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The Philadelphia Urban Food and Fitness Alliance (PUFFA) Shapes Up Two Community’s Spaces, Ideas and Bodies

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Summary

The innovative work of the Philadelphia Urban Food and Fitness Alliance (PUFFA) focuses on connecting young people with the need to improve access to healthy foods and play spaces and to provide them with the skills they need to become successful policy advocates (Health Promotion Council 2010). PUFFA’s innovative engagement of youth from low-income communities has created new young proponents of nutrition. PUFFA staff follow the young people’s lead in creating a unique social network though “edutainment” means, including YouTube video sharing, text messages, Facebook, Twitter and more. These tools, along with positive peer and adult modeling, connect participants to their communities and prepare them to advocate for food system changes. Vanessa Briggs, HPC’s executive director, described the program goals “as a process of incorporating community voices and fostering partnerships with organizations that can lend expertise, training and technical assistance. The key is breaking down racial and cultural barriers,, which leads to awareness and food systems change.”

Summary

The innovative work of the Philadelphia Urban Food and Fitness Alliance (PUFFA) focuses on connecting young people with the need to improve access to healthy foods and play spaces and to provide them with the skills they need to become successful policy advocates (Health Promotion Council 2010). PUFFA’s innovative engagement of youth from low-income communities has created new young proponents of nutrition. PUFFA staff follow the young people’s lead in creating a unique social network though “edutainment” means, including YouTube video sharing, text messages, Facebook, Twitter and more. These tools, along with positive peer and adult modeling, connect participants to their communities and prepare them to advocate for food system changes. Vanessa Briggs, HPC’s executive director, described the program goals “as a process of incorporating community voices and fostering partnerships with organizations that can lend expertise, training and technical assistance. The key is breaking down racial and cultural barriers,, which leads to awareness and food systems change.”

Introduction

Introduction

In 2005, the W. K. Kellogg Foundation Food & Community Partner identified nine communities across the country as having a great need to improve access to healthy foods and play spaces and to advocate for policy changes. The Health Promotion Council (HPC) was invited to submit a grant proposal to receive a $1.2 million award from Kellogg. Out of this grant initiative, the Philadelphia Urban Food and Fitness Alliance (PUFFA) was carefully planned and put into action.  PUFFA has taken the HPC in innovative new directions. PUFFA’s multiple, concurrently run interventions all relate to three overarching goals: “improving healthy food available for our children at school, increasing access to safe and pleasant places for play and physical activity in our communities, [and] increasing healthy food in our communities” (PUFFA: About Us 2010). This includes property beautification and transforming land into places for activity, as well as fostering positive relations between residents, decision-makers and community-based organizations.

The Major Issues: Food, Space and Health

On the whole, Americans weigh too much, eat poorly and move too little. In 2010, nearly 34 percent of American adults and 17 percent of children were considered obese (Belluck 2010). Nationally, nearly 40 percent of African American and Hispanic children are overweight. Across America, 23.5 million individuals are challenged by poor diet and inadequate exercise (Learn the Facts 2011). Locally, even though Philadelphia has a number of advanced medical centers, obesity and type 2 diabetes are on the rise (Philadelphia Health Management Corporation 2004).

Individuals living in lower income areas face a particularly tough situation when trying to reduce their health risks, with fewer clean and safe places to exercise, as well as less appealing and cost-effective food choices. The Food Trust’s 2004 report indicates that Philadelphia requires at least 70 more supermarkets to be able to provide enough fresh food in all areas (Lyderson 2008). What is often most readily available in many neighborhoods is packaged snack foods at convenience stores, gas station hot dogs, and fast food burgers and milkshakes. Outdoor exercise is limited by crime and pollution. Though Philadelphia has 63 parks and 52 recreational facilities, “Almost half of Philadelphians polled had stayed away from a park in the previous year because they feared for their children’s safety or their own” (Systems and Policy Change Stories 2010). Broken glass, theft, drug use and harassment are common concerns.  Families that are struggling financially because of low income, childcare costs and other bills may default to eating less healthy foods because they are “food insecure”—lacking nutritionally appropriate, affordable choices. Twenty-three percent of children live with food insecurity (Understanding Hunger and Obesity 2011). In 2009, the U.S. Department of Agriculture (USDA) released an updated Thrifty Food Plan to help families budget for groceries (Nord et al. 2010). Although the plan has some useful elements, it does not factor in other related circumstances, such as the difficulty of getting to a shop with fresh food, the reduced quality of school lunches or unfamiliarity with cooking and eating a variety of produce. Cooking fresh foods takes time and planning. In PUFFA’s focus groups (2008-2009), residents of West Philadelphia and South Philadelphia reported that their time is limited because of the long hours they work. Purchasing fruit and vegetables from food trucks is an option, but most do not accept government ACCESS cards.

