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Research Study

Leah’s end goal is to see policy changed so that low-income families everywhere, regardless of where they live, can access fresh and nutritious food. She believes that collaborative efforts for more just and sustainable food policies and food systems can be achieved through community-based initiatives. Leah hopes the utilization data that comes from this proposed Research Study will help in the war against food insecurity.

Introduction

It's acknowledged that one of our health care policy challenges is controlling health costs while sustaining health and health care. It's also acknowledged that covering the costs of food access for this population group appears to be unsustainable. 

 

But does anyone really know? 

 

A population health approach to study health and health care costs among a sample-size population group within the environment of a three-year research study would finally provide the evidence-based data needed to know how much feeding the poor really costs over time.

Currently, Ontario’s healthcare insurance covers the cost of treating chronic diseases caused from malnourishment and physical inactivity, and that also includes the costs associated with endocrinological care and managing and treating the associated morbid conditions. 

Goals

The proposed research study aims to reach a deeper understanding of patient disparities along the healthcare cost pathway to put forward a patient typology. Moreover, from a practical point of view, it’s of great interest to integrate together the patient cost pathway and the patient profile to give a better understanding of their contribution to the overall goal of decreasing costs on the health care system. Bringing together findings of patient cost, pathway, and profiles will paint a crystal clear portrait of the current true costs of not covering nutritious food [and a physical regime if applicable] under the provincial health insurance plan, for low-income citizens. 

Objectives

The objectives of this research include the modelling of the cost stages underlying the patient pathway through the health care system and to identify the ‘cost points’ between patients and healthcare providers. Furthermore, objectives will also include the modelling of the cost stages underlying the patient pathway when a nutrition-based preventative program is applied. The program titled ‘Fresh Food Weekly’ will deliver nutritious and locally-sourced food to study participants homes on a weekly basis for a minimum of 156 weeks. Using this nutrition delivery channel, we aim to compare the true costs patients incur throughout their healthcare pathway over time and through the various stages of treating and managing their morbid condition(s) to the true costs of preventing their chronic disease(s) altogether. In this sense, the nutrition-based intervention is a form of immunity treatment with the intent of creating a ‘more resistant to chronic disease’ population group. 

 

Priority Questions To Be Answered To Inform Home Health Care Policy 

  1. What are all the costs associated with treating and managing the progression of each chronic disease over time with no intervention (when a morbid condition appears, when it worsens, when it improves, when it’s gone, when it comes back, etc.). 

  2. What are all the costs associated with treating and managing the progression of each chronic disease over time with the intervention? 

  3. What are the costs of immunizing an entire population group via the provision of nutritious food? 

  4. How are food prescriptions impacting both health and social outcomes at each stage of the disease’s progression? 

Our role

Fresh Food Weekly’s role in the proposed Research Study would simply be to do the weekly food deliveries to Study Participants. 

 

Between June 2022 and February 2024, Fresh Food Weekly raised +$174K and spent $93K on wholesale fresh food, and also received fresh food donations, which collectively, had a retail value of $362K. To accomplish this, +400 volunteers were coordinated to deliver this food to the front doorsteps of the same low-income families on a biweekly basis. This created food security within a very targeted population group (about 82% were on disability while the rest were old age). 

This demonstrates many things, one of the most important things being that Canadians don’t want to see their vulnerable neighbours starve if there’s a simple and cost-effective way to feed them. 

The successful execution and delivery of the Fresh Food Weekly meal box program over the last 20 months has demonstrated that Fresh Food Weekly’s operating model is sound and could be used as the blueprint for designing the food procurement and delivery processes for the proposed Research Study. 

This proposed research study is expected to provide the knowledge utilization data needed to determine if a nutrition-based intervention program such as Fresh Food Weekly has the potential to reduce the long-term demand for health care services and thereby drastically decrease health care costs in Canada. 

Research Study: Food Security in North America

CIHR & SSHRC grants

Research Partner Joins Fresh Food Weekly

Fresh Food Weekly has partnered with Simon Berge, an Associate Professor, and Chair of the Department of Leadership and Organizations at Dalhousie University, to apply for a Canadian Institutes of Health Research (CIHR) grant, as well as a Social Sciences and Humanities Research Council (SSHRC) grant. Simon has a big track record for securing grants, as well as 10 years of working experience in Ontario’s provincial agriculture sector, specifically in policy development. 

