Fighting Hunger, Feeding Health

The college's nutrition education programs teach good eating for good health.
by Gary Abdullah

To fight hunger, Luz Cruz drives. From house to substandard house, through good weather and bad, she leaves the highways to travel hard-to-find back roads. As a nutrition education adviser for Penn State Cooperative Extension’s Expanded Food and Nutrition Education Program (EFNEP) in Chester, Delaware, and Montgomery Counties, she teaches low-income families how to get and prepare the foods offered by the Pennsylvania Department of Welfare, local food banks, and other social service agencies.

Nutrition Links coordinator Elise Gurgevich works with nutrition educators across the state to tailor services to a county’s specific needs.

Her clients are mainly Mexican migrant labor families who come to Pennsylvania to work for mushroom companies and other agricultural producers. “Some have been here a week, some have been here 10 years,” she says. “Most are living on $800 to $1,200 per month. Because many lack transportation, they need to live close to the mushroom houses and farms where they find work. The families are scattered all over, so I go to them. I work with about 15 families each week, and I go anywhere I can to reach them. I do a lot of driving all over Delaware and Chester Counties.”

As poverty in Pennsylvania hovers near 13 percent, the nutrition expertise people like Cruz offer is taking on unprecedented importance. Many Pennsylvania food banks and food-rescue programs are seeing last year’s donors and volunteers return as this year’s clients. For the third year in a row, the number of people facing hunger—especially children—has risen, according to U.S. Department of Agriculture data. Often, the problem is not just food. Many participants in assistance programs just don’t know how to cook—they’ve never learned how to combine available ingredients into consistently nutritious meals, so even when they’re not hungry, they’re often not getting good nutrition.

Penn State Cooperative Extension is responding with innovative programs that provide critical information about nutrition and health to thousands of Pennsylvanians. The college’s flagship nutrition program is the two-pronged Nutrition Links, comprising EFNEP and the Pennsylvania Nutrition Education Program (PA NEP). Both programs employ nutrition advisers to help people living at or near the poverty level gain the knowledge, skills, attitudes, and behaviors necessary to create a healthy diet for themselves and their families.

“EFNEP is specifically for low-income families with children,” says Nutrition Links state coordinator Elise Gurgevich. “When it was established 35 years ago, cooperative extension was selected to administer the program because it had the infrastructure to effectively reach low-income adults and youth. The federal government saw the need for better nutritional training to improve the health of low-income families, and Pennsylvania was one of the first states to institute it as a pilot program."

Advisers started with door-to-door visits to low-income neighborhoods and expanded to offer education from churches,
community centers, welfare offices, and other sites.” EFNEP also includes a 4-H component, which offers nutritional training to children and teens in low-income urban and rural areas. Participants get opportunities to make healthy food choices, enjoy physical activity, and receive instruction in avoiding substance abuse and related topics.

Families without children can learn about nutrition through the Pennsylvania Nutrition Education Program. “PA NEP is open to anyone eligible for food stamps,” Gurgevich explains. “It can reach a larger audience and do a lot more food demonstrations and other one-time educational activities. They complement each other—PA NEP can pick up on audiences that EFNEP can’t reach.”

Nutrition Links education/development/training specialist Julie Haines (left) trains Nutrition Links advisers (from left) Karen Serball, Tammy Heikes, and Renee Penn to conduct a cooking demonstration. EFNEP and PA NEP advisers reach thousands of clients each year through cooking demonstrations and exhibits, food tastings, farmers’ market demonstrations, and after-school presentations.

Between the two arms of Nutrition Links, and similar programs offered at the county level, the college reaches thousands of Pennsylvanians with information about nutrition and health. In 2003, EFNEP delivered services to 3,642 low-income adults and 11,623 low-income youth. Almost 50 percent of clients were from ethnic minority populations and 83 percent of families had children under age 13. In 2002–03, PA NEP made over 201,906 indirect contacts with newsletters, inserts, and other services.

Advisers also completed 2,351 food demonstrations and exhibits for 25,904 participants, including cooking demonstrations, food tastings, and farm stand and farmers’ market demonstrations. They also presented almost 1,000 nutritional lessons around the state in the form of one-time consultations, lesson series, or individual counseling, and conducted 29 after-school programs that reached 550 children.

“We’re all interconnected,” says Dorothy Lisle, manager of PA NEP. “We just need to be flexible and creative in matching programs to community needs. The common denominator is meeting local needs.”

In Allegheny County, educator Cynthia Stevens (above left) teaches young men to turn available unprepared foods into nutritionally balanced meals.

