Implementing a Nutrition Quality Rating System

1. Implementing a Nutrition Quality Rating System Elizabeth Campbell, MA, RD Associate Specialist University of California at Berkeley The Dr. Robert C and Veronica Atkins Center for Weight and Health

2. Presentation Overview • Why is this important? • Health implications versus customer service • Results from CNY study • Method to improve nutrition quality • Define CHOP • A Case Study: Los Angeles Regional Foodbank • What do stakeholders think? • Example of quantitative data • Hear from those implementing nutrition rating systems

3. Background • Demand for emergency food has changed over the past 20 years • Simultaneously, the United States is facing an obesity epidemic • Demand for emergency food has increased in light of the economic recession • Food Banks have seen an increase in the amount of energy-dense, nutrient-poor food donations

4. Health Implications vs. Customer Service Approach • Documentation that nutritious food is better for food insecure individuals • Emergency food recipients may prefer or want foods of minimal nutritional value • No data exists to measure food preferences of low income individuals

5. Evaluation of “No Soda and No Candy Policy” • Objective 1: Evaluate the impact of the FBCNY’s “No Soda and No Candy” policy on the types of donated foods and beverages accepted • Objective 2: Assess Emergency Food Program (EFP) recipients’ preferences for foods and beverages • Objective 3: Assess the EFP directors’ perceptions of recipients’ food and beverage preferences and their own decisions about what foods and beverages to stock

6. Methods • Instruments: • Interviewer administered questionnaire (Directors and Guests) • Food pantry inventory assessment • Food bag checklists • 15 random food pantries from the FBCNY service area • A 20-guest pilot study was conducted in 2008

7. Sample Size

8. Characteristics of Respondents • The majority of guests were white females between the ages of 35 and 64 • Only 64% of guests indicated that they or a member of their household received food stamps • 28% reported that someone in their household participated in the SLP • Only 9% participated in the SFSP • 75% of guests interviewed were unemployed

9. Considerations for Food Selection by Emergency Food Guests • 98% indicated having nutritious food available for them at theFPwas very important/important • However, 94% reported that taste was also a very important/important consideration when choosing food for their households • Approximately 70% of guests did not place a priority on receiving snacks at the food pantry by reporting it was somewhat or not important to them • Guests (94% very important/important) placed a high priority on the availability of staple items

10. Guests’ Food Preferences

13. Specific Items Preferred by Guests in Rank Order

14. Directors’ Perspectives for Food Pantry Distribution

15. Directors’ Perceived Barriers

16. Discussion • To what extent can the emergency food system change nutrition and procurement policies to meet demand of guests? • Introduction of nutritional rating systems

17. Choose Healthy Options Program (CHOP) A comprehensive program developed by the Greater Pittsburgh Community Food Bank to promote the acquisition, distribution, and consumption of healthier food.

18. 1 Choose frequently Choose moderately 2 3 Choose sparingly MC Minimal contribution NR Not rated Food Ratings

19. Case Study:Los Angeles Regional Foodbank • Qualitative Data • Interviews with 7 staff members • Interviews with 3 emergency food programs • Interview with BOD • Quantitative Data • Example of a quarterly report • Suggestions on how to use data

20. Staff Interviews Selection Process: Why Choose CHOP? • Evaluated 3 existing rating systems • CHOP was the most developed and easiest to use • CHOP relies on the food label • Easy to train non-nutrition professional to read the label and rate the product

21. Staff Interviews Implementation: Greatest Challenges? • Changing the mind set of staff, etc • Monumental change in FB operations • Determining which food categories to label • Determining if initial calculation of ranking was appropriate • i.e. peanut butter and whole raw chicken • Development of excel worksheet for calculations

22. Staff Interviews Implementation: Key to Success? • Important to have a “champion” • Supportive Executive Director • Education of staff and board members

23. Staff Interviews Implementation: Resources Needed? • Excel expertise • Small change in Navision process • Potential for additional need for transportation and storage of healthier foods • i.e. refrigerated trucks, freezer space, etc…

24. Staff Interviews Implementation: Communication Methods? • Strategic plan • Internal staff meetings • Agency conference • Newsletter/memo • Monitoring staff/word of mouth

25. Staff Interviews Follow-Up: What kind of feedback exists? • Originally there was pushback from staff • Staff have embraced new mind set • Internal strategic changes • i.e. donor solicitor actively seeking better ranked foods • i.e. addition of delivery programs • i.e. set nutrition policy; target nutrition education needs • No negative response from agencies • Some agencies have thankedthemfor creating a “buying guide” for them

26. Staff Interviews Follow-Up: Recommendations • Be sure to spend the time up front educating staff • Need staff buy-in • It’s much easier than you think • Be creative with ways to deliver new products • May work best at food bank level • Treat it like a customer service opportunity • Be sure to review items after ranking; determine what works best for your agency

27. Agency Interviews Attitude Towards Nutrition Quality: • Generally, nutrition was important • Mixed opinions on what is priority • Quantity vs. Quality • Mixed opinion on types of foods that clients want

28. Agency Interviews Barriers to Improvement: • Quality vs. Quantity • Not enough funding • Storage • Delivery • Client preference

29. Agency Interviews Possible Solutions to Improvement: • Find more funding • Talk to USDA about improving subsidies • General sense of “doing their best”

30. Agency Interviews Perception of Policy Communication Method: • Two of the agencies said the agency conference was a great way to communicate • Two agencies remember receiving memo • One agency was not familiar with the rating system

31. Agency Interviews Perception of CHOP: • Mixed reviews • Very helpful • Aware of system; not helpful or applicable • Not aware of system

32. BOD Interview Key Concerns: • Potential decrease in shared maintenance fees • More costs and less revenue • Loss of donations • Upsetting donors

33. BOD Interview Rationale for Change in Mission Objectives: • Perfect storm for change • Research overwhelming in regards to need for improvement in nutrition quality of low income clients • Bad economy==PR opportunity and free advertising • Financially situated to “take a risk”

34. BOD Interview Recommendations: • You have to make a change; it’s the right thing to do • Leads to increased funding • Any change is a step in the right direction

35. Quantitative Data Example: Third Quarter Report

36. Quantitative Data

37. Quantitative Data Ways to Utilize Data: • Measurement of overall success • Strategic planning for food solicitation • Goal setting for education and outreach

38. Panel/Group Discussion • Briefly explain your organization’s reason for implementing a rating system? • Briefly explain your rating system? • Briefly explain how your organization uses its rating system. • What are the greatest challenges? • What are the greatest benefits?

39. Questions?