Simon Berge Profile Image

Simon is also the Director of the Research Centre on Co-operative Enterprises, and an Associate Professor of the Department of Business and Administration at the University of Winnipeg. He’s also an Instructor for the University of Cape Breton’s Master of Business Administration in Community Economic Development. Simon holds a Doctor of Philosophy in Rural Studies from the School of Environmental Design and Rural Development at the University of Guelph, as well as a Master of Business Administration in Finance from McMaster University’s DeGroote School of Business, as well as a Bachelor of Science in Biology from the University of Prince Edward Island in 1992. To learn more about Simon’s professional background and interests, read more about him on Dalhousie University’s website

Our next step is to apply for funding for a CIHR grant to measure health outcomes, as well as a SSHRC grant to measure social outcomes. But before we can do that, we're looking for some research partners to join us. 

 

Simon has completed the proposal that includes the general concept of the proposed research study and it's been sent to several different researchers/research groups so far, both in the health sector and the agriculture sector. 

Research Study Proposal Cover Image.png

Why The CIHR Focus?

The Canadian Institutes of Health Research (CIHR) is a federal funding agency that works with the federal Health Minister of Canada to advise on health care policies. Additionally, they're committed to funding health projects that engage people with Lived Experience. 

The CIHR’s Strategic Plan: Year 3

In the CIHR’s Strategic Plan 2021-2031, Year 3 is 2023-2024 and they’ve made Priority D all about engaging with people with Lived Experience, and they will continue to do so up until 2027:

CIHR Priority D: Lived Experience
CIHR Priority D: Lived Experience

Research areas of exploration

Health Minister Mark Holland: August 18, 2023

2 mins, 17 secs.

Health Minister Mark Holland spoke at the Canadian Medical Association (CMA) in Ottawa about federal transfers and the future of health care in Canada. He was joined by Kathleen Ross, the new president of the CMA, and the panel moderator Jennifer Ditchburn, president of the Institute for Research on Public Policy. You can view the whole discussion on YouTube here, but we’ve provided a compilation of key remarks about their take on the importance of Lived Experience. 

Is Our Healthcare System on Life Support?

6 mins, 7 secs.

In this video, Tony Clement interviews Dr. Jack Mintz, a World-Renowned Economist, Academic & Public Policy Analyst, and President’s Fellow of the School of Public Policy at the University of Calgary. In this in-depth discussion on Canada’s distressed healthcare system, Dr. Mintz speaks to some alternatives to funding it. Fresh Food Weekly sees his 'Variable Premium' alternative as the way our healthcare system should be funded. 

The Role of Lived Experience in Qualitative Interviews 

Our proposed Research Study will ensure the Lived Experiences of participants are rigorously researched. Leah is looking forward to providing input on the direction and structure of qualitative interviews as she herself has had these same Lived Experiences. This is why she was able to provide such an impactful nutrition-based intervention program in her local community and it’s why she’s so determined to ensure the voiceless start getting heard at the public-policy-making tables.

Qualitative Interviews

Challenges of Diabetes Self-Management in Adults Affected by Food Insecurity in a Large Ur

In this research article titled, ‘Challenges of Diabetes Self-Management in Adults Affected by Food Insecurity in a Large Urban Centre of Ontario, Canada’, the research team has demonstrated a significant effort to extract the Lived Experienced reported by participants who experienced food insecurity and how that impacted their ability to manage the disease. In this Study’s methodology for gathering data, participants were encouraged to elaborate on their Lived Experiences. Participants also received a CAN$30 honorarium at the end of their interviews. All interviews were digitally recorded and transcribed verbatim.  The research team’s analysis process required six phases, beginning with the review of interview transcripts, while making notes to return to later. The second phase involved developing preliminary codes to capture as many potential themes as possible. Transcript excerpts were then grouped under these codes. Following phase two, clusters of codes were grouped into ten major themes using the repetition technique where recurring topics generated the most relevant ideas. In the third phase, thematic networks were used to systematically present the study findings by listing themes from specific to broad; basic, organizing, and global themes. In phases four to six, data was synthesized to produce three main themes that captured the experiences of people with diabetes who were food insecure:  Barriers to preparing and accessing appropriate food,  Social isolation, and  Enhancing agency and resilience.

Participant dashboard prototype

Participant Dashboard.png

Our proposed activities (outside food delivery)

Critical Outcomes

Although the proposed Research Study is in its infancy stages and is currently being planned, the input from new partners will be crucial to determining the activities that will take place during the proposed Study. That being said, some critical outcomes and activities for this Project aim to include: 

1. Mitigation of systemic inequalities to improve food system outcomes for disabled, elderly and Indigenous population groups. 

