Great Plains Food Bank

Report date
February 2021

What has been most instrumental to your progress?

We approached the grant period with a clear, determined idea about how to move forward with the work. We adopted a model of systems change, Collective Impact, and expected that the work would be somewhat linear. As we dug deeper into the work of health equity and learned about the shifting needs and focus of our partners and communities, we knew flexibility was absolutely necessary.
As a result, we leaned into a process of rapid cycle testing new ideas which allowed us to test, assess, and retest innovations. This iterative process allowed us to be adaptive to the changing needs of not only our organization, the global crisis we are in the midst of, but also what we have been learning along the way.
Outside of programmatic innovations, some of our most valuable learning has come from a local group, the Cass Clay Hunger Coalition, which we have had the opportunity to co-facilitate, help guide strategically, and test ideas with. This group is a collection of cross-sector collaborators centered on actionable strategies to improve the health, nutrition, and equitable food access for everyone living in Cass (ND) and Clay (MN) counties.
The value of relationship-building has been a primary intentionality over the course of the past few years. Upon launching our work at the Intersection of Hunger & Health, we had commitments and interest from a variety of key stakeholders across our service area. Public Health units, non-profit health systems, tribal health, and those working tangential to food/health have been important partners in this work.
Through consistent communication, one-on-one meetings, and community meetings, we’ve been able to build our credibility as innovators and collaborators ready to effect systems change. This has been made possible by taking care to build relationships laterally and vertically within organizations. While we aren’t the only organization doing hunger-relief work in the region, the trust we’ve built with healthcare partners and community health experts have made space for innovation. This trust means that our partners are willing to take a leap of faith with us, have big conversations and test out ideas together. This integrated relationship building has really enmeshed our organizations at every level and allowed for the sparking of new, yet uncharted innovations.
Part of our work focused on uncovering and addressing the root causes of hunger at GPFB is centered on shared language and definitions - an important tool for creating shared initiatives and measuring outcomes consistently. The healthcare industry tends to be silo-ed due to the necessity of unique language and definitions; things that describe patients, interactions, technology, practices, billing, and its unique culture. As we pursued relationships and new pilot programs, we put particular emphasis on learning and becoming food bank experts in that unique language.
As a result, we’ve made strides in becoming a trusted partner in their work. This allows us space to educate our partners about the unique food insecurity and hunger relief language. We talk about patients and clients collectively, social determinants of health in tandem with root causes of hunger, and discuss time and resources in terms of outcomes and reimbursement. This shift has deepened our relationships, level of trust, and partner engagement.

Key lessons learned

Health Equity is transformational work, but includes actionable and measurable steps. Our team has been in a constant state of learning and shifting focus. And although health equity was a “known” component of our work, our knowledge has deepened in significant ways. Our ability to leverage health equity improvements is beginning to shift from transactional to transformational. We aren’t there yet and we know that this is long term work, but our ability to frame and measure the actionable parts of our work as they contribute to transformational change is significant.
Put more simply, we have a better grasp of the social and structural reforms necessary for true systemic change. We’ll continue to develop the individual level interventions that we’ve tested these past few years – increased food access for people facing chronic disease and creating opportunities for health behavior change through programming and education. But as we continue to shift our work toward community and societal level impacts, the emphasis will be placed more heavily on unpacking the structural qualities affecting those experiencing food insecurity, poverty, and poor health.

Reflections on the community innovation process

The elements that make up the process diagram are an incredibly useful illustration of the framework guiding us the past few years. Starting in 2018, we began to build knowledge collectively around the central issue of food insecurity tied to increased poor health outcomes. By lifting up client voices, through the Hunger in ND 2018 study, we were building shared knowledge around the specific hunger/health issues affecting our neighbors. This data collection process is iterative. One of the most important changes that we’ve adopted is the importance of racial and socioeconomic data to support an equity lens.
As we’ve moved from generating ideas into testing and implementing solutions, we’ve been primarily focused on individual and community level needs. We’ve been able to leverage a growing excitement for new solutions that include collaborative partners committed to increasing access to nutritious foods. As we reflect on the process of innovation, the most valuable component is the fact that this is 3D, rather than linear. The permission to skip steps, pivot, learn, & leverage new knowledge and partners has been critical for our ability to embed this process into our culture.

Progress toward an innovation

Over the course of the last several years we have begun the important first steps of co-creating an ecosystem and culture that recognizes hunger as a health crisis and food as medicine. While we value the innovations that have resulted thus far we see this work as unfinished, but can point to incredible strides toward this bold vision. At the beginning of this work, we started with emerging knowledge about the needs in our state and leveraged relationships to activate, test, and evaluate new solutions.
As a result, we have healthcare partners across the state committed to working alongside us in the communities we collectively serve. Through an iterative process, we’ve built three new statewide programs, currently serving 40 sites (and growing) in urban and rural communities across our service area. Together, we’ve impacted hundreds of patient households and in the last year alone, we’ve provided over 5000 meals and screened nearly 300 individuals for food insecurity during a regular health visit. We have been able to positively influence systems, places, and people to pursue this critical work at the intersection of hunger and health.

What's next?

We have laid the groundwork for a new pillar of the foundational work of GPFB, but also used this process and the journey as a springboard for future ground-breaking work. We have piloted 3 “screen and intervene” program models for support at the intersection of hunger and health: Wellness Pantry, Medically Tailored Meals, and SNAP Rx. Each providing care management, nutrition support, and long term household level benefits.
As we move ahead, we plan to sustain and replicate these primary program models. We also plan to engage our healthcare partners in a more robust data and referral sharing platform. With more holistic data, we hope to better identify disparities created by gender, place, race, means, and status. We also plan to collect and activate biomedical data to fully measure impacts on long term health outcomes. At GPFB, we know that it takes more than food to end hunger. So we’ll continue to explore the connections between food insecurity and other complexities of life; both social and structural.

If you could do it all over again...

A known path isn’t necessary and in some ways, it may inhibit the ability to be nimble and responsive. This past year, in particular, has shown us that we must be prepared enough as an organization to respond to immediate needs, but flexible enough to set aside old structures, processes, or plans that don’t move us toward innovation. Our team has gained skills around cultural competence, equity and inclusion, disaster response and recovery, and welcomed new knowledge, skills, and relationships that have redirected our focus and path forward. And that’s a good thing.