Create Healthy Choices: Thumbs Up for Healthy Choices – Food Pantries (Thumbs Up) is a policy, systems, and environment (PSE) change intervention designed to improve the visibility and appeal of healthy choices for pantry users, leading to an increased selection of these healthy choices. Thumbs Up utilizes low-cost nudge strategies to make healthy choices easier in pantries. Prior to implementing Thumbs Up, educators evaluate the pantry’s readiness for change by conducting a baseline assessment using an adapted version of Illinois Extension’s Nutrition Environment Food Pantry Assessment Tool (NEFPAT). Once the baseline is established, educators work with pantries to identify areas the pantry management is interested in improving. Educators then use nutrition criteria outlined in the toolkit to identify foods that are low in sodium, added sugar, and saturated fat. At the end of a pantry’s partnership with SNAP-Ed, or the end of the fiscal year, the NEFPAT is used again to track changes made to improve the visibility and appeal of healthy items.
Target Behavior: Healthy Eating
Intervention Type: PSE Change
Intervention Reach and Adoption
Thumbs Up is designed for food pantry clients at client-choice food pantries. Client-choice food pantries allow pantry users to go through the pantry and select the items they would like. During FY 2018, 24 food pantries in Utah partnered with 13 SNAP-Ed educators to implement the program which represents 18% of total pantries, not necessarily client-choice pantries, statewide. There are approximately 135 food pantries in Utah. Most food pantries in Utah have income-based eligibility requirements. While requirements vary, the majority of pantry users are < 185% of the poverty level. The program also has some intervention recommendations for pantries that are not client-choice food pantries.
Setting: Food pantries
Target Audience: Homeless/Food Pantry Clients
Thumbs Up includes a toolkit, an environmental assessment tool, shelf labels, and other printed materials used to nudge pantry users to make healthy choices and promote the program. These intervention components help make the healthy choice the easy choice in pantries by improving their visibility and appeal. Core components include the toolkit, which contains the essential nutrition guidelines, the shelf labels, and an environmental scan tool. The large banners and client handouts, as well as regular education booths, are also critical to increase awareness and improve the impact of Thumbs Up. The best practice for pantry user education is waiting area booths where people can learn about the Thumbs Up program and taste a sample of a recipe created using available healthy foods. The NEFPAT environmental scan tool tracks changes that result from Thumbs Up, but other pantry based scans can be used. Educators are encouraged to use results from the baseline scan to work with pantry managers to determine what changes they would like to start with. If pantries are lacking healthy options, conducting complimentary healthy food drives is encouraged. Nutrition criteria for Thumbs Up are based on Feeding America’s Foods 2 Encourage (F2E).
All intervention materials are available electronically at no cost. Materials include:
- Thumbs Up for Healthy Choices Toolkit – includes nutrition criteria, product placement suggestions, description of all the available nudge and promotional materials
- Printable files for shelf labels, posters, banners, handouts
- Nudge and promotional materials
- Modified Nutrition Environment Food Pantry Assessment Tool
Materials available at no cost.
Needs assessments are conducted bi-annually with Thumbs Up pantries. The Nutrition Environment Food Pantry Assessment Tool is used to identify and track changes in healthy food access pre- and post-intervention. In FY 2018, 24 food pantries (18% of food pantries in Utah) made at least one change in writing or practice to expand access or improve appeal for healthy eating. Nutrition supports adopted included the use of shelf labels to identify healthy items, changes in food donation toward healthier food, improved appeal, layout or display of healthy foods, and increases in fresh produce offerings. A one-time outcome evaluation of pantry users’ selection and use of targeted products was also conducted. Ninety-four percent of clients familiar with the program (n=158) agreed Thumbs Up made it easier to make healthy choices in the pantry. Sixty-five percent reported they ate healthier since the program started, and 68% reported their family ate healthier. Sixty-nine percent agreed they were more likely to choose an unfamiliar food with a Thumbs Up label.
Additional Thumbs Up publications can be found online:
● Thumbs Up for Health Choices: Making the Healthy Choice, the Easy Choice in Utah’s Food Pantries
● Promoting Client Nutrition in Urban Utah Food Pantries
Evidence-based Approach: Practice-tested
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)|
|Sectors of Influence|
- ST5: 6 SNAP-Ed trainings conducted in FY 2018 and 2019
- ST5b: 24 pantries in FY 2018 with an identified need for improving access or creating appeal for nutrition and physical activity supports
- MT5a: 24 sites, 18% of pantries in Utah, made at least one change in writing or practice to expand access or improve appeal for healthy eating
- MT5d: 42 environmental changes
- MT5e: 9 promotional efforts for a PSE change
- MT5f: 33,213 individuals reach (estimated)
A modified version of the Nutrition Environment Food Pantry Assessment Tool (NEFPAT) by Illinois Extension is used for assessment of Thumbs Up and is available online in print format. Permission was granted to make changes to the tool to reflect the specific implementation of the Thumbs Up program. NEFPAT is used to track changes to the physical environment.
Website: The Create Better Health website includes information on Utah State University Extension’s Create Better Health Utah (SNAP-Ed) program including ways to plan, cook, and eat healthy meals, as well as move more.