2. The use of policy and regulatory tools to create food security and develop infrastructure.   

3. Identify and apply for funding from local governments to engage in food systems planning. 

Project Activities

1. Establish a formal committee to allow scientists and policy-makers to discuss issues. 

2. Utilize various “brokerage mechanisms” which include arranging seminars for policy-makers, and retaining individuals to act as research brokers or translators. Such individuals take the findings from researchers and bring them to the attention of policy-makers and others. 

3. Create links between researchers and policy-makers so that together, at the priority setting interface, they produce a research agenda that reflects a clear synthesis between the needs of the Participants (the people), the policy-makers, and the researcher. 

4. Develop a database of evidence and review of research when preparing evidence to inform policies on the reduction of health inequalities. 

5. Act as a mechanism that synthesizes research, as well as identifies research that should be acted upon versus research that shouldn’t. 

A Physical Regime for Participants

We've noticed that when medical doctors speak on improving health outcomes, they never say “nutritious food improves health”. Instead, they always say “nutritious food and a physical regime improves health”. That’s why we want to consider providing opportunities for children Participants, and [some] adults in the proposed Research Study to participate in physical activities. 

School Bus & Kids
School Bus & Kids

Landmark Bus Lines located here in Barrie, Ont., does all our county’s school buses and we reached out to them to find out if; 1) they would be able to do school bus transportation for this proposed program, and 2) if so, how much it would cost. Based on this information, they provided a quote for the cost to take one bus from a public housing complex in Barrie, to its nearest recreation centre, and then back home a couple hours later, and we’ve been quoted $250.00, and each bus has 46 seats.

Physical Regime

Swimming Lessons

We could provide swimming lessons to children through The City of Barrie’s registered recreation programs. The City’s swimming lessons are very affordable, run weekly throughout the year in 12-week sessions and are run at three different recreation centres in Barrie. They also run a bunch of different swimming lessons, for different age groups and swimming levels, all at the same time. Leah Dyck had her daughter in these swimming lessons for years. 

Kids Swimming
Kids Swimming

We could also provide bathing suits and beach towels each year, since children grow each year and need bigger sizes each year. There’s a wholesale store in Toronto, Ont., that works with charities to help them even further with wholesale pricing. One bus for 12 weeks would be around $3,000.00. 

Beach Towels
Boys Swim Trunks
Girls Bathing Suits

Trampolining Lessons

We could also provide trampolining lessons to children and adults at Vertical Zone Trampoline Club in Barrie. Trampolining lessons are very affordable - although they’re slightly more costly than the swimming lessons. Trampolining is one of the most effective forms of cardiovascular exercise in terms of getting your heart rate up. In fact, research shows that trampolines can actually be a better alternative for a workout than running or hitting the gym. 

Kid Trampolining
Physical Regime
Physical Regime
Physical Regime
Teens Trampolining

Recreation Equipment

Many years ago in Barrie, the Big Brothers Big Sisters charity partnered with Redwood Park Communities and Barrie public housing to distribute hundreds of new bicycles to children in public housing (which included Leah’s daughter, Niah, who was quite young at the time).

Kids on Bikes
Mom & Son Rollerblading

They way they did it was, they had all the bikes displayed nicely in a big warehouse downtown Barrie and then they picked up kids (and one parent per household) on a school bus and brought them to the bikes so each child could look at them all, and try them out by riding them around. There were also several bike technicians on-site to adjust bicycle seats and helmets to fit kid’s different sizes as well. Then, children got back on the bus and their bikes were delivered to them at home afterwards. At the beginning of the Research Study, we could try to make something like this happen as well, so each child in the Study could have a bicycle. We could even do this for things like skateboards and rollerblades as well. We could also consider getting bicycles and rollerblades for adults, especially for adults with children to encourage family outings. 

Our areas of interest

Guelph Study Cover Image

Prescription-Based Produce Research Study in Guelph, Ontario

UK Study Cover Image

Fresh street: the development and feasibility of a place-based, subsidy for fresh fruit and vegetables in the United Kingdom 

Social Health Study Cover Image

A Systematic Literature Review of Nutrition Interventions Implemented to Address Food Insecurity as a Social Determinant of Health in North Carolina 

Mental Health Study Cover Image

Household food insecurity and health service use for mental and substance use disorders among children and adolescents in Ontario, Canada 

Virginia Study Cover Image

Feasibility of an experiential community garden and nutrition programme for youth living in public housing in Virginia, USA

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