1. MPH 608 HEALTH COMMUNICATION AND INFORMATICS
Sample Materials for
Healthy Eating is a S.N.A.P.
Campaign
Final writing assignment; week 8
Steven C. Banjoff
6/12/2015
An examinationof the benefitsandevaluationmethodsassociatedwith the “HealthyEatingisa
S.N.A.P.” over-sizedpostcardmail campaign andthe “Come meetyourgrower”communityevent. A
detaileddescriptionof bothsample materialsislocatedinAppendixA of the document.

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Key Benefits of the postcard mail campaign (Appendix A)
The growing body of evidence that Americans are not eating the recommended amounts
of fruits and vegetables (United States Department of Agriculture, 2009), the USDA launched
the 5 a Day program nearly twenty years ago through public and private partnerships. Yet fruit
and vegetable consumption has actually dropped during the years 1999-2008 (Rossenfeld, 2010),
and many urban, disadvantaged, minority, individuals are increasingly residing in food deserts.
High profile efforts such as the First Lady’s Let’s Move campaign (Office of the First Lady,
2010), the USDA’s 5 a Day program, and the generally accepted belief that fresh foods are
healthier than highly processed foods indicates a growing awareness of the benefits of
consuming more fruits and vegetables. There is a need to communicate to those who are most
vulnerable, residing in food deserts, how they can accomplish the desired behavior of increasing
consumption of fruits and vegetables, while also reinforcing the overall health benefit of their
regular consumption. The over-sized postcard mailer (detailed description found in Appendix
A), a quarterly yearlong campaign, designed using Social Cognitive Theory, and The Health
Belief Model (Schiavo, 2014a). The goal being to improve and compliment existing health
literacy, raise awareness of availability, motivate, facilitate, improve performance, and raise self
efficacy in a cost effective, malleable, and easily adaptable ( i.e. social media, posters, web site,
etc…) campaign.
Health Literacy and Belief Benefits of Postcard Campaign
Demographics indicate that education attainment levels in the target area are lower than
the county average (Cleveland City Planning, 2014) making the possibility of low health literacy
and general reading comprehension a reality. To combat this fact the health message on the front

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of the post-card will turn research-supported evidence into simple, concise, and relevant
messages that are culturally appropriate. Due to the concise nature, inclusion of a Spanish
without becoming cluttered or confusing. The target population has a majority of African
American residents with a growing Hispanic minority (U.S. Census Bureau, 2014). A simple,
understandable health message appeals to the African American’s health belief of illness being a
consequence of an inadequate diet (Schiavo, 2014b). The postcard also improves the perception
of the food environment, which is justifiably negative due to the elements that exist in a food
desert (Fish, Brown, & Quandt, 2015), by raising awareness of the healthy food available in their
area, and nearby farmers markets that accept and participate in the SNAP Double Produce Perks
Program (Cleveland-Cuyahoga County Food Policy Coalition, 2014). The postcard image
depicts multiple ethnicities, shopping together, addressing fear of experiencing discrimination
shopping at an unfamiliar place (Zenk, et al., 2012), while also being comprised of more female
shoppers to mirror the population more likely to be shopping (Hale, 2011). Children and males
still play a role in the scene to reflect a friendly family atmosphere, and all aspects of the image
strive to reflect “people just like you” shop here.
Motivational and Empowerment Benefits of Postcard Campaign
The prominent placement of the phrase, Take Advantage of Double Produce Perks
Today!, located on the lower banner of the front with locations of markets in the area on the back
offering the incentive, is a crucial element of the communication. Surveys conducted by the
Cleveland-Cuyahoga County Food Policy Coalition, have shown of the 1059 SNAP participants
who shopped at farmers markets, 85% felt incentives were extremely important to bringing them
to the market (CCPFC, 2014). Surveys also revealed 37% of the 536 respondents found out
about the incentive program at the farmers market, and 22% informed through word of mouth

