Wholesome Wave’s Tangelo App

Through the use of the Tangelo app, Wholesome Wave (WW) will demonstrate how to eliminate food deserts as we know it and shrink the significant health gap between those who are nutritionally insecure and their more affluent neighbors. The Tangelo app customizes content specifically targeting low-income neighborhoods, raises private funds, for those who qualify, to apply to their virtual wallet, delivers food purchases directly to the user’s door, or a designated pick-up location, while customizing content and social service offerings based on the specific medical and other needs of the user. Ultimately,Tangelo will deliver food purchases made with the federal Supplemental Nutrition Assistance Program (SNAP). Wholesome Wave is partnering with Seeds of Hope, Cal Fresh (the SNAP program in California), and respected local retailers including Northgate Gonzáles Market to expand the existing pilot to Los Angelinos.

Specifically targeting low-income neighborhoods, Wholesome Wave will demonstrate how to eliminate food deserts as we know it. Wholesome Wave strives to reverse the tide of diet-related disease that is ravaging the most marginalized among us while contributing to decreasing this scenario in future generations. It is simply not right that access to the most healthy food is determined by race and income. Driven by our conviction that people want to feed their families well, regardless of their income, our goal is to strengthen the accountability of food systems to create healthy food environments and reduce chronic illness. Wholesome Wave empowers economically-challenged people who struggle with hunger by providing them the purchasing power to choose fresh fruits and vegetables and works with bi-partisan policy makers to embed our practices into health policy. Outcomes from Wholesome Wave programs have successfully influenced public policy at the national level. WW has played a significant and historic role as a thought leader and advocate in the field of nutrition incentives, resulting in an impact on federal nutrition policy. Our vision is to catalyze a meaningful shift in public health by making it possible for low-income Americans to eat more fruits and vegetables and be well.  

Tangelo informs users of nutrition and budgeting information to shift spending towards nutritious purchases, while integrating health data such as HbA1C, BMI, and blood glucose levels from healthcare partners. Tangelo also allows users to track their progress by historically analyzing all user activity, i.e. fruit and vegetable purchases, and makes recipes available, as well as other nutrition education content available in the app's marketplace. User’s will make purchases by accessing their virtual wallet with downloads of preloaded virtual wallets with money to spend already available to those who qualify. Once users enter their form of payment they can access produce and other grocery items as well as the marketplace to place their order. For those who receive SNAP benefits and/or prepaid virtual wallets, fruits and vegetables are restricted purchases while other grocery items are paid for by the user’s own form of payment. Connection of users to appointments at local social service equity organizations, food pantries, and other essential social services are based on the user’s geolocation. Users will also have access to critical services like telehealth for advice from a qualified medical health or nutrition professional.

This app is available for everyone and targets specific categories of users — whether by zip code, occupation, unemployment status, age, or a variety of other demographics and personalizes the health and economic benefit for each. The pilot began in February of this year and in the wake of Covid-19, the Los Angeles County Department of Public Health and the California Employment Development Department have approached Wholesome Wave with an interest in piloting the app to reach 10,000 recently unemployed Los Angelinos.

Diversifying food options to allow for more nutritious diets is not accessible to major segments of the U.S. population. Wholesome Wave has been promoting greater consumption of fruits and vegetables directly increasing the consumption of low-carbon protein options to consumers since inception. The supply chain of food made available through the Tangelo app is either directly or indirectly sourced produce from various partners including local farmers, wholesalers, and retailers. Wholesome Wave’s current goal is to apply innovative strategies to determine the best resources to meet supply and demand while ensuring the highest quality consumer experience. 

