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Nutritional Intervention Plan

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A Spoonful of Health:

A Nutritional Intervention Plan for the Columbus Community

Community Partner: Columbus Early Learning Centers

Group Members: Izzy Birdsall, Kay Goheen, Emma Lazor, Morgan Malloy, Diana Salih

Dr. Ingrid Adams


Abstract

Background and Needs: In Franklin county, approximately 18% of individuals experience food

insecurity. Families at the Columbus Early Learning Centers are part of this 18%, as the median income is

far below the poverty line. Both the Broad Street and Main Street Early Learning Centers provide families

with food bags to help combat the food insecurity rate, however, many families expressed that the lack of

adequate nutritional skills and knowledge prevents them from fully utilizing the food in the bags. A

Spoonful of Health: A Nutritional Intervention Plan for the Columbus Community is designed to fill these

gaps, providing easy, healthy recipes in each bag. Recipes will be created based on survey results as well

as on the items that will be in the food bag. The meals will be designed to be healthy and kid-friendly.

Goals and Objectives: The goal of the interventional program is to combat food insecurity while also

satisfying the nutritional needs of the Columbus Early Learning Center families by providing simple

recipes that incorporate a variety of nourishing components. Objectives include preventing food waste

and decreasing food insecurity, increasing nutritional knowledge and awareness on how to creatively use

the food items received in their food bags, increasing knowledge and awareness around nutrition for

healthy brain development in children 6 weeks to 5 years of age, and increasing self efficacy in using new

recipes to support a healthy lifestyle.

Description of Program:

A Spoonful of Health: A Nutritional Intervention Plan for the Columbus Community involves providing

monthly recipes to families at the Broad and Main Street Early Learning Centers based on food items they

receive in their food bags. Included in the recipes will be information on how to make healthy, easy meals

as well as nutritional meals that will cater to young children. By providing recipes to families at the Early

Learning Centers, the plan of this program is to implement self-efficacy in helping families utilize

different foods and cook healthy meals, consequently decreasing the rate of food insecurity in Franklin

County.
Evaluation:

The inputs, short term goals, medium term goals, and long term goals will all be assessed via parents

surveys done at regular intervals throughout the year. The inputs include volunteers needed to distribute

recipes. The short term goals include the process of efficiently providing recipes and increasing

nutritional awareness. The medium term goals include removing unpopular items and assessing behavior

changes towards cooking and eating healthy meals. The long term goals include increasing food security,

reducing food waste, and maintenance of a healthy lifestyle. By surveying the families at different

intervals, the program can continue to progress and improve, ultimately reaching the long term goals of

greater food security within the families.

Conclusion:

The intervention will provide families with the necessary nutritional knowledge, skills, and directions to

create healthy meals for their families via creative recipes tailored to the needs and wants of the

community.

Implication:

This program will help to foster healthy lifestyles by encouraging self-efficacy in food insecure

individuals, therefore combating the prevalence of food insecurity in Franklin County.


Needs Assessment

Description of Community:

The Broad Street and Main Street Early Learning Centers are both located in the eastern,

downtown area of Columbus, Ohio. They both identify as properties in Franklin county and under the zip

code 43205. Of the 12,739 people in this zip code, 54% are African American, 35.8% are Caucasian and

8% identify with two or more races. According to United States Zip Codes, there is a greater ratio of

early-aged adults between their 20s and 40s than there are middle-aged adults, and there is a higher

percentage of single adults than there are families (Zip Code 43205). Of the students in the public school

system, 73.7% are eligible to participate in the free or reduced school lunch program. The median

household income is $36,693 and there is an unemployment rate of 5.7%, which is higher than both the

Franklin County and Ohio unemployment rates. The average household size is 2 people and 74% of

families do not have children.