As a result of past and present systemic racism, African Americans, Hispanics and other minorities are the most likely populations to find their eating choices limited by the presence of food deserts (Understanding Hunger and Obesity 2011). The results of these limitations can be fatal. The Food Trust’s 2004 report notes, “Using 1998 city data on mortality, the study found that there were 7,586 diet-related deaths per square mile in the city [Philadelphia], including stomach, cardiovascular and other diseases” (Lyderson 2008). Stressful aspects of this lifestyle may make it difficult for individuals and communities to get involved in the national and state policies that could improve such circumstances.

School Lunches

School Lunches: Where Young People and Food Policy Meet

One major challenge affecting children’s health is the availability and nutritional quality of the meals served by the National School Lunch and Breakfast Programs. In 2009, the National School Lunch Program cost about $10 billion and the School Breakfast Program cost about $2.6 billion. On a typical school day, 32.2 million lunches and 11 million breakfasts were served to students. School Food Authorities (SFAs), the officials in charge of choosing meal options, must operate as nonprofits and receive reimbursement depending on the number of free meals they provide to qualifying children (Ollinger, Ralston, and Guthrie 2011). Although SFAs must plan for meals that meet basic nutritional guidelines, they often must make difficult choices to keep the costs within budget and keep the program running. Low-quality choices keep the cycle of poor nutrition spiraling. SFAs do have the choice to set a slightly higher price per meal for food that is more appealing, thereby recovering some loss. For example, canned fruit can be replaced with a fresh salad. Families who can afford to pay a little extra—one dollar or less—will ensure that all the children will receive the higher-quality food (Ollinger, Ralston, and Guthrie 2011).

In addition to the cost and quality of the food itself, many school districts, including Philadelphia, are challenged by the lack of space and budget for full-service kitchens. Many schools have to make do with satellite kitchens, which have food warmers that can heat up pre-plated meals, but are not capable of cooking fresh foods. At the close of the 2011 school year, monetary shortages caused 26 schools to lose their kitchens, leaving only 62 of the 257 schools in the Philadelphia district with full-service kitchens.

Initiatives that bring local produce to schools, like the Farm to School Program, need to think creatively about how to purvey fresh, non-packaged foods to school children. Alyssa Moles of The Food Trust says, “We worry about meal participation rates. While we recognize that the pre-plated meals are nutritionally sound—they meet the USDA guidelines—there’s a stigma attached to them” (Graham 2011). A few dangers exist here. Children may choose not to eat the pre-plated food and instead eat junk food or choose less healthy à la carte options in the cafeteria. Or children who choose pre-plated food may be missing an opportunity to eat fresh food at home.

Getting nutritional food to kids during the summer months when school is not in session is also a concern. The federal government offers states two summer options to ensure that children are fed. The Summer Food Service Program and the Seamless Summer Option are open to low-income children who may not otherwise be guaranteed food to eat in their homes (Seamless Summer Option 2011). Yet the quality of food offered in satellite kitchens cannot possibly make up for the lack of fresh meals that offer the most nutritional variety.

Along with school food, a vital issue that often deters young people, especially teens, from living a healthier lifestyle is peer pressure against it. Research indicates that adolescents mentally link healthy foods to their family. Treats and junk food, like cupcakes, chicken nuggets or candy bars, are what teenagers will typically choose over healthier options (Cannuscio, Weiss, and Asch 2010). The average child now eats three snacks a day (Learn the Facts 2011). In 2007, 78.6 percent of high school students polled reported eating fewer than five fruit servings that week (Potter et al. 2011). Youth said that healthy food tasted “nasty or gross,” and they don’t have the interest or motivation to be physically active (Carter et al. 2005: 98). Even for the most independent teen, going against the group is difficult.

