Exploring the Effectiveness of an Occupation-Based Program Aimed at Reducing Food Insecurity

RESEARCH QUESTION: What is the impact of an occupation based program on maximizing food resources and reducing food insecurity?

BACKGROUND: Poverty and hunger are persistent problems in the United States. In 2011, 17.9 million people struggled to access, obtain, and manage food resources. This struggle is referred to as food insecurity. To combat hunger, food-insecure individuals use a number of strategies such as involuntary dietary restriction, rationing food, or choosing inexpensive food alternatives that contribute to poor nutrition, as well as consuming nonfood items.

In 2011, the U.S. government spent $94.8 billion on food assistance programs. However, these programs have had marginal impact on reducing the number of people who are food insecure. Federally funded programs and local food pantries primarily focus on the provision of food without regard to habits and performance skills required to use food resources effectively. The level of food insecurity in the United States has remained unchanged since 2008, thus highlighting the need for programming alternatives. Gans et al. reported that programming that is tailored to the individual is more successful than those that have a fixed curriculum.

Occupational therapists have expertise in developing individualized programs. This project demonstrates the preliminary results of an individualized occupation-based program designed to reduce food insecurity.

DESIGN: Quantitative

PARTICIPANTS: After institutional review board approval, participants were recruited from members of the Getting Ahead Program at Hope House for the Homeless, which is a community agency whose mission is to eliminate homelessness and alleviate poverty in the local area. The Getting Ahead Program focuses on building specific skills to help individuals move out of poverty.

Participants were recruited through informational flyers posted at Hope House as well as direct mailing of flyers to all participants of the Getting Ahead Program. The participants included both men and women. The number of participants was 14. The number of participants was determined by space availability.

METHOD: Data were collected using two pre–post measures: a modified Canadian Occupational Performance Measure (COPM) and a newly designed Making Meals Performance Measure (MMPM). The COPM is a client-centered semistructured interview. This tool was used to obtain self-perceptual change over time in performance problems specifically pre- to postintervention. The MMPM is a tool designed to measure (1) how many meals a participant can make with a specified number of food items, (2) the number of food items available versus the number of food items used, (3) the number of food units used, and (4) the complexity of the meals created. This tool is in the process of being validated

ANALYSIS: The COPM was analyzed by comparing preintervention scores with scores at postintervention to determine the amount of change. The MMPM was analyzed using a paired t test to determine significant change.

RESULTS: The preliminary data collected from the MMPM shows a clinically relevant change in participants’ ability to conceptualize possible meals based on available foods. The data also support that participants are more satisfied with their knowledge and skills regarding food resource management. Preliminary data from the COPM indicates that all program participants achieved a clinically significant change in both their food management performance as well as their level of satisfaction

DISCUSSION: This study explored the impact of a program designed to maximize food resources and, thus, reduce food insecurity. The program was individualized to the specific needs of the participants and was occupation based. The outcome measures indicate improvement in knowledge, skills, and satisfaction. However, continued research is needed to measure the lasting impact on reducing food insecurity

IMPACT STATEMENT: This proposal is important because it sheds light on the effectiveness of occupational therapy intervention in an area of national importance. It is also important that a tool was designed to address occupational performance in managing food resources where no comparable assessment existed. Valid outcome measures are important to occupational therapy because the profession continues to contribute to resolution of societal need