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Phase: Final Evaluation

Addressing Native American Health, Food Sovereignty & Food Security through Food Partnerships

Our food bank seeks to collaborate with MN Native American communities to improve health outcomes through culturally appropriate foods.

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*Please Upload User Experience Map (as attachment) and any additional Beneficiary Feedback in this field

Our User Experience Map is also included as an attachment below.

Explain your project idea in two sentences.

This project will bring healthy, Native foods to food-insecure Native American participants with diabetes. We seek to improve outcomes related to health, food security and other areas.

What is your organization name? Explain your organization in one sentence.

Second Harvest Heartland works in MN-U.S.A. to end hunger through community partnerships.

Is this project idea new for you or your organization? If no, how much have you already executed on?

This project is an extension of current projects we are implementing with health care partners. For example, we are currently providing healthy food boxes and education to food-insecure patients with diabetes and heart disease, and evaluating outcomes. Many of these patients are Somali-American.

What is the problem you aim to solve with this idea? How would you define this problem as urgent and a priority in your target community?

This project seeks to solve issues related to Native American food insecurity and high rates of diabetes. The USDA notes that 23% of Native people are food insecure, and Native people are 2.3 times as likely as Whites to have diabetes.

What is the timeline for your project idea? What are the key steps for implementation in the next 1-3 years?

1. Identify community partners & gain commitments to collaborate. 2. Refine program elements based on partner inputs; e.g., content of food boxes and educational materials based on feedback from Native American chefs, farmers and dieticians. 3. Implement a pilot project with 1 clinic or classroom-based program, likely serving up to 50 individuals in total. 4. Evaluate results; including client satisfaction and health outcomes. 5. Bring project to scale and create financial sustainability.

Describe the individual or team that will implement this idea (if a partnership, please explain breakdown of responsibility).

Our FOODRx team will implement this project. The team includes a program manager, registered dietician, research coordinator and other individuals. We will likely partner with clinics, diabetes educators, dieticians, chefs, farmers, Native American organizations and academic researchers.

What do you need the most support with in this project idea?

  • Financial Business Model

What is your primary goal over the next 6 weeks of Refinement?

  • Collaborate with others in the sector

How do you currently measure (or plan to measure) results for this project?

In similar projects, we are currently evaluating the impact of healthy food and education on health, food security and self-care outcomes among people with diabetes or heart disease. We are also seeking to determine ROI on the interventions, with the long-term goal of making the provision of healthy food a billable/reimbursable service, much like a prescription for medicine. In collaboration with our partners, we will create a similar evaluation plan for this project.

How has your project proposal changed due to your user research during the Beneficiary Feedback Phase?

During this phase, we have gained a better understanding of how our potential clients learn best, and make long-term changes to their health and food-related behavior. Group, community and social support (rather than individual participation) will assist our clients best. Group-oriented sequences within community settings, with group goal setting, will be utilized in our project.

(Optional) What are some of your still unanswered questions or concerns about this idea?

We are still seeking information about: -Most effective ways to identify appropriate clients (Native Americans who are food insecure & diabetic). -Shelf-stable, culturally appropriate foods that we can include in the program, particularly those grown locally and with traditional Native practices that promote food sovereignty. -Effective passive education materials that resonate with the Native American community; e.g., materials that reflect the connection between earth, food and body.

Second Harvest Heartland is a major regional food bank serving 59 counties in Minnesota and western Wisconsin.  In the past 2 years, our organization has devoted increasing amounts of attention and resources to the interplay between food and health. We launched our FOODRx initiative in 2016.  Currently, FOODRx is evaluating the impact of healthy foods on low-income populations with chronic diseases, such as diabetes.  Our organization is now looking to extend this work by collaborating with local Native American communities to address food insecurity, healthy food access and chronic health concerns.  We have in place a framework for work such as this, and our Native community partners will drive conversations and decision making about program implementation and use of resources.  

Minneapolis is home to one of the largest urban Native American populations in the United States.  On the whole, the population is disproportionately impacted by health conditions such as diabetes and heart disease.  Our partners have identified an opportunity to cooperatively address food insecurity, lack of access to healthy foods and to improve health outcomes for community members.  Our current FOODRx framework provides an opportunity for the partners to test and evaluate various community-driven approaches to this work.

