Brighter Bites

Summary

Brighter Bites aims to increase consumption of fresh fruits and vegetables in underserved communities. The model is intended to be easily replicable in new communities. The program reaches families by partnering with schools, Head Start programs, afterschool programs, and camps where 80% or more of the students receive free or reduced lunch. During each of the 24 weeks of the program (8 weeks in the fall, spring, and summer), every participating family receives two bags containing approximately 50 servings of fresh produce— enough for two servings of fruit and vegetables a day for a family of four. The produce, donated by local food banks, is bagged by parents and other volunteers in a co-op model that strengthens social ties among participating families. The food is then distributed to families at pick-up time. As families pick up the bags, the children and parents sample healthy “brighter bites”—dishes created using that week’s produce. The recipes are included in the bags, along with bilingual nutrition handbooks, tip sheets, and other recipes. Over the course of the season, students also participate in the Coordinated Approach to Child Health (CATCH) program in the classroom, a validated healthy lifestyle curriculum. To date, Brighter Bites has served more than 30,000 families and distributed nearly 14 million pounds of produce in the state of Texas.

Keys to Success

Based in behavioral theory

Brighter Bites is based on two behavioral theories: Social Cognitive Theory and the Theory of Planned Behavior.^[1] Both theories state that behaviors are socially influenced. Social Cognitive Theory argues that our own behaviors are influenced by the behaviors we observe in others. The Theory of Planned Behavior, similarly, explains that the social norms we observe, and our attitudes toward them, determine our behaviors. Brighter Bites relies on the power of social interaction, within communities, schools, and networks of people, to change behavior that will improve healthy eating.

Strengthening social networks

To make healthy nutrition habits a shared norm, Brighter Bites works to build relationships among the people involved. Participants report enjoying the time they spend volunteering to sort and distribute produce because it helps them build relationships with other parents in the program.^[2] These relationships likely increase retention and positive attitudes toward the program. Strong social support also has the potential to help maintain the impact of the program after it ends. The use of schools as the organizing location further facilitates relationship building, as it naturally ties together parents of similarly aged children.

Participant engagement

The co-op model, which requires parent participants
to volunteer on produce distribution days,^[3] likely also increases retention in the Brighter Bites program. Engaging parents in a co-op program increases participant ownership of healthy eating. This involvement may also help to reduce any sense of stigma that may result from seeing
the produce as a “handout.” Mandatory engagement also contributes to the network-building element of the program.

Multi-generational Engagement

Brighter Bites is, at its core, a childhood obesity intervention, but it approaches this challenge by engaging elementary school students and their parents. Engaging both generations yields many benefits. Parents heavily influence their children’s nutritional habits, including their interactions with food environments.^[4] By engaging parents, Brighter Bites can influence behavioral change in the people who purchase and prepare food—and who serve as role models—for children. While Brighter Bites is focused on fruit and vegetable distribution, parents noted statistically significant increases in other healthy food behaviors, including cooking meals from scratch, eating dinners as a family, using nutrition labels to inform food purchases, and limiting children’s intake of sugar-sweetened beverages at mealtimes.^[5]

In addition, by using schools
as program locations, Brighter Bites can easily identify communities with the highest need by identifying schools
that have high rates of free/reduced-price lunches, etc.^[6] This school-based system easily connects the Brighter Bites program with
the highest need participants, without additional costs and effort dedicated to advertising, recruiting, and screening
for need.

Identifying high-need populations

Brighter Bites uses socioeconomic indicators to select participant schools, working with elementary schools that have high percentages of student receiving free or reduced-price lunch—Title I schools.^[7] xxx (Title I schools have a high proportion of families defined as “low-income.”) Participant populations, at least in the initial pilot programs, were predominantly Hispanic/Latino or African American, and the program materials were offered in both English and Spanish.^[8] Brighter Bites, therefore, reaches populations with disproportionate rates of obesity and type 2 diabetes, suggesting that it has the potential to reduce health disparities if it displays long-term success.

Effective partnerships to achieve scale and convenience

Several crucial partnerships allow Brighter Bites to succeed. By using schools as the basis of interaction, Brighter Bites readily identifies target populations while simultaneously increasing convenience for parents. Distribution days and cooking demonstrations are timed so that parents can pick up their children from school, receive produce, and sample a recipe all at the same time.^[9] Additionally, the school setting facilitates the multi-element and multi-generational nature of the program. Children learn about healthy lifestyles through the Coordinated Approach to Child Health (CATCH) curriculum in school and concurrently experience healthier behaviors at home.^[10]

Further, partnerships with for-profit entities such as retailers (Target and H-E-B Grocery), distributors (Sysco and Hardie’s Fresh Foods), and industry networks (Produce Marketing Association and Produce Alliance) enable Brighter Bites to work directly with all facets of the produce industry, understand their capabilities, and communicate the necessity for more fresh fruits and vegetables in the communities that need it most. Brighter Bites receives most of its food through donations from local food banks like the Houston Food Bank as well as produce growers and distributors.^[11] These partnerships are mutually beneficial—they create a convenient pathway for food banks to reach high-need families, help the food industry overcome the challenge of “last mile” produce delivery, and allow Brighter Bites to distribute fruits and vegetables at a low cost.

Ability to Inspire

Perhaps the most illustrative indication of the success of the initial pilot programs is the rapid expansion of Brighter Bites in recent years. During the 2013–14 school year, Brighter Bites reached over 2,000 families in Houston. The following year, this number increased to 3,350, along with another 1,800 families through a program expansion in Dallas.^[12] The program has since expanded to the Austin area as well.^[13] Brighter Bites also received the 2016 Texas Health Champion Award during Texas Obesity Awareness Week.

Brighter Bites Co-Founders Lisa Helfman and Dr. Shreela Sharma have been key inspirational contributors to the success of Brighter Bites, both its impact and expansion. They are advocates for the growth of produce availability and the implementation of nutrition and culinary education as a catalyst for behavior change and improved long-term health outcomes.

Ms. Helfman regularly participates on national panels where she has the opportunity to advocate for Brighter Bites amid industry leaders of all kinds. Dr. Sharma has testified on Capitol Hill in front of the U.S. House Committee on Agriculture, published her research on Brighter Bites in peer-reviewed journals, and presented her studies at national conferences.

Brighter Bites will expand programming to New York City, the Washington Metropolitan Area, and Southwest Florida over the course of 2017-18.

Cost Effectiveness

Thanks to its co-op model and its partnerships with food banks and the produce industry, Brighter Bites operates at an impressively low cost. A 2016 study of the program found that families, on average, received 50-60 servings of vegetables per week at a cost of $2.65 per family per week. These costs were primarily associated with the expenses of taking inventory of and delivering the produce.^[14] While reliance on donated produce may pose a challenge to scaling Brighter Bites, it does indicate a model for replicating the program in a cost-effective way.

Drawbacks and Limitations

Brighter Bites is still too young to know whether it will demonstrate long-term impacts on healthy eating behaviors and childhood obesity. Studies of early Brighter Bites programs indicate that healthy eating behaviors were more prevalent at the midpoint of the program than at the end, raising concerns regarding long-term behavior change.^[15] It is unclear whether increases in fruit and vegetable consumption can be sustained after families finish the program, particularly in those households where budget considerations are the primary factor limiting fruit and vegetable consumption. Additionally, analyses of Brighter Bites have acknowledged that there is the potential for selection bias, with families more enthusiastic about healthy eating more likely to opt in to the program in the first place.^[16]