An Education Slideshow to Increase Nutrition Awareness of Heart Healthy Snacks for Oregon State Inmates Collaboration with Oregon Department of Corrections (ODOC) Katharine Parker & Amy King, DTR Betty Hansen, RDN Goal Increase inmates’ consumption and awareness of heart-healthy snacks, through an informative slideshow regarding the snack food items available at the Commissaries within the Oregon Department of Correction (ODOC) facilities. Objectives 1. At least 25% of the inmates surveyed will watch at least 10 slides within a month of premiering the slideshow. 2. Inmates will be able to list two heart-healthy snack items available at the Commissary. 3. The warehouse sales of heart-healthy snack items will increase by a total of 5% after the nutrition slideshow premiers. Significance  1,430,208 inmates nationwide in state and federal facilities in  14,571 inmates within Oregon 4.  Table 1: Cardiovascular disease incidences within ODOC inmates. Methods & Design  We created a nutritional PowerPoint, where each slide featured a heart- healthy snack food item offered in the Commissary. Each slide has a picture and nutritional information. We promoted 32 snacks total.  We also included nutrition education slides with various topics: heart disease, how to prevent heart disease, whole grains, sodium, how to read nutrition labels, portion sizes, fiber, and differences in fats.  The video has 47 slides and is 8 minutes and 40 seconds in length. It is being played on the informational channel within all 14 facilities. Inmates are able to view the video through televisions in their cells and common areas.  We created a flyer to be posted near the dining hall, advertising our nutrition slideshow. Implementation Table 3: Implementation Timeline. Correctional Facilities # of with CVD Total%age with CVD Coffee Creek3901, % Columbia River % Deer Ridge % Eastern Oregon5121, % Mill Creek % Oregon State % Oregon State Penitentiary 6492, % Powder River % Santiam % Shutter Creek % Snake River14783, % South Fork Forest % Two Rivers7981, % Warner Creek % Total509414, % average Commissary:  Products offered are currently based on profit margins.  Most items are unhealthy, such as candy and snack foods.  Is one of few opportunities inmates have to make personal food choices.  Excessive weight gain is frequent among incarcerated women 2.  Currently, limited nutrition education is offered. More is needed to keep inmates healthy for when they are released. QuestionPossible AnswersResults 1. Did you watch the nutrition slideshow on Heart-Healthy snacks in the Commissary? Yes No 64.9% 35.1% 2. How did you find out about the slideshow? Circle all that apply. I saw the flyer Someone told me about it I always watch the info channel I was randomly flipping through the channels and came across it Other: (please explain) 1.8% 20% 12.7% 25.5% 40% “Made to watch it due to: yard being closed, changing the common area TV to it, was showed before movies” 3. How many slides did you read? More than 10 30% 21.7% 48.3% 4. List two heart-healthy snacks offered in the Commissary. Yes – they were able to No – they were not able to 83.6% 16.4% 5. After watching the slideshow, did you buy any heart-healthy snacks? Yes No 34.4% 65.6% - 6 inmates wrote comments about the prices of the healthier items being too high 6. Was the nutrition information presented clearly? Yes No 86.9% 13.1% We received 61 completed surveys by inmates who saw the slideshow at OSP and PRCF. 33 surveys were thrown out due to being incomplete or were completed by inmates who did not see the slideshow. We are still awaiting surveys from CCF and SRCI. Results Table 2: Inmate Survey Responses from OSP and PRCF. Implementation DetailOriginal DateActual Date Final nutrition slideshow version completed. January 10, 2014January 20, 2014 Slideshow goes live within all ODOC facilities February 1 st March 5 th – OSP, SRCI March 8 th – CCCF, PRCF Evaluation  To measure our first two objectives, we created an inmate survey to be completed at four of the largest facilities: OSP, CCF, SRCI, and PRCF, starting March 17, 2014, or two weeks since the slideshow’s premiere.  To measure our third objective, we conducted a data analysis of the warehouse computerized software sales system. We measured three weeks out of the month of November, 2013 to serve as a baseline for comparison, or “pre-implementation sales.” Then, we analyzed three weeks from March, 2014 to represent outcome data, immediately after implementation, to establish effectiveness.  We did not account for additional steps in our original implementation, creating several delays:  Inmate Johnson was added on to the project to convert the slides into a DVD movie and add music.  Betty Hansen had to order additional DVDs in order to burn the video.  The Postal Service’s time to mail the DVDs to all the institutions.  Processing time within the facilities to air the DVD.  Inmates are able to watch the slideshow from personal televisions in their cells, common areas, and are being required to watch it before movies. Conclusion  Prices on these healthier items need to be lowered for inmates.  Sales need to be analyzed from the same month, one year later to avoid seasonal discrepancies and allow the video to be aired longer.  Inmates are receptive to nutrition education and are able to understand it through video displays. Acknowledgements Thank you to Betty Hansen, RDN; Gary Johnson; Jennifer Young, MPH, RD; David Gillies; and Grey Aktin. This project is made possible by The Oregon Department of Corrections. References 1. DOC Operations Division. Oregon Accountability Model reports / Correctional Facility Facts Sheets – Clarke JG, Waring ME. Overweight, Obesity and Weight Change among Incarcerated Women. J Correct Health Care 2012;18: Stephan, James J. Census of State and Federal Correctional Facilities, Bureau of Justice Statistics Revised 4/2/2010, Accessed 11/3/2013; 4. DOC Operations Division. Oregon Accountability Model reports / Correctional Facility Facts Sheets. Oregon.gov. Revised Each Facility is different 2009 – 2013 Accessed 11/1/2013; Graph 1: Total Commissary Warehouse Sales for All ODOC Facilities.