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Nutrition Network Needs Assessment

Nutrition Network Needs Assessment. January 26, 2012 Joan.Agostinelli@azdhs.gov. Identifying Need. Trend going in wrong direction Disparities among subgroups Comparison to standard or goal Comparison to reference group AZ vs. U.S. or County vs. State Partner/stakeholder input.

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Nutrition Network Needs Assessment

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  1. Nutrition Network Needs Assessment January 26, 2012Joan.Agostinelli@azdhs.gov

  2. Identifying Need • Trend going in wrong direction • Disparities among subgroups • Comparison to standard or goal • Comparison to reference group • AZ vs. U.S. or • County vs. State • Partner/stakeholder input

  3. Why Do Needs Assessments? • Helps prioritize limited resources • Identify gaps • Where are resources going compared to where is the need? • Intervene where we can make a difference • Required by USDA

  4. Required to Address • Description of the target audience • Their nutrition-related behavioral and lifestyle characteristics • Availability of other programs that target same population • Areas where target audience is underserved • Implications for planning.

  5. Data Sources • U. S. Census, including American Community Survey (ACS) • SNAP Utilization data • Behavior Risk Factor Surveillance System (BRFSS) • Youth Risk Behavior Survey (YRBS) • Program evaluation data (quantitative and qualitative) • Social marketing studies

  6. Arizona Per Capita Income • Tends to be lower than U.S. averages. • 91% of national average in 2010

  7. Median Household Income

  8. Unemployment • Historic low in 2007 of 3.6% in Arizona. • Climbed to over 10% by end of 2010. • 36% decrease in construction jobs over last decade • 173,600 in 2001 • 111,600 in 2010

  9. Unemployment in Arizona 2010 • Higher rates in rural areas, • Lowest rates in Maricopa and Pima County, • However, majority of unemployed people live in Maricopa and Pima County

  10. Distribution of Unemployed People

  11. Federal Poverty Guidelines2010 Contiguous U. S.

  12. Poverty Rates 2010

  13. Food Insecurity • One in five Arizona households (20.8%) reported not having enough money to buy food that they needed during prior 12 months (rank=15) • 29% of households with children did not have enough money to buy food (rank=7)

  14. Arizona Poverty Rates 2010by Age Group • 24.4% of children under the age of 18 in poverty

  15. Children Under Age 5 Poverty Rate by Race

  16. Racial Composition ofChildren Under Age 5 in Poverty

  17. Arizona Resident Incomes 2010as a Percent of Federal Poverty Level

  18. SNAP Participation

  19. Target for Nutrition Education • Certified Eligible – SNAP participants • Likely Eligible • Income below 130% FPL • Location proxies: food banks, food pantries, soup kitchens, public housing, SNAP/TANF job readiness programs • Potentially Eligible • Locations where 50% have incomes below 185% FPL • Retail grocery stores with $50,000 average SNAP benefit redemption

  20. More Recent SNAP Participation(Arizona, July 2011) • 477,227 households • 1,102,573 people • 568,882 adults • 533,691 children

  21. Households with ChildrenLikely Eligible (<130%FPL) vs. Not eligible (>=130%FPL)

  22. Family Composition and Labor Force ParticipationLikely Eligible (<130%FPL) vs. Not eligible (>=130%FPL)

  23. Among Likely Eligible PopulationDuring the last 12 months . . . • 22.6% in families with no workers • 51.3% had one worker • 21.0% had two workers • 5.1% had three or more workers

  24. Educational Attainment Arizona AdultsAge 25 and OlderLikely Eligible (<130%FPL) vs. Not eligible (>=130%FPL)

  25. Overall Health Ratings

  26. Likely eligible population is also more likely to report . . . • Health problems that limit their activities (32% vs. 19%) • No health insurance (28% vs. 13%) • Needed a doctor within last year but did not see one because of cost (vs. 31% vs. 7%)

  27. Fruits and Vegetable Consumption Among Target Population

  28. Adults Consuming 5 or More Fruits and Vegetables Daily by Income AZ 2010 = 25.2%

  29. Daily Intake of Fruits and Vegetables Among Likely Eligible Adults

  30. Trans-Theoretical Model • Not thinking about it • Thinking about it and plan to start within 6 months • Definitely planning to start in next month • Trying to do it now • Already doing it