Of course, some youth are extremely active and health conscious—involved in sports, working at physically demanding jobs or simply for their personal enjoyment. Unfortunately, as a whole, this population struggles to obtain proper nutrition and exercise. Time, space and budgetary constraints have resulted in physical education being greatly reduced in schools, leaving many without the opportunity to be active during the school day. The National Association for Sports and Physical Education advises older children to get at least four hours of exercise a week. Schools are now considering a once or twice per week gym period to be a costly extra that might have to be expendable (Dakss 2009). Currently, only half of Philadelphia students are attending a weekly gym period (Shanklin et al. 2008).

PUFFA’s Innovative Approach:

A Youth Focus  PUFFA’s innovative approach has created a multicultural, youth-led, food-focused network in low-income areas not usually engaged in policy change. This network prepares young people to advocate for food system changes using “edutainment” tools, like technology, positive modeling and social networking. The concept of “edutainment” is that individuals take in information more quickly and easily if it is presented in a fun format (Bergmann, Clifford, and Wolf 2010).

Although people of any age are capable of improving their health, adolescents and children have a significant advantage; unhealthy habits are not yet set in stone, and they naturally have a higher metabolism than adults. Children age 18 and younger are an excellent group to target with preventative programming, with the aim that they will grow up making wiser food choices, and subsequently pass those lessons along to their own children. Young people also often have more free time and energy to become involved in social justice issues, including altering relevant policies. They also can be a significant positive influence on their parents, grandparents, cousins and younger siblings and the culture of their neighborhood. Educating youth can be powerful, but some unique barriers must be addressed to successfully get their interest, buy-in and cooperation.

The Art of Engaging Young People

The Art of Engaging Young People: Technology, Edutainment and Positive Modeling

Teaching healthy cooking techniques and advocacy skills and promoting exercise are some of the standard tools for involving individuals in making healthier food choices, which can lead to such downstream benefits as land beautification and creating sustainable food systems. PUFFA is doing all of that and more by adding customized, innovative programs designed to deeply engage adolescents. The combination of positive modeling, “edutainment” and technology is attractive and motivating to teens. PUFFA staff encourage young people to learn about and advocate for health through the modalities that are the most exciting and comfortable to them: Internet and video. Not only does this put participants in control of the information they want to market, it also allows them to engage other young people in a similar fashion.

Encouraging networking skills gives teens the confidence to be able to advocate for social causes. The program has utilized nearly every social networking technology available, including Flip Cam video share, Mobile Commons texting, blogging, Twitter, Wii fitness, Facebook and creating and posting public service announcements on YouTube. In addition, PUFFA has partnered with WHYY Public Media Commons, which has enabled participants to create more professional video productions and obtain broader media exposure. The success of an initiative like PUFFA comes down to connecting with youth through any means necessary. PUFFA has done an extraordinary job of this. Approximately 35 teens attend a monthly gathering called SALT (Students Advocating Lifestyle Transformations) and PUFFA to be a part of the discussions and enjoy good, nutritious food and an upbeat atmosphere.

PUFFA has created a wide variety of imaginative edutainment options. For example, participants can use Mobile Commons, a web- and text-based mobile marketing platform, to create short texts that encourage healthier eating and send them to peers. Each text is thoughtful and positive. Imagine checking one’s inbox on a rainy Tuesday and reading, “Be a veggie monster, not a cookie monster!” Or perhaps, “Bruce Lee says: ‘drink more watah!’” Other past messages include “Be active to stay attractive,” “Eat healthy, grow stronger, eat healthy, play longer” and “Go green, eat green!” The healthy lifestyle messages are a quick, low-cost, sustainable, easily understood and enjoyable effort to keep healthy eating on people’s minds. These messages are also easily accessed; anyone can join the communication stream by sending a text with the word “PUFFA” to 30644.

Positive modeling, by peers or adults, is also a vital piece of PUFFA’s youth programming. Peer models can have a special impact. A teen mentor study that paired teens trained in nutrition with younger children reported a statistically significant increase in the children’s intention to eat healthier and in their basic nutrition knowledge (Smith 2011). Research by Lowe et al. suggests that modeling motivates young people if the model is slightly older, if they admire the model or if they witness the behavior being rewarded (2004). SALT & PUFFA is a prime illustration of positive modeling. PUFFA Program Director D-L Wormley said that she knew that for SALT & PUFFA to be successful, she had to minimize adult input. The teens have control over the process, with the help of a nutrition educator and a few Youth Adult Mentors who help organize menus, schedules, ideas and projects. Voluntary Junior Chefs prepare the meal, and others staff the sign-in table and set up music. Youth-led educational stations switch topics of interest each month, allowing participants to take in information as they please. Tiffany Spraggins, PUFFA’s youth supervisor, leads icebreakers, group discussions and brainstorming sessions. This format allows teens to model positive behaviors for one another, as well as for some adult modeling. In addition, it spurs advocacy ideas that are led by youth to support positive changes in community and school food systems.