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(CCPFC, 2014). Mean households that receive SNAP benefits targeted by the postcard number
nearly 92,000 (U.S. Census Bureau, 2014), greatly increasing first hand communication of this
vital incentive, and where it is offered.
The final aspect of the postcard is the inclusion of a simple, affordable, and tasteful
recipe on the back, created by local chefs. This provides information on how to utilize the
produce they are being encouraged to buy. The recipe also may increase the likelihood of
postcard retention and referencing, increasing exposure to the overall message. A website link
provided enables access to more recipes for those with internet capabilities.
Evaluation of Postcard Mail Campaign (Appendix A)
The overall goal of the postcard is to increase the number of individuals, especially those
most at risk, in Cuyahoga County, consuming the recommended amount of fruits and vegetables
from less than 25% (Community Commons, 2015) to a 2-3% increase in recommended
consumption. Determination if the goal is realized through; written and phone surveys of
SNAP participants, random person-to-person surveys at grocery stores, farmers markets, and
other food retailers.
People and Situational Contributing Factors
The situational factors present in the food desert of Greater Cleveland, high population
density, high unemployment, transportation problems, and economic difficulty (United States
Department of Agriculture, 2009) it is important to evaluate if the incentive offered is enough to
overcome real and perceived difficulties. Point of sale surveys, sales data, and phone surveys
should show an increase of use of the produce perks program.

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Resources
The cost of 20,000 color double-sided postcards at Staples is $2,233.98 (Staples, 2014),
this represents an extremely economical communication capable of reaching many individuals at
a low cost per head. The development of the postcard requires limited person-hours to create
and has the ability to be quickly distributed and absorbed. The creation, purchasing, and
distribution of the postcard is well within the organizational budget, with cost savings provided
through donated time, expertise, and resources of our participating partnerships. The USDA
provides the necessary contact information uses existing organizational and multiple partner
competencies. Since partnerships are a vital component, continuing evaluation of
communications between partners through regularly scheduled bi-monthly meetings of key
representatives is an integral part of the evaluation plan concerning the most efficient use of
resources and content.
New Media Strategies and Incorporation of Other Program Components
The content of the postcard is digitally created allowing for transfer into alternate media
strategies i.e. flyers, electronic, posters, and radio script. The content also has the ability to be
easily shared with existing electronic media outlets of other key stakeholders. The incentive
program has been shown to raise overall sales of the vast majority of farmers markets that
participated (CCPFPC, 2014), which provides motivation for those not currently participating in
the program to join and increase capacity. The campaign has quarterly mailings, giving ability to
keep the information relevant, content malleable, and ease of integrating with new emerging
initiatives.

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Short-Term Goals
To increase the number of SNAP participants shopping at local farmers markets, an
important source of quality fresh produce in an otherwise food desert of the urban area of
Cleveland, to at least 2%. Roughly, 1% of the 92,000 households (U.S. Census Bureau, 2014)
utilized farmers markets during 2014 (CCCFPC, 2014). Determination if this increase is realized
will be through survey of participating markets sales reports.
Establish a telephone survey of SNAP recipients to be conducted at the beginning and
end of the yearlong promotion to determine actual food behavior, perceptions, and adequacy of
incentives. A modest improvement of 2-3% of these process and progress indicators should be
seen over the yearly data. The survey will help increase the limited data concerning the complex
relationship of multiple factors concerning food consumption behavior, contributing to the
understanding needed to create a more optimal program.
Key Benefits of the Meet Your Grower Community Event (Appendix B)
Research has indicated use and spoilage concerns (Phipps, Stites, Wallace, & Braitman,
2013), transportation concerns, negative perceptions (Fish, Brown, & Quandt, 2015),
socioeconomic status (Williams, Thorton, Ball, & Crawford, 2011) fear of discrimination (Zenk,
et al., 2012) and convenience (Wiig & Smith, 2008) affect food purchasing behavior. The Meet
Your Grower community event (Appendix B) uses Social Cognitive Theory to ameliorate the
negative impact these concerns create regarding healthy food consumption. The collaborative,
multifaceted effort provides an opportunity to raise awareness, increase role models, increase
social cohesiveness, empower, and motivate concerned individuals to improve their

