A considerable number of Americans are not consuming the right amount of vegetables and fruits. As of 2013, about 13% of the entire USA population was consuming the required daily intake of fruits (one and a half to cups) and 9% consuming the recommended vegetables daily intake (two to three cups daily) (Hamilton,2017). It shows that more than 85% of the entire USA population is not meeting the daily recommended intake of fruits and vegetates. Nonetheless, the most affected population is the low-income individuals for they do not have the income that can help them purchase the fruits and vegetables. It has left the population vulnerable to some types of cancer, type 2 diabetes a cardiovascular disease (Hamilton, 2017). In order to meet their daily intake of food, the low-income population has been forced to seek assistance from the various food stamp programs that have been organized by the federal government. According to a 2000 survey, about 50% of all the food-insecure households were part of at least one food stamp program (Berner& O’Brien, 2004). However, over the years, there has been an increased decline in the number of participants in the food stamp programs. In North Carolina, there was a 6.12% decline in food stamp participation (Berner & O’ Brien, 2004). Additionally, there has similarly been a tremendous decline in the federal allocated budgets towards the food stamp programs. As a result, a substantial number of people have turned to private programs that offer food stamp assistance. It is therefore evident that the role of emergency food providers in the USA has been growing tremendously as low-income individuals seek nutritional aid. However, this growing role of EFP can have severe implications, and there is a need to come up with programs that will support evidence-based nutrition education and prevention of obesity for all the people eligible for EFP nutritional assistance.
The rationale for the Evaluation
According to Rigdon et al. (2017), one in every seven Americans is part of Supplementary Nutrition Assistance Program. The principal aim of this program is to ensure that all Americans from the low-income brackets can get access to highly nutritious and a well-balanced diet. Nonetheless, Rigdon et al. (2017) state that there is a direct relationship between the SNAP participation and burden of nutrition-related diseases such as obesity. It is further supported by previous studies conducted by Leung & Villamor (2011), they have been able to link an increased body mass index and SNAP participation. Obesity has over the years grown to become a significant economic burden not only in the USA but the entire globe. In the USA, about two-thirds of the population is regarded as being overweight while the remaining one-third is obese. The most negative economic impact results from an increased healthcare cost spending arising from the fact that, obesity lays down a foundation for the emergence of other severe and chronic illnesses such as arthritis, asthma, coronary heart diseases, hypercholesterolemia, type 2 diabetes, and hypertension. As obesity levels increase, so does the associated medical spending in managing these chronic illnesses (Hammond & Levine, 2010). Therefore, with the SNAP programs helping out millions of low-income individuals, it is highly likely they are putting them at even more risks of serious health-related conditions. It is therefore vital for the SNAP participants and programs to be equipped with evidence-based nutrition education and obesity prevention strategies that will ensure that the beneficiaries can lead a healthy life free from obesity and its risk factors.
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Theoretical Model Underlying the Intervention
According to Subramain (2015), most of the nutritional educators training programs have minimal theoretical frameworks that can be used in gauging the effectiveness of the programs. However, the SPAP-Ed programs are one that can ensure all the participants of the SNAP can lead healthier lives. In the case of this intervention, the theoretical framework that will be used in evaluating the intervention is one based on the New World Kirkpatrick Model (Subramain, 2015) . The conceptual framework will be used in assessing whether the intervention is effective in solving the populations’ problem. In order to come up with a program that will surpass all stakeholders’ expectations, it is only right if it is evaluated according to the four-step Kirkpatrick learning model; reaction, learning, behavior, and results.
According to the reaction step, it is used in determining the nutritional educator’s reaction to the entire training (Subramain, 2015). It is the only vita for one to determine how they felt in relation to the intervention’s strategies. In order to assess their satisfaction rates, it is vital to look at their levels of relevance and engagement. The engagement is determined by the active participation of the educators in the program at this moment they can seek clarifications, ask questions and contribute to the entire learning intervention. Additionally, the relevance is determined by the educators putting into practice the goals of the intervention towards ensuring the population will have optimum nutrition and health.