The Success of PUFFA's Youth

The Success of PUFFA’s Youth

PUFFA is also aware that simply giving out information without an associated action plan has limited value. The focus of programs like SALT & PUFFA is to discuss issues such as healthier possibilities for school lunches and then take the next step to try to implement changes. In other words, youth are able to apply what they learn about nutrition and healthy living to advocacy efforts targeting state and national health policies that affect them and their family, friends and communities. PUFFA participants have narrowed their focus to issues surrounding school food and, in particular, schools that are limited to satellite kitchens.

In support of their efforts, PUFFA youth have written petitions, contacted legislators and collaborated with the Philadelphia School District by proposing menu adjustments. Participants have attended and spoken at conferences and meetings, such as Temple University’s Celebration of Black Writing and the Philadelphia School District’s School Reform Commission. Some choose to participate in the 2011 PUFFA Summer Internship, a 6-week, 20-hour paid program. Experiences include touring farmer’s markets, community workdays at Philabundance and youth-oriented urban agriculture and gardening sites, and Media Camp. Others are becoming further involved by joining with one of PUFFA’s many partners, including Teens 4 Good, Fair Food and the Philadelphia Horticulture Society. PUFFA is preparing today’s teenagers to acquire the leadership skills necessary to ensure that quality community development and social policy continue to improve long into the future.

One Participant’s Story

LaQuanda Dobson, a PUFFA participant, is an inspiring illustration of the power of youth voices advocating for foods that promote health. A 19-year-old graduate of University City High School, she speaks at events throughout the country, most recently at an “Appetite for Change” event in Delaware County. Her interest in a healthy lifestyle stems from the untimely death of her beloved aunt who had type 2 diabetes. Ms. Dobson explained that this loss increased her awareness of diseases and she soon found her interest piqued by how much eating habits are linked to overall health.

After the death of her aunt, Ms. Dobson started reading about diseases, which inspired her to change what she ate. A passionate cook, she dabbled with swapping healthier alternatives into her recipes. Soon after, she was encouraging her family to try her healthy experiments. “I started small,” she said, “first with some whole grains, and it grew from there.”

In ninth grade, Ms. Dobson took her first dip into organized food advocacy, joining the Food Justice Movement. In tenth grade, she was one of three youth involved with the Agatston Urban Nutrition Initiative (AUNI), which promotes healthy living in West Philadelphia. AUNI participants were invited to join in PUFFA activities, which led her to SALT & PUFFA. What keeps her coming back is the way it brings community members together, even with racial, cultural and language differences. She says that she always feels welcome there and likes how adults became the guests at the youth’s meetings, not the other way around. She also loves the healthy food, physical activity and new cooking techniques she has learned.

As Ms. Dobson plans for her career and future, her interest in health is more than a hobby. She is currently an employee of the University Nutrition Initiative, where she is placed at the School of the Future. There, Ms. Dobson passes on her passion for healthy living by teaching, advocating for and supervising students. The Initiative focuses on equipping young people with the tools to cook, participate in physical activities and plan for further education. With her commitment to improving the lives of individuals in her community and at her job, Ms. Dobson is a wonderful role model for her students and, surely, a powerful future leader in food systems reform.