While the percentage of individuals that did not graduate high school is among the highest in the

country, the percentage of individuals that did go on to earn their college degree is higher than many other

zip codes, indicating promise for the future generations. 85.1% of children are enrolled in public schools,

4.5% are enrolled in private, and 10.5% are not enrolled in school at all. At the Broad Street and Main

Street Early Learning Centers specifically, there are 79 students ages 0-6. Of those children, 56.9% are

African American, 27.8% are Caucasian and 15.2% identify with two or more races. The median

household income is between $10,000 and $19,000 and 67% have an income below $40,000 (United

States: Social Explorer) The average household size is about 4 people. Despite the lower high school

graduation rates, compared to other ZIPs, a much higher percentage of the population has received a

college degree.
Description of Problem:

Food insecurity is defined as the lack of consistent access to enough food for every person in a

household to live an active, healthy life (Feeding America, para. 1). According to Feeding America, food

insecurity affected 16.5% of Franklin County’s total population and 19.4% of children in Franklin County

in 2020. Studies have found children from homes of high food insecurity were more likely to grow up

with poor academic and cognitive function and performance and intellectual achievement later in life

(Perez-Escamilla et al., 2012). It was also found by Stephanie Ettinger and her colleagues that families

participating in SNAP programs were associated with higher food security and improved health,

education, and economic outcomes compared to families who did not participate (Ettinger et al., 2019).

The Columbus Early Learning Center has multiple locations in Franklin county and are on a

mission to help low income families with their children's education. One way they support this is through

the donation of food bags in partnership with the Broad Street Food Pantry. Pre-COVID-19 pandemic,

families were able to go into the pantry and pick the item they needed themselves. Today, families are not

able to pick their own food and bags are prepackaged. As families are not able to pick and choose what

goes into their monthly food bags, they are struggling with knowing what to do with certain food items

they are receiving and general nutrition information in regards to the food they receive in their monthly

food bags.

In addition to that, the community is also facing an issue with food waste, and inadequate

nutrition. As families are getting their food as pre packed bags, they are not making the decision on what

to take home to cook for the family. Survey results that participants do not utilize all the food they get.

When surveyed, we found 51% of families gave their donated food away and 72% of families were

interested in receiving recipes with their food bags. Respondents to the survey revealed that they do not

usually eat certain types of food or they do not have ideas on what to do with the food they get in the bag.

Moreover, survey results showed that people in this community are lacking information about

consuming a different variety of food choices including vegetables, fruits, meat and dairy to avoid
malnutrition. In the same manner, survey results showed that they lack nutritional information about

which foods are good for brain development for their children as they grow.

Identification of Gaps:

In this project, we will examine the effectiveness of distributing recipes and other nutritional

information to families at the Broad Street and Main Street Early Learning Centers. Survey results

showed that 72% of families would like recipes to better use the food they receive and make healthier

meals, especially for younger children. Also, 44% of families expressed interest in receiving information

about how to best feed preschool children or toddlers for brain development. Families experiencing food

insecurity often do not have the access to the resources to best prepare the food they receive from food

banks, especially during the past year due to their lack of choice in what food comes in each bag. A

systematic review of interventions at food pantries has shown that nutrition education and the customer

choice model are helpful to increase families’ knowledge about nutrition and meal preparation, as well as

to increase their food security status and intake of fresh fruits and vegetables (An, Ruopeng, et al. 2020).

However, there is little evidence regarding the effectiveness of interventions involving nutrition education

when families cannot choose what goes into their food bags, which occurs at the Early Learning Centers

due to the impact of COVID-19. Research is lacking about the use of these recipes and information by

families without the option of choice and how these interventions impact food security or health

outcomes. This project will help fill the gap in the literature.
Program Development

Description of Proposed Intervention:

We plan to provide monthly recipes to families at the Broad and Main Street Early Learning

Centers based on food items they receive in their food bags. The recipes will include information about

how to make canned or boxed foods healthier, as well as recipes specific for feeding younger children.

