title: FEAST: Empowering Community Residents to Use Technology to Assess and Advocate for Healthy Food Environments.
abstract: Creating environments that support healthy eating is important for successful aging, particularly in light of the growing population of older adults in the United States. There is an urgent need to identify innovative upstream solutions to barriers experienced by older adults in accessing and buying healthy food. FEAST (Food Environment Assessment STudy) is an effort that is part of the global Our Voice initiative, which utilizes a combination of technology and community-engaged methods to empower citizen scientists (i.e., community residents) to: (1) use the Healthy Neighborhood Discovery Tool (Discovery Tool) mobile application to collect data (geocoded photos, audio narratives) about aspects of their environment that facilitate or hinder healthy living; and (2) use findings to advocate for change in partnership with local decision and policy makers. In FEAST, 23 racially/ethnically diverse, low-income, and food-insecure older adults residing in urban, North San Mateo County, CA, were recruited to use the Discovery Tool to examine factors that facilitated or hindered their access to food as well as their food-related behaviors. Participants collectively reviewed data retrieved from the Discovery Tool and identified and prioritized important, yet feasible, issues to address. Access to affordable healthy food and transportation were identified as the major barriers to eating healthfully and navigating their neighborhood food environments. Subsequently, participants were trained in advocacy skills and shared their findings with relevant decision and policymakers, who in turn dispelled myths and discussed and shared resources to address relevant community needs. Proximal and distal effects of the community-engaged process at 3, 6, 12, and 24 months were documented and revealed individual-, community-, and policy-level impacts. Finally, FEAST contributes to the evidence on multi-level challenges that low-income, racially/ethnically diverse older adults experience when accessing, choosing and buying healthy foods.
authors.affiliation: Department of Global Community Health and Behavioral Science, Tulane University School of Public Health & Tropical Medicine, 1440 Canal Street, Ste 2200, New Orleans, LA, 70112, USA. jsheats@tulane.edu.|Healthy Aging Research and Technology Solutions (HARTS) Lab, Stanford Prevention Research Center, Stanford University School of Medicine, 1070 Arastradero Road, Ste 100, Palo Alto, CA, USA. jsheats@tulane.edu.
authors.forename: Jylana L
authors.initials: JL
authors.lastname: Sheats
authors.affiliation: Healthy Aging Research and Technology Solutions (HARTS) Lab, Stanford Prevention Research Center, Stanford University School of Medicine, 1070 Arastradero Road, Ste 100, Palo Alto, CA, USA.
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Winter
authors.affiliation: San Mateo Medical Center, 222 W. 39th Avenue, San Mateo, CA, 94403, USA.
authors.forename: Priscilla Padilla
authors.initials: PP
authors.lastname: Romero
authors.affiliation: Healthy Aging Research and Technology Solutions (HARTS) Lab, Stanford Prevention Research Center, Stanford University School of Medicine, 1070 Arastradero Road, Ste 100, Palo Alto, CA, USA.
authors.forename: Abby C
authors.initials: AC
authors.lastname: King
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002140:California; D000072001:Diet, Healthy / Q000379:methods*; D004777:Environment; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D011203:Poverty; D011209:Power, Psychological; D012107:Research Design; D012111:Residence Characteristics; D012931:Social Environment; D014481:United States; D014504:Urban Health
keywords: Advocacy; Aging; Community-based participatory research; Food access; Food environment; Food security; Minority health; Mobile health; Urban health