Explain your idea

Our idea is to expand our FOODRx model in a manner that helps Native American communities address issues related to health, food insecurity and food access in a community-driven, client-centered and culturally affirming manner. For example, in partnership with a health care provider, we have recently implemented a pilot program in which food insecure and low-income diabetic patients receive culturally- and disease-appropriate food boxes and education to complement their standard of care. We have implemented a customized approach to this program that incorporates Somali and Hispanic foods and recipes. Building upon these efforts, we have identified an opportunity to assist Native American communities with similar activities, to include food interventions, research and/or program evaluation. Doing so will help solve several community concerns and problems. Regarding peace, this project has potential to help reconcile past trauma related to the loss of food sovereignty and food systems due to colonization. It also addresses prosperity by assisting Native American people to improve their food security and health, which are associated with improved economic status and outcomes. In terms of planet, this project intends to utilize the expertise and resources of local chefs, nutrition experts, food growers to create sustainable, and culturally affirming eating patterns that affirm Native connections to the land. Currently, Second Harvest Heartland serves Native American people through our food banking activities, through which we distribute donated food to food pantries and meal programs that serve this population. While increasing amounts of this food consists of fresh fruits and vegetables, much of the food we distribute is not particular to the Native population and its chronic disease management needs (e.g., diabetes). Expansion of the FOODRx program will allow us to refine and test our approach to food distribution to Native communities, and allow us to help organizations looking to better implement chronic disease management for their Native patients. Data supports the need to conduct this work. A recent newsletter by Notah Begay III Foundation notes that, "If nothing changes, half of all Native American children are at risk for being a type 2 diabetic, which decreases their life expectancy by 27 years." Second Harvest Heartland learned of many issues such as these at the Native American Nutrition Conference held in Minneapolis in September 2016. Second Harvest Heartland also sees an opportunity for this program to be replicated with indigenous populations across the globe whose food systems have been impacted by colonization, and are food insecure and suffering from the consequential negative health outcomes. Our framework has potential to assist other food banks and hunger relief organizations to utilize their resources and infrastructure in ways that complement the efforts of indigenous peoples.

Who Benefits?

The primary beneficiaries of this program will be Native American participants. They will benefit from having access to culturally and disease appropriate foods that enhance their health, economic outcomes and connections to their cultural values. In addition, this project provides an opportunity to conduct research and program evaluation to add to the evidence base that helps to advocate for pro-Native public food policy changes. The project will help add to the written body of knowledge in the areas of Native health equity and food sovereignty. Though our work will be focused locally, results will be shared elsewhere. As a nonprofit food bank, Second Harvest Heartland will benefit by learning more about the specific needs of Native American populations, so that we may serve them more effectively. By being collaborative partners with Native American-led coalitions, groups and organizations, we can continue to build trust with Native & other communities across our service area

How is your idea unique?

Our idea is unique because to our knowledge, no program exists that offers food boxes (which include food, recipes and passive disease management education) to address the specific health and cultural concerns of low-income Native American people who are food insecure. A unique advantage of our approach is that we already have an operational framework in place that has been vetted, tested and proven successful. We are looking to extend it to serve an additional community to add breadth to our efforts, and to develop and enhance our relationship with the currently underserved Native American community. In this manner, FOODRx will serve as a bridge to additional collaboration. This program will complement the activities of Seeds of Native Health and the University of Minnesota's Healthy Foods, Healthy Lives Institute. Our activities will extend this work, and provide an opportunity to test and evaluate strategies that affirm these organizations' prior learning.

Idea Proposal Stage

  • Research & Early Testing: I am exploring my idea, gathering the inspiration and information I need to test it with real users.
  • Prototyping: I have done some small tests or experiments with prospective users to continue developing my idea.

