Equitable Approaches for Public Health Data Collection Among Diverse Populations: Findings from a National Evaluation of Fruit and Vegetable Incentives.

Abstract

Objective: Public health approaches for addressing diet-related health in the United States (US) include nutrition incentive (NI) and produce prescription (PPR) projects. These projects, funded through the US Department of Agriculture Gus Schumacher Nutrition Incentive Program (GusNIP), aim to support intake of fruits and vegetables through healthy food incentives. Measuring GusNIP impact is vital to assessing the ability of incentives to improve public health nutrition outcomes across populations. Shared measures used across GusNIP projects assess fruit and vegetable intake, food security, demographics, among other variables, through a participant survey. This study explored challenges and opportunities to support evaluation across GusNIP.

Design: This qualitative study used a sociodemographic survey, semi-structured interviews, and focus groups. Descriptive statistics were used to summarize survey data and applied thematic analysis was used to identify patterns in interview and focus group data.

Setting: Data collection occurred in the United States virtually using Qualtrics and Zoom, fall 2021 to fall 2022.

Participants: 18 GusNIP PPR and NI data collectors, 24 external evaluators, and 11 GusNIP Training, Technical Assistance, Evaluation, and Information Center's (NTAE) staff participated.

Results: Opportunities to improve evaluation among GusNIP's participants include tailoring surveys to specific subpopulations, translations, culturally appropriate food examples, avoiding stigmatizing language, using mixed methods, and intentional strategies to enhance representation.

Conclusion: To increase applicability, evaluation tools must reflect the experiences across populations. This study provides insights that can guide future NI and PPR evaluations, helping to more effectively measure and understand outcomes of all communities.