  31. Post Campaign Report: Adult Readinessto Eat More Fruits and Vegetable • 46% said they already ate 5+ servings • 42% said they were trying to eat more • 10% said they definitely planned to eat more in the next month • 2% said they are thinking about eating more and plan to start in the next six months • Less than half of 1% said they were not thinking about eating more fruits and vegetables

  32. Before Implementation of Fruits and Veggies – More MattersTM*Most students already . . . • Could pick at least one food that was a fruit (96%) and one that was a vegetable (91%) • Knew which foods had a lot of vitamin C (64%) • Said they ate fruits and vegetables as snacks (86%) *Curriculum administered to elementary students age 7 through 10

  33. Before Implementation of Fruits and Veggies – More MattersTM* Among Elementary Students * • 15% knew how many grams of fiber were needed to stay healthy • 37% knew which foods had fiber • 27% knew which foods had a lot of vitamin A *Curriculum administered to elementary students age 7 through 10

  34. Milk/CalciumAmong Target Population

  35. Adult Milk Drinking(from Food Behavior Checklist Survey) • Over past three years, findings have not changed significantly: • One in three eligible adults drink milk every day • One-fourth said they drink milk often • 15% do not drink milk

  36. Adult Milk Drinking – Fat Content(from Food Behavior Checklist Survey) • 5% drank fat-free milk • 24% drank 1% milk • 38% drank 2% milk • 28% drank whole milk

  37. Adult Milk Drinking HabitsPrior to Launch of Go Low Campaign • 31% in maintenance stage • 18% action stage - trying to switch • 9% preparation stage - definitely planning to change in the next month. • 9% contemplating changing to low fat or fat free milk in the next six months (half drank 2%, 25% drank whole milk). • 33% in pre-conceptualization stage – not thinking about changing, or did not perceive or personalize risks.

  38. Beliefs about Milk (Adults) • Drinkers of 2% milk: • Say it is not as thick as whole milk, but not watery like 1% low fat milk (“happy medium”). • Many switched from whole milk and now feel they have made the healthy choice. • Drinkers of 1% milk: • Talk mainly about fewer calories and less fat, although a few described liking the taste. • Drinkers of Fat-free milk: • talked almost exclusively about the health benefits.

  39. Post Go-Low Social Marketing Campaign • 46% of moms and 56% of children drank 2% milk. • 23% of moms and 32% of children drank whole milk. • 64% of moms believed lot fat and fat free milk have same amount of vitamins and minerals as whole milk. • 82% agreed that drinking low fat or fat-free milk is an important part of a healthy diet.

  40. Adolescents Milk Consumption (YRBS 2009)* • 14% of high school students reported drinking three glasses of milk or more per day during the week before the survey: • 8% of girls • 19%of boys • 28% drank a soda at least once per day in the previous week *Includes all high school students, statistics specific to low-income youth not available.

  41. Building Better Bones Pretest – 5th Graders • 67% knew which fast foods had the most calcium and least fat • 47% could identify foods without calcium • 37% knew how many daily servings of dairy they should have, and the age at which 90 percent of bone density is built • 15% knew percent daily value for calcium needed for students their age • 20% knew what osteoporosis was • 23% had at least 3 servings of milk the day before.

  42. Whole GrainsAmong Target Population

  43. Whole Grains (Westgroup) • Mothers understand that whole grain foods are supposed to be good for you • Some say more nutrients, others say good source of fiber • Know little about specific vitamins and minerals and why they are good for you. • Could identify some ultimate benefits, such as improving digestion, helping with heart health, and helping to control weight. • Some believe whole grains give you energy and lower cholesterol. • Messages about fiber resonated more than vitamins and minerals, especially with Hispanics.

  44. Confusion about Whole Grain, Whole What, Multigrain, and Stone-Ground • Use whole grain and whole wheat interchangeably • Uncertain whether multigrain is a whole grain • Unclear about whether products that don’t say “100% whole grain” or “100% whole wheat” are truly whole grain or whole wheat. • Some look for “lowers cholesterol” or the Heart Healthy or red heart logo, or the wheat stalk on the package.

  45. Eating Whole Grains • Most say they have whole grain foods at home, with whole grain/whole wheat bread and oatmeal being named most often. • Some moms who eat whole grain still serve white bread to their children (“tastes better”), although . . . • Some serve whole wheat bread to children so they will develop healthy eating habits.

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