1. University of Hawai‘i at Mānoa
Carissa Poon
University of Hawai‘i at Mānoa
College of Tropical Agriculture and Human Services
Cooperative Extension Service
Nutrition Education for Wellness Program

2. Agenda Collaborators Project Goals Development
Pilot Testing & Training
Assessment
Toolkit
Web Resource

3. Collaborators University of Hawaii at Manoa
Hawaii Department of Health
Healthy Hawaii Initiative (HHI)
Nutrition Education for Wellness (NEW)
Hawaii SNAP-Ed
College of Tropical Agriculture and Human Resources – Cooperative Extension Service
KTA
Julia Zee
Hilo WIC
Grocery Store Tour Project

4. Project Goal
Increase the awareness and positive attitudes toward the importance of eating fruits and veggies among the FSP eligible population served by local program contractors.

5. Project Objectives Adapt existing materials and models for the GST
Develop Toolkit resource for GST leaders
Develop informational leaflet for GST participants
Test and evaluate the GST curriculum, Toolkit, and leaflet at a FSNE eligible grocery store
Provide Train the Trainer sessions
Recruit participants for GST on Big Island
Implement 12 GST at four different grocery stores on the Big Island
Work with HHI to evaluate and measure impact and effectiveness of GST

6. Nutrition Messages for Supermarket Tours
Development
Table 1 – Summary of Nutrition Messages from Various Supermarket Tours between 2000 and 2006
Nutrition Messages for Supermarket Tours
Learn to read food labels and ingredients lists
Find good sources for grains and protein
Create a healthy personalized grocery shopping experience based on food preferences, lifestyle, food budget, cooking skills, time restraints, and medical conditions (high blood pressure, high cholesterol, diabetes)
Learn how to prepare quick and easy meals and snacks for the busy individual or family
Learn seasonality of fruits and veggies; the months that these products are available in order to purchase the highest quality produce
Focus of nutrition messages in table 1 are from supermarket tours conducted between
References:
Lee, S, Liffman, C, et al. The Supermarket Tour. Waterloo Public Interest Research Group (WPIRG), University of Waterloo; Available at:
Grocery Store Tour Lesson Plan. Wellness First Program, Department of Nutrition at University of Georgia; Available at:
Healthy Eating In Stores for You. Nutrition Labelling Education Centre, Dietitians of Canada; Available at:
Supermarket Tours. Dole’s Classroom Resources, Dole 5 A Day; Available at:
Supermarket Tours. Healthy Food for All; Available at:
Virtual Grocery Store Tour. American Diabetes Association; Available at:
Purpose:
Help public be more Informed and knowledgeable about healthy eating and making healthy choices in the grocery store
Interactive tour allows for shared experiences and active participation and listening using real food examples at their usual point of purchase
(Lee, et al. 2008); (Wellness First Program, Univ. Georgia, 2008); (Nutrition Labelling Education Centre, Dietitians of Canada, 2005); Dole 5 A Day, 2008); (Healthy Food For All, 2008); (American Diabetes Association, 2008)

7. Four Concepts Throughout Tour:
Development
Four Concepts Throughout Tour:
All forms of f&v’s matter – fresh, frozen, canned, dried, and 100% juice.
Drain all canned produce.
Buy what is on sale.
Seasonality of local produce.
Three in-house pilot tests were conducted during the months of April and May 2008 amongst NEW program staff and nutritionists.
Pilots were completed prior to scheduling KTA grocery store tours which were given throughout the months of June to September 2008.

8. Recruitment
Clients recruited through Julia Zee, Extension Agent on Big Island, and through WIC offices, and other community agencies.
Flyers posted at WIC offices, tickets issued for interested clients.

