Promoting Awareness of SNAP Among Iowans Age 50+ with the Wellness and Independence Through Nutrition (WIN) Program

Introduction

Food insecurity among older adults is a growing national concern. Food insecurity, defined as limited, uncertain or inadequate access to a safe and nutritious food supply, among adults age 50+, is linked to many health and well-being complications that arise from both nutrition and non-nutrition related outcomes (Lee, Fischer, & Johnson, 2010). Nationally, it is estimated that three in 10 people eligible for the Supplemental Nutrition Assistance Program (SNAP) are not enrolled (Food Research and Action Center, 2013). In 2014, two in five adults age 50+ had a food-related hardship, and one in five had challenges purchasing nutrient-rich foods (AARP Foundation, 2014).

One means of promoting food security among adults age 50+ is informing them about SNAP. Participation in SNAP can help adults age 50+ who are food insecure overcome the financial barriers to consuming foods necessary to improve and/or maintain their health. Additionally, SNAP participation is associated with reduced rates and severity of poverty (Squires, 2014).

Extension can be an integral partner in promoting SNAP outreach awareness for adults age 50+ years. However, potential negative stigma associated with SNAP can create a challenge for outreach efforts. The National Center on Aging (NCOA, 2015) states that many midlife and older adults are hesitant to apply for SNAP because of the myths surrounding those who qualify and how the program functions. The key to overcoming this stigma is developing an outreach program that emphasizes the benefits to SNAP while addressing myths that create the negative stigma.

One such program is the Wellness and Independence through Nutrition (WIN) Program (www.extension.iastate.edu/humansciences/food-assistance-outreach), an Extension-delivered SNAP awareness outreach program for adults age 50+. It is implemented in 31 Iowa counties where SNAP enrollment among this age group is low.

WIN Program Description

Korlagunta, Hermann, Parker, and Payton (2014) recommended that multiple factors be incorporated into SNAP education for older adults, including well-being (e.g., physical, self-reliance, and emotional). Additionally, Hoerr, Francis, Margrett, Peterson, and Franke (submitted for publication) identified wellness and independence as two leading motivators for adults age 50+ when making health-promoting lifestyle decisions. Because the target audiences are similar, it is reasonable to apply the same recommendations to SNAP outreach. Therefore, the WIN Program was designed to promote SNAP as a way to emphasize wellness and independence among adults age 50+.

The WIN Program is designed to:

1. Increase awareness of SNAP and how it can help maintain good health and independence for adults ages 50+.
2. Increase SNAP enrollment among Iowans ages 50+ with limited resources currently eligible for, but not enrolled for, receiving SNAP.
3. Increase the number of volunteer educators advocating the benefits of SNAP to the target audience.

The WIN Program is comprised of six outreach programming options (Table 1). These outreach efforts incorporate strategies to lessen the stigma associated with SNAP including promoting SNAP as a wellness program through a variety of outreach programs (Food Research and Action Center, 2011).

Table 1.
Description of WIN Program Outreach Sessions

Program	Description
General Outreach Item
WIN Guidea	Guidebook that outlines SNAP eligibility criteria, the application process, addresses myths and provides general low-budget nutrition information. Provided at each outreach session.
Direct Outreach sessions (i.e., interactive between the volunteer educator and participants)
MyPlate Bingo	Discusses how SNAP helps older adults meet MyPlate recommendations Informs older adults about health benefits associated with different food groups and low cost ways to meet these recommendations.
Seasoning Savvy	Discusses how SNAP allows buying vegetable seeds or offsets the expense of herbs and spices to help lower sodium intake. Conducted after another WIN Program session per funding agency's request
Gardening- How to Grow Your Wallet! Game	Explains how SNAP can be used to purchase plants and seeds to grow vegetables to supplement the food supply. Includes a matching game that focuses on container garden vegetables. Participants receive recipes that use container garden vegetables.
Indirect Outreach Sessions (i.e., limited interaction between volunteer educator and participants)
Gardening-How to Grow Your Wallet! DVD	Explains how SNAP can be used to purchase plants and seeds to grow vegetables to supplement the food supply. Participants view an instructional video, created by the University of Illinois Urbana-Champaign Extension on how to create and care for a container garden.
WIN Guide DVD	Video (PowerPoint presentation with voiceover recording) that discusses the WIN Guide information.
WIN Guide Display	Interactive display that addresses SNAP myths. Used during local fairs, farmers markets, congregate mealsites, etc.
Note: aAvailable in Spanish

The WIN Program outreach sessions are conducted by volunteer educators in a variety of locales serving adults age 50+ with limited resources (e.g., congregate mealsites, senior health fairs, Section 8 senior apartments, farmer's markets, and county/state fairs) as recommended by Parsons and Morales (2014).

