Healthy for Life Community Nutrition Program (HFL)

American Heart Association

Overview

The Healthy for Life (HFL) Community Nutrition Program is direct education designed to change relationships with food and nutrition by inspiring individuals and families to make healthy food choices part of their everyday lives. It was designed from the community engagement model, emphasizing participants’ contribution in refining the program. Also, community fit was ensured through the consideration of existing programs along with the target population and facilitator capabilities. Program material was designed to be culturally relevant and facilitators should connect and establish a reciprocal sense of trust and respect among participants. The materials are flexible and can accommodate individuals with time constraints, limited budgets, and minimal nutrition knowledge. The program aims to improve participant confidence and attitudes to sustain healthy behavior change. The recommendation is to offer at least four educational experiences, over 2-3 months to equips individuals with the knowledge, skills, and confidence to discover, choose, and prepare healthy food. Through facilitated food discovery experiences, participants will build food literacy to improve their health.  

Target Behavior: Healthy Eating  
Intervention Type: Direct Education 

Intervention Reach and Adoption

Healthy for Life targets communities with the greatest need in a variety of settings. To date, the program has been implemented by more than 70 community-based organizations. The program aims to empower communities by providing community-based organizations with impactful, science-based educational experiences to ultimately equip individuals with the skills and confidence to shop and prepare healthy home cooked meals. Participants in the program during the initial year (2016) were predominately female, Hispanic or African Americanlower income, younger than 34 years old, had high school or lower educational attainment, and had two or more children living in their household.  

Setting: Community (Live), Faith-based community, Food pantries, Health care, Worksite (Work).  
Target Audience: Middle School, High School, Parents/Mothers/Fathers, Adults, Older Adults 
Race/Ethnicity: African American, White 

Intervention Components

Healthy for Life enables community organizations to equip individuals with the skills to make healthy changes using a train-the-trainer model. Lessons are structured to provide experiences and exposure to healthier foods and habits (tastings, grocery store tours, hands-on skills practice) while improving key behaviors (such as budgeting, cooking and grocery shopping). HFL equips participants with the knowledge, skills, and confidence to discover, choose, and prepare healthy food. The recommendation is to offer at least four educational experiences, within 2-3 months (preferably every two weeks). The facilitator may select any of the educational materials which are grouped into themes: Your Well-being, Cooking Skills & Food, Grocery Shopping, Gardening in Your Neighborhood, Globally Inspired Home Cooking, and Growing Healthy Habits. Each theme includes several individual educational experiences, with 30+ currently provided across the themes. 

Intervention Materials

The lessons provide exposure to healthier foods and habits while improving key behaviors. The materials are grouped into themes: Your Well-being, Cooking Skills & Food, Grocery Shopping, Gardening in Your Neighborhood, Globally Inspired Home Cooking, and Growing Healthy Habits. Each theme includes several individual educational experiences. All the experiences contain a facilitator guide, demonstrations, handouts, and videos. Materials are available in English and Spanish. 

For more information about the materials included with the HFL, visit: heart.org/healthyforlife 

Intervention Costs

Materials available at no cost. However, tools need to be requested and reviewed for potential use by American Heart Association’s Center for Health Metrics and Evaluation. 

Evidence Summary

The AHA Center for Health Metrics and Evaluation (CHME) assessed whether the HFL curriculum positively impacts the targeted population by evaluating changes in participant confidence to shop for and prepare healthy foods, frequency of healthy shopping behaviors, and consumption of healthy foods through a pre-post study design. Additionally, CHME developed one-minute surveys to determine if the experiences met the learning objectives of each respective lesson. Focus groups were also held at select community-based organizations to gather qualitative participant feedback regarding the Healthy for Life educational experiences. A total of seven focus groups were conducted during August and September of 2017. Each focus group represented a different demographic of Healthy for Life’s target population. Recordings of the focus group discussions were analyzed to detect pertinent themes among responses. Many participants positively discussed learning how to incorporate healthier foods in their diets, utilize healthier preparation methods, and read nutrition labels. 

In 2019, surveys of 418 Healthy for Life participants assessed changes in participant confidence in the preparation of healthy foods at home, consumption of fruits, vegetables and whole grains, and frequency of healthy shopping habits over time. Pre-post survey results indicate that participants benefitted from the Healthy for Life curriculum. Key findings include:  

  • On average, respondents increased their daily fruit & vegetable consumption by 0.43 serving(s).  
  • Almost half (44%) of participants increased their daily fruit and vegetable consumption by 1 or more servings.  
  • 34% of respondents increased their level of confidence to substitute healthier cooking and food preparation methods  
  • 37.5% of respondents increased their level of confidence to eat the recommended serving sizes 
  • 30.1% of respondents reported increased frequency of reading food labels and checking the nutritional values when purchasing food.  

Evidence-based Approach: Practice-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, MT2
Environmental Settings
Sectors of Influence

MT1: Healthy Eating 

  • MT1j31% of participants increased their daily whole grain consumption by one or more servings 
  • MT1l: 40% of participants increased their daily fruit consumption by one or more servings 
  • MT1m: 33% of participants increased their daily vegetable consumption by one or more servings 

MT2: Food Resource Management 

  • MT2b: 31% reported increased frequency of reading food labels and checking the nutritional values when  purchasing food 
  • MT2m30% increased their level of confidence to prepare healthy meals at home 

Evaluation Materials

The Healthy for Life evaluation tools include a pre/post survey to assess changes in participant confidence to prepare healthy foods at homefrequency of healthy shopping behaviors, and consumption of fruits and vegetables. 

The Healthy for Life evaluation survey should be administered at the beginning of the first educational experience and then again at the end of final experience or every three months following the first educational experience.

Additional Information

Website: The Healthy for Life website (www.heart.org/healthyforlife) includes more about the HFL Community Nutrition Program and other health topics and resources. 

Contact Person(s):
Heather Gavras  
Phone: 630-561-5545
Emailheather.gavras@heart.org or healthyforlife@heart.org