Reviews of many similar studies have shown that “food pantry initiatives that provide nutrition education

and recipe demonstrations can increase the variety of fruits and vegetables and the amount of produce

clients consume, and can improve nutrition knowledge, home cooking skills and habits, and food security

status” (“Healthy food initiatives” 2020). Providing recipes to families at the Early Learning Centers will

help them to improve their confidence in creating healthy meals for their family and can allow them to

make the best use of the food they have, decreasing the prevalence of food insecurity. After gathering

information about what will be included in the next food bag distributed at the centers, we will put

together a document with healthy recipes that highlight the main food items, as well as foods that families

have expressed that they don’t use or give away for various reasons.

One barrier to this intervention is making and sending the documents to the centers in advance so

they can print and distribute them with the bags. There may not be a lot of time between when we find out

what will be in the bags each week and when it is time to distribute the bags, so we will have to create the

document quickly each month. Any challenges with this fast timeline can be made easier by forming a list

of healthy recipes in advance with common ingredients found in the food bags. This will shorten the time

it will take to make the document each month to ensure that it can be distributed on time.

Goals and Objectives:

To prevent food waste and decrease food insecurity in families from the Columbus Early

Learning Center, families will be able to increase knowledge and awareness on how to creatively use the

food items received in their food bags, increase knowledge and awareness around nutrition for healthy

brain development in children 6 weeks to 5 years of age, and increase self efficacy in using new recipes to

support a healthy lifestyle.


Theory of Behavior Change:

The theory of behavior change that can be used to develop this intervention is the

Transtheoretical Stages of Change Model. This model is founded on the foundational principles that

behavior change takes place through a series of steps and that to be effective, an intervention must be able

to be tailored to a specific stage according to the individual. Because the Columbus Early Learning Center

caters to a variety of different families from diverse socioeconomic backgrounds, this would be the most

constructive behavior change model to use as it recognizes that not every family will be at the same stage.

Some families may be in the precontemplation stage, believing that there is no need for an intervention

and may not want to take the time to cook the recipes provided, while others may be in the action stage,

ready to take on the kitchen with the provided ingredients. Based on the survey results, many individuals

appear to be at the contemplation stage. This stage reflects individuals who see the possibility to change

but have not yet taken action to implement those changes. Our intervention plan will implement those

changes by providing recipes and nutritional information to the participants as well as information on

removing barriers. We will incorporate the Transtheoretical Stages of Change Model by realizing the

many different stages individuals and families may be in and ensuring that we are offering adequate

nutritional information, diversifying the menu to adhere to dietary needs/allergy restrictions, providing

support, and encouraging self-efficacy.

Implementation Plan:

We will begin to implement the program by gathering information on what will be included in the

food bags given to the families for the month. When we acquire these details, we will start to assemble

recipes which we will place on a recipe card, print and stuff into the food bags. The recipes will be

creative, using information from the internet, our own knowledge, and the knowledge to develop healthy,

non-time-consuming meals and snacks. After families have received their monthly bags and are given

adequate time to utilize the recipes (30 days), we will create and send out another survey. This survey will

consist of progress-tracking questions which will be used to determine the effectiveness of the

intervention. If progress does not appear to be made, we will reassess the plan. If families appear to be
satisfied and express healthy differences made in their lifestyles, we will continue implementing the plan,

constantly improving and staying open to suggestions.


Program Evaluation

Evaluation Plan:

Inputs: volunteers to distribute recipes

Short term goals: provide recipes, increase awareness about eating variety and colorful food.

Medium term goals: remove unpopular items and replace, behavioral changes toward cooking and eating

Long term goals: increase food security, reduce food waste, maintain a healthy lifestyle

These goals will be evaluated via parent surveys done at regular intervals throughout the year. Long term

goals will be evaluated yearly and/or at the end of a child's enrollment in the program. In the case of

multiple children in one family each child will be given an individual parent survey. With continuous

input from families the program can continue to improve fluidly over time and reach our long term goals

of greater food security within the families.

Evaluation Questions:

Did people in the community increase their knowledge about eating various types of food?

Did people have changed their behavior toward removing unwanted food as a result of this program?

What challenges did people confront as a result of implementing behavioral change toward food recipes?

Did people find the recipes easy to make and enjoyable?