Tell us more about you

Second Harvest Heartland is a nonprofit organization with the mission of ending hunger through community partnerships. We serve hungry individuals in 59 counties in the U.S. states of Minnesota and Wisconsin. In summary, the project described here will be a program for Second Harvest Heartland. It tackles the problem of getting additional healthy food to food insecure individuals who are also trying to manage diet-related chronic diseases. It addresses this problem by working collaboratively with the Native American community to identify and source culturally appropriate foods, and to develop menus and education designed for the nutritional needs of low-income, Native American people. The primary goal is to help improve health outcomes among those participating in the program, with additional potential to also improve their financial wellbeing. Our approach will be to operate the program in a culturally affirming and sustainable way, that takes into account the past trauma experienced by Native American community members, and the close relationship the Native population has with the earth and the food it provides. The program has intersections with peace, prosperity, and planet. The program proposed here is an expansion of our current FOODRx program, and will be fully integrated into our ongoing program. As part of our work in the next 12 months, we will solidify partnerships and collaborative efforts with Native-led organizations and initiatives that are seeking to improve food security and health outcomes for Native people.

Expertise in sector

  • 7+ years

Organization Filing Status

  • Yes, we are a registered non-profit.
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Attachments (2)

Second Harvest Heartand User Experience 5-2017.pdf

This document serves as the User Experience Map for our proposed project.

FoodRx Visual_FINAL.pdf

This document describes the intersection between hunger and health, for food insecure individuals served by Second Harvest Heartland in Minnesota and western Wisconsin (U.S.A.)

19 comments

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Photo of Kate Rushton
Team

Hi Jeff,

I hope you are having a nice long weekend break.

There is an idea that was submitted earlier on this challenge that might interest you called Indigenous Wisdom & Modern Innovations: Bridging Divides to Transform the World submitted by Karen which mentions the Healthy Native Communities Fellowship curriculum.

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Photo of Jeff
Team

Wonderful!  Thank you very much, Kate!

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Photo of GYST Fermentation Bar
Team

This project is an important one for our Minnesota community - thank you! Similar to a project we are working on with Appetite for Change and Lily Springs Farm, we are all thinking about "cultural revival" for health promotion, peace and prosperity. Food is the ultimate healer. I look forward to our paths crossing as all of our organizations continue to work with food to inspire real social and economic change.

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Photo of Jeff
Team

Thanks for your post!  Yes, let's continue our work and seek additional ways to partner and collaborate!  It seems like a critical mass of people is now recognizing the need for these efforts - let's keep the momentum going.

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Photo of OpenIDEO
Team

GYST Fermentation Bar , Appetite For Change and Jeff! Excited to see potential collaborations please let us know if anything comes to fruition!

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Photo of Appetite For Change null
Team

Exciting to see this project. AFC has done Fruit&VeggieRx in North Minneapolis, so we should definitely connect. We've loved working with Marcus on the MN Food Charter Network Policy Action team, and there are so many great ways we could partner in the future! Best of luck on this challenge, your project is so needed in our communities!

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Photo of Jeff
Team

Thank you for your post!  We continue to hear so many great things about your organization and work, and always appreciate the opportunity to work with your staff members, too.  Looking forward to more partnership opportunities ahead!

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Photo of OpenIDEO
Team

Hi Jeff and Team!

We’re excited to share with you feedback and questions from the BridgeBuilder team and an external set of experts. We encourage you to think about this feedback as you continue to improve and refine your idea. You are welcome to respond in the comments section and/or to incorporate feedback into the text of your idea. Your idea and all associated comments will all be reviewed during the final review process.

• One expert shared: “A very interesting and important idea. I would love to see it built out to better understand time, place, demand, cost, scale.”

When thinking about desirability, feasibility and viability here’s what experts shared:
• One expert shared, “I think this idea is feasible as it will tap into a need that you have identified with the community. The business model is critical though for working on how they could make this a billable/reimbursable service and show the ROI to enable further investment”
• Another shared: “Desirable yes! To assess if this idea is feasible and viable I would need additional information.”

Human-centered design starts with the people you’re designing for and ends with new solutions that are tailor-made to suit their real needs. How does this idea consider user needs?
• Yes, it would be helpful to understand additional learnings from beneficiary feedback (your comment update was helpful!). What are the specifics needs you’ve discovered from the people you are building for and how have you integrated this into your design?

Outstanding comments and questions: How will you find the "lost" knowledge to best use the native foods and develop the right interventions?

Thank you so much for sharing the important work you are doing!

