Food insecurity is defined as reduced access to a sufficient quantity and quality of food, which limits the variety or desirability of one’s diet . Access to healthy food is a fundamental human right, yet food insecurity remains a significant public health problem across the United States, with an estimated 37 million individuals experiencing some level of food insecurity . Hunger, poverty, and food insecurity consequently influence individual health and well-being [2, 3]. Well documented in the literature are the relationships between socioeconomic status, race, and food insecurity . The consequences of food insecurity include lower economic productivity, increased co-morbidities in adults, and increased learning/developmental concerns in children . Rates of food insecurity for men, women, and children continue to impact many families, with an estimated 9.7 million adults and 6.5 million children living in food-insecure households . These families experience unreliable income and unexpected financial burdens and may qualify for federal food assistance programs; however, they may also rely on food banks and emergency food pantries to help ends meet during difficult times .
According to the 2014 Hunger in America Report, it was determined that over 84% of US households who utilized EFPs were food insecure . The concept of an emergency food pantries (EFPs) was developed in the late 1960s in the United States and originated in a church using the support of a faith-based model to provide food and social support . The purpose of the “emergency” food pantry was to serve families on a short-term basis, however, due to more significant economic and social issues, this trend has changed, and many pantries now provide services long-term . Pantries offer an invaluable source of supplemental food, at no cost, to fill the gap when other costs of living limit funds available for the purchase of food . Communities who are reliant on supplemental food resources are often limited in food choices, notably healthy choices . As a result, communities that rely on supplemental food have been shown to have poor diet quality along with increased rates of chronic disease, including obesity, metabolic syndrome, cardiovascular disease, hypertension, and diabetes [1, 8,9,10,11,12].
Since the inception of the food pantry model 60 years ago, EFPs have attempted to expand their services to address the social networks and environmental triggers that influence food insecurity . These services target how to move families towards food security and self-sufficiency while continuing to provide food. As a result, some EFPs may offer a comprehensive model that includes nutrition education . Other EFPs have implemented programming that addresses the diverse needs of their communities, including specific and cultural food preferences, general health and wellness care, and assistance in household and food budgeting skills [14, 15]. While there have been previous innovative nutrition education programs in the literature, gaps exist as to the best method of education delivery, and by whom, to effectively impact an EFP patron’s food knowledge and healthy eating behaviors.
Peer mentors, community health promoters, and health educators are viewed as leaders in their communities and have been used successfully worldwide to educate and promote health [16, 17]. The peer mentoring recruitment process intentionally seeks out mentors who are of a similar age or have had similar life experiences as their target audience. Peer mentors who are also members of the same community often share similar cultural beliefs, practices, and experiential knowledge that deepen a shared understanding of the challenges faced by community members [16,17,18]. The peer mentor and mentee connection also foster relationships that an outside expert could never accomplish. Due to this unique relationship, peer mentors can be effective in many settings from academic to low-income community settings, where health education is particularly pertinent and where behavioral interventions can be measured [17, 19]. Peer mentors have also been found to be successful when appropriately trained in nutrition to deliver health information targeting children or in facilitating changes in health-related behaviors, including physical activity, smoking, and condom use in both adults and adolescents [17, 19,20,21,22]. Therefore, utilizing peer mentors to deliver health-promoting messages or nutrition education may be an innovative approach to reach underserved and economically disadvantaged populations .
Utilizing a peer mentoring model within an EFP and adapted from the concept of a community health educator may be a key strategy in addressing health and wellness in families experiencing food insecurity. The peer mentoring model has been identified as a significant mechanism for helping individuals (both mentor and mentee) develop a sense of purpose and belonging through a supportive relationship, and this also builds and strengthens their social networks . Although peer mentors are recognized for their effectiveness in general community settings, little research has been done to determine the effectiveness of peer-led nutrition interventions in low-income populations using the EFP environment. To address this gap, a nutrition education pilot program was developed using peer mentors in a community EFP setting to teach nutrition education and necessary cooking skills to their fellow community members. Titled Community Cooks, this innovative approach of nutrition education in an EFP used a train-the-trainer peer mentor model. This research aimed to identify the successes and challenges of using a peer mentor model within an EFP by conducting focus groups and a qualitative program evaluation. These findings may be used to inform others about the peer mentor model as an approach to deliver nutrition education for EFP community residents.
Theoretical framework for model development
The authors of this manuscript used two theoretical frameworks to support the program development and implementation: 1) Albert Bandura’s Social Cognitive Theory, and 2) The Socio-Ecological Model. Using Bandura’s Social Cognitive Theory (SCT), the authors theorized that having a peer mentor as a positive role model may increase good nutritional choices and decisions among EFP members . The major component of SCT is delivered through observational learning. SCT encompasses the process of learning desirable behaviors by observing the behavior of others. The observer then replicates these behaviors in order to maximize outcomes. The Community Cooks program used peer mentors chosen from the local community to serve as role models for delivering education on healthy food choices, lifestyle, and cooking information to the community at large. This model draws on key components of SCT by then infusing concepts of self-efficacy and through role-modeling by enabling the community members to be able to replicate these behaviors on their own.
The Socio-Ecological Model has also been well established within health and wellness in terms of dietary patterns (e.g., individuals tend to model food choices and behaviors based on social interactions such as children modeling food choices after their parents) thus supporting the model’s use for the Community Cooks program . This model notes that individuals, families, and communities influence food choices, and opportunities for health promotion, and disease prevention . Therefore, employing these education strategies within the target audiences’ community will expand not only the reach but also the relevance to community members.
Integrating theoretical frameworks such as SCT and the Socio-Ecological Model within a peer mentoring program is supported when using curricula delivered in regularly scheduled meetings where peer mentors can receive social support, and develop mentoring skills while gaining self-efficacy and influencing behavior change within themselves and others [21, 25, 26].