March 2013

A Qualitative Study of Nutrition-Based Initiatives at Selected Food Banks in the Feeding America Network

             Food banks are the foundation of the US emergency food system. Although their primary mission is to alleviate hunger, the rise in obesity and diet-related diseases among food insecure individuals has led some food bank personnel to actively promote more nutritious products.  This study used a qualitative interview approach to assess nutrition-related policies and practices among a sample of 20 food banks from the national Feeding America network. 

             This study focused on Feeding America food banks because of this organization’s prominence in the US emergency food system. In order to capture the diverse context, influences, and barriers related to nutrition-based initiatives,  the food banks were selected purposively from the Feeding America website to ensure variation in size (indicated by pounds of products distributed in 2009), geographic location (determined by US Census regions) and use of nutrition-based initiatives. Participants were recruited in through electronic invitations and some specific food banks with nutrition based initiatives were targeted for participation. The final sample included directors, chief executive officers, and staff in charge of nutrition, programs, and procurement. Data collection was based on interview questions that asked facilitators about any barriers to implementing nutrition-based initiatives, as well as details about different systems. Data were collected in-person or by phone by one of the authors from June to October 2010.

             The results of the study revealed how some food banks are effectively altering their operational strategies to address concerns about poor nutrition. Two potential changes that were discussed were setting up nutrition-profiling systems and establishing nutrition policies. Implementing more fresh produce was also identified.

            The first resulted change involved nutrition profiling. Several interviewees described using ranking systems or algorithms to quantitatively score the nutritional value of the foods distributed. Three food banks used similar ranking systems based on data from Nutrition Facts labels to designate whether the item should be eaten regularly, moderately, or occasionally. Foods were then labeled with numbers (eg, 1, 2,3) or colors (eg, green, yellow, red) on agency ordering menus with the goal of guiding their choices. An additional food bank devised an algorithm to rank products. A 10-point scale provided a relative value for each pound of food and reflected the notion that not all pounds are equally valuable. The factors evaluated nutritional value, availability, economic worth, and client preference.

           The second style of change discussed was the idea of nutrition policies as guided efforts to eliminate specific products, such as soda, candy, or other unhealthy products, from food bank distribution systems. Policies were controversial because of the perception that they can jeopardize donor relationships and limit client choice. One participant shared, “People should have choices, and our job is to make sure they have healthy things to choose from. Then, if they want to supplement it with pop, cookies, . . . then that needs to be their choice.”

           The importance of providing more fresh produce was discussed by many interviewees. Reasons for this were the relatively high cost of produce and the concern that food-insecure households might only consume fresh fruits and vegetables intermittently. In addition, individuals living in communities that lack mainstream grocery stores might not have regular access to fresh produce.

Handforth, B., Hennink, M., Schwartz, M. (2013). A qualitative study of nutrition-based initiatives at selected food banks in the feeding America network. Journal of the Academy of Nutrition and Dietetics, 113(3), 411-415

Understanding and Addressing Barrier to Healthy Eating among Low-Income Americans

              I chose this article due to the fact that individuals with food insecurity have been observed to have higher rates of obesity compared to those who are food secure.  This study explores the factors that influence food purchasing behaviors in households with food security versus food insecurity. The study used a mixed methods approach of concept mapping, which examined the perceptions and preferences driving food purchasing behaviors.

                26 men and women with food security and 41 men and women with food insecurity from 4 Boston, MA neighborhoods were involved in completing the concept mapping process. Concept mapping is an approach that allowed the participants to identify, list, and rate according to importance of the topic.  The participants identified 163 unique factors that influenced their food purchasing behaviors.  Examples of statements included “ freezer space” or  “ease of theft”. These factors were grouped into 8 separate clusters/concepts that reflected their perceptions of factors hindering healthy eating.  

                Key findings from this study suggested average cluster ratings were similar between participants with food security and food insecurity, suggesting that similar food purchasing behaviors are practiced and are perceived similarly in how they hinder or promote healthy eating. The most notable difference between groups was the rating for convenience.  Prevalence of overweight and obesity was greater among participants with food insecurity (80.5%) compared with those with food security (61.5%). Overall, according to this study, food security status does not appear to play a role in perceived importance of factors that hinder healthy eating.

Walker, R., Kawachi, I. (2011). Use of concept mapping to explore influence of food security on food buying practice. Journal of the Academy of Nutrition and Dietetics, 112(5), 711-717