The Results of PUFFA's Food Systems Changes

The Results of PUFFA’s Food Systems Changes: West and South Philadelphia

In addition to its youth-oriented programming, PUFFA is bringing its attention and energy directly to two multiethnic, multicultural and multilingual low-income Philadelphia communities: South Philadelphia and West Philadelphia. PUFFA led adult focus groups to ascertain residents’ needs. Included were recommendations to employ young people to be trained to deliver groceries on bikes, provide lower-cost bus fares for individuals to travel for fresh produce, partner with residential entrepreneurs to open dance clubs for exercise and train community members to provide exercise classes (PUFFA: Adult Focus Groups 2008).  The South Philadelphia community is a crossroads of culture and diversity. The median household income is $25,729 (South Philadelphia Business Association 2011). The South Philadelphia Business Association describes the area’s demographics as 54.9 percent African American, 36.5 percent Caucasian, 5.9 percent Asian and 2.1 percent Latino. The Business Association also notes that 7.3 percent of residents are immigrants, and 13 percent speak a language other than or in addition to English. Other minorities, including Laotian, Cambodian, Vietnamese, Bhutanese, Middle Eastern and Mexican families, have roots in this area. This diversity has its drawbacks; as Sarun Chan, the Youth Program Director at the Cambodian Association of Greater Philadelphia, comments: “The area is very diverse, but the neighborhoods are still segregated” (Weaver 2011).   Before a sustained food system could have impact in South Philadelphia, local organizations and cultures had to unite. Mifflin Square Park, the Houston Community Center and Murphy Recreational Center were all targeted as ideal sites to clean up and implement programming. But first, the Cambodian Association of Greater Philadelphia and the City of Philadelphia’s Parks and Recreation Department had to come to an agreement concerning how the spaces were to be used. The two groups had a history of misunderstandings, and PUFFA saw this as an opportunity to create an alliance and informal contract. This achievement marked the start of using the community spaces in new ways.

Out of these efforts came the Friends of Mifflin Square, an organization with community members and affiliated individuals. Current programming is blossoming. The Houston Community Center’s garden plots attract community adolescents who can sell the produce. Mifflin Square Park hosts movie nights, the uGO! Fitness Challenge, dance contests, barbeques, basketball tournaments and a Multicultural Day to help bridge diverse populations. All of these activities have contributed to a positive change in the interactions and feelings of community members.  The changes at the Houston Community Center’s Orchard Lots and Gardens have  affected many of the involved youth. A few are interviewed in a short documentary called Maintain and Sustain (2010), created by PUFFA teens Durrell Hospendale, James Purcell, Stephanie Jackson, Dameda Moore and Omar Epps and WHYY Public Media Commons. In it, Charles Jones, from Teens 4 Good, states: 

We’ve formed a family, a certain connection to the community. Whereas, when we first came, we didn’t really have an appreciation for it because we hadn’t really put in any time. But over time, it just sort of became part of us. It keeps us out of trouble. We know that while we’re here, we feel safe.

PUFFA is also working with is the Walnut Hill neighborhood in West Philadelphia. Walnut Hill has approximately 6,975 residents in an area of 0.2808 square miles (Walnut Hill Community Association 2011). According to the 2000 census, the median family income was $19,772 and approximately 81 percent of residents are African American, with about 3 percent Latino and 5 percent Asian-American (Walnut Hill Steering Committee 2007). The Enterprise Center Community Development Corporate is PUFFA’s key community partner in working with Walnut Hill. Residents, young and old, are benefiting from and participating in this partnership.   One of the most exciting Walnut Hill initiatives is the community farm at 4610 Market Street. The farm has plots for individual gardening, but it also hosts a youth farmers’ venture. Local teenagers, including PUFFA Youth Cameron Taylor, are putting on their business hats, marketing and selling the produce grown at the farm. The Philly Rooted Grower’s Cooperative connects youth with appropriate farmer’s markets to further their business. Participants currently sell produce at four locations, with the option to join a Community Supported Agriculture program. Each share costs $200 and will provide the buyers with a season of fresh, beautiful produce, while also supporting the young farmers (The Enterprise Center 2011).

The Cost of PUFFA and a Social Return on Investment Formula

The Cost of PUFFA and a Social Return on Investment Formula

Calculating the true cost of PUFFA is challenging, because of the various stages of the grant, the level of in-kind support from all of the partners, other sources of funds, and budget reallocations to support the changing needs of the initiatives. The costs associated with the SALT & PUFFA program, though, are more easily quantifiable and offer a means to explore the social return on investment from PUFFA.

