POW Number: 3.A
July 1, 2002

POW Title: To Achieve a Healthier, More Well-Nourished Population

Situation Statement:

Pennsylvania has the largest rural population and the second-largest senior population (16%) in the U.S. and is largely Caucasian (88%) with increasing numbers of African Americans and Hispanics. Diseases that have lifestyle antecedents - heart disease, cancer, cerebrovascular disease, and diabetes - are among the six leading causes of death in Pennsylvania.

According to the BHRFS of 1996, a significant portion of residents are physically inactive, overweight, not eating fruits and vegetables 5 or more times a day, and have elevated blood cholesterol, all predisposing risk factors for chronic diseases. While many are eating a diet too rich in calories and fat, some are not getting enough calcium, folacin, or iron from their diets. Many Pennsylvanians are not following the principles embedded in the USDA Food Guide Pyramid and balancing caloric intake with regular physical activity, creating the need for programs that will help people adopt lifestyle practices that promote health and wellness.

Over half of Americans eat meals and snacks away from home on any given day, choosing foods that are higher in fat and saturated fat and have less calcium, iron, and fiber than foods prepared in the home. The fiber content of away-from-home meals is 25 percent less than that of home-prepared meals. The huge variety of convenience foods and meal choices available has increased the number of consumers at all economic levels and stages of the life cycle who do not have basic food shopping, food preparation, and preservation skills. Many of those practicing home food preservation are not aware of safer, more up-to-date practices. Because our food supply includes a bewildering array of foods, the ability to understand and use the information on a food label is increasingly important, but many consumers cannot understand this information or still only focus on a few items on the Nutrition Facts panel.

The increased interest in ethnic foods, opportunities for eating out and a decrease in food skills offer opportunities for educational programs that emphasize how to make food choices both in the supermarket and for away-from-home meals, as well as teaching basic food preparation and preservation skills. Such programs especially need to target those with fewer economic and social resources, those who might be food insecure, and those at vulnerable life cycle stages: teenagers, pregnant women, families with young children, single parents, the elderly, and caregivers. Teens and parents of young children need to understand the benefits of breast-feeding and the basic principles of feeding infants and children.

In an increasingly complex food supply, the opportunity increases for purveyors of misinformation to attract buyers. Consumers are increasingly interested in herbal remedies, fad diets, dietary supplements, alternative medicine, and foods with associated health benefits, real or otherwise.

Americans are expected to spend $30 billion on such items by the year 2010. However many of these items are not well regulated and some cause serious side effects or even death. Programs that teach consumers how to evaluate claims associated with any herb, food, supplement, or diet plan are needed.

SUB POW: 3.A.1. Wellness and Food Choices

Objective: 3.A.1.1. Help clientele to use the USDA Food Guide Pyramid to evaluate a day's food intake.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who can correctly place at least 50% of what they ate into the appropriate food group on the Food Guide Pyramid.

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number who can identify foods or food groups missing from a days intake and suggest, with at least 50% accuracy, a food choice to complete the minimal number of servings recommended.

Objective: 3.A.1.2. Encourage program participants to improve dietary patterns based on the USDA Food Guide Pyramid.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who indicate eating at least three servings from the Bread, Cereals and Grain group and at least one from every other Food Guide Pyramid Group in a given day.

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number who indicate they eat breakfast within two hours of rising.
  3. Number who indicate they follow a pattern of 3 meals a day plus a recommended number of snacks in a given day.

Objective: 3.A.1.3. Enhance the ability of clientele to use the Nutrition Facts panel to compare and choose fresh, canned or frozen foods.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who can use the Nutrition Facts panel on two foods to correctly identify which contains the most or least of the nutrient of interest (either as grams or % Daily Value).

Special Indicators (suggested by the POW team):

  1. Number who completed evaluation tool.
  2. Number who report increasing the frequency of using the Nutrition Facts panel to make food choices.

Objective: 3.A.1.4. Raise clientele awareness of appropriate body weight and its role in maintaining health.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who can accurately estimate whether they are at an appropriate weight using an appropriate standard.

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number who can name three chronic diseases in which the risk of occurrence is increased by being overweight.

Objective: 3.A.1.5 Help clientele to recognize their own risk of developing the prevalent chronic diseases.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who can evaluate their own risk of developing chronic disease (diabetes, high blood pressure, heart disease, cancer, osteoporosis) using any one of a number of available tools (i.e. food records, worksheets in Eat Five, Calcium Rich Eating, etc.).

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.

Objective: 3.A.1.6. Help clientele to recognize the role of good nutrition in delaying or reducing the effects of chronic health problems.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who can name two dietary strategies that will reduce the risk of a chronic disease (including heart disease, high blood pressure, cancer, diabetes and/or osteoporosis).

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number who provide or influence food choices or service to others (including parents, providers of elder care, child care providers, agency personnel participating in an extension train-the-trainer program, etc.) who report planning to adopt one strategy that will help improve the nutritional intake/diet of those others.

Objective: 3.A.1.7. Help clientele to recognize the role of physical activity in wellness.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who complete an assessment of their personal activity pattern over a time period and compare this to the current recommended pattern.

Special Indicators (suggested by the POW team):

  1. Number who report plans to increase their level of physical activity in the near future as a result of a given program.

Objective: 3.A.1.8. Encourage clientele to adopt health promoting eating patterns.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who estimate their current nutrient intake using an appropriate assessment tool and evaluate the suitability of that intake.