Logic Model:

Situation: A community needs assessment at the Early Childcare Center revealed that Parents are experiencing food insecurity, food

waste and lack of the knowledge about eating nutritional food that are beneficial for brain development for their children as they grow

because they don’t have the opportunity to choose what goes into their food bags during the pandemic. The intervention is aimed to

help decrease food insecurity and provide monthly food recipes to increase nutritional awareness about food that they don’t usually eat

and to decrease food waste.

Outputs Outcomes

Inputs Activities Participants Short-term Medium-term Long-term

-People design
monthly food
-Design and send -Food -Provide monthly - - Increase
recipes for the
monthly food recipes Behavioral food security
centers. pantries food recipes
to the centers to give changes - Reduce
-Volunteers deliver -Parents -Increase
ideas for cooking the toward food waste
recipes to the
food they don’t awareness and cooking - Improve
centers
usually eat. and eating diet quality
-Survey to evaluate knowledge about
of low
the intervention eating a variety
income
of food families

-Increase
knowledge about
nutritional foods
that are
beneficial for
brain
development for
their children as
they grow.
Budget:

Direct costs

A. Salaries and wages


1 Project staff $5,760

B. Fringe benefits $0.00

C. Total salaries, wages, and fringe benefits $5,760

D. Equipment
1 lamination machine $49.99
1 printer $229.89

E. Material and supplies


3 ream white cardstock (1,500 sheets) $20.97
3 packs laminating sheets (600 sheets) $74.16 ($24.72 x 3)
1 slide paper trimmer $7.99
2 pack ink cartridges $109.38 ($54.69 x 2)

F. All other direct costs $26.88

Total direct costs $6,279.26

Indirect costs $0.00

Total cost $6,279.26

Budget narrative:

A. Salaries and wages: This project would require the hiring of a part time project employee that would

be paid $12 working up to 10 hours a week. They would be in charge of planning recipes, printing, and

preparing recipe cards to be stuffed into bags as well as being in contact with those needed to facilitate

bag stuffing and contents of food bags for recipe planning. They would also be in charge of printing

evaluations for the staff of CELC to distribute. This totals $5,760 per year. B. Fringe benefits: The

employee we plan to hire is only part time, so no fringe benefits are needed. C. Total salaries, wages,

and fringe benefits: Since we did not need to include fringe benefits due to our employee being part

time, the total for salaries, wages, and fringe benefits is $5,760. D. Equipment: For the Columbus Early

Learning Child Center (CELC) to carry out this project, they will need additional equipment. To create
quality recipe cards, a lamination machine will be needed for $49.99 and a printer will be needed for

$229.89. These two items are slightly higher priced because they are higher quality that will last the

facility a longer time than cheaper items. This makes the total amount budgeted for high quality, long

lasting equipment $279.88. E. Material and supplies: To complete the recipe cards, CELC would also

need 3 reams (20 lb box; each recipe card taking ½ sheet maximum) of cardstock paper costing $20.97, 3

packs of laminating sheets (600 sheets total) costing $74.16, 1 paper trimmer costing $7.99, and 2 packs

of ink cartridges costing $109.38 ($54.69 each). This comes to a total of $212.20 for materials and

supplies. F. All other direct costs: Additional costs needed include another ream of paper and ink to

print follow up surveys and evaluations to give to the families totaling $26.88. Total direct costs as well

as total cost of project comes out to $6,279.26 due to no additional indirect costs.