The total annual budget for SALT & PUFFA is approximately $12,660, for 12 monthly meetings. The bulk of this goes towards a nutrition educator ($5,000) and the physical space and meals ($2,500). The Wii fitness equipment and cameras each cost approximately $500. Two thousand dollars is budgeted for travel tokens for participants. A Youth Supervisor, who typically works about 10-12 hours per month on the event, earns a salary of approximately $2,160 per year.   The costs to administer SALT & PUFFA are minimal in relation to the dollars spent nationally as a result of weight-related healthcare issues. Today, 9 percent ($147 billion/year) of U.S. healthcare costs are attributable to weight-related issues. This cost is projected to rise to $344 billion in 2018 (Rising Obesity 2009). Research verifies that youth associate eating junk food with fitting in with peers (Cannuscio, Weiss, and Asch 2010). PUFFA’s innovative model neutralizes this negative pattern by ensuring that youth have access to adult and peer modeling of healthy habits. Information is presented through fun edutainment methods, providing young participants with the opportunity to learn critical advocacy skills, thereby increasing the likelihood that youth will develop a lifelong commitment to healthy eating and healthy lifestyle choices.
We hypothesize that PUFFA participants will gain less additional weight, stay at or lose weight over time as a result of their involvement in the program. Each one percent reduction in body weight equates with a reduction in an individual’s lifetime healthcare costs of approximately $440. Deducting $150 per individual to account for costs associated with living longer brings the total projected savings to $290 per one percent reduction in weight (Dall et al. 2010).   The formula below assumes that 35 PUFFA teens are involved in SALT & PUFFA, each with five outside peers who regularly read SALT & PUFFA’s texts (for a total of 210 teens). It also assumes that each participant is invested in reducing his or her caloric intake and commits to eliminating at least one junk food snack, at approximately 500 calories per snack, per week. 

Step 1: Cutting out 500 calories per week translates into approximate monthly weight loss of 1.5 pounds. The rate of weight loss will increase or decrease depending on the number of 500-calorie snack reductions made. “A pound of body fat equates to approximately 3,500 calories. So if you have a calorie deficit of 500 calories (meaning that you burn 500 calories more than you eat each day) you would lose approximately one pound per week” (What it takes to lose a pound, n.d.). 

Step 2: If each of the 210 teens assumed above lost one percent of body weight (about 1.65 lb for a weight of 165 lb), together their total cost savings, based on $290 saved per one pound lost, will be $60,900. Subtracting the $12,660 that it costs annually to administer SALT & PUFFA from the total equals a net $48,240 in savings. 

Step 3: If each teen lost 5 percent of body weight, individual lifetime healthcare savings come to $1,450 ($2,200 total minus prolonged life costs of $750). Together, total cost savings achieved by a 5 percent weight reduction for 210 individuals are $304,500, or $291,840 after program costs are deducted. If each of the 210 teens loses 10 percent of body weight, the total savings would be $609,000, or $596,340 after subtracting program costs. 

Individuals who maintain a healthy weight avoid these extra costs altogether and are at a lower risk for developing numerous health problems (Rising Obesity 2009).

Measuring Success, Balancing Risks and Sustaining the Program

Measuring Success, Balancing Risks and Sustaining the Program

The success and effectiveness of PUFFA are evaluated in several ways. Kellogg, the funder, requires staff to track and record each partnership and alliance created and utilized. Codes are available to distinguish between types of organizational cooperation, and a detailed description is necessary when an alliance is no longer active. This system provides an up-to-date log and history that helps PUFFA understand the differing quality of the relationships they have in the community. This is essential in program development because staff can work to strengthen ties in weak areas and seek resources from new, untapped organizations. The existence of active partnerships that have regular communication is a major factor when weighing the success of PUFFA.  PUFFA also collects satisfaction survey results from participants, as well as data to put together narratives about systems changes they have contributed to. Individual satisfaction surveys ensure that participants’ needs are being heard and met, just as much as organizational partnerships are. The results of each survey guide PUFFA’s next steps. Systems change descriptions capture some of the individual experiences, as well as telling the community’s story. Kellogg encourages staff to share both successful outcomes and failures, as well as any surprising results. As an illustration, the narrative that documented the 2010 South Philadelphia Mifflin Square Park project includes community survey results:

Among adults surveyed, the most common neighborhood venues for physical activity were the resident’s homes (70%), walking in the neighborhood (44%), parks (47%), playgrounds (18%) and fitness centers (18%). Barriers to being physically active in PUFFA’s target South Philadelphia neighborhoods include neighborhood safety concerns (21%), lack of personal initiative (24%), lack of facilities (30%) and no time for physical activity (25%) (Systems and Policy Change Stories 2010).