In case you missed it, check out this Storytelling Toolkit for inspiration for crafting strong and compelling stories: http://ideo.to/DXld5g Storytelling is an incredibly useful tool to articulate an idea and make it come to life for those reading it. Don’t forget - June 16 at 11:59PM PST is your last day to make changes to your idea on the OpenIDEO platform.

Have questions? Email us at bridgebuilder@ideo.com.

Looking forward to reading more!

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Photo of Jeff
Team

Thanks for this feedback!  In terms of potential scale and scope of this pilot project, our team would like to pursue a project that engages about 50 to 100 participants.  The participants would most likely be engaged in a cohort/learning group model of about 10 people per group, in order to provide diabetes education and support alongside the distribution of Native foods.

We are currently operating a 3-year health and hunger project with a total project budget of $1.7 million.  The project provides healthy foods to people receiving treatment for diabetes and heart disease, and also includes education components through our partnership with MN healthcare providers.  This project is operating  at a clinic and a hospital, and has a substantial research and evaluation element, including a financial ROI component.  This project will provide us with an infrastructure and framework for our project with local Native American communities.  Our current project also includes many elements of patient-centered design, and we have developed a HIPAA-compliant patient data warehouse.  The current project has utilized the services of an earned revenue/payment model consultant, who is developing models for our education and food interventions to be billable patient services.  The Minnesota Department of Human Services and several area foundations are funding these activities.  5.0 FTE's at Second Harvest Heartland are currently implementing our hunger and health-related work.

Our current work has also provided us with a framework for providing culturally appropriate food, recipes and education to people from various backgrounds.  For example, we offer food boxes with Somali and Hispanic foods.  Our dietitian developed the food box contents with community representatives, and she also worked with these partners to develop recipes that utilize the contents of the food boxes.  We include feedback surveys in each food box.  To date, the surveys indicate patients are very pleased with the contents of their food boxes and with the recipe selections.

In terms of finding and including foods that reflect Native traditions, work completed by Seeds of Native Health will provide us with an excellent starting point.  Dream of Wild Health farm will also be a resource for gathering information related to growing and accessing affirming foods.

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Photo of Kate Rushton
Team

Hi Jeff,

It is great to see a user journey for the program and all the progression on your project proposal.

For this project and in general, are there certain organisations operating in specific geographies or sectors that you would like to connect to?

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Photo of Jeff
Team

Thanks for the question, Kate. We have identified several potential partners with roots in our 41-county Minnesota service area, which includes the Minneapolis-St. Paul metropolitan area.  One potential partner is the local Department of Indian Work (Family Education Diabetes).  Yeoun-Jee Pine is the coordinator of the program, who has also shared her thesis with us and is interested in seeing our project progress.  We think we could learn a great deal from the participants in this program about how they stay engaged.  A registered dietician on our staff (Kristin) is in conversation with another dietician at the Indian Health Board Clinic Diabetes Management Program.  Staff there is reviewing a sample menu and education pieces that we are proposing to provide within our project.  This organization has a diabetes management program that has been working hard to engage their clients, and we could learn from them.  One way we could partner is to offer a monthly healthy food box to their patients, and this could provide an incentive for their patients to remain engaged in other activities at the organization. 

We will also want to engage with the Shakopee Mdewakanton Sioux Community - Seeds of Native Health Initiative.  We attended a conference sponsored by the organization in September 2016, and we're currently exploring how we could take part in their 2017 conference.  Another partner we'd like to engage is the Ho-Chunk Nation.  We have had recent conversations with a member, who has given us feedback on our project and local community needs.

In terms of food-related partners, we'd like to engage with the Dream of Wild Health farm, which is a Native-led, Native-grown farm.  This organization likely has ideas regarding the types of food we should be accessing for clients.  A local business we'd like to engage is the Sioux Chef (Sean Sherman), who operates a food truck and catering company that provides indigenous cuisine, and wants to provide indigenous foods to the masses.  Another chef we'd like to engage is Jason Champagne, who is a wellness chef for the Shakopee Mdewakanton Sioux Community, and he is a student researcher. 

In terms of research, we have learned of research partnerships with the University of Minnesota and local Native communities.  These past partnerships have potential to assist us in developing our client-centered and community-driven evaluation plans.

