This Month Remember to Thank a Georgia Farmer for Feeding the World

By Mary Virginia Coffman

It's hard enough to be food insecure without also developing a chronic illness. The least expensive foods often undermine health, contributing to diet-related diseases such as diabetes, high blood pressure, weight imbalances (too high or low), and heart disease. The stress of not knowing if you can feed your family makes the diseases worse. Enter Wholesome Wave Georgia's Georgia Food for Health program, which "provides food insecure households with diet-related illnesses nutrition education and fresh food prescriptions redeemable at participating local produce retailers."

Launched in 2015, the Georgia Food for Health program has partnered with several sites, including the Food as Real Medicine Rx, or FARM-Rx, program in Athens, Georgia since 2017. The FARM-Rx team consists of leaders from Wholesome Wave Georgia, the Athens Farmers Market, Mercy Health Center, and Athens Cooperative Extension.

Erica Sanchez, the Mercy Health Center lead, exudes, "Our patients are able to get access to food and education that they wouldn't have had access to before. It's not just the resources, but the community rallying around this one common cause that's my favorite! I've never seen so many community agencies in unison before."

Georgia Food For Health Serves Athens Food insecure households under FARM-RX

FARM-Rx works with food-insecure families with diet-related illnesses to provide virtual health classes during the 2020 and 2021 program seasons to accommodate the pandemic. Photo credit: Jackie Dallas

Monica Bledsoe, who coordinates FARM-Rx at the Athens Farmers Market, explains that Wholesome Wave Georgia partners with the program in two ways. First, they provide funding for supplies, transportation, and the produce prescriptions.

Secondly, Wholesome Wave Georgia performs a needs assessment, designs the program guidelines, and evaluates the program when it ends. Along with identifying diet-related health conditions, they uncover unexpected needs. Erica observes, "If people need electricity," then they won't have refrigeration for perishable foods. "To have Wholesome Wave Georgia steer the macro side of the program while we [do] the more day to day tasks" allows the program to thrive. "They were just incredible."

Athens' FARM-Rx program is tightly woven through partnerships. Following the guidelines, Mercy Health Center identifies the participants, tracks targeted metabolic medical factors before and after the program, and writes vegetable and fruit prescriptions. Participants take the prescriptions, worth $1.00 per family member per day, to the Athens Farmers Market, where they can redeem them for farm fresh produce. The Athens Cooperative Extension teaches six weekly culinary education classes and six monthly wellness education classes. "We make sure to feed the entire family through these guidelines," says Monica.

The Extension provides a number of valuable print and digital resources, including recipe cards, blogs, and videos. Photo Credit: Jackie Dallas

Jackie Dallas, the FARM-Rx lead at the Cooperative Extension explains, "we are helping people understand the relationship between having a healthy lifestyle and preventing chronic disease or managing a disease diagnosis." The participants learn that, "their personal efforts are the medicine."

The classes have proven very popular. Recipes have flavors from around the world and a Georgia flare. The Extension provides a number of valuable resources, including recipe cards, blogs, and videos of "traditional recipes made in a healthier way," says Monica.

"We have seen a decrease in food insecurity, an increase in consumption of fruits and vegetables, and this last year we saw some exciting clinical results, which is all the more amazing given that they are also coping with the pandemic," says Jackie. "That's what we're ultimately trying to do: make small changes that lead to bigger changes."

Erica observes that because of the classes, "I see [the participants] being more confident in their ability to take care of themselves. They are building self-efficacy and they are improving their health literacy."

Adopting Virtual Programming With The Pandemic

This innovative program had to pivot on a dime when the COVID-19 pandemic arrived in Georgia.

"All of our classes went from in person to being completely online," says Monica. "For a participant to be eligible for the program they needed to be able to watch the classes through a phone or a computer at home." Citing the needs assessment, she observes, "luckily, our research showed that a lot of families do have access to a smart phone."