These stories allow PUFFA to put its work into context, along with providing the larger-scale results.   Information that is not currently collected, but may be advantageous in the future, is data regarding individual youth progress. Following participants’ rate of high school graduation, college and career choices and future involvement with food systems policy would provide another means to evaluate PUFFA’s impact on community members.   A major challenge exists for this intervention model. PUFFA receives the Kellogg grant in three stages: Planning, Implementation and Sustaining. PUFFA is halfway through the three-year Implementation stage. HPC will soon learn whether Kellogg will provide the next round of funding to support the Sustainability stage. If not, PUFFA’s community efforts over the past few years will not disappear. In fact, PUFFA’s goals are designed to be sustainable through building community capacity. PUFFA teaches community members how to recognize what changes need to be made as well as the skills to be able to take appropriate action, even without PUFFA’s or Kellogg’s support. Their ultimate results are the long-term success of communities advocating for themselves.

This means that PUFFA might be working to put themselves out of business. There is no doubt that the West and South Philadelphia communities are capable of pulling together and organizing themselves around social issues. PUFFA’s work is capable of being continued through a volunteer base or incorporated into another agency’s goals. Yet, at this point in time, the real risk is the unknown of how well and how long this progress will continue without PUFFA to lead the support of partnerships, facilitate collaboration and provide technical assistance and training.  Other programs in Philadelphia share PUFFA’s main goals and focus. Teens 4 Good encourages adolescents to take initiative in their communities to improve fresh food options with community gardens and policy advocacy (Teens 4 Good 2010). Healthy Kids, Healthy Communities is another HPC venture that connects youth in after-school settings with resources to better their community (Healthy Kids, Healthy Communities 2010). Nu Sigma Youth Services, Inc., also works toward these goals, with a special focus on the involvement of African American youth (Nu Sigma Youth Services n.d.). But none of these other organizations utilizes quite the same innovative components to engage youth as PUFFA.   PUFFA is a potentially scalable model. What puts the program at risk is what could make scaling a success: most people, with preparation and confidence, are capable of becoming advocates for the cause of healthier food and lifestyles. Communities fundamentally desire safer and more beautiful public spaces and healthier lives for residents, even if that means a great deal of work and cooperation to get there. A program like PUFFA pushes individuals to make connections between communities, for example, through SALT & PUFFA meetings. This programmatic structure is not precisely replicable because so much is based on the unique nature of each neighborhood’s needs, but it is a “catchy” goal that communities may see value in and buy into. The spirit of positive action is easily spread from one organization or individual to others. Vanessa Briggs speaks to this:

The model has great potential for replication in that it relies on the uniqueness of each neighborhood to identify and own its food system/health issue. Additionally the adaptability of having it be birthed from a customized neighborhood approach lends to greater commitment and thus sustainability. With youth being the constant driving force of change, using a youth-led approach to advocate for policy change at a community level lends to greater success, replication and ability to break down racial divides between communities. This peer-to-peer advocacy approach has a lasting impact and most importantly trains and builds our future leaders through the creation of sustained social networks among youth.

Barriers and Risks to Policy Change

Barriers and Risks to Policy Change

The School District of Philadelphia, even with substantial 2011 budget cuts, has been cooperating with PUFFA’s efforts. The district has taken into consideration the menu changes that PUFFA recommends and is open to hearing further suggestions. But this may not last long either, as the School District is forced to stretch its limited resources in a variety of directions. In comparison with keeping a neighborhood school’s doors open and attempting to lay off as few education professionals as possible, food and exercise might once again become last priorities.  Health and weight are major national priorities lately. First Lady Michelle Obama’s Let’s Move! Campaign set out to, in one generation, reduce the health risks associated with poor eating habits and little exercise. Schools have more incentive than ever to get involved through initiatives like the HealthierUS School Challenge, which provides monetary rewards to educational institutions that are making active play and fresh, healthy foods a priority. Involved schools can look forward to the opportunity to be recognized for their efforts (Learn the Facts 2011). Philadelphia is benefiting from these changes, as programs such as PUFFA receive interest, funding and positive attention. But the danger exists that this attention will not last, especially if the Let’s Move! Campaign fails.  PUFFA has a lot to contribute to the nation’s future, including reduced racism and an increased understanding of other cultures, healthier communities that communicate and cooperate, individuals who are knowledgeable and capable food systems advocates, invested youth leaders and a reduced national health bill. These long-term goals are worth funding, and it’s worth waiting to see the potential results of these changes.