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number who indicate a program has given them more confidence in selecting foods with an appropriate level of nutrient (calcium, fat, fiber, vitamins, etc.).
  3. Number who report they are making food choices that match the Food Guide Pyramid and/or that affect the level of important nutrients or substances (calcium, vitamins, fat, fiber, minerals, phytochemicals, etc.) in their diet.

 

SUB POW: 3.A.2. Food and Nutrition Life Skills Across the Life Cycle

Objective: 3.A.2.1. Enhance ability of participants to use recommended food preservation practices when preserving foods at home. (Home food preservation activities should be reported under Objective 2.A.1.7)

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who correctly identify one or more recommended food preservation practices.

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number who identify one or more low acid foods requiring the use of a pressure canner and/or one or more high acid foods that can be processed in a boiling water bath canner.
  3. Number who identify one or more techniques for freezing and/or drying high quality foods.
  4. Number who assess the amount of preserved food needed based on family size and the value of preserving food based on cost and the time available, compared to the past.
  5. Number who have had their pressure canner dial gauges checked for accuracy.

Objective: 3.A.2.2. Enhance ability of participants to demonstrate skills for basic food selection, preparation, and storage in order to provide a healthy diet.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who demonstrate skills for basic food selection, preparation and storage.

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number who understand cooking terms, demonstrate correct preparation techniques and/or produce an acceptable final food product based on the use of a recipe.
  3. Number who use one or more recommended criteria for selecting high quality foods.
  4. Number who apply recommended methods for food storage and/or sanitation of the food handling environment.

Objective: 3.A.2.3. Encourage participants to use various recommended meal preparation techniques to provide quick healthy meals.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who report using one or more recommended techniques for providing quick, healthy meals (i.e. adoption of new recipe idea, shopping technique, food preparation).

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number who can correctly identify appropriate uses of time-saving appliances such as the microwave oven, food processor, and slow or pressure cooker.

Objective: 3.A.2.4. Encourage participants to use meal planning strategies that are economical, appropriate for the situation, and/or promote healthful eating.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who can develop meal plans for at least two days that fit the USDA Food Guide Pyramid, their personal, family, or client food preferences, and their budgetary constraints.

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number who use two or more recommended techniques to save money when purchasing foods.

Objective: 3.A.2.5. Raise participants' awareness of how dining out and/or use of convenience foods affects the food budget and the nutrient quality of meals.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who can compare the cost of one or more foods purchased in a restaurant or fast food establishment with the cost of similar foods prepared at home.

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number who can identify two ways to select foods to make healthier meals using convenience foods or when making food choices from a restaurant menu.

Objective: 3.A.2.6. Encourage participants to use appropriate infant and child feeding practices.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who report using one or more recommended feeding techniques for children under the age of one.

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number who can identify an appropriate meal pattern and/or provide healthful meals and snacks.
  3. Number who can identify at least one strategy they used in solving a problem feeding behavior in their child.

Objective: 3.A.2.7. Raise participants' awareness of the importance of a nutritious diet for good health.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who can correctly identify three nutrient dense foods to include in the diet.

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number who can correctly identify two or more foods that provide a specific nutrient to increase or decrease in their diet.

Objective: 3.A.2.8. Encourage participants to demonstrate sensitivity in feeding older and/or debilitated adults.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who can identify at least two feeding sensitivity factors that can affect older and/or debilitated adults.

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number who implement one or more recommended or new techniques to increase a successful feeding.

 

SUB POW: 3.A.3. Combating Misinformation That Influences Food and Health Decision Making

Objective: 3.A.3.1. Help clientele to evaluate popular food and health media.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who can correctly list two pieces of information to look for in any media piece that will help them determine the reliability of the information.

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number who can list two research-based sources of information about nutrition and/or health (web sites, books, magazines, organizations, newsletters, etc.).

Objective: 3.A.3.2. Help clientele to recognize that there can be serious interactions between food, drugs, and herbs.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who can correctly identify at least two medications that have the potential to interact with food.

Special Indicators (suggested by the POW team):

  1. Number of participants of evaluation tool.
  2. Number who can correctly identify at least two potential interactions between herbal supplements, medications and/or nutritional supplements.

 

SUB POW: 3.A.4. Food Security

Objective: 3.A.4.1. Raise clientele awareness of culturally appropriate, healthful, low-cost food.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who can list one or more food assistance resources in their community or county (i.e. food banks, soup kitchens, church programs, etc.).

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number who can identify one or more sources of healthful, culturally appropriate, low-cost foods (i.e. farmer markets or warehouse supermarkets rather than 7-11s) in their community.

Objective: 3.A.4.2. Help clientele to provide safe, healthful food that matches the needs of their resource-stressed audience.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who can correctly list at least two rules for determining if donated food is safe to provide to the needy.

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number who can assemble a food package that meets the requirements of the USDA Food Guide Pyramid, the special nutritional needs of family members ( i.e., very young children, presence of diabetes, etc.) and/or that is culturally appropriate.

Objective: 3.A.4.3. Encourage connections between community food system members and emergency food assistance providers to provide broad community food assistance.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of new linkages between food assistance organizations and representatives of other food sectors (producers, processors, retailers, etc.) that provide new food resources.
    2. Number of new coalitions formed to address food insecurity.

Objective: 3.A.4.4. Enhance ability of clientele to successfully feed their family.

Output/Outcome Indicators (These indicators will be captured in the database for FY2003):

    1. Number of participants.
    2. Number of participants who can demonstrate how to prepare a meal from the contents of a food package or their own cupboards to feed their family.

Special Indicators (suggested by the POW team):

  1. Number of participants who completed evaluation tool.
  2. Number of clientele who report not running out of food before the next paycheck (end of the month).

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