Improving public health data collection approaches across populations: findings from a national evaluation of fruit and vegetable incentives.

Objective: Public health approaches for addressing diet-related health in the USA 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 the intake of fruits and vegetables through healthy food incentives. Measuring the 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 and demographics, among other variables, through a participant survey. This study explored challenges and opportunities to evaluation across populations within a national public health oriented program, GusNIP.

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

Setting: Data collection occurred in the USA virtually using Qualtrics and Zoom from fall 2021 to fall 2022.

Participants: Eighteen GusNIP PPR and NI data collectors, twenty-four external evaluators and eleven GusNIP National Training, Technical Assistance, Evaluation, and Information Center staff participated.

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

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