The WIN Program volunteer educators are recruited through volunteer agencies (e.g., Retired Seniors Volunteer Program), college student listservs (e.g., gerontology, nutrition, and health promotion), and local county-based Extension personnel. The WIN Program volunteer educators attend a training workshop (about 2 hours) conducted by Extension specialists. During these training workshops, volunteer educators receive a comprehensive WIN Program manual, view instructional videos on how to implement the various WIN Program sessions, and are trained how to complete volunteer reporting forms.

Methods

Participants are asked to complete a six-question evaluation at the end of each WIN Program session. These evaluations inquire about the role of nutrition in maintaining one's health, SNAP use (past and present), SNAP's role in helping people afford healthy foods, and food security. The evaluation also includes an optional section for participants to request assistance in applying for SNAP.

Findings

The WIN Program has reached 1,803 adults in Iowa between the ages of 50 and 101 and trained 27 volunteer educators over a 2-year period. Over one-quarter of the participants (n=473, 26.2%) completed a program evaluation.

The majority of participants who completed an evaluation attended a MyPlate Bingo session, had never received SNAP benefits, and correctly answered a nutrition and/or SNAP question correctly after attending a WIN session (Table 2).

Table 2.
WIN Program Participation Overview (n=473 participants)^a

	Number	Percent (%)
Session Attended
MyPlate Bingo	190	40.2
Seasoning Savvy	91	19.2
WIN Guide Display	88	18.6
Gardening-How to Grow Your Wallet! Game	44	9.3
WIN Guide DVD	41	8.7
Gardening-How to Grow Your Wallet! DVD	19	4.0
Answered at least one nutrition question correctly following a WIN session	363	76.7
Answered at least one SNAP question correctly following a WIN session	392	82.9
Reported never having received SNAP	294	62.2
Reported "Yes" to the following food security question: "In the last 30 days, did you ever eat less than you felt you should because there wasn't enough money for food."	35	7.4
Requested assistance applying for SNAP	98	20.7
aBased on program evaluation responses

WIN Program Impacts

During this 2-year timeframe, 98 adults were referred to the Iowa Food Bank Association (IFBA) for assistance in completing an online SNAP application. If each individual referred to the IFBA met the eligibility criteria and received SNAP benefits, the potential annual economic impact for this group would be $94,080 (98 adults x $80 average SNAP [in Iowa] to adults age 50+ x 12 months). Additionally, every $1.00 provided in SNAP benefits generates $1.73 in local economic activity (NCOA, 2015). Thus, the potential overall economic impact of the WIN Program to the 98 adults who were referred is estimated to be $162,758.40.

Summary

The WIN Program appears to be effective in promoting SNAP awareness among adults age 50+. The variety of WIN Program outreach sessions provides many opportunities for WIN Program volunteer educators to inform adults of how SNAP benefits can aid in promoting wellness.

The following characteristics likely contribute to the WIN Program success:

• Ready-to-go curriculum with training workshop,
• Use of volunteers for outreach efforts,
• Variety of outreach programming activities, and
• Wellness-focus of program.

Acknowledgements

The authors acknowledge the participants, volunteer educators, and Iowa State University Extension and Outreach for their hard work and dedication to the WIN Program. The program is funded by USDA's SNAP program through the Iowa Department of Human Services.

References

Food Research and Action Center. (2011). Making a difference: Effective SNAP strategies tailored to target groups and locations. Retrieved from: http://www.frac.org/pdf/making_a_difference.pdf

Hoerr, K., Francis, S. L., Margrett, J., Peterson, M., & Franke, W. Promoting the congregate meal program to the next generation of rural-residing older adults. Manuscript submitted for publication.

Korlagunta, K., Hermann, J., Parker, S., & Payton, M. (2014). Factors within multiple socio-ecological model levels of influence affecting older SNAP participants' ability to grocery shop and prepare food. Journal of Extension [On-line], 52(1) Article 1RIB3. Available at: http://www.joe.org/joe/2014february/rb3.php

Lee, J. S., Fischer J. G., & Johnson, M. A. (2010). Food Insecurity, Food and Nutrition Programs, and Aging: Experiences from Georgia. The Journal of Nutrition for the Elderly. 29.2, 116-149.

National Council on Aging (2015). Facts about SNAP and senior hunger. Retrieved from: http://www.ncoa.org/assets/files/pdf/NCOA-SNAP-Infographic_0714.pdf.

Parsons, M., & Morales, A. (2013). Starting a supplemental nutrition assistance program: Information for starting this program at a farmers market. Journal of Extension [On-line], 51(1) Article 1TOT5. Available at: http://www.joe.org/joe/2013february/tt5.php

Squires, B. (2014). Why are we encouraging struggling seniors to enroll in SNAP. Retrieved from: http://www.aarp.org/aarp-foundation/our-work/hunger/info-2012/snap-food-benefits-help-seniors-enroll.html