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1
Dr. Tia HendersonUpstream Public Health
The HIA Scoping Process & Stakeholder Engagement:Lessons from the Oregon Farm to School and School Garden Policy HIA
Presentation Overview
Policy descriptionStakeholder engagementScopingLessons learned
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What is “Farm to School”?
Programs include at least one:Procure local foods (“local” = produced or processed in Oregon)Education that includes foods, agriculture, or nutrition, usually in gardensPromotional materials on local foods and nutrition
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Oregon HB 2800Oregon HB 2800
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Introduced: $22.6 million Economic Development funds
Components:Reimbursement ProgramLunch – 15 centsBreakfast – 7 cents
Competitive Education Grants150 gardens
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Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
World Health Organization
How will HB 2800 affect Oregonians’ health?
HIA Goals
1. Inform Oregon legislative decision process2. Outline linkages & magnitude of
interactions between the policy and health outcomes
3. Inform agency work plans4. Inform regional institutional procurement
efforts5. Create model F2SSG state-wide policy HIA
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F2SSG HIA Stakeholder Engagement
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Assessment
Reporting
Evaluation, Monitoring
Recommendations
Screening
Scoping
2 Advisory Committees
Key Informant InterviewsNetwork Survey
2 Community Forums
Communications Workshop
HB 2800 Policy & Health Determinants
How does the proposed policy
and lead to health
outcomes?
Social Capital
Diet and Nutrition
Employment
affect health determinant
s
Environmental Health
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F2SSG K-12 Education
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Screening
Scoping
Assessment
Recommendations
Reporting
Monitoring & Evaluation
Stakeholder Input in the Scoping Process
Research Team – 1st draft
Advisory Committees – expanded, revised, prioritized
Survey – Oregon F2SSG Network confirmed, finalized
Committee Edits to Rough Scope
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Research Team Condense Scope
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Reimburse School
Districts
Food, Garden
& Agricult
ure Educati
on Grant Progra
m
Student gardening
Food activities in gardens, classroom & cafeteria
School promotion of new local options
Environmental Health Outcomes
F2SSG K-12 Education Program Outcomes
HB 2800 Components & HIA Scope:
Health Determinant Pathways Summary School
districts’ purchase of Oregon food School menu options
Employment Outcomes
Social Capital Outcomes
Diet & Nutrition Outcomes
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Policy Health Outcomes
Direct Impacts Intermediate Outcomes
Committee Scope Prioritization, Part 1
Pathway Criteria:Most directly affected by policyAffect groups most impacted by policyInclude vulnerable populations affected by policy
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Health Outcomes
Intermediate Outcomes
Diet & Nutrition Outcomes
1
F2SSG K-12 Education Program Outcomes
2
Employment Outcomes
2
Social Capital Outcomes
4
Environmental Health Outcomes
3
School district purchase of Oregon food
Youth consumption of fat, sodium, sugar
Youth consumption of fruits and vegetables
∆ Youth diet and nutrition
Youth educational attainment
Youth cognitive development
Youth learning outcomes
Positive behaviors
Risk of chronic conditions
Overweight and obesity
Food, Garden & Agriculture Grant Program
School promotion of new options
Youth participation in National meal programs
Nutrition service staff knowledge & skills about local food
∆ School menu options
Food Insecurity
Reimburse
School District
s
Policy Health Outcomes
Direct Impacts Intermediate Outcomes
Sample Diet and Nutrition Pathway
Scope Example of Research Topics: How will the Policy reimbursement impact diet and nutrition?
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Could increase school staff skills in using Oregon food sources.
Could change school menus to offer new options. Could increase the # of meals bought at school.
How will this impact health? New menu options could increase fruit and
vegetable consumption and decrease intake of salt, fat & sugar
Nutrition helps kids focus, improve their learning outcomes and lead to graduating.
Nutrition can help kids sleep better. Nutrition influences children’s cognitive
development and behavior. Diet can influence child overweight or obese and
risk of chronic diseases (i.e. diabetes, cardiovascular disease, diet-related cancer)
Impacted Populations•Students eating school meals•Low-income youth in the Free and Reduced meal program (includes vulnerable populations i.e. Latino, African American; Native American; Asian American)•School staff
Committee Scope Prioritization, Part 2
Criteria:Add most value to analysisAvailable dataAccessible literatureFeasible to answer without primary data collection
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Sample Scope Topic Priorities
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Health Determinant Topic Related Health Outcomes
Employment Ability for job to help workers pay bills e.g. food, healthcare, housing
Food security, chronic diseases
Employment Increase demand for Oregon food products
Community food security
Diet and Nutrition Child learning outcomes, ability to focus
Learning and graduation
F2SSG K-12 Education Child understanding of food and nutrition
Obesity, chronic illness
Diet and Nutrition and F2SSG K-12 Education
Child food preferences Obesity, chronic illness
Verified Scope
F2SSG Network Survey
Questions:How strongly do you think each group will be affected?Did we miss anyone?How much chance will the policy result in the following impacts?Did we miss any impacts?
Sent to 141 subscribers21% respondedConfirmed impacted
groupsConfirmed potential
impacts
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Lesson Learned: Involve Experts of All Kinds
LegislatorsGeneral publicState agency Farm to School
coordinatorsFarm to School Network
membersProducers and processorsChild nutrition service directorsNational and state researchersMembers of policy advocacy
coalition
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Image From Growing Gardens
Lesson Learned:Stakeholder Involvement in
Scope
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Helped HIA Research Team…Understand policy
landscapeRevise scopeFind data sourcesUnderstand program
barriers and successesClarify issues, nuances
going forward to Assessment
Set a good foundation for Recommendations
Key Findings
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Image courtesy of Truitt Brothers
Economic:$19.6 million = 270 jobs in 2 years Purchase of Oregon productsDiet & Nutrition Meal participation Food security for families with children Child preferences for fruits and veggies Child consumption of fruits and veggies
F2SSG Education: Child healthy eating behaviors Knowledge, learning, academic achievement potential
HIA Policy Recommendations
To increase positive job growth and food security:#1 Modify the eligible items for reimbursement program to
“produced” or “processed”
To increase child nutrition, food security, and student learning:# 2 Education Grants – prioritize schools serving:
a. Low income populations orb. Ethnically and culturally diverse student populations orc. Food insecure areas
#3 Education Grants – prioritize schools developing multi-component programs
Procurement Promotion Educationw/Community Support
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Oregon HB 2800Oregon HB 2800
Recommendations incorporated from HIA:
Modified the eligible items for reimbursement program to “produced” or “processed”
Prioritized low income populations in education grants
Amended: $2 millionGeneral Fund
Component:One Competitive Grant
Program3-4 Districts$1.75 million reimburse Lunch - 15 cents
$0.25 million for food, garden, agriculture activities
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Acknowledgments – Thank You
All members of our advisory committeesSodexo and Ecotrust for use of dataAll community members who attended a forum or workshopAll stakeholders who gave input through interviewsAll advisors who gave input on the data or reportThe Northwest Health Foundation and the Human Impact ProjectResearch team members 24