The learning step is used in determining the effectiveness and entire success of the program. In most cases, an intervention must have a set of learning objectives (Subramain, 2015) . It is based on the levels of skills, knowledge, attitude confidence and commitment the educators will have in ensuring the entire intervention is a success. The behavior step is undertaken several weeks after the program has been implemented (Subramain, 2015) . This is through observing whether the educators have changed in relation to their performance metrics and whether they are using the acquired knowledge and skills in convincing the population about ways of following a healthy life as they use the SNAPs. The results phase is the final step, and this is whereby the outcomes of the entire intervention are determined. (Subramain, 2015). This is by assessing whether the program was successful and if it has delivered tangible results.
Findings of Prior Studies Evaluating Outcomes of the Intervention
According to Molnar et al. (2001), there has been a tremendous increase in the number of people who seek food assistance form private food assistance programs. Nonetheless, according to a study conducted in East Alabama, the food programs cannot distribute sufficient food to the individuals and their families, and this affects their overall nutrition intake. The most vital factors are that the food programs will continue to become a critical source of assistance for these people and thus there is a need to ensure that they can cover all the food needs of the population. This can only be made possible through ensuring that the policymakers ’ ad members of the general public including the SNAPs understand the situations of food bank users. It will enable them to set policies and interventions that can positively impact the well-being of the vulnerable populations relying on the food stamp programs.
Additionally, according to a study conducted by Hamilton (2017) on the impacts of P2P and how they can be made successful, they found out that increased education of the nutritional educator and participants was vital. This is similar to the SNAP intervention whereby there is a need to ensure that the educators and participants need to be provided with information regarding how to live a healthy life and this will enable them to make healthy lifestyle choices thus reducing the disease burdens brought about by poor nutrition. Additionally, according to a study conducted in North Carolina, it was able to find out that having limited access to healthy foods is associated with poor health outcomes (McGuirt, 2016). As a result, there are a variety of programs that aim at supporting this population in meeting their daily nutritional needs. However, according to McGuirt (2016), an integration of Community Supported Agriculture program within existing programs will ensure that they increase their overall outcomes by improving the nutritional needs of their customers.
Limitations in Existing Research
According to the aim of the intervention, it is to ensure that it promotes complimentary direct education, community, public health and multi-level interventions that will improve the nutritional intake and overall health of individuals who use food stamps. This has been supported by various researches such as Berner & O’Brien (2004), Hamilton (2017), Leung & Villamor (2011), McGuirt (2016 and Ridgon et al. (2017). Nonetheless, the major imitation against the findings of these studies arises from the fact that researchers did not account for prior social conditions that might have led to the development of nutritional disorders such as obesity before the participants joined the SNAPs. The participants might have had prior food insecurities that made them engage in obesogenic variations in diet and encouraged them to sign up in SNAP.
Berner, M., & O’Brien, K. (2004). The shifting pattern of food security support: food stamp and food bank usage in North Carolina. Nonprofit and voluntary sector quarterly , 33 (4), 655-672.
Hamilton, D. (2017). Increasing Farmers Market Access among Low-Income Shoppers in Washington State: Understanding the Role of Peer-to-Peer Programs (Doctoral dissertation). University of Washington, Washington, USA.
Hammond, R. A., & Levine, R. (2010). The economic impact of obesity in the United States. Diabetes, metabolic syndrome, and obesity: targets and therapy , 3 , 285.
Leung, C.W., & Villamor, E. (2011). Is participation in food and income assistance programmes associated with obesity in California adults? Results from a state-wide survey. Public Health Nutr . 14, 645e652. doi: https://doi.org/10.1017/S1368980010002090
McGuirt, J. (2016). Formative Evaluation of a Food Access Enhanced Nutrition Education Program
Molnar, J. J., Duffy, P. A., Claxton, L., & Bailey, C. (2001). Private food assistance in a small metropolitan area: Urban resources and rural needs. J. Soc. & Soc. Welfare , 28 , 187.
Rigdon, J., Berkowitz, S. A., Seligman, H. K., & Basu, S. (2017). Re-evaluating associations between the Supplemental Nutrition Assistance Program participation and body mass index in the context of unmeasured confounders. Social Science & Medicine , 192 , 112-124.
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