Washington State s Large-scale FINI Project. Bridget Igoe, MPH, RD Office of Healthy Communities Washington State Department of Health March 2017

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1 Washington State s Large-scale FINI Project Bridget Igoe, MPH, RD Office of Healthy Communities Washington State Department of Health March 2017

2 Outline Scope and structure of project Key outcomes (so far) Evaluation Overview

3 Food Insecurity Nutrition Incentive (FINI) Grant Program Managed by National Institute of Food and Agriculture at USDA For more info, visit their webpage Goal: Increase the purchase of fruits and vegetables and improve the nutrition and health status of SNAP clients Strategy: Provide incentives at the point of purchase

4 At a glance FINI in WA Project Name Complete Eats Start End April 1, 2015 March 31, 2020 Award $5.86M Subawardees 11 diverse food system stakeholders Incentive Strategies 1. Farmers Market Match 2. Fruit and Vegetable Prescriptions 3. Fruit and Vegetable Coupons Outlets ~80 markets/csa ~170 Safeway grocery stores Potential reach 836,000 SNAP participants

5 Lead Implementing Partners West Sound Farmers Market Catholic Charities of Spokane City of Seattle s Office of Sustainability and Environment MultiCare Health System s Center for Healthy Living Safeway/Albertsons Skagit Valley Farmers Market Coalition Spokane Regional Health District UnitedHealthcare Community Plan University of Washington Center for Public Health Nutrition* Washington State University Clark County Extension Virginia Mason Memorial Hospital *Evaluation partner for the farmers market incentive program

6 Sources for SNAP data: American Community Survey, Last update: May, Locations of WA FINI Strategies

7 Incentives Strategy Incentive Form Terms and Conditions Eligible F/V $1:$1SNAP $5 flat $2:$6SNAP $4:$10SNAP $6:$15SNAP $10 Rx $20 Rx $40 Rx $3:$10SNAP $5:$10SNAP Market tokens and paper market currency Paper voucher Catalina coupon; generated/ redeemed by POS Use SNAP benefits to purchase any SNAP-eligible item Get market tokens to buy F/V No purchase necessary; 1- month expiration; Prescription can be used like cash to buy F/V only Use SNAP benefits to purchase F/V Get dollars off the next purchase of F/V; 1-month expiration

8 FINI Advisory Network Diverse food system stakeholders Defined roles 5 action groups

9 The Network Anti-Hunger and Nutrition Coalition Childhood Obesity Prevention Coalition Children's Alliance Department of Agriculture Department of Social and Health Services Empire Health Foundation Foundation for Healthy Generations Got Green Governor's Council on Health Disparities Governor Jay Inslee s Office Northwest Harvest OneAmerica Seattle YMCA Senator Patty Murray s Office State Board of Health University of Washington School of Public Health Washington State Farmers Market Association Washington State University - Extension WithinReach

10 Key achievements and outcomes (so far)

11 Farmers Market Match Scaling up and expanding existing programming Using technology for point-of-sale data collection Outreach, promotion, direct education Peer-to-peer engagement strategies Cooking-based nutrition education Local agencies that serve SNAP clients

12 Farmers Market Match Outcomes 73 Farmers markets in 18 counties participated in K SNAP transactions $640K SNAP$ spent at farmers markets $408K FINI-funded incentives spent at farmers markets $1.05M $1.88M Total SNAP$ and incentives spent at farmers markets Overall economic impact

13 Fruit and Vegetable Prescriptions Connects medical system and local food system Testing a variety of models that vary by Sites (clinics, community venues) Provider (PCP, allied health professionals, CHWs) Patient encounter (1:1 visits, classes) Retail outlets (Safeway, farmers markets) Frequency and dose

14 Fruit and Vegetable Prescriptions

15 Fruit and Vegetable Prescriptions Preliminary Data (Q3 2016) 11 Distribution sites in 7 counties offered Rx incentives 884 $4K $9K Complete Eats Rx vouchers issued between July 1 September 30, 2016 Complete Eats Rx vouchers redeemed to buy fresh fruits and vegetables at Safeway (50% redemption rate). Fresh Bucks Rx redeemed to buy fresh fruits and vegetables at farmers markets (63% redemption rate)

16 Fruit and Vegetable Prescriptions Preliminary Data Month # Rx vouchers redeemed at Safeway July'16 8 Aug 129 Sep 239 Oct 492 Nov 582 Dec 571 Jan' Total 2552

17 Fruit and Vegetable Coupons Launching June 2017 in Safeway stores Catalina coupon Spend $10 on qualifying fruits and vegetables using your SNAP benefits and get: A. $3 off next purchase B. $3 off next purchase of fruits and vegetables C. $5 off next purchase D. $5 off next purchase of fruits and vegetables Community-based promotion

18 Evaluation Overview System/ Process Evaluation Essential strategies for implementation Factors affecting program implementation Outcome Evaluation Reach Impact on shoppers food purchasing behaviors Impact on client health outcomes (for Rx strategy) Revenue and cost implications Within and across all 3 incentive strategies Mixed Methods

19 Bridget Igoe DOH FINI webpage