Given the demonstration of Covid-19’s disproportionate effect on low-income people, Wholesome Wave’s response to this pandemic in Los Angeles gives us the chance to lead a bold and coordinated effort. Tangelo connects food insecure populations to fresh produce at scale and enables the practice of food as medicine by working with private and public sectors to support affordable healthy food and more. The customizable program dashboard consistently engages consumers in a variety of ways by providing access to easy to understand information about their specific health needs while connecting to critical information about their health and health in general with embedded video. The digital wallet incentivizes use of fresh produce and private and public partners can directly support consumers within the app, and choose incentive dollars that unlock additional in-app dollars based on actions taken by the user. Some examples of actions include using GPS check-in at a local event, completing an interactive quiz or survey to collect valuable data, making a telehealth appointment with a local hospital or community clinic, and connecting a bluetooth enabled device to monitor glucose. Unlocked dollars are spent directly through Tangelo’s in-app market. Items with the Wholesome Wave logo indicate coverage by incentive dollars. All activities are made available through the customizable dashboards for individual consumer usage and quantified and qualified for partners.

The app is available on iphone and Android. Programmatic data feeds enable all data to be managed, stored, and evaluated through the platform. Health data from healthcare partners is integrated through approved connected medical devices and Electronic Medical Records (EMR) integration. Tangelo’s machine learning algorithms:

• Correlate historical engagement and transactional data.

• Automatically discover key indicators that predict each participant's path, each step of the way.

• Engage individual participants with the right outreach tools to get them to perform desired

actions.

• Create custom program paths with effective content and cadence for individual participants.

The Tangelo app’s usage is still in its infancy stage and evidence is not yet available.

Statement of Problem: Tangelo Smartphone Application Technology: Insufficient operation of highly scalable fresh fruit and vegetable access with comprehensive user friendly and user managed healthcare tools. 

Goals and Objectives: Goal: Eliminate food deserts. Tangelo Objective 1: Enable policy for Tangelo to home deliver fresh produce purchases made with the federal Supplemental Nutrition Assistance Program (SNAP) purchases. Tangelo  Objective 2: Shift spending towards nutritious purchases. 

Solutions and Activities: Integrate health data such as HbA1C, BMI, and blood glucose levels from healthcare partners to participants to access.

Target Population: Available for everyone and targets specific categories of users — whether by zip code, occupation, unemployment status, age, or a variety of other demographics, and personalizes the health and economic benefit for each.

Resources Towards the Project: Currently the app raises private funds for those who qualify. Development of platforms on iphone and Android technology. 

Impact: Too soon to quantify or qualify.

Wholesome Wave is currently on course to serve 10,000 people who are nutritionally insecure and experience chronic illness in the U.S. The organization has been in communication with an organization in Canada to pilot the app in that country as Canada does not have a formal nutrition program and according to the Canadian Institutes of Health and Research, 70% of social service recipients are also food insecure. Work in Canada would enable the Tangelo app to reach an additional 10,000 people by next year, and at least 50,000 by year five in both countries. We expect that all targeted users will directly be impacted by the apps offerings.

Simultaneously, Tangelo will continue to expand into U.S. communities where the prevalence of the critical combination of low-income and living with one or more morbidity issues leads to extreme health outcomes for a specific group of people. We plan to partner with hospitals and healthcare institutions to implement the app to its patients, and will perform research and evaluation on all findings. 

There is also a deepened sense of urgency to address food insecurity head on. The current United States administration has made two recent moves that impact food insecure families dramatically:

1) recent cuts to the National Institute of Food and Agriculture have depleted the ability of the institute to administer much-needed grant programs including the broadly bi-partisan Gus Schumacher Nutrition Incentive Program, and;

2) the move to cut $5.5 billion from the SNAP program over the next five years will negatively impact 1 million recipients who rely on the program to address food insecurity.

Considering the current science that demonstrates the significant impact of food insecurity on diet-related disease, these changes will not only exacerbate food insecurity, but also have significant impact on public health.

In Canada, lack of food has been subsidized with money. Shifting perspective to provide fresh produce instead of money may be a challenge. The current communication with Canada is the first time Wholesome Wave will be working internationally and we are unsure how this solution will be met by the general population and specifically by the families and individuals the Tangelo app will target.