Timeline:

Task Time to complete Start date End date Personnel

responsible

Creating survey to 27 days Feb 15 March 13 MM IB KG EL

determine gap in DS

service

Administering 1 day March 16 (returned from MM IB KG

survey to parents staff) March 19

Organizing survey 6 days March 19 March 24 EL DS

results

Program 12 day April 7 April 18 MM IB EL

development
Program evaluation 12 days April 7 April 18 DS KG

Budget 2 days April 15 April 17 MM

Cover/title page 2 days April 15 April 16 IB

Appendix 1 week April 15 April 20 DS

Abstract 1 week April 15 April 20 IB

Power point 2 days April 19 April 20 KG

Follow up program Continuous April 21 N/A Staff at Columbus

evaluations Childcare
Appendices:

Appendix 1: Survey conducted at Main and Broad Street Early Learning Centers (March 16th,

2021)

We would like to know how we can improve the food bags that families receive. Please take a few
minutes to complete the survey.
Parent (names): _________________________
Child name(s): __________________________
CELC center: ___________________________

1. How satisfied are you with the following food items you get from the Early Childhood Learning Center?
Please check one box for each food group listed:

Very Satisfied Satisfied Unsatisfied Very Unsatisfied

Vegetables

Fruit

Grain (bread, pasta, etc)

Protein (meat, dairy, etc)

2. Do you use all of the food you receive from the pantry?
a. Yes
b. No
3. If you DO NOT use certain food items, please list the items and provide a reason as to why you do not
use them.
____________________________________________________________________________________
____________________________________________________________________________________
4. If you do not use all of the food, what do you do with the excess?
a. Share with another family
b. Give it away
c. Other: ________________________________________________________________________
5. Do you shop for groceries at other stores? Check all that apply:
___ Supermarkets (Kroger’s, Giant Eagle, Aldi, etc)
___ Retail Stores (Target, Walmart, Meijer, etc)
___ Wholesale Stores (Costco, Sam’s Club, etc)
___ Convenience Stores
6. What type of information would be useful to you? Please check all that apply:
___ Recipes
___ Cooking videos
___ How to feed preschool children
___ Best food for brain development
___ Cooking on a budget
___ Other: ________________________________________________________________________
7. What can we do to improve the food bags that you receive?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

Survey Results (n=39)

CELC center
Broad Street 31

Main Street 8

1. How satisfied are you with the following food items you get from the Early Childhood Learning Center?
Please check one box for each food group listed:
very satisfied satisfied unsatisfied no answer

vegetables 16 18 5 0

fruit 20 15 3 1

grain 18 17 4 0

protein 20 15 4 0

2. Do you use all of the food you receive from the pantry?
yes 13

no 26

3. If you DO NOT use certain food items, please list the items and provide a reason as to why you do not
use them.
- mac & cheese (10)
- beans (1)
- trail mix (4)
- pastas/rice (5)
- dairy (2)
- canned goods (4)
- meat/tuna (9)
- sugary cereal (1)
- too much in bags/donate extra (4)
- no answer (12)

4. If you do not use all of the food, what do you do with the excess?
Share with another family 20

Give it away 20

No answer 4

5. Do you shop for groceries at other stores? Check all that apply:
supermarkets 33

retail stores 24

convenience stores 3

wholesale stores 15

no answer 5

6.What type of information would be useful to you? Please check all that apply:
recipes 28

best food for brain development 16

how to feed preschool children 8

cooking on a budget 18

cooking videos 9

no answer 7

7. What can we do to improve the food bags that you receive?


- more protein (2)
- fruit/vegetable variety (8)
- spaghetti/scalloped potatoes (2)
- household essentials (2)
- different nuts (1)
- less canned food (1)
- adjust based on child’s age (1)
- cornbread/bread/cheese (2)
- dessert/snack options (4)
- nothing/grateful (10)
- option to give extra to others (3)
- option to get extra (1)
- no answer (11)

Appendix 2. Evaluation Questions:

Did people in the community increase their knowledge about eating various types of food?

Did people have changed their behavior toward removing unwanted food as a result of this program?

What challenges did people confront as a result of implementing behavioral change toward food recipes?

Did people find the recipes easy to make and enjoyable?

