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 a variety of fruits and vegetables, whole grains, lean protein, healthy fats—less sodium and added sugars) as well as support functional and active aging by promoting affordable and accessible physical activity strategies guided by the Physical Activity Guidelines for Americans older adult recommendations. 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. Each session is designed to be interactive with a group discussion, goal setting, physical activity discussion, and recipe tasting. Puzzles and games in the newsletter reinforce educational content.

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

Intervention Type: Direct Education

Intervention Reach and Adoption

Fresh Conversations is designed to work with low-income and underserved SNAP-eligible adults aged 60+.

Setting: Faith-based 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. 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. Other agencies may modify materials to reflect the needs of their audience (demographic, cultural, social) including testimonials, and recipes/food sampling.

Intervention Materials

Intervention Materials:

  • Newsletters
  • Facilitator guides

Training Materials:

  • Fresh Conversations Facilitator Training
  • Implementation Guide
  • Civil Rights Training

Intervention Costs

Materials are available at no cost if no changes/edits are made to the program files.

Evidence Summary

Four manuscripts have been published from the 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.

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 ST1 ST3 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 Fresh Conversations 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:
Hailey Boudreau – Program Manager
515-782-9451
hailey.boudreau@idph.iowa.gov