A 2011 graduate of the University of Pennsylvania’s School of Social Policy and Practice, Suzanne Nelson is a licensed social worker. She is currently a student at the Fels Institute of Government, attaining a Certificate in Nonprofit Administration. Her professional background includes intensive case management in homeless and substance relief services, as well as school social work in the Philadelphia School District.

References

References

Belluck, P. (2010, January 13). Obesity Rates Hit Plateau in U.S., Data Suggest. The New York Times. Available at http://www.nytimes.com/2010/01/14/health/14obese.html.

Bergmann, L., D. Clifford, and C. Wolf. (2010). Edutainment and Teen Modeling May Spark Interest in Nutrition & Physical Activity in Elementary School Audiences. Journal of Nutrition Education and Behavior, 42: 139-141.

Carter, B. J., A. S. Birnbaum, L. Hark, B. Vickery, C. Potter, and M. P. Osborne. (2005). Using Media Messaging to Promote Healthful Eating and Physical Activity Among Urban Youth. Journal of Nutrition Education and Behavior, 37(2): 98-99.

Cannuscio, C. C., E. E. Weiss, and D. A. Asch. (2010). The Contribution of Urban Foodways to Health Disparities. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 87(3): 381-393.

Dakss, B. (2009, February 11). Obesity Up, Phys Ed Down. CBS.com website. Available at http://www.cbsnews.com/stories/2005/01/27/earlyshow/contributors/debbyeturner/main669760.shtml.

Dall, T. M., Y. Zhang, S. Zhang, D. R. Arday, N. Sahai, P. Dorn, and A. Jain. (2010). Weight Loss and Lifetime Medical Expenditures: A Case Study with TRICARE Prime Beneficiaries. American Journal of Preventative Medicine, 40(3): 338-344.

The Enterprise Center: Community Farm (2011). Available at http://www.theenterprisecentercdc.org/cdc/projects/community-farm/.

Graham, K. A. (2011, June 30). 26 Philadelphia Schools Losing Full-Service Kitchens. PhiladelphiaInquirer. Available at http://articles.philly.com/2011-06-30/news/29722033_1_school-meals-kitchens-elementary-schools.

Health Promotion Council: Building Connections to Health. (2010). Available at http://www.hpcpa.org/site/index.php.

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Hospendale, T., J. Purcell, S. Jackson, and D. Moore. (producers). (2010). Maintain and Sustain [motion picture]. Available at http://www.youtube.com/watch?v=jTX-y4CIS5w.

Learn the Facts. (2011). Let’s Move! website. Available at http://www.letsmove.gov/learn-facts/epidemic-childhood-obesity.

Lowe, C. F., P. J. Horne, K. Tapper, M. Bowdery, and C. Egerton. (2004). Effects of a Peer Modeling and Rewards-Based Intervention to Increase Fruit and Vegetable Consumption in Children. European Journal of Clinical Nutrition, 58: 510-522.

Lydersen, K. (2008, Summer). Making Food Deserts Bloom. Shelterforce: The Journal of Affordable Housing and Community Building. National Housing Institute website. Available at http://www.shelterforce.org/article/984/making_food_deserts_bloom/.

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Ollinger, M., K. Ralston, and J. Guthrie. (2011). School Foodservice Costs: Location Matters. U.S. Department of Agriculture, Economic Research Report, 117: 1-44.

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Potter, S. C., D. Schneider, K. K. Coyle, G. May, L. Robin, and J. Seymour. (2011). What Works? Process Evaluation of a School-Based Fruit and Vegetable Distribution Program in Mississippi. Journal of School Health, 81(4): 202-211.

PUFFA: About Us. (2010). Available at https://bhcusa.serverdata.net/philadelphia/about/default.aspx

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Smith, L. H. (2011). Piloting the Use of Teen Mentors to Promote a Healthy Diet and Physical Activity among Children in Appalachia. Journal for Specialists in Pediatric Nursing, 16: 16-26.

The South Philadelphia Business Association: Demographics. (2011). Available at http://www.southphiladelphiaba.org/demographics.asp.

Systems and Policy Change Stories. (2010). Philadelphia Urban Food and Fitness Alliance: Cross Site Evaluation.

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Weaver, S. (2011, February 23). Friends of Mifflin Square Create Cultural Cohesion. South Philly Review. Available at http://www.southphillyreview.com/news/Friends-of-Mifflin-Square-create-cultural-cohesion-116773249.html.

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Issue 8 | Nominated Innovations