Meet the founder: FoodShot winner About Fresh talks transforming healthcare to improve food accessibility

“We need to broaden the definition of what constitutes access to food,” says About Fresh CEO Josh Trautwein.

As he notes, millions of Americans who live without access to food that’s both affordable and nutritious.

Boston-based About Fresh wants to strengthen the link between food accessibility and health outcomes through its Fresh Connect initiative. With this food prescription program, healthcare organizations cover the cost of healthy foods for patients and measure the impacts of doing so. All enrollment and analytics are compliant with the US Health Insurance Portability and Accountability Act (HIPPA).

After assessing Fresh Connect patients, a healthcare team can set a monthly budget healthcare will cover, as well as which foods are eligible. Patients then receive a debit card with pre-loaded funds to use at participating retailers.

Trautwein is especially keen to emphasize healthcare: “We really want to be a contributor to the transformation of healthcare and embed food as a permanent feature of how we take care of people.”

The credo and technology powering About Fresh recently won the company a GroundBreaker Prize in the BioActive Foods category from investment platform FoodShot Global and the Foundation for Food & Agriculture Research (FFAR). The team received $120,000 for “improving access to nutrient-dense and optimized foods that support brain, immune system, cardiovascular, metabolic and gut health.”

Below, Trautwein (JT) discusses the About Fresh model, how he nearly didn’t apply for FoodShot and what’s next for the company’s mission.

AFN: How did About Fresh originate?

JT: My first job out of school was at a community health center, coordinating a really wide range of health and wellness programs for our community of primarily low-income patients. 

Through one of my programs, I collaborated with clinicians on developing healthy lifestyle strategies for a group of low-income single moms. At the same time they were running that program, the only grocery store in the neighborhood closed down. 

That inspired [the mission] at About Fresh — that disconnect between our food system and our healthcare system. We know food is super important to our health outcomes. But it’s totally divorced from how we take care of people. 

Out of the community health center experience we developed our first program, which is called Fresh Truck. We convert school buses into mobile markets, which we still continue to operate today around Boston. We host a series of block parties that celebrate food, culture, promote nutrition education.

AFN: And that also evolved into Fresh Connect?

JT: We heard from our network of dietitians, social workers and shoppers that money [was] still getting in the way of accessing food. But those social workers and dietitians also had funds available to cover the cost of food. That really brought into focus for us the potential to create a food prescription. 

We created a coupon model where our healthcare partners fund food for patients. Now that’s evolved into technology-enabled platform called Fresh Connect made up of a web application that manages all aspects of the program, then a debit card that can be loaded with funds from a healthcare provider. [The debit card] is programmed with spend parameters based on a patient’s health profile.

We’re also adapting our Fresh Connect debit card as a payment method at a national network of retailers. So we’re able to give people a lot of options around where they can go shopping. 

AFN: What have been the greatest challenges so far for the company?

JT: At the beginning I think just understanding the fundamentals of like leadership, organizational development, like managing a board. 

Building programs in the nonprofit sector means you often run up against a lot of the entrenched institutional forces that govern the development of new programs. So that’s challenging — managing that network of potential collaborators, potential partners. You run into detractors also. Thoughtfully navigating all of those relationships is really hard. That was something that I didn’t see coming. [I was] a little bit naive and expecting human services to be more open than perhaps it was. 

Now we’re operating at the institutional level, with a national network of prominent health systems and strategic partners. And so now we’re navigating the bureaucracy and complexity that comes along with Medicaid, with contracting across states and within health systems, navigating HIPAA, and then assembling a really complex constellation of technology. 

AFN: What do the detractors say?

JT: I’m referring to a lot of well-meaning folks that have strong but sometimes unmovable convictions around the food system overall. For example, lots of really passionate folks are advocating for local food systems.

I believe in that too. However, we’re trying to address the health disparities that are attributed to lack of access to healthy food. We’ve made decisions in favor of that mission that sometimes run counter to the mission of folks [promoting] localized food systems. 

So there’s just a healthy tension that sometimes arises around the approach towards blending these missions. Out of that tension comes growth. It’s not all been negative.

Then there are some organizations and that have been doing work for a long time that are have convictions and beliefs based on their tenure. And that’s just relational. It sometimes just takes patience and grace and humility. 

AFN: How did you get involved with FoodShot?

JT: Foodshot seemed great from the outset. The first round of the process involved writing a letter of intent to say we’d like to apply for this grant. And then depending upon that initial letter, they invite you to submit a full application.

Then we were invited to submit a grant application, and that was accompanied by a lot more information about the grant. Then there was a deeper list of questions as part of the next round. 

We read the grant application and thought, “this actually isn’t for us.” [Foodshot] was more about supporting innovation around hard sciences like soil innovation, developing new types of probiotics, and exploration of the microbiome.

We’re leveraging financial technology to develop a consumer product; we’re not doing any of that deep science. So I wrote back to Sarah [Eckhouse, executive director of FoodShot Global], and I said “we really appreciate you all inviting us to apply, but it doesn’t seem like we’re the right fit and we just want to be mindful on both sides of our time.” 

She acknowledged that we were totally outside of the box. What we landed on is that there’s a beautiful synergy between what we’re building and what Foodshot has historically supported. 

AFN: Elaborate on that.

JT: There’s so much great innovation: alternative plant-based meats, regenerative agriculture, improving soil health and reducing soil degradation. Growing techniques, ingredients that are additive to health as opposed to adverse, new ingredients that make foods healthier.

What Sarah and I came back to was, how do we connect those foods to the people that need them?

A lot of those foods are oftentimes expensive and out of reach for different reasons. And that’s where we came in. Sarah really saw that, and we really united around that central theme. 

That’s what our grant application was anchored on: how Fresh Connect can really be this infrastructure that puts all the great innovation [within] reach for the people that need it the most. 

AFN: What’s the biggest thing we need to understand about food accessibility and insecurity?

JT: We need to broaden the definition of what constitutes access to food. 

You could have a grocery store right next door with all the fresh food in the world. But if you didn’t have money in the bank and had a really limited grocery budget, you’re going to struggle to access the food you need in order to be healthy. 

We see this play out in real time across both of our programs: you could have all the motivation in the world. You could have that grocery store close by with all that fresh, culturally relevant food. If you are not empowering people with money in the bank to access that food, it’s all for naught. 

We believe people have left purchasing power and affordability out of the equation of what constitutes access. And we did too. Our original program [Fresh Truck] was just focused on getting food into neighborhoods. We had to evolve our thinking.

AFN: What’s next?

JT: We’re looking forward to a ton of growth in terms of our retail network and expanding it nationally. In line with that, we’re expanding our healthcare partnerships, and those healthcare partnerships will be really focused on dynamic learning and generating data that we can use to support continued advocacy to expand Medicaid investment, Medicare investment. It will also help us demonstrate political impacts of food, and also the impact that investing in Fresh can have on just addressing food insecurity and reducing just the baseline stress that comes along with food insecurity.

In order to recruit healthcare as an investor, we need to generate a lot of data. And so that’s a huge part of the work going forward. It’s so so important over the course of the next five years that we invest heavily into really dynamic research and evaluation so we can present healthcare with the evidence that says, Yes, this is improving health outcomes. It’s improving people’s lives, and it’s saving you money.