baltimore children and their caregivers: a pilot study. Medscape General Medicine, 9(1), 48. • Stergiopoulos, V., Dewa, C., Tanner, G., Chau, N., Pett, M., & Connelly, J. (2010). Addressing the Needs of the Street Homeless: A Collaborative Approach.International Journal of Mental Health, 39(1), 3-15. Retrieved from Academic Search Premier database. • United States Department of Agriculture (2010). My pyramid. Retrieved from http://www.mypyramid.gov/index.html. • Weiser, S.D., Bangsberg, D.R., Kegeles, S., Ragland, K., Kushel, M.B., & Frongillo, E.A. (2009). Food insecurity among homeless and marginally housed individuals living with HIV/AIDS in San Francisco. AIDS and Behavior, 13(5), 841-848. • Wicks, R., Trevena, L.J., Quine, S. (2006). Experiences of food insecurity among urban soup kitchen consumers: Insights for improving nutrition well-being. Journal of the American Dietetic Association, 106, 921-924. • Yousey, Y., Leake, J., Wdowik, M., & Janken, J.K. (2007). Education in a homeless shelter to improve the nutrition of young children. Public Health Nursing, 24(3), 249-255.