Building a new life after years of homelessness presents many challenges. For those living in a single-room occupancy (SRO) residential hotel with just a microwave to prepare meals, avoiding poor nutrition is one of them. That quickly became obvious to Jennifer Lee and Amy Stevenson after speaking with residents in supportive housing run by Episcopal Community Services (ECS) in San Francisco’s Tenderloin neighborhood. “Nutrition was a major concern,” says Lee.
Lee and Stevenson, who were looking to develop a project for an assignment in their Community Health class at Samuel Merritt University School of Nursing (SMU) addressed the residents’ concerns by creating a program that encouraged healthy eating on a budget. It culminated in a shopping trip to Heart of the City Farmers’ Market, a nearby farmers’ market that takes place on Sundays and Wednesdays.
“We conducted four weeks of nutrition education, including how to read food labels, appropriate portion sizes, how to store produce, and how to maximize buying power at the farmers’ market,” Stevenson explains. “The farmers’ market was only a few blocks away but many of the residents felt it was not for them, so at the end of the semester we took 16 residents there and gave them five dollars to shop. They really enjoyed the trip and many have since returned to the farmers’ market to purchase their produce.”
With such a positive response, Lee and Stevenson applied for San Francisco Bay Area Schweitzer Fellowships with an eye toward expanding it to eight other SROs run by ECS in the Tenderloin and South of Market neighborhoods. The expansion means that Lee and Stevenson now spent just five weeks at each location, as opposed to the 16 weeks they spent at their pilot site. This initially concerned them because it leaves less time to build trust and form relationships with people who often have difficulty trusting others after years of surviving on the streets. “It is not as much time to come in as strangers, build trust, and have people take a field trip with you,” Stevenson says.
Their fears about being unable to connect with residents quickly melted away.. It turns out that nutrition is an effective icebreaker. “At each location the residents began to bring us their health concerns and questions,” says Stevenson. “This benign little topic of nutrition was the key to opening up the door to deeper discussions regarding their health.”
Those conversations are particularly gratifying for Lee, who sees obesity as one of the most pressing health issues of our time. “So many people are overweight and suffer from other conditions, such as diabetes and high cholesterol,” she says. “Addressing obesity starts with education. People need to understand that what they are eating impacts their health and their weight, especially the damaging effects of sugar, since it is in so many of the items we all eat.”
Residents seem to be getting the message. Lee recalls one woman, recently diagnosed with Type II diabetes, who told them she realized after participating in several of their classes that she needed to make improvements in her dietary choices. “She wanted to do this so that she would not only better her own health, but also that of her children,” says Lee.
“The lasting impact I hope our project has is that residents will make better choices when it comes to their diets and continue to shop at the farmers’ market,” Lee adds. “This will hopefully lead to better health outcomes for them.”
Lee and Stevenson have ensured their project will be sustained beyond their Fellowship year by securing a grant from the Scott Beamer Fund at Samuel Merritt University and matching funds from ECS. The two worked with their faculty advisor and a Community Health professor on the grant application process, providing information about what worked and did not work during their Fellowships along with their nutrition curriculum and the educational games they incorporated into the program. The funding will allow SMU nursing students from future Community Health classes to expand the educational program and continue the subsidized trips to the farmers’ market. The project will be incorporated into the SMU nursing program. To promote the project, the university produced this heartwarming video featuring Lee, Stevenson and some of their students on a trip to the farmers’ market.
Stevenson says she is grateful for the opportunity the Schweitzer Fellowship gave her to see their “little idea” grow into a project and then be expanded and continued beyond her tenure as a Fellow. “I was recently asked what is the one thing I am most proud of in my professional career and I said it is the work I have done as a Schweitzer Fellow,” she says. “As with all volunteer opportunities you get back more than you give. I feel so blessed to have the residents share their lives with me and I can only hope I helped make a small impact in some way.”
Lee is in agreement about the impact of her Fellowship. “It has been so rewarding to work on this project,” she says. “I have really enjoyed getting to know all the residents we have met and being a part of their lives. The ability to build connections with people is something that will definitely be helpful for me in my future career as a nurse case manager.”