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Looking for the answers
LOOKING FOR THE ANSWERS Carolyn Gustafson and Winifred Steiner An interagency project defines the problems, assesses the interest and carries out nutrition education programs to implement an effective Food Stamp Program.
What should we do that would be meaningful in extending nutrition information to low-income families? This was the problem that confronted the nutrition education committee when Santa Clara County began the Food Stamp Program in March, 1967. The obvious answer would be to issue a newsletter, but the committee had reservations. In a county with a large number of Mexican-American families, how could we be sure that a newsletter in English would be read? Also considering cultural eating patterns, would "Anglo" recipes and menus be well received? As the committee deliberated, it became apparent that the only way to find out what could be done would be to undertake a survey. A survey was made of 156 families who were eligible to participate in the Food Stamp Program. At the time of the survey, only 28 per cent of the families surveyed were using food stamps. The 156 participating families were composed of 26 seasonal farm worker families, 70 families who attend the Health Department's Child Health Conferences, and 60 families who utilize the Homemaker's Service from the County Welfare Department (Table 1). The survey contained 38 questions, many of which were subdivided for more refined inquiry. The schedule covered eight broad areas: family food habits and attitudes, food preparation facilities, meal planning, reading habits and use of written materials, grocery shopping habits, food stamps ~nd their use, food and nutrition info'rmation, desired and preferred method of presentation, and family statistics, size, schooling, income, occupation, etc. When the survey was tabulated, it confirmed the lack of nutrition and food
THE A UTHORS are formerly Public Health Nutritionist, Santa Clara County (Calif.) Health Dept., and Home Advisor, (Santa Clara County) Agricultural Extension Service, University of California. 12 I JOURNAL OF NUTRITION EDUCATION
TABLE 1 Characteristics of Families by Survey Groups
CHC
Seasonal Farm Workers
Homemakers
Total
70
26
60
156
Average Family Size
5
7
7
5
Average Education-years
9.8
7.1
8.6
8.9
Characteristics
Number of Mothers Interviewed
Average Annual Income ($)
4,848
3,191
4,071
4,380
Average Monthly Expenditure per person for food ($)
buying information on the part of the families. It also showed a desire by the families to receive information. In particUlar, families requested information on foods to feed the family, cooking, use of recipes, food budgeting, and handling children (See Table 2). The homemaker group (60 families) showed a definite preference for receiving information at small group meetings (Table 2). This choice may be due to the relationship these families have developed with the homemakers of the Welfare Department. The homemaker families showed an increased use of the food stamps, money saving ideas, better menu planning, use of the newspaper for shopping information, use of written shopping lists, and a higher amount of money spent per person per month for food. A sizeable number indicated that they would like to receive written information (Table 2). Of the 80 respondents who received free grocery advertisements, 85 per cent said they read them. This would indicate that a high percentage of the families would read a newsletter. The findings showed that meat is the favorite food and when money is scarce, it is the first food eliminated. This would suggest teaching the use of meat substi-
17.40
17.50
18.50
17.74
tutes and providing information on lowcost meat dishes. Nonfat milk is seldom used except in the families receiving homemaker assistance. Information on using nonfat milk, its importance nutritionally, and its economy could be an important part of the education program. The less well-liked foods included vegetables, milk, and eggs. Since cereals were well-liked, it would be logical to provide information on combination dishes using meat and cereals. Dinner-in-a-dish type meals incorporating vegetables could also be included. The survey showed that the average monthly amount spent on food was $17.74 per person per month (Table 1). This is considerably below the USDA allowance for a low-cost minimum adequate diet. Either the families are reporting inaccurately or they are spending far too little. If the latter is the case, they need encouragement to use food stamps. While the survey was in process, the committee decided that there was need for immediate action, specifically, to provide information to professional people on the use of food stamps and to do some immediate teaching on nutrition and food buying to participating families. To this end, the committee sponsored a series of meetings for professional peoFALL, 1969
pie to acquaint them with the Food Stamp Program and to urge them to encourage low-income families to participate. In addition, letters with similar information were sent to ministers, college faculty, community leaders and community organizations. The committee also prepared a series of releases on food stamps for use in newsletters of local agencies and organizations. A demonstration kitchen project was also undertaken as an immediate activity. Welfare Homemakers were trained to present simple food preparation demonstrations which incorporated food buying and nutrition information. A series of 10 training meetings were held, covering the use of foods from the Four Food Groups. To assist the homemakers in their teaching, a detailed lesson plan was prepared, which included the recipes to be demonstrated, supplies and equipment needed, nutritional information about the foods used and their importance, cost comparisons of the foods used and information on food buying. Suggestions for motivating families to try the recipes, for involving the children, and for serving the foods attractively were all part of the plan. The homemakers presented demonstrations in the homes of 70 families with whom they work. The demonstrations were well received and it is significant that many families are now using nonfat dry milk and more vegetables. Two Mexican-American homemakers were helpful in suggesting adaptations of the recipes to suit Mexican-American tastes. Since the survey was completed, Santa Clara County has been designated as one
