53,211 total unique visits since launch in September 2013
36,266 unique visits from California residents since launch
34 organizations and county offices in California have integrated EatFresh.org into their programming and processes
- 71% of EatFresh.org users enrolled in CalFresh or other means-tested program had not attended an in-person nutrition workshop or class
28% increase in new users to EatFresh.org since launch
86% of users (versus 83% nonusers, p<.001) cook meals at home
71% of users have made at least one recipe from EatFresh.org (31% have made one recipe, 20% have made two recipes, and 20% have made three or more recipes)
44 questions submitted and answered on Ask a Dietitian
Average of 102 text messages per month sent directly from EatFresh.org recipes
Our impact evaluation results are finally here! From November 2013 to October 2014, Aetna Foundation funded an impact evaluation of EatFresh.org. The purpose of EatFresh.org is to encourage low-income Californians to cook more frequently at home and to increase their consumption of fruits and vegetables. Weinreich Communications conducted a comprehensive evaluation of the effectiveness of EatFresh.org, including:
- Website and social media usage tracking,
- Website user satisfaction survey,
- Key informant interviews,
- Focus groups, and
- Knowledge, Attitude, and Behavior (KAB) survey.
Overall, EatFresh.org is well-received by its users, with the recipes being the most popular element of the website. Users feel the website is easy to use, appealing, and culturally appropriate. The number of visitors to the site is fairly steady from month-to-month, with a 28% increase in new users over the past year. Most visitors to the site reported that they were able to successfully achieve what they had come on the website to do, and many users have incorporated EatFresh.org into their meal planning process. Additionally, most of the focus group participants reported using the website in some way to aid with eating healthy, whether in changing their attitudes, finding new recipes, or receiving guidance on things like finding local farmers' markets.
One of the most exciting findings from this evaluation was that 71% of users who are participating in CalFresh or another means-tested program had not attended a community nutrition or cooking class. The California SNAP-Ed program is designed to work throughout the Socio-Ecological Model and reach the target population in a variety of ways – direct education (classes), indirect education (health fairs), social marketing, etc. Policy, systems, and environmental change (PSE) interventions are emerging, and the USDA has classified EatFresh.org as a PSE intervention. This evaluation clearly demonstrates that this intervention is reaching our target population in a way that other interventions are not.
Though there was not a clear dose-response relationship among those who used EatFresh.org, users were significantly more likely to:
- Know how to read a nutrition label
- Know how to use a grocery list when they shop
- Believe that what you eat can make a difference in your chances of getting heart disease or cancer
- Believe that they will have more energy if they eat fruits and vegetables
- Read a label for nutrition information when shopping
- Use a grocery list when shopping
- Avoid foods with added fats, salt, and sugar
- Plan meals before shopping
- Cook dinner at home.
Differences were also found between men and women, among various age groups, and among language groups.
Because there is no direct pathway for users on EatFresh.org, it is difficult to assess the exposure or dosage of specific messages received. In 2015, we plan to build an online curriculum using EatFresh.org as the primary resource. This curriculum will include individualized learning informed by the Stages of Change Model and a knowledge assessment, allowing us to determine specific KAB impacts of the website on our users. By providing a pathway to exploration and ensuring they are being exposed to different areas of the website, we can more accurately assess the effectiveness of delivering evidence-based nutrition messaging through the EatFresh.org format. For FFY2015, a formative and process evaluation will be completed as we build out the curriculum.
Supported by the Aetna Foundation, a national foundation based in Hartford, Connecticut that supports projects to promote wellness, health, and access to high-quality health care for everyone. The views presented here are those of the author and not necessarily those of the Aetna Foundation, its directors, officers, or staff.