Developing the Food Assortment Scoring Tool (FAST) Caitlin Caspi, ScD University of Minnesota Family Medicine and Community Health NOPREN Hunger Safety Net Work Group September 25, 2017

Challenges in the hunger relief network Demand Low appeal leads to slow movement of healthy food through the system Supply Constraints on what is offered to clients

What are the needs for addressing healthy food supply? A way of measuring nutritional quality A way to provide feedback to donors and decision- makers Changes in ordering practices of food pantry staff New procurement strategies

Attempts to use HEI-2010 to measure supply

Challenges of using HEI-2010 in hunger relief Based on calorie density Complex coding system Need researcher assistance to calculate Difficult to combine data from multiple sources (food orders, donations, retail rescue)

Challenges of using HEI-2010 in hunger relief FAST Based on calorie density Complex coding system Need researcher assistance to calculate Difficult to combine data from multiple sources (food orders, donations, retail rescue) Based on weight Comprehensible coding system Can be calculated by food pantries themselves More easily incorporates food from multiple sources

Food Assortment Scoring Tool (FAST) Supported by Target Foundations Social Service Grants 2016-2017, in collaboration with The Food Group and Second Harvest Heartland

Overview: How the FAST is calculated Sort foods into defined food categories Weigh the food in each category and calculate a gross weight share for each category Multiply each gross weight share by a model parameter that reflects its healthfulness Sum all of the categories to create a total score (range 0-100)

Creating FAST food categories: A balancing act Validity Feasibility Is simple and transparent Categories are intuitive Small number of categories Correlates with HEI-2010 Categories align with other standards Large number of categories

Final FAST categories FAST category Coefficient 1 Fresh Fruits and Vegetables 63.4 2 Processed Fruits and Vegetables 79.2 3 Whole grains 111.1 4 Non-whole grains 35.2 5 Beverages 67.1 6 Dessert and snacks 35.5 7 Dairy 69.1 8 Vegetable Protein 132.2 9 Meat, poultry, fish, and eggs 63.3 10 High Processed meat 3.2 11 Mixed meals and side dishes 47.8 12 Condiments baking and cooking 37.5 13 Baby food   49.4 Obtained monthly invoices from two food banks over two years Modeled category parameters based on HEI-2010 scores and corresponding food assortment from the data (King et al. 2016)* 5,786 “food pantry month” observations Categories were broadly based on the Uniform Number Codes (UNC) used by Feeding America Network In general, less nutritious items can be grouped together Some categories reflect nutritional priorities Grains: Whole grains vs. non-whole grains Meats: Lean vs. processed meats FAST parameters take into account both the nutritional quality of the food in the category and the average weight of items in the category, so they cannot be directly compared with one another. For example, foods in the fresh fruits and vegetables category are nutritious (for which the category parameter is higher), but tend to be heavy (for which the category parameter is lower). Coefficient estimation procedures described in King et al., 2016 How healthy is hunger relief food? Am J Ag Econ, 2016 98 (2): 533-548.

FAST tool available at: https://www.healthdisparities.umn.edu/research-studies/hitt-4-health

Procedures for sorting food into categories FAST Category Examples Processed Fruits and Vegetables Canned corn Canned peaches Raisins Dried cherries Applesauce Frozen fruits, sweetened Canned Pumpkin Tomato/pasta/spaghetti sauce (no meat or cheese) Potato wedges Pickled vegetable Canned mushrooms Rotel tomatoes Hash browns Sauerkraut Dried potatoes Canned olives Pickles Canned olives (not stuffed) Mixed Meals and Side dishes Soups Hamburger helper Macaroni and cheese (even if whole grain) Lean cuisine Prepared deli sandwiches Canned chili containing meat Stuffed bread French toast Vegetables with sauce Restaurant meals Pork and beans Canned meat stew Canned pasta w meat Broth Fresh salsa Prepared salads, tuna salad, macaroni salad, broccoli salad, salad mixes with dressing

Average Availability Measure Correlation with HEI-2010 Average Availability Measure Client Cart Measure Flow Measure Description A precise one-time count of all items on the shelf available to clients Food selected by clients the end of their visit Food restocked on the shelf over a period of 5 days N 5 food pantries 60 clients

Average Availability Measure Correlation with HEI-2010 Average Availability Measure Client Cart Measure Flow Measure Description A precise one-time count of all items on the shelf available to clients Food selected by clients the end of their visit Food restocked on the shelf over a period of 5 days N 5 food pantries 60 clients Total HEI Score (min-max) 70.9 (60.6 -76.8) 69.6 (41.9 – 92.4) -- TOTAL FAST Score (min-max) 63.8 (55.8-72.2) 62.5 (50.3-79.6) 61.5 (54.9-66.0) Correlation 0.80 0.66

Conclusion FAST is a 13 category measure based on food weight FAST is a simple, transparent tool appropriate for use in food pantries FAST correlates reasonably well with HEI-2010 Food banks (The Food Group and Second Harvest Heartland) are currently integrating FAST scores into food pantry invoices