Fresh Conversations

Iowa Department of Public Health

Overview

Fresh Conversations (FC) is a direct education, newsletter-based intervention for seniors. FC targets behaviors known to reduce chronic disease burden and promote healthy aging. It promotes healthier food and beverage choices across food groups to move closer to Dietary Guidelines for Americans (eat variety of fruits and vegetables, whole grains, lean protein, healthy fats—less sodium and added sugars). Participants meet monthly for 30-45 minute interactive sessions led by a trained facilitator. Each participant receives a 4-page newsletter. Facilitators use a companion facilitator guide with behavioral objectives, key nutrition messages, facilitation dialogue, activities and recipe tasting options. Physical activity demos are part of each meeting. Each session is designed to be interactive with a group discussion, goal setting, physical activity break, and recipe tasting. Puzzles and games in newsletter reinforce educational content.

Target Behavior:  Healthy Eating, Physical Activity and Reducing Screen Time

Intervention Type: Direct Education

Intervention Reach and Adoption

FC targets low-income and underserved SNAP-eligible seniors at Area Agencies on Aging (AAA) congregate meal sites and senior housing apartments.

Setting: Community; Other: AAA congregate meal/dining sites, senior housing

Target Audience: Older Adults

Race/Ethnicity: American Indian or Alaskan Native, Asian, Black or African American, White, Hispanic/Latino, Non-Hispanic/Latino.

Intervention Components

FC includes newsletters and facilitation guides, which include optional activities. Food tasting/sampling is considered essential along with goal setting (action steps–small steps, big results). Interactive facilitation is key to program success. Training video and manual demonstrate “likability” factor for facilitators and desired participant experience. Physical activity demonstrations are recommended at each meeting. Other agencies may modify materials to reflect the needs of their senior audience (demographic, cultural, social) including testimonials, and recipes/food sampling.

Intervention Materials

Intervention Materials:

  • Newsletters
  • Facilitator guides

Training Materials:

Intervention Materials

Materials are available at not cost if no changes/edits are made to the program files.

Evidence Summary

Four manuscripts have been published from FC program. Significant results reported in 2011 pilot study (nutritional risk and dietary frequency) and 2015 impact study (nutritional risk). Both used a validated tool for older adults (Dietary Screening Tool or DST) that was tested with an older demographic, similar to congregate meal participants in Iowa. Nutritional risk score does not fit neatly with MT1 but other data were provided for indicators. The DST will be used again in a repeat impact study planned for 2020. SNAP-Ed programs using FC are encouraged to include DST in their evaluation.

Evidence-based Approach: Research-tested

Evaluation Indicators

Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.

Readiness and Capacity – Short Term (ST) Changes – Medium Term (MT) Effectiveness and Maintenance – Long Term (LT) Population Results (R)
Individual MT1, MT3, MT4
Environmental Settings
Sectors of Influence
  • MT1c: A 2018 survey revealed 82.1% of FC participants agreed to strongly agreed that FC helped them eat more than one fruit daily. A 2015 impact study showed moderate intake frequency of fruits.
  • MT1d: A 2018 survey revealed 82.3% of FC participants agreed to strongly agreed that FC helped them eat more than one fruit daily; A 2015 impact study showed moderate intake frequency of vegetables
  • MT1f: A 2018 survey revealed 61.7% of FC participants agreed to strongly agreed that they used MyPlate to make food choices
  • MT1h: A 2018 survey revealed 77.8% of FC participants agreed to strongly agreed that FC helped them drink fewer beverages with added sugar
  • MT1i: A 2018 survey revealed 71.3% of FC participants agreed to strongly agreed that FC helped them consume dairy and/or soy products daily; a 2015 impact study found high dietary intake frequencies of dairy
  • MT1j: A 2018 survey revealed 75.1% of FC participants agreed to strongly agreed that FC helped them consume fewer refined grains; a 2015 impact study found moderate dietary intake frequencies of total and whole grains
  • MT1k: A 2018 survey revealed 73.7% of FC participants agreed to strongly agreed that FC helped them consume less refined sugar; a 2015 impact study found moderate dietary intake frequencies of added fats, sugars and sweets
  • MT3a: A 2018 survey revealed 79.6% of FC participants agreed to strongly agreed that FC helped them be more physically active.
  • MT4a: A 2015 impact study found the majority of FC participants washed their hands when working with food
  • MT4b: A 2015 impact study found the majority of FC participants used separate cutting boards for produce and meats, and washed their cutting boards in between uses.

Evaluation Materials

  • Pre (baseline), Mid (4 months), and Post (8 months) Questionnaire with sociodemographic questions and the following validated tools/scales:
    • Dietary Screening Tool (Bailey et.al, 2009 and 2007)
    • Nutrition self-efficacy scale (Schwarzer & Renner, 2000)
    • Multidimensional Outcome Expectations for Exercise Scale (Wójcicki et al, 2009)
    • Self-Efficacy for Exercise Scale (Resnick et al, 2000)
    • Food Safety Quiz (Cooperative Extension Service, 2014)
    • US Household Food Security Survey Module: Six-Item Short Form (ERS, 2014)
  • FC evaluation and satisfaction survey (created by team)
  • Facilitator interview and PA focus group guides
  • Fidelity checklist (created by team)
  • Theoretical construct validity reviews of newsletters and guides (created by team)

Additional Information

Website: The FC website (http://idph.iowa.gov/inn/fresh-conversations) includes a description of the program, as well as training materials, resources, and promotional materials.

Contact Person:
Doris Montgomery
(515) 661-7913
doris.montgomery@idph.iowa.gov