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    • Knowing that behavior change is a

    2018-11-05

    Knowing that behavior change is a process that involves several stages, the Freshplace intervention also uses the Stages of Change Model (Prochaska, 1983) to help clients make positive changes in behavior by setting small, achievable goals. Given that self-efficacy appears to regulate transitioning between all stages of change bidirectionally, high self-efficacy acts as a universal facilitator of progression through all stages of behavior change (Bandura, 1998).
    Research goals This study builds upon previous research on food security, diet quality and obesity (Robaina & Martin, 2013) and tests the hypothesis that participating in Freshplace increases self-efficacy, which in turn decreases the prevalence of food insecurity. The research team developed a self-efficacy scale for food security to measure self-efficacy within the context of an emergency food assistance program intervention. Hereafter, the term “self-efficacy” refers to “self-efficacy for food security” specific for this intervention. To the authors’ knowledge, no other study has explored the relationship between food insecurity and self-efficacy in this context. As such, the goals of this study were to (1) identify associations between self-efficacy and food security; (2) evaluate whether the Freshplace intervention increases self-efficacy; and (3) evaluate whether self-efficacy reduces the food insecurity of study participants over 18 months.
    The freshplace food pantry intervention There are three major components of Freshplace that make it different from traditional food pantries, each of which are designed to increase the food security and self-efficacy of members: (1) fresh food, including fruits, vegetables, meat, and dairy, is provided in client-choice format where members choose their own food and shop with dignity, and nutrition education is offered on site; (2) program members attend monthly case management meetings with a Project Manager during which they receive motivational interviewing; and (3) individualized referral services to hcv protease inhibitor programs and social services, providing assistance with housing, education, employment, health care, and other basic needs, are offered to members based on their goals (Robaina & Martin, 2013). Another core feature of Freshplace is that members are given appointment times so Controlling elements do not wait in line. Traditional food pantries commonly hand out pre-packaged bags of non-perishable food to clients who wait in line and do not offer any additional services.
    Materials and methods
    Results
    Discussion Self-efficacy was strongly associated with food security at each quarter. Similar to other health interventions that find self-efficacy as a key lever for behavior change, (Walpole, Dettmer, Morrongiello, McCrindle, & Hamilton 2013; Richert et al., 2010; King, Glasgow, & Toobert, 2010) our results document significant improvements in food security with increased self-efficacy. The Freshplace intervention decreased VLFS and improved self-efficacy among members. High self-efficacy was also associated with a decrease in VLFS among study participants. Based on these outcomes, food pantries are encouraged to adopt strategies for boosting self-efficacy, such as serving food in a client-choice format, offering motivational interviewing, and providing targeted referral services. The role of self-efficacy in behavior change has been evaluated in the context of chronic disease management (King, Glasgow, & Toobert, 2010; Lyles, Wolf, & Schillinger, 2013) , weight loss (Walpole, Dettmer, Morrongiello, McCrindle, & Hamilton, 2013), nutrition (Richert et al., 2010; Anderson, Winett, Wojcik, & Williams, 2010), and exercise programs (Anderson, Winett, Wojcik, & Williamsc, 2010; Williams & French, 2011), but there is no research on the effect of self-efficacy on food security in the setting of an emergency food assistance program. It is important to explore the association between self-efficacy and food security in disadvantaged populations, because they often experience chronic diseases and poor nutrition, and self-efficacy can be a powerful mechanism for managing disease and utilizing existing health promotion programs.