Refugee populations face significant barriers accessing culturally appropriate fresh fruits and vegetables. Utah has upwards of 50,000 refugees and accepts more than 1,100 additional refugees each year (Utah Department of Health [UDOH], n.d.). The majority of these refugees are located in a small urban community in Salt Lake County (Board of Advisors for the Utah Refugee Services Office, 2016). This community resides within a USDA designated food desert (U.S. Department of Agriculture, n.d.), represents populations from 15 countries speaking 26 languages, is comprised of 57% women and has an average family size of 5. The median income is $15,000-$24,000, and 72% of families have accessed food assistance. Eighty-two percent have previous farming experience, which often goes unused (UDOH, n.d.; International Rescue Committee, n.d.).
PSE Change Solution
The Utah Comprehensive Cancer Control (CCC) Program identified nutrition as a priority in the 2016-2020 Utah State Cancer Plan and offered the state’s comprehensive cancer control coalition, Utah Cancer Action Network (UCAN), and community partners the opportunity to develop projects to address this need. The International Rescue Committee (IRC), one of two refugee resettlement agencies in Utah, applied for funding to expand their New Roots program, which connects refugees with community gardens in Salt Lake County. In year 1, IRC developed a farmers’ market to allow refugee gardeners to sell their produce back to the community. IRC established baseline nutrition access and consumption data and measured change over the course of the season. Gardeners were given business training to help them develop a sustainable business, and community members were educated on nutrition and cooking to increase utilization of the market. In year 2, IRC built on the success of year 1 and acquired an abandoned lot from South Salt Lake City to develop additional garden space and expand the market. In year 3, Utah CCC linked the Utah WISEWOMAN program to this population and offered health coaching and screening services to refugee woman participating in the market.
Build a partnership between Utah CCC and IRC to better understand and reach the refugee population in Utah (Step 1: Engage).
Assess the need within the target population by reviewing available data on the refugee population including access issues and food insecurity. This includes establishing baseline nutrition data in the target population to measure change over the intervention (Step 3: Assess).
Provide education to the target population to increase their capacity to benefit from the intervention (Step 5: Promote).
Evaluate changes in fruit and vegetable consumption within the target population (Step 7: Evaluate).
Fruit and vegetable consumption in the target population increased 25% after the intervention. IRC developed a comprehensive toolkit detailing methods for cities to use community gardens to improve the health of low-income urban populations. Salt Lake County dedicated urban lots to become New Roots gardens, providing food for an additional 500 refugees and improving the food and physical environments. The success of these efforts has allowed the program to expand beyond the farmers’ market to developing relationships with schools to provide fresh food to those institutions.
Success Factors and Key Questions Addressed
Was enough awareness about the PSE change established to ensure successful and seamless implementation? If so, how did you generate awareness?
IRC capitalized on their relationship with the refugee population to distribute materials advertising available garden plots and opportunities to participate in the farmers’ market. Interest was high, and the demand for available garden space exceeded the supply. At the end of year 1, IRC expanded outreach efforts to focus on families instead of individuals and opened additional gardens for families.
Were stakeholders committed and engaged?
This has been a new area for Utah CCC to address, and interest in the community was very high. IRC was incredibly dedicated to the success of this project because of the benefits it brings to refugees including health, skill development, and integration into their new community. Salt Lake County demonstrated a commitment to expanding these efforts after year 1 and were willing partners in providing space to expand the gardens.
How were sufficient resources secured to ensure successful implementation and sustainability of the PSE change?
This intervention required collaboration with multiple community organizations beyond Utah CCC. IRC partnered with Salt Lake County, Utah State University Extension’s SNAP Education Program, the Sunnyvale Neighborhood Center and the Utah Department of Food and Agriculture for different components of this project. Utah CCC provided funding though State Cancer Plan implementation grants, which provided IRC the funds necessary to establish other partnerships in the community. These partnerships have allowed the program to expand rapidly. Interest in the community and among the target population continues to grow.
How will you continuously engage stakeholders to keep momentum going?
Utah CCC has continued to partner with IRC to provide State Cancer Plan implementation funding to support these efforts. In addition, partnerships have been established with other programs funded by the Centers for Disease Control and Prevention (CDC), including the Utah WISEWOMAN program, the Breast and Cervical Cancer Early Detection Program, and the CDC DP14-1422 grant-funded programs that are focused on preventing obesity, diabetes, heart disease and stroke. The expanded partnerships have resulted in additional funding to this program. In addition, Utah CCC is connecting UCAN partners to participate with IRC in expanding this program.