Create Better Health (Utah SNAP-Ed) adapted the Thumbs Up nudge program, titled Create Healthy Choices (CHC), to better partner with rural food pantries and extend the impact of the program through online training videos. The CHC program is designed to use marketing strategies to encourage consumers to select healthier food items in pantry and retail settings. While this program worked well in urban pantries, there were barriers to its implementation in rural settings. Barriers included rare and unique distribution times and dates, limited staff size, and resource allocation. To address this issue, the project team conducted formative evaluation through interviews with eight rural food pantry managers and four focus groups with food pantry clients.
Evaluation findings guided updates to the CHC toolkit and the creation of short training videos on how to implement the program. Through a partnership with Utah State Department of Health, the Thumbs Up nudge program materials were translated into a variety of languages, including Spanish, Arabic, Dari, Farsi, French, and Somali. The toolkit and videos were disseminated to Create Better Health staff and program partners through training and the staff website.
Results and Key Findings
Utah State University County Extension faculty and Create Better Health staff assisted with recruitment of focus group participants and supported use of the adapted program in rural and urban pantries. On-campus faculty led research efforts and supervised the student and program coordinators who helped with research, toolkit adaptations, video production, and program dissemination.
Qualitative data analysis of the interviews and focus groups resulted in five considerations for improving the efficacy of CHC in rural pantry settings.
- Support the capacity of food pantries to receive and distribute healthy food options.
- Provide materials in Spanish.
- Support pantries in recruiting and training volunteers to help with understaffing.
- Work with partners to increase healthy food donations.
- Provide healthy recipes and cooking demonstrations highlighting less familiar pantry ingredients.
The project resulted in a formative research report which identified opportunities to adapt the CHC program to better accommodate the logistics of rural pantries and needs of their clients. Findings from this research report led to the creation of the CHC Toolkit. The toolkit can be found on the Create Better Health Staff Website and the USDA SNAP-Ed Toolkit website. In response to the findings, the research team added content to the toolkit aimed to connect pantries with partners who could help obtain funding for equipment and other resources not available through Create Better Health. The toolkit also provides a variety of options for healthy food drives and continues to encourage sharing healthy recipes, food demonstrations, and samples.
In response to the statewide need to serve the growing Latino population, which was noted in the findings, Create Better Health hired additional Spanish-speaking staff and a full-time Latino Programming Coordinator to help ensure materials in all program areas, including CHC, are translated and culturally relevant for the Hispanic/Latino audience.
To support pantry volunteers, new training videos were made available to pantry workers, volunteers, and partners. Five short videos were published on YouTube and shared under Partner Resources tab on the Create Better Health Staff website.
The CHC Toolkit was introduced statewide to Create Better Health staff in 2022. During the grant period, COVID-19 impacted how many urban pantries provided food to clients. This made the new toolkit useful in both urban and rural locations. In 2022, 43 pantries participated in the program including 21 new pantries. The program reached over 54,000 Utahns who visited the pantries during that time.
Additionally, a new assessment tool, adapted from Illinois Extension’s Nutrition Environment Food Pantry Assessment Tool, was added to the toolkit to help guide intervention recommendations. This tool helped track improvements toward healthy food access and education by providing a list of questions and observations to analyze the food environment. The Nutrition Environment Food Pantry Assessment Tool can be viewed on the Create Healthy Choices project resources page (PDF, 479KB).
A Create Healthy Choice Pantry Pick List was also added to provide pantry managers and Create Better Health staff with specific interventions focused on increasing healthy food choices.
- Fifty percent of pantries improved their baseline assessment scores by at least 3 points in 2022.
- Twenty-six pantries continued using Create Healthy Choices strategies, such as nudges and meal kits, after three months.
- Sixteen pantries benefited in periodic healthy food drives or garden donations but have yet to use nudges and other components of the toolkit.
- One pantry participated in a base assessment but did not implement other changes.
Due to the COVID-19 pandemic, food security became a focus for many public health organizations and agencies. The training videos developed for this project became a key tool to support the Utah Department of Health and Human Services, which adopted the Create Healthy Choices Toolkit and implemented the program in 16 food pantries including 7 new partner pantries. As of January 10, 2023, the training videos have 1,176 total views.
As SNAP-Ed programs seek to improve the availability, visibility, and appeal of healthy options in food pantries, Create Healthy Choices (Thumbs Up) provides useful information and a possible roadmap. It increases the selection of targeted, more nutritious items by food pantry patrons.
See more information about the Create Healthy Choices program