9. Materials Outlined handout for participants
Recipes from NEW’s Heritage of Taste for Health (HOT) cookbook
Script for tour guide
Pre and Post Question Tally Sheet
Buy Fresh Buy Local Seasonality Guide for participants
Disclosure statement
Incentives
HOT cookbook
$5.00 KTA Gift Certificate

10. Materials Outlined handout for participants
Outline of the tour’s events including the four concepts

11. Materials
Recipes from NEW’s Heritage of Taste for Health (HOT) cookbook
Recipes used as sample shopping list to guide participants throughout the store
Participants led to canned, frozen, fresh produce aisles
Other aisles were shown as appropriate to the recipe
Important that tour guide knows the store layout so they lead participants smoothly

12. Materials

13. Materials
Buy Fresh Buy Local Seasonality Guide for participants

14. Materials Incentives HOT cookbook $5.00 KTA Gift Certificate
A low income population may be more likely to increase its f&v consumption behavior when incentives such as coupons improve affordability.
Grocery Store Tour Lesson Plan. Wellness First Program, Department of Nutrition at University of Georgia; Available at:
In the study by Anderson (2001), there was a higher success rate of the participant coming back to the store where the coupon was given and purchasing fresh fruits and vegetables, particularly low-income families.
With incentives and knowledge on the subject, participants are more likely to come back and show what they have learned and purchase certain items they learned about during their grocery store tour
Anderson, JV, Bybee, DI, et al. 5 A Day Fruit and Vegetable Intervention Improves Consumption in a Low Income Population. Journal of the American Dietetic Association 2001;101(2):

15. Pilot Testing In-house with NEW team on Oahu
Primary contact on Big Island – Julia Zee
WIC recruitment
Other community agencies
KTA stores – local supermarket chain

16. Training KTA stores: 4 Agency tours completed: 5
3 tour times offered each day
35 tour opportunities offered
Agency tours completed: 5
Client tours completed: 12
Agency participants: 29
Client participants: 36
Total participants: 65

17. Pre-tour Survey Statements Post-Tour Survey Statements
Assessment
Table 3 – Pre and Post-Tour Statements
Pre-tour Survey Statements
Fresh, frozen, canned, dried, and 100% juice, are the different forms of fruits and veggies.
2. When fruits and veggies are in season, it means fruits and veggies are fresh, they cost less, and tastes better.
3. I drain the liquid out of all my canned veggies and fruits.
4. I am confident in myself when it comes to shopping for fruits and veggies to make healthy meals that fit into my lifestyle and budget.
Post-Tour Survey Statements
5. How many would be interested in participating in another tour like this about other areas of healthy eating?

18. Results 18% ↑ in knowledge that of fruits and veggies matter.
45% ↑ in knowledge of what of Hawaii’s fruits and veggies means.
64% ↑ in intent to out of all canned fruits and veggies.
35% ↑ in for healthy meals.
97% total participants wanted exploring other topics.
all forms
seasonality
drain liquid
confidence in shopping
additional tours

19. Continuing Education
Table 5 (a) – GST Post-Tour Comments on Additional Tour Topics
▪ what’s the difference between fresh and frozen (nutritional value?)
▪ want to learn about the food pyramid
▪ sugar substitutes
▪ don't know what is "healthy"
▪ nutrition label reading
▪ more nutrition education
▪ more hands on
▪ healthy foods to eat, what is not healthy
▪ new recipes
▪ fast time saving recipes
▪ different recipes to use ▪ like to learn about dishes with beans as an ingredient
▪ meat cuts
Continuing Nutrition Education
Food Skills

20. Continuing Education
Table 5 (b) – GST Post-Tour Comments on Additional Tour Topics
▪ client just moved from Georgia, so learned about local foods and local produce.
▪ new produce
▪ want to learn to cook local food
▪ stuff for working mothers for school-aged children
▪ what juices are good?
▪ healthier snacks
▪ what affects baby when pregnant?
▪ what is good for healthy baby to eat
Local Foods
Mothers and Children

21. Continuing Education ▪ unit pricing
Table 5 (c) – GST Post-Tour Comments on Additional Tour Topics
▪ unit pricing
▪ want different prices of different items
▪ like baked goods - which are inexpensive and healthy, convenient and fast
▪ different grains; which ones are more nutritious
▪ whole grains
▪ what cereals are good?
▪ nutrition bars, are they a substitute for breakfast?
Resource Management
Whole Grains

22. Toolkit Available on Web Introduction Tour Script Handouts Recipes
Recruitment
Food Safety
Food Shopping

23. Web
Resources

24. Web Resources

25. Web Resources

26. Web Resources

27. Mahalo
(thank you)