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Photo of Jeff
Team

Update: Over the past several weeks, Alexandra De Kesel Lofthus and her team at Second Harvest Heartland have continued to explore our idea with various additional community members and the feedback continues to be positive and insightful. Their contacts have shared some of the potential struggles we may encounter (e.g., class engagement, the introduction of fry bread into the community and the impacts it has had, lack of trust of outsiders, transportation issues) and some have offered to serve as an “ambassador” and introduce us to additional contacts within the Native American community. Robert Pilot is a member of the Ho-Chunk nation and offered to make the introduction to Danielle DeLong. Danielle is a team member at Indian Education at St. Paul Public Schools and also from the Ho-Chunk Nation. Kelly Coughlin from the People’s Center Health Services encouraged us to reach out to the Native American Community Clinic. The NACC clinic has a special program for diabetes prevention and management. The program overview can be found: http://nacc-healthcare.org/special-programs/

We are developing a solid network of supporters and potential stakeholders and gathering valuable information that will help us shape the service. If funding is received for this work, we plan to formally engage our ever growing network and schedule an open meeting for all those that are interested to begin discussing how this program should be further developed and utilizing the tools provided by OpenIDEO to facilitate the conversations.

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Photo of Melinda Kramer
Team

This sounds like a great project! Who are your Native American community partners? Will there be a specific focus on supporting Indigenous foodways? Looking forward to learning more!

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Photo of Jeff
Team

Hello Melinda!  Our team has identified a handful of community partners we would like to approach for further engagement. They include Native community diabetes educators, local Native chefs, a local Native American farm(practicing a tradition of Native agriculture) and additional individuals interested in this work.  The team has not yet reached out to them regarding this specific project because they would like to determine the level of funding and resources available to better understand the scope of work we could pursue. Our team has had previous conversations with several of them regarding the general concept, and have received positive feedback. Thanks again for inquiring about our idea!

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Photo of Melinda Kramer
Team

That's great to hear, Jeff! It sounds like you're hoping to potentially partner with a wide breadth of Indigenous organizations, and that seems like it can only deepen the impact of such promising work! Best of luck, and thank you for answering my questions!

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Photo of Kate Rushton
Team

Hi Jeff,

Are you able to share a bit more information on the feedback you have received? Are you able to share a quote/anonymous quote?

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Photo of Jeff
Team

Thanks for the question, Kate!  Some of the feedback we've integrated into our project most recently is from a thesis written and shared with us by Yeou-Jee Pine and submitted to the University of Minnesota (titled "An approach to nutrition education for urban American Indians in the Twin Cities."  Yeou-Jee serves as the Diabetes Education Coordinator at the Department of Indian Work in St. Paul, MN, U.S.A.  The thesis was particularly insightful in helping us consider in what context to offer the food boxes and educational components (e.g., group learning and shared participation/goals).  Our project manager Alexandra met Yeoun-Jee last fall at a Family Education Diabetes Series at the University of Minnesota.

Kristen Williamson, who is a Registered Dietician and serves as a Program Coordinator at our organization, received feedback from a fellow Registered Dietician who works with the Diabetes Management Program at the Indian Health Board Clinic.  Kristen says, "My contact had a positive response to the idea of the program and saw a high need within the client population she serves.  She mentioned they provide several resources to the population they serve but have a difficult time with client retention in classes and other educational programs.  This is where we believe the wrap-around services and food distributions to be of assistance for participant retention.  The classes themselves, similar to the set-up we have proposed, were well received by those attending."

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Photo of Kate Rushton
Team

Hi Jeff!

This is a really interesting project!

I can see how you address prosperity and potentially peace, but would you consider adding a summary e.g.

'This idea is a_________________ [campaign/app/service/program/online platform/toolkit/social enterprise/etc.].

It tackles the problem of _____________[short problem statement].

It addresses the problem by :__________[what your idea looks like in practice]. It intersects XYZ topics (peace, prosperity, or planet).’

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Photo of Jeff
Team

Thanks for your feedback, Kate.  At your suggestion, our team added additional information in the "Tell Us More About You" section.  Your summary template was very helpful in creating a succinct project vision -- thanks again!

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