FALL, 1969
TABLE 2 Percentages of Interviewees in Each Survey Group Who Want Information By Subject Area and Method of Presentation CHC and Farm Workers
Homemakers
Total Interviewees
Read
Small Groups
Read
Small Groups
Read
%
%
%
%
%
%
What to feed the family
41
59
77
23
54
46
Cooking
52
48
80
18
63
37
Recipe use
36
64
72
29
49
51
Serving food
60
48
75
25
64
36
Food budgeting
48
52
78
22
59
41
Handling children
64
36
82
18
72
38
Subject Area
Small Groups
of 12 counties in California to have ENEP, Expanded Nutrition Education Program. Under the administration of the University of California Agricultural Extension Service, Program Assistants from low-income areas are trained to teach basic nutrition, meal planning, food buying and food preparation to low-income families. The ENEP Program Assistants have effectively continued the work of the demonstration kitchen project in the areas they serve. Utilizing the information from the survey, the committee decided there is a need to acquaint more people with the Food Stamp Program-both those who are eligible and the professional people who could encourage participation. To encourage more families to use food stamps, a "flier" was developed. In easy-to-read language, it acquaints fam-
ilies with the Food Stamp Program in Santa Clara County. This flier has successfully been used in a card table project with volunteer organizations and ENEP Program Assistants providing the staffing. Card tables were set up in four markets in the East San Jose area once a week for a month. Questions regarding food stamps were answered and families were encouraged to participate in Food Stamp and ENEP programs. One hundred and nine contacts were made for both programs. The information gained from the survey continues to guide the committee. Currently a "door knob" project is in preparation. Fliers in English and Spanish with information regarding food stamps are being prepared. Volunteers are being recruited to hang them on door knobs in selected neighborhoods, areas where elderly pensioners live, student housing areas, and low-income neighborhoods. The committee also has arranged to place food stamp posters in city buses. Funding for this was secured from the Santa Clara - San Mateo Interagency Nutrition Council. Another project to publicize the nutrition education programs was a booth at the Santa Clara County Fair which the committee set up and staffed. The food stamp flier and ENEP nutrition education materials were displayed. Requests to participate in both programs were secured. The committee continues to grow as people in the helping professions and interested volunteers become members. New projects are under discussion and the committee anticipates many more effective projects geared to improving the nutrition and the well-being of lowincome families.
JOURNAL OF NUTRITION EDUCATION I 13
What should we do that would be meaningful in extending nutrition information to low-income families? This was the problem that confronted the nutrition education committee when Santa Clara County began the Food Stamp Program in March, 1967. The obvious answer would be to issue a newsletter, but the committee had reservations. In a county with a large number of Mexican-American families, how could we be sure that a newsletter in English would be read? Also considering cultural eating patterns, would "Anglo" recipes and menus be well received? As the committee deliberated, it became apparent that the only way to find out what could be done would be to undertake a survey. A survey was made of 156 families who were eligible to participate in the Food Stamp Program. At the time of the survey, only 28 per cent of the families surveyed were using food stamps. The 156 participating families were composed of 26 seasonal farm worker families, 70 families who attend the Health Department's Child Health Conferences, and 60 families who utilize the Homemaker's Service from the County Welfare Department (Table 1). The survey contained 38 questions, many of which were subdivided for more refined inquiry. The schedule covered eight broad areas: family food habits and attitudes, food preparation facilities, meal planning, reading habits and use of written materials, grocery shopping habits, food stamps ~nd their use, food and nutrition info'rmation, desired and preferred method of presentation, and family statistics, size, schooling, income, occupation, etc. When the survey was tabulated, it confirmed the lack of nutrition and food
THE A UTHORS are formerly Public Health Nutritionist, Santa Clara County (Calif.) Health Dept., and Home Advisor, (Santa Clara County) Agricultural Extension Service, University of California. 12 I JOURNAL OF NUTRITION EDUCATION
TABLE 1 Characteristics of Families by Survey Groups
CHC
Seasonal Farm Workers
Homemakers
Total
70
26
60
156
Average Family Size
5
7
7
5
Average Education-years
9.8
7.1
8.6
8.9
Characteristics
Number of Mothers Interviewed
Average Annual Income ($)
4,848
3,191
4,071
4,380
Average Monthly Expenditure per person for food ($)
buying information on the part of the families. It also showed a desire by the families to receive information. In particUlar, families requested information on foods to feed the family, cooking, use of recipes, food budgeting, and handling children (See Table 2). The homemaker group (60 families) showed a definite preference for receiving information at small group meetings (Table 2). This choice may be due to the relationship these families have developed with the homemakers of the Welfare Department. The homemaker families showed an increased use of the food stamps, money saving ideas, better menu planning, use of the newspaper for shopping information, use of written shopping lists, and a higher amount of money spent per person per month for food. A sizeable number indicated that they would like to receive written information (Table 2). Of the 80 respondents who received free grocery advertisements, 85 per cent said they read them. This would indicate that a high percentage of the families would read a newsletter. The findings showed that meat is the favorite food and when money is scarce, it is the first food eliminated. This would suggest teaching the use of meat substi-