Usually participants shop at the Athens Farmers Market. During the 2020 program, Monica explains, "we partnered with a local CSA (community supported agriculture) called Collective Harvest [that] sources from a lot of the farms that sell at the farmers market. We offered both a contactless pickup and a delivery option."

The FARM-Rx program in 2020 and 2021 provided contactless pickup and delivery for CSA boxes of fresh produce sourced from local farms. Photo Credit: Monica Bledsoe

The challenges of the pandemic brought some silver linings. "The convenience the CSA offered with their cold storage and multiple days of operation actually helped the program!" says Monica. "We saw that our participants had a 97% redemption rate for fruits and vegetables." It worked so well, "we plan to continue it this year."

Even so, she continues, "One of our goals for the 2021 program is to make market visits to be more of a habit with the participants. We want them to come out with their families, have a good time, get to know the farmers, and see all the produce."

Jackie notes the creative resilience of her SNAP-Ed health and wellness educators. "My three assistants were 100% all in even though they had never done a food demonstration on camera. The participants could see that these ladies were invested" in their success. The teachers "always interacted with everyone through every class even though there were a lot of things to juggle." The summer of 2021, "we will be 100% virtual again" because chronic disease makes COVID-19 risky for the participants.

The CSA boxes meant the participants weren't choosing their own produce, and they provided some surprises! Jackie saw an opportunity. "We were able to offer some bonus [class] sessions," says Jackie. "What's in your CSA box that you don't know? We were able to have a more interactive discussion. We taught how to cook [the new vegetable] and the nutritional value." Participants reported that the experience made them more adventurous with their produce choices.

Farm-rx's Impact on Chronic Illness

2020 FARM-Rx participants learned how to make nutritious and delicious meals with fresh ingredients like these tacos. Photo Credit: Jackie Dallas

The health outcomes of the 2020 FARM-Rx program were extremely satisfying.

Erica reports that, "we were mainly targeting diabetes as a chronic illness. Last year we had the goal of seeing people with an A1C of over 14% fall below 7%. They didn't just do that, they fell out of the diabetic range completely, so they were down to 5.9%! [Some] people who had diabetes went down below prediabetes [levels]. Someone fell to 4.3%!"

"One of the participants is a woman who has struggled with being underweight [and malnourished] her whole life because she couldn't afford enough food," says Monica. "Through the nutritional guidance of our health courses she was able to put on weight successfully and affordably." Erica exclaimed, "She put on 10 pounds! It was incredible to see."

Creating Community in COVID-19

Participants are asked to report on their experience during the evaluation. Their comments revealed something that delighted the team.

"The shared purpose was an additional benefit they received," Monica says. "They'd see each other at Mercy Health [for program checkups] and recognize each other [from Zoom calls]. That was really helpful especially during a time when there was a lot of fear about connecting with other people [because of COVID-19]. Being able to have that in a safe space was just a really good benefit."

FARM-Rx program participants in 2020 learned more about fruits and vegetables and enjoyed the virtual camaraderie with their peers. Photo Credit: Jackie Dallas

Jackie's voice held well deserved pride. "We had the highest retention rate and the highest redemption rate in the state for [the 2020] program. We had a very positive set of medical outcomes."

She marveled at the biggest impact of the program. "The thing that people learned the most was information about fruits and vegetables, what they should eat, how they should prepare them. But their answer for what they got out of it the most was a sense of community. It was a really nice takeaway for us that this was the most important thing."

What's next for farm-Rx

Monica, Jackie, and Erica spoke excitedly about the 2021 program, which kicked off May 15. Erica is thrilled. "This year we will be in peak farm and farmers market hours and months!"

Monica sums it up. "Wholesome Wave Georgia has provided funding for up to 50 participants, and the Athens Farmers Market has matched that funding. We will be able to host up to 100 participants this year. For the fifth year we will be five times bigger!"

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Source: https://www.wholesomewavegeorgia.org/blog/farmrx

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