Validation Of a Novel Method to Evaluate Local-scale Community-based Interventions That Improve Access to Fruits and Vegetables
Abstract Body: Background: Adequate intake of fruits and vegetables (FV) is important for cardiovascular health. Evaluating community-based dietary programs in under-resourced areas is challenging, necessitating innovative data collection methods. These methods must adapt to community contexts, enhancing the accessibility of impact evaluation for programs operating in neighborhood settings, including community centers, schools, and farmers’ markets. Aims: This study aimed to develop and pilot a survey instrument designed to overcome barriers in data collection within community-based programs, focusing on measuring changes in health behaviors. The tool aims to validate a concise set of process and outcome measures, addressing the evaluation challenges of small, local initiatives. Methods: The survey development was a theory-driven, participatory process with stakeholders to ensure the tool was culturally sensitive and capable of capturing data relevant to health outcomes. The survey was pilot tested in four Social Impact Fund programs in California, Florida, and Georgia. One program provided free meals, two provided discounted produce, and one was a traditional farmers’ market stand. The bilingual survey (English and Spanish) covered demographics, program participation, frequency of FV intake, and barriers to healthy eating. It was delivered via in-person interviews, tablets, and personal smartphones. Results: The pilot achieved high feasibility, with a 98.2% completion rate from 111 participants for the 20-item survey, taking an average of eight minutes. Overall, 62.5% (95% CI 49.7, 75.3) of participants said that their FV intake increased due to the programs, with the top reasons being affordability and quality. Participants also reported barriers to increasing FV intake, Figure 1, with 50% (95% CI 39.9, 60.1) saying cost, followed by time constraints and accessibility. Conclusion: The pilot results affirm the feasibility of evaluating programs aiming to improve diet in high-disparity neighborhoods. The results indicate a strong community desire for such programs and underscore a pivotal finding: when fruits and vegetables are affordable and accessible and meals are readily available at a low cost, community members are more likely to adopt healthier diets. This participatory approach proves that a well-validated, concise survey tool can efficiently collect health data in unconventional settings, promoting health equity by adapting to specific needs of communities.
Ewald, Louisa
( Institute for Health Metrics and Evaluation
, Seattle
, Washington
, United States
)
Ugo-ike, Claire
( American Heart Association
, Dallas
, Texas
, United States
)
Legrand, Kate
( Institute for Health Metrics and Evaluation
, Seattle
, Washington
, United States
)
Honeycutt, Sally
( American Heart Association
, Dallas
, Texas
, United States
)
Hall, Jennifer
( American Heart Association
, Dallas
, Texas
, United States
)
Gakidou, Emmanuela
( Institute for Health Metrics and Evaluation
, Seattle
, Washington
, United States
)
Mokdad, Ali
( Institute for Health Metrics and Evaluation
, Seattle
, Washington
, United States
)
Roth, Gregory
( Institute for Health Metrics and Evaluation
, Seattle
, Washington
, United States
)
Author Disclosures:
Louisa Ewald:DO NOT have relevant financial relationships
| Claire Ugo-Ike:DO NOT have relevant financial relationships
| Kate LeGrand:DO NOT have relevant financial relationships
| Sally Honeycutt:DO NOT have relevant financial relationships
| Jennifer Hall:No Answer
| Emmanuela Gakidou:No Answer
| Ali Mokdad:No Answer
| Gregory Roth:No Answer