20 research outputs found

    Measuring and Testing How Food Policy Councils Function to Influence Their Food Systems

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    The number of Food Policy Councils (FPCs) in the United States (US), Canada, and Native American & First Nations increased from 43 in 2005 to 278 in 2015. The Centers for Disease Control and Prevention recommend establishing FPCs to improve the local and state food environments. Despite increased interest in FPCs, there is little evidence about what makes FPCs effective. First, we conducted a case study of an FPC in a rural county to understand how a council facilitates change across their food system using interviews (n=8) and network analysis (n=12). Council members indicated that council connections helped them work more effectively in their home organizations. Social network analysis revealed a dense network of connections and complemented qualitative findings. This case study illustrates connections between FPC members in a rural county, and identifies examples of how FPCs can facilitate policy, systems, and environmental-level change in their communities. Next, we developed and tested the Food Policy Council Self-Assessment Tool (FPC-SAT). The assessment measures council members’ perceptions of the following concepts: leadership, breadth of active membership, council climate, formality of council structure, knowledge sharing, relationships, member empowerment, community context, synergy, and impacts on the food system. All 278 FPCs listed on the Food Policy Network’s directory were recruited. Responses from 354 FPC members from 94 councils were used to test the assessment. Cronbach alpha ranged from 0.79 – 0.93 for the scales. FPC members reported the lowest mean scores on the breadth of active membership scale (mean=2.49, SD=0.622) and highest on the leadership scale (mean=3.45, SD=0.452). This study contributes to measurement development and FPC members’ perceptions of how their councils functions. Finally, we used responses from the FPC-SAT to evaluate the relationships between organizational capacity, social capital, and council effectiveness in FPCs. Structural equation modeling was used to test and revise an FPC Framework. A revised FPC Framework was a good fit with the data (n=354, χ2=40.085, df=24, p-value=0.021, CFI=0.988, TLI=0.982, RMSEA=0.044, p-close=0.650). The FPC Framework can guide capacity building interventions and evaluations. The evidence-informed framework can help FPCs efficiently work toward achieving their mission of improving their local food system.Doctor of Philosoph

    Using Behavior Over Time Graphs to Spur Systems Thinking Among Public Health Practitioners

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    Public health practitioners can use Behavior Over Time (BOT) graphs to spur discussion and systems thinking around complex challenges. Multiple large systems, such as health care, the economy, and education, affect chronic disease rates in the United States. System thinking tools can build public health practitioners’ capacity to understand these systems and collaborate within and across sectors to improve population health. BOT graphs show a variable, or variables (y axis) over time (x axis). Although analyzing trends is not new to public health, drawing BOT graphs, annotating the events and systemic forces that are likely to influence the depicted trends, and then discussing the graphs in a diverse group provides an opportunity for public health practitioners to hear each other’s perspectives and creates a more holistic understanding of the key factors that contribute to a trend. We describe how BOT graphs are used in public health, how they can be used to generate group discussion, and how this process can advance systems-level thinking. Then we describe how BOT graphs were used with groups of maternal and child health (MCH) practitioners and partners (N = 101) during a training session to advance their thinking about MCH challenges. Eighty-six percent of the 84 participants who completed an evaluation agreed or strongly agreed that they would use this BOT graph process to engage stakeholders in their home states and jurisdictions. The BOT graph process we describe can be applied to a variety of public health issues and used by practitioners, stakeholders, and researchers

    Food Policy Council Self-Assessment Tool: Development, Testing, and Results

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    A large number of food policy councils (FPCs) exist in the United States, Canada, and Tribal Nations (N = 278), yet there are no tools designed to measure their members' perceptions of organizational capacity, social capital, and council effectiveness. Without such tools, it is challenging to determine best practices for FPCs and to measure change within and across councils over time. This study describes the development, testing, and findings from the Food Policy Council Self-Assessment Tool (FPC-SAT). The assessment measures council practices and council members' perceptions of the following concepts: leadership, breadth of active membership, council climate, formality of council structure, knowledge sharing, relationships, member empowerment, community context, synergy, and impacts on the food system. All 278 FPCs listed on the Food Policy Network's Online Directory were recruited to complete the FPC-SAT. Internal reliability (Cronbach's α) and inter-rater reliability (AD, rWG(J), ICC [intraclass correlations][1], ICC[2]) were calculated, and exploratory and a confirmatory factor analyses were conducted. Responses from 354 FPC members from 94 councils were used to test the assessment. Cronbach's α ranged from 0.79 to 0.93 for the scales. FPC members reported the lowest mean scores on the breadth of active membership scale (2.49; standard deviation [SD], 0.62), indicating room for improvement, and highest on the leadership scale (3.45; SD, 0.45). The valid FPC-SAT can be used to identify FPC strengths and areas for improvement, measure differences across FPCs, and measure change in FPCs over time