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environment. The event will be held at the Refugee Empowerment Agriculture Program (REAP)
site, which is the largest contiguous urban farm in the Nation (The Refugee Response, 2010)
giving it the ability to change perceptions of area food availability and be a source of pride.
Health Literacy and Belief Benefits of Meet Your Grower Community Event (Appendix B)
Walking tours of tours of the farm provide tour members the opportunity to bond and
share information among each other while provided growing, nutritional, storage, and usage
information by their guide. In addition to increasing awareness, people who might not have
realized the scale of what is happening in their city, now have a physical sense of its size. The
staff at REAP have experience relating and training of agricultural information and provide an
excellent resource to facilitate the transfer of knowledge and stimulate conversation. Existing
informational materials regarding nutrition and various health associations, healthy recipes, and
area availability allows attendees the ability to pick information most important to them, and
provides an opportunity for further investigation.
Motivational and Empowerment Benefits of Meet Your Grower Community Event
(Appendix B)
The increased knowledge can give the participants the confidence in their abilities to
select, prepare, and grow their own vegetables. A bolstered feeling of self-efficacy may enable
individuals to participate in the local community garden, or investigate starting one in their own
community. The addition of food vendors offering tastes of dishes prepared from the fields they
just toured could motivate individuals to expand their palate to include healthy alternatives. The
experience of learning, sharing knowledge, and sharing food may encourage new partnerships to

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form and foster further exchanges of ideas. The opportunity for bonds to form between suppliers
and consumers is created with the personal glimpse into who grows their food and do grow it,
may encourage greater patronage to establishments that offer locally grown fresh foods.
Participation of representatives from the Cleveland’s Community Garden program,
Summer Sprout and the Cleveland Block Grant Program provide interested individuals with the
tools to change their environment, provide a source of neighborhood pride, and become valuable
role models for others. By communicating what resources such as soil testing, seeds, starter
plants, soil amendments, and funding (Ohio State University, 2015), (City of Cleveland, 2015)
available empowers interested groups who assumed they lacked the resources and expertise to
pursue such an endeavor. Expansion or greater participation of the more than 200 area
community gardens, as of 2009, continue to improve the existing environment and may lead to
the possibility of economic gain (Sturpka, 2009). SNAP representatives are also present to
provide information on eligibility and applications for SNAP. Partnerships between Healthy
Eating is a SNAP, Cleveland Foodbank, neighborhood churches and other organizations ensures
the most vulnerable, those that lack transportation, and others who may not be exposed to flyers,
and Fox 8’s Kickin’ it with Kenny promotional spot an opportunity to participate.
Support and resources made available through political action and programs have been a
critical component to fostering the changes and the continued improvement to the urban
environment in Cleveland. Having political leaders representing the neighborhoods of Cleveland
present to communicate what they are doing, demonstrates commitment to improving healthy
food access by city leaders.

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Evaluation of the Meet Your Grower Community Event
The overall goal of the community event is to increase the consumption of healthy foods in
Greater Cleveland by providing an 8-hour event with scheduled activities, entertainment, and
refreshments that increases awareness and empowerment provided by the various programs
available through the attendance of an event. It seeks to connect the city’s food consumers with
the city’s food producers in a meaningful manner. The population of Cleveland is 390,113 (U.S.
Census Bureau, 2014), if the event reaches approximately 5% of the population it should be
viewed as a success.
People and Situational Contributing Factors
Because the event is being held on the west-side of the city, evaluation of if eastern
neighborhoods attended the event are needed. Informal exit polling can indicate if the event
drew individuals from the eastern portion of town. It would be optimum to have equal
participation from all quadrants of the city, but transportation limitations, convenience, and
competing events may limit participation of some city residents. The use of regular partnership
planning committee meetings is in place to help mitigate, and anticipate these hurdles. The
meetings will also be an excellent opportunity for any participant to air competitive concerns by
hosting the event at REAP’s facility. Since this is an outdoor event, weather considerations will
always be a concern. It is important to evaluate the need for temporary shelter from the
elements, and there are adequate contingency plans in place if the event needs to be canceled or
shortened due to severe weather.