In the United States, WW will continue to use findings from its program to provide evidence and research on the need for more accessible produce. Learnings from WW’s programs have guided the design of Tangelo, and resulted in a study of Wholesome Wave programs published by the United States, Centers for Disease Control in June 2019. That study found that low income children who were overweight or had obesity in a 4- to 6-month produce prescription program at federally qualified health centers, were found to have a dose propensity–adjusted increase in fruit and vegetable consumption of 0.32 cups per day for each additional program visit, with an equal portion attributed to changes in vegetable consumption and fruit consumption. Furthermore, Wholesome Wave programs show improved health outcomes and healthy behavior changes:

● In a 2016 partnership with Target and Eisner Health in Los Angeles, more than half the pediatric patients decreased their BMI and 57% of participating families reported improvements in the health of their children. The intervention was honored by the United States Chamber of Commerce and has evolved into a 3-year, multi-million dollar partnership between Target and Wholesome Wave impacting nearly 8,000 participants.

For our work in Canada, WW is seeking support in establishing government relations, public relations as well as access to networks of experts and partners, private sector partners, and convening with peer ventures in the field of nutrition and health. 

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Wholesome Wave currently employs three full-time program managers for this solution.

Founded in 2007 by James Beard Award-winning Chef Michel Nischan and former U. S. Secretary of Agriculture Gus Schumacher, Wholesome Wave  addresses the complex issues of food insecurity with innovative and disruptive programs. We have been pioneering innovative solutions for more than a decade. WW has supported and developed over 60 nutrition incentive programs at markets throughout the country. These have included doubling SNAP for fruits and vegetables, the development of innovative payment technologies, and designing and deploying Rx produce prescription programs nationally. Wholesome Wave empowers economically-challenged people who struggle with hunger by providing them the purchasing power to choose fresh fruits and vegetables and work with bi-partisan policy makers to embed initiatives into health policy.

Wholesome Wave has also begun to establish a National Produce Prescriptive Collaborative (NPPC) consisting of leading organizations in the field of Foods as Medicine and open to all like-minded organizations. NPCC members include the following:

• DC Greens

• Reinvestment Partners

• Eat SF

• Washington State Department of Health

• United Fresh Produce

• Socially Determined

• Share our Strength

• Tufts University

• UC Davis Healthcare

• Boston Consulting Group

• Population Health Alliance and;

Food is Medicine organizations for broader field collaboration:

• Food is Medicine Coalition

• The GusNIP National Technical Assistance center

• Google Refresh

• The Aspen Institute

• Trust for America’s Health

The collaborative will identify and disseminate best practices; advocate common impact measures and standards; build support for systemic change; and lead a movement aimed at democratizing access to fruits and vegetables for millions more Americans. Wholesome Wave is partnering with DAISA Enterprises, a national strategic consulting firm that supports the realization of equitable food systems and vibrant communities through field-scan research, recommendations, and large-scale funding initiative management, for network management and engagement in the field scan and research dissemination. DAISA has extensive experience with food and health systems field-building research and convening for national foundations, including Robert Wood Johnson and Kresge Foundations. Weight Watchers (WW) Good is a partner in the Tangelo pilot in Los Angeles. Walmart supported the app’s development.

As a 501(c) (3) tax-exempt nonprofit, Wholesome Wave was founded with the intention of creating value for the community while sustaining itself as a business entity. Our model includes diverse revenue, operations and expenses, program expenses, and capital structure. Each operating in alignment with the mission driven focus. The mission of Wholesome Wave is to empower under-served consumers to make healthier food choices by increasing affordable access to healthy, fruits and vegetables.

Wholesome Wave’s vision is a world where everyone can afford to eat healthy. With your support, we can build a replicable model that will serve and strengthen all of the organization's efforts and position us to further advocate for systems change. The partners and collaborators on this opportunity are those Wholesome Wave would like to work with in actualizing our vision. 

Wholesome Wave has been doing this work for ten years and has lacked broad exposure as much of the work is community-based. Working with local organizations do not typically have the resources for media exposure. While we do have research and evaluation partner, we are continuously seeking more partnerships to document our impact.

Partnership with MIT faculty, initiatives and/or Solve Members can support Wholesome Wave in collecting data and evaluating the user’s benefit of the Tangelo app, and support research and evaluation of primary markets the app operates in.