17.40
17.50
18.50
17.74
tutes and providing information on lowcost meat dishes. Nonfat milk is seldom used except in the families receiving homemaker assistance. Information on using nonfat milk, its importance nutritionally, and its economy could be an important part of the education program. The less well-liked foods included vegetables, milk, and eggs. Since cereals were well-liked, it would be logical to provide information on combination dishes using meat and cereals. Dinner-in-a-dish type meals incorporating vegetables could also be included. The survey showed that the average monthly amount spent on food was $17.74 per person per month (Table 1). This is considerably below the USDA allowance for a low-cost minimum adequate diet. Either the families are reporting inaccurately or they are spending far too little. If the latter is the case, they need encouragement to use food stamps. While the survey was in process, the committee decided that there was need for immediate action, specifically, to provide information to professional people on the use of food stamps and to do some immediate teaching on nutrition and food buying to participating families. To this end, the committee sponsored a series of meetings for professional peoFALL, 1969
pie to acquaint them with the Food Stamp Program and to urge them to encourage low-income families to participate. In addition, letters with similar information were sent to ministers, college faculty, community leaders and community organizations. The committee also prepared a series of releases on food stamps for use in newsletters of local agencies and organizations. A demonstration kitchen project was also undertaken as an immediate activity. Welfare Homemakers were trained to present simple food preparation demonstrations which incorporated food buying and nutrition information. A series of 10 training meetings were held, covering the use of foods from the Four Food Groups. To assist the homemakers in their teaching, a detailed lesson plan was prepared, which included the recipes to be demonstrated, supplies and equipment needed, nutritional information about the foods used and their importance, cost comparisons of the foods used and information on food buying. Suggestions for motivating families to try the recipes, for involving the children, and for serving the foods attractively were all part of the plan. The homemakers presented demonstrations in the homes of 70 families with whom they work. The demonstrations were well received and it is significant that many families are now using nonfat dry milk and more vegetables. Two Mexican-American homemakers were helpful in suggesting adaptations of the recipes to suit Mexican-American tastes. Since the survey was completed, Santa Clara County has been designated as one
FALL, 1969
TABLE 2 Percentages of Interviewees in Each Survey Group Who Want Information By Subject Area and Method of Presentation CHC and Farm Workers
Homemakers
Total Interviewees
Read
Small Groups
Read
Small Groups
Read
%
%
%
%
%
%
What to feed the family
41
59
77
23
54
46
Cooking
52
48
80
18
63
37
Recipe use
36
64
72
29
49
51
Serving food
60
48
75
25
64
36
Food budgeting
48
52
78
22
59
41
Handling children
64
36
82
18
72
38
Subject Area
Small Groups
of 12 counties in California to have ENEP, Expanded Nutrition Education Program. Under the administration of the University of California Agricultural Extension Service, Program Assistants from low-income areas are trained to teach basic nutrition, meal planning, food buying and food preparation to low-income families. The ENEP Program Assistants have effectively continued the work of the demonstration kitchen project in the areas they serve. Utilizing the information from the survey, the committee decided there is a need to acquaint more people with the Food Stamp Program-both those who are eligible and the professional people who could encourage participation. To encourage more families to use food stamps, a "flier" was developed. In easy-to-read language, it acquaints fam-
ilies with the Food Stamp Program in Santa Clara County. This flier has successfully been used in a card table project with volunteer organizations and ENEP Program Assistants providing the staffing. Card tables were set up in four markets in the East San Jose area once a week for a month. Questions regarding food stamps were answered and families were encouraged to participate in Food Stamp and ENEP programs. One hundred and nine contacts were made for both programs. The information gained from the survey continues to guide the committee. Currently a "door knob" project is in preparation. Fliers in English and Spanish with information regarding food stamps are being prepared. Volunteers are being recruited to hang them on door knobs in selected neighborhoods, areas where elderly pensioners live, student housing areas, and low-income neighborhoods. The committee also has arranged to place food stamp posters in city buses. Funding for this was secured from the Santa Clara - San Mateo Interagency Nutrition Council. Another project to publicize the nutrition education programs was a booth at the Santa Clara County Fair which the committee set up and staffed. The food stamp flier and ENEP nutrition education materials were displayed. Requests to participate in both programs were secured. The committee continues to grow as people in the helping professions and interested volunteers become members. New projects are under discussion and the committee anticipates many more effective projects geared to improving the nutrition and the well-being of lowincome families.
JOURNAL OF NUTRITION EDUCATION I 13