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Resources
The use of multiple partners, with common goals such as, REAP, the Cleveland-
Cuyahoga Coalition on Food Policy, The City of Cleveland Planning Commission, and others
provides a wide array of culturally sensitive, knowledgeable volunteer pool to staff the event.
The area resides alongside Cleveland’s Historic West Side Market and provides ample parking
and is located next a RTA transit station providing easy access from public transportation. The
participation of so many vibrant individuals all looking to improve access to healthy produce is
sure to be infectious and create a positive encounter.
New Media Strategies and Incorporation of Other Program Components
Advertising for the community event will first be created as a digital image, allowing the
components of the resulting flyer to be easily included in a event partner or stakeholder can
include on their own Web site. Local channel Fox 8 has a history of promoting good nutrition in
the Cleveland area. They featured the community supported agriculture endeavor Rising Harvest
on the daily morning Kickin’ it with Kenny segment. Having their support has given the event
valuable television airtime exposure.
Short Term Results
Exit polls conducted at the event indicate: That attendees have a different view of the
availability of area produce. Attendees felt they had learned something new and positive about
their community, something that they could take pride in. They left the event with a greater
sense of empowerment. They had a better understanding of who is growing their food, and the
many different programs and options they have available to purchase them. They intended to tell
others of what they learned at the event. The event left them motivated to consume more fruits

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and vegetables. The event gave them confidence to join a community garden, or to start a garden
of their own.

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Appendix A
Postcard Description
The postcard will be a double sided color print the size of the card is 8.50” x 5.59” to
provide ample room for our message. The upper banner of the front of the card will include
“Healthy Eating is a SNAP” with the word healthy spelled using caricatures of fruits and
vegetables. In smaller font and directly below, this same phrase will be expressed in Spanish.
This is a planned quarterly mailing, the image between the upper and lower banner portion will
vary slightly with the seasons. In general, it will depict women, children, and men of varying
ethnicities, happily buying produce in a market. Photos were taken at the Historic West Side
Market to provide visual effect. The lower banner will feature simple nutrition messages that
correspond to the seasonal availability of produce. For example, since the promotion is due to
start in spring the initial postcard will have “Your (heart symbol) loves leafy greens”. The
reverse portion of the postcard will proclaim, “Take advantage of double produce perks today!
Directly below, again in smaller font this same phrase is expressed in Spanish. The remaining
portion of the postcard will be divided into two equal left-right halves. The left quadrant will
contain the farmers market names and addresses participating in the double perks program. The
right quadrant will have simple, easy to prepare and economical recipes designed by area chefs.
The initial postcard will include a grilled/baked stuffed vegetable dish created by celebrity
Cleveland native chef Michael Symon. The postcard will be made of durable 80lb stock and
glossy making it a durable medium that can be saved and shared.

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Appendix B
The Meet Your Grower Community Event
The Meet Your Grower is a carefully planned and coordinated partnership of area
stakeholders to engage the citizens of Cleveland. The event is being held at the largest
contiguous urban garden in the Nation. REAP has generously volunteered its staff (whom are
already accustomed to giving tours of the farm). In attendance are representatives from area
community supported agriculture, area farmers market owners, political and community leaders.
Musical entertainment is provided by area musicians, along with refreshments and healthy food
items will be available at a nominal cost and provided by local restaurants. The advertisement
content will be digitally created to facilitate the information to be used through several media
channels. The content will be arranged similar to a concert promotion poster. An image of the
various staff members selected from the participating members will be taken with the backdrop
of REAP’s facilities in the background. Information on scheduled tour times, varying program
information opportunities, musical performers, and participating food vendors will also be
prominently featured within the body of the advertisement. The bottom portion will give credit
and appreciation to all the contributors that made the event possible.

