Overview
Obesity and related health issues such as diabetes, cardiovascular disease and several forms of cancer are epidemic within this country. Within Saint Louis these are some of the leading causes of illness and death, particularly within our African American communities. Improving our nutritional intake and increasing our levels of physical activity are critical if we want to turn these trends around.
The Garden of Eden is one response to move us in this direction. It is unique in that it was generated from dialogues within community health ministries (initiated by Interfaith Partnership’s Abraham’s Children). These faith communities partnered with academic and business leaders (including Saint Louis University and Saint Louis Produce Market) to help their ideas come to fruition, and to obtain funds from the Centers for Disease Control and Prevention.

Design
The Garden of Eden is designed to create community infrastructures and supports to enable people to make healthy choices. One main aspect of this program is the development of a community run produce market located in a local church that provides high quality, affordable fruits and vegetables. We provide transportation to the store from the churches and local senior centers. In addition, local community residents provide supportive nutritional information and cooking demonstrations within the store and at their churches. We are also currently working with community members to develop culturally appropriate opportunities for physical activity.

Steps We Have Taken

• Hired health advocates, store clerks and a store manager
  To do so we jointly generated criteria (interest in health, ability to work well with others, ability to reach out to community to get participation, ability to work with pastor and within church, etc.), and got recommendations from pastors and other church leaders based on our discussions with them regarding our criteria.
  
  
• Held training sessions with the health advocates, store clerks and the store manager
  The training sessions covered information on the association of spirituality and health, nutrition, social support, stages of change, preparing cooking demonstrations and recipe cards, and research policies and procedures. The training was provided jointly by members of the faith community, business partners, and SLU staff (health educators, nutritionists) and was held in the participating churches. In addition, the store clerk and store manager were able to spend time at a local grocery store for on the job training in accepting produce shipments, stocking and displaying produce, pricing produce, etc.
  
  
• Held weekly team meetings
  As a result of these meetings, we have worked through many of the initial challenges in moving from a proposal to implementation of activities, and have been able to incorporate the newly hired health advocates, clerks and store manager into our decision making processes more fully. This has provided us with opportunities to better understand how we will each be able to contribute to the Garden of Eden project. As more tangible progress, we have created a project logo, determined a vendor/ supplier for produce, determined appropriate display options, opened the store, created church bulletin boards, and finalized and provided newsletters. All of these have been jointly discussed and decisions rendered by all partners.
  
  
• Created a survey instrument
  A pre-post survey of health advocates knowledge, skills, and confidence in working as part of the Garden of Eden was administered as part of the training. The items on the survey were similar to the items for the project participants. As a result, the staff were able to more clearly articulate those areas of the survey that were confusing (e.g., introduction to sections, survey items, response categories). In addition, as a result of the training, we all more clearly understood the integration of the various elements of the project and were better able to identify areas that were missing from the survey that would be helpful to track and/or use for program implementation. These changes were made to the survey and were used in the survey administration training provided to health advocates and community interviewers, and is currently being used as the participant pretest.
  
  
• Recruited participants for the store
  The health advocates have been recruiting participants by speaking at local churches an senior centers, attending community and church health fairs, passing out flyers at church, and attending meetings of local civic groups.
  
  
• Created a transportation system to the store that meets their needs
  While we initially assumed that each church would require similar transportation systems, we have seen that we will need to adjust our initial plans and now pick people up from the churches as well as local senior centers.
  
  
• Collaborated with churches
  We have begun developing our information programs at the churches. This includes providing information for church bulletin boards such as Garden of Eden newsletters, flyers, and calendars. In addition we are soliciting fruit and vegetable recipes from church members. We have been compiling these and will decide which to highlight at various cooking demonstrations, in newsletters etc. We also hope to begin to have church members provide testimonials and work with pastors to encourage health focused sermons.