Appendix 3. Recipes

Next Level Boxed Mac and Cheese


Ingredients
- box of mac and cheese
- 2 tbsp butter
- ¼ cup milk
- 1 cup shredded cheddar cheese
- ½ cup crushed crackers & 1 tbsp butter
optional add ins: garlic clove, parsley, bacon bits, broccoli, shredded chicken, spinach, cherry tomatoes
Directions
- preheat oven to 425 F
- cook noodles according to package, subtract 1-2 minutes so they can finish cooking in the oven
- drain noodles and add butter, milk, ½ of the cheese, cheese packet and any add ins in the hot stove pot,
add noodles and stir until combined
- mix crackers with 1 tbsp melted butter and set aside
- transfer mac & cheese to a buttered baking dish and sprinkle with cheese and crushed crackers, bake
for 10-15 minutes or until crackers are slightly browned
- garnish with other add ins and enjoy!

Pantry Friendly Shepherd's Pie


Ingredients
- 2 cans beef stew
- 1 can cream of mushroom soup
- 1 can peas
- 1 can diced carrots
- 1 box instant potatoes
Directions
- preheat oven to 450 F
- mix beef stew, soup, peas and carrots in a bowl and pour into a deep baking dish
- make instant potatoes according to package and spread evenly on stew mixture
- bake for 30-45 minutes or until potatoes are golden brown and stew mixture is how and enjoy!

Create Your Own Minestrone Soup


Ingredients
- onions, garlic, celery, carrots, peas, beans, zucchini, potatoes, diced tomatoes, pepper, etc (anything
you have or would like to add)
- broth (chicken, beef, vegetable)
- noodles (any kind!)
- seasoning (salt, pepper, basil, rosemary oregano, parsley, etc)
Directions
- saute onions, garlic, pepper, celery and seasonings in a large pot
- add in tomato, potato and broth and bring to a boil, simmer for 10 minutes with lid
- add in zucchini, beans, green beans, spinach and pasta, continue to simmer for 20 minutes without lid
or until pasta and greens are cooked
- add more seasoning and parmesan cheese if desired and enjoy!
References

An, Ruopeng, et al. “A Systematic Review of Food Pantry-Based Interventions in the USA: Public Health
Nutrition.” Cambridge Core, Cambridge University Press, 5 Mar. 2019,
www.cambridge.org/core/journals/public-health-nutrition/article/systematic-review-of-food-pantrybased-
interventions-in-the-usa/830BEECA6763B588234EA2E1220D02E3.

Ettinger de Cuba, Stephanie, et al. “Loss Of SNAP Is Associated With Food Insecurity And Poor Health
In Working Families With Young Children.” Health Affairs, vol. 38, no. 5, May 2019, pp. 765–73.
healthaffairs.org (Atypon), doi:10.1377/hlthaff.2018.05265.

Fuentes, Laura. “Stove Top Minestrone Soup.” Laura Fuentes, 30 Oct. 2020,
www.laurafuentes.com/vegetarian-minestrone-soup-recipe/.

“Healthy Food Initiatives in Food Pantries.” County Health Rankings & Roadmaps, 20 Dec. 2020,
www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/strategies/healthy-
food-initiatives-in-food-pantries.

McMahan, Dana. “7 Chefs Create Food Pantry Friendly Recipes.” Journal, The Courier-Journal, 28 Nov.
2016,www.courier-journal.com/story/entertainment/dining/restaurant/2016/11/28/7-chefs-create-food-
pantry-friendly-recipes/94294274/.

Perez-Escamilla, Fafael, and Rodrigo Pinheiro de Toledo Vianna. "Food Insecurity and the Behavioral
and Intellectual Development of Children: A Review of the Evidence." Journal of Applied Research on
Children 3.1 (2012): 9.

United States: Social Explorer. Social Explorer. (n.d.). https://www.socialexplorer.com/product-


maps/us_demography.

“Upgraded Boxed Mac and Cheese.” That's Tasty, www.thatstasty.com/recipe/upgraded-boxed-mac-and-


cheese/.

What Is Food Insecurity? | Feeding America. https://www.feedingamerica.org/hunger-in-america/food-


insecurity. Accessed 16 Apr. 2021.
ZIP Code 43205. ZIP Code 43205 Map, Demographics, More for Columbus, OH. (n.d.).
https://www.unitedstateszipcodes.org/43205/.

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