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Appendix C
References:
Cityof Cleveland.(2015). BlockGrant Program.RetrievedfromCityof ClevelandWebsite:
http://www.city.cleveland.oh.us/CityofCleveland/Home/Government/CityAgencies/Community
Development/BlockGrantProgram
ClevelandCityPlanning.(2014). 2014 Neighborhood FactSheets.RetrievedfromClevelandCityPlanning
Commission:http://planning.city.cleveland.oh.us/2010census/factsheets.php
Cleveland-CuyahogaCountyFoodPolicyCoalition.(2014). DoubleValueProducePerks2014 Report.
Cleveland,OHhttp://cccfoodpolicy.org/sites/default/files/resources/2013report_final_0.pdf:
Cleveland-CuyahogaCountyFoodPolicyCoalition.
CommunityCommons.(2015). Community Health NeedsAssessmentFullHealth IndicatorsReport.
RetrievedfromCommunityCommons,date accessed4/3/15:
http://assessment.communitycommons.org/CHNA/report.aspx?page=1&id=710
Fish,C.,Brown,J.,& Quandt,S.(2015). AfricanAmericanandLatinoLow Income Families’Food
ShoppingBehaviors:PromotingFruitandVegetable. Journalof Immigrantand Minority Health,
Volume17 Issue2, 498-505, DOI 10.1007/s10903-013-9956-8.
Hale,T. (2011, March 11). In U.S.Men are Shopping MoreThan Ever,While Women are Watching More
TV.RetrievedfromNeilsenConsumer:http://www.nielsen.com/us/en/insights/news/2011/in-u-
s-men-are-shopping-more-than-ever-while-women-are-watching-more-tv.html
Office of the FirstLady.(2010, February9). First Lady Michelle Obama LaunchesLet'sMove:America's
Moveto Raise a Healthier Generation of Kids.RetrievedfromThe White House Website,date
accessed6/12/2015: https://www.whitehouse.gov/the-press-office/first-lady-michelle-obama-
launches-lets-move-americas-move-raise-a-healthier-genera
OhioState University.(2015,August13). 2014 SummerSproutReport. Cleveland,
http://cuyahoga.osu.edu/sites/cuyahoga/files/imce/Program_Pages/ANR/SummerSprout/2014
%20Summer%20Sprout%20Report.pdf:OSUextensionCuyahogaCounty.Retrievedfrom
Burton,Bell,Carr DevelopementWebsite .
Phipps,E.,Stites,S.,Wallace,S.,&Braitman,L. (2013). FreshFruitand VegetablePurchasesinanUrban
SupermarketbyLow-income Households. Journalof Nutrition Education and BehaviorVolume
45, Issue2,, 165-170, doi:10.1016/j.jneb.2012.04.018.
Rossenfeld,A.(2010). The Fruit and VegetableChallenge:How Federal Spending FallsShortof
Addressing PublicHealthNeeds. Web.http://www.pbhfoundation.org/:Produce forBetter
HealthFoundation.

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Schiavo,R.(2014a). CurrentHealthCommunicationTheoriesandIssues,KeyTheoretical Influencesin
HealthCommunication(chapter2).InR. Schiavo, Health Communication fromTheory to Practice
(pp.33-82). SanFrancisco,CA: Jossey-Bass.
Schiavo,R.(2014b). Culture andOtherInfluencesonHealthConceptionsof HealthandIllness,chapter3.
In R. Schiavo, HealthCommunication fromTheory to Practice,second edition (pp.83-100). San
Francisco,CA:Jossey-Bass.
Staples.(2014). Staples Copy and Print.RetrievedfromStaplesWebsite:
http://www.staples.com/sbd/content/copyandprint/postcards.html
Sturpka,M. (2009, July6). Cleveland'sforprofit community gardensaregrowing.Retrievedfrom
Cleveland.com:http://blog.cleveland.com/metro/2009/07/clevelands_forprofit_urban_gar.html
The Refugee Response.(2010). The RefugeeEmpowermentAgricultureProgram.RetrievedfromThe
Refugee Response Website:http://therefugeeresponse.org/our-work/reap
U.S. CensusBureau.(2014). American FactFinder. RetrievedfromU.S.Departmentof Commerce United
StatesCensusBureau:
http://factfinder.census.gov/rest/dnldController/deliver?_ts=445011178441
UnitedStatesDepartment of Agriculture.(2009, June). Accessto Affordableand NutriousFood:
Measuring and Understanding Food Deserts. RetrievedfromUSDA WebSite,date accessed
6/5/2015: http://www.ers.usda.gov/media/242675/ap036_1_.pdf
Wiig,K.,& Smith,C. (2008). The art of groceryshoppingona foodstampbudget:factorsinfluencingthe
foodchoicesof low-income womenastheytryto make endsmeet. PublicHealth Nutrition:
12(10), 1726–1734 doi:10.1017/S1368980008004102.
Williams,L.,Thorton,L.,Ball,K.,& Crawford,D. (2011). Is the objective foodenvironmentassociated
withperceptionsof the foodenvironment? PublicHealth Nutrition:15(2), 291-298,
doi:10.1017/S1368980011001947.
Zenk,S.,Shulz,A.,Israel,B.,Mentz,G., Miranda,P.,Opperman,A.,& Odoms-Young,A.(2012).Food
shoppingbehavioursandexposuretodiscrimination. PublicHealth Nutrition:17(5), 1167-1176,
doi:10.1017/S136898001300075X.