The Nutrition Information Resource Center is just such a response to local needs: the college’s nutrition advisers and extension educators said they needed access to up-to-date and accurate teaching aids, but budgets at the local level often created barriers. Faculty at the University Park campus responded by gathering food models, kids’ storybooks and textbooks, videos, hand puppets, and curriculum notebooks to support the advisers’ needs. “The center functions like a resource lending library for nutrition educators when they don’t have enough money to purchase a curriculum,” says food scientist Audrey Maretzki, principal investigator for PA NEP. “Instead, they can borrow it from us and if they like it, maybe eventually they can buy it. We also run an e-mail question-and-answer service with a searchable Web site linked to other sites that have been reviewed for accuracy and completeness. Graduate students staff the service and strive to answer questions quickly.”

The benefits of these programs often transcend nutrition education. For instance, EFNEP also serves as a sort of community-based career and personal development agency. Nutrition advisers are actively recruited from the ranks of the program’s clientele, which benefits both employee and employer.

“Our advisers are hired out of the local community so that they can use our program as an entry-level position and go on to bigger and better positions in nutrition or other fields,” says Gurgevich. “We don’t require college degrees and we provide extensive nutrition education along with training in case management, time management, and other professional skills. Our goal is to give them skills, opportunities, and experiences that will allow them to get jobs in other human-service organizations. Because the advisers often have started out as clients, they can relate to how it feels to use a food pantry. Now they’re able to make a contribution and give back to the program and the clients.”

Cruz’s dedication to her work, for example, stems from her own experience. She grew up as a member of a second-generation migrant family from Puerto Rico, struggling with underemployment, language barriers, and an indifferent community. Often, they were not sure where the next meal was coming from. As a former EFNEP client, she was once in the same situation as the people she now helps. Like many advisers, Cruz’s effectiveness hinges on her acceptance and credibility in the community. She gets clients through referrals from a complex partnership of migrant education and support groups, federal and state agencies, Hispanic civic groups, and word-of-mouth endorsement through the migrant community grapevine. “It says a lot if they let me into their homes to teach them,” she says.

The success of the college’s nutrition programs is due in large part to their sensitivity to diversity and their ability to tailor educational efforts to the needs of the local community.

Lisa Janasko, nutrition educator in Allegheny County, assembles food and seasonings as she prepares for a demonstration. Educators often are invited to present cooking lessons at local food banks, churches, and other organizations, so their demonstrations must be completely self-contained.

“Because we’re very community-based, we get a lot more done with less waste,” says Lisle. “There’s no set curriculum that has to be used, so there’s variety and flexibility throughout the state as each program reaches its local target audience. And the important thing is, it’s working.”

Evaluation figures bear out these programs’ success: participants consistently increase their consumption of fruits, vegetables, and calcium-rich foods, and show improvement in other indicators of overall dietary health. Participants also improve their food safety practices and spend their food dollars more wisely. For every dollar spent on EFNEP, for instance, $2.48 is saved on food expenditures, reducing the need for emergency food assistance.

“Nutrition is a tough area to get rapid change in because we’ve been eating all our lives, and we need to continue doing it—it’s not like smoking, where you can stop,” Lisle says. “But we do a regular evaluation of each of the projects to assess if people are really learning and changing. And the results are slow, but positive.”

Marilyn Corbin, assistant director of Penn State Cooperative Extension and state program leader for children, youth, and families, points out that very few other activities allow Penn State to so directly fulfill its outreach mission as a University and a College of Agricultural Sciences while meeting such basic, powerful needs for it citizens.

“So many things we do involve nutrition—you can hardly do anything in outreach and extension without touching foods and nutrition,” she points out. “It’s a core program within our organization. If you think about agriculture and what we do from the production to the consumption of food, nutrition education is central to our mission.”

That mission is one that still inspires advisers like Luz Cruz. “I’ve been offered all kinds of jobs, but this is perfect for me,” she says. “The program works and I can see that we make a difference. The best part is when I can see families use what I just taught them. I can see changes people make in their eating habits, and that makes me feel good.”

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Faculty and staff referenced in this article are Marilyn Corbin, state program leader for children, youth, and families; Luz Cruz, nutrition education adviser in Chester, Delaware, and Montgomery Counties; Elise Gurgevich, state coordinator for Nutrition Links; Dorothy Lisle, manager of the Pennsylvania Nutrition Education Program (PA NEP); and Audrey Maretzki, professor of food science and nutrition.