    Developing Theory to Guide Building Practitioners’ Capacity to Implement Evidence-Based Interventions

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    Public health and other community-based practitioners have access to a growing number of evidence-based interventions (EBIs), and yet EBIs continue to be underused. One reason for this underuse is that practitioners often lack the capacity (knowledge, skills, and motivation) to select, adapt, and implement EBIs. Training, technical assistance, and other capacity-building strategies can be effective at increasing EBI adoption and implementation. However, little is known about how to design capacity-building strategies or tailor them to differences in capacity required across varying EBIs and practice contexts. To address this need, we conducted a scoping study of frameworks and theories detailing variations in EBIs or practice contexts and how to tailor capacity-building to address those variations. Using an iterative process, we consolidated constructs and propositions across 24 frameworks and developed a beginning theory to describe salient variations in EBIs (complexity and uncertainty) and practice contexts (decision-making structure, general capacity to innovate, resource and values fit with EBI, and unity vs. polarization of stakeholder support). The theory also includes propositions for tailoring capacity-building strategies to address salient variations. To have wide-reaching and lasting impact, the dissemination of EBIs needs to be coupled with strategies that build practitioners’ capacity to adopt and implement a variety of EBIs across diverse practice contexts

    Nutrition-related policy and environmental strategies to prevent obesity in rural communities: A systematic review of the literature, 2002-2013

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    Introduction Residents of rural communities in the United States are at higher risk for obesity than their urban and suburban counterparts. Policy and environmental-change strategies supporting healthier dietary intake can prevent obesity and promote health equity. Evidence in support of these strategies is based largely on urban and suburban studies; little is known about use of these strategies in rural communities. The purpose of this review was to synthesize available evidence on the adaptation, implementation, and effectiveness of policy and environmental obesity-prevention strategies in rural settings. Methods The review was guided by a list of Centers for Disease Control and Prevention Recommended Community Strategies and Measurements to Prevent Obesity in the United States, commonly known as the COCOMO strategies. We searched PubMed, Cumulative Index of Nursing and Allied Health Literature, Public Affairs Information Service, and Cochrane databases for articles published from 2002 through 2013 that reported findings from research on nutrition-related policy and environmental strategies in rural communities in the United States and Canada. Two researchers independently abstracted data from each article, and resolved discrepancies by consensus. Results Of the 663 articles retrieved, 33 met inclusion criteria. The interventions most commonly focused on increasing access to more nutritious foods and beverages or decreasing access to less nutritious options. Rural adaptations included accommodating distance to food sources, tailoring to local food cultures, and building community partnerships. Conclusions Findings from this literature review provide guidance on adapting and implementing policy and environmental strategies in rural communities

    What strategies are used to build practitioners’ capacity to implement community-based interventions and are they effective?: a systematic review

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    Abstract Background Numerous agencies are providing training, technical assistance, and other support to build community-based practitioners’ capacity to adopt and implement evidence-based prevention interventions. Yet, little is known about how best to design capacity-building interventions to optimize their effectiveness. Wandersman et al. (Am J Community Psychol.50:445–59, 2102) proposed the Evidence-Based System of Innovation Support (EBSIS) as a framework to guide research and thereby strengthen the evidence base for building practitioners’ capacity. The purpose of this review was to contribute to further development of the EBSIS by systematically reviewing empirical studies of capacity-building interventions to identify (1) the range of strategies used, (2) variations in the way they were structured, and (3) evidence for their effectiveness at increasing practitioners’ capacity to use evidence-based prevention interventions. Methods PubMed, EMBASE, and CINAHL were searched for English-language articles reporting findings of empirical studies of capacity-building interventions that were published between January 2000 and January 2014 and were intended to increase use of evidence-based prevention interventions in non-clinical settings. To maximize review data, studies were not excluded a priori based on design or methodological quality. Using the EBSIS as a guide, two researchers independently extracted data from included studies. Vote counting and meta-summary methods were used to summarize findings. Results The review included 42 publications reporting findings from 29 studies. In addition to confirming the strategies and structures described in the EBSIS, the review identified two new strategies and two variations in structure. Capacity-building interventions were found to be effective at increasing practitioners’ adoption (n = 10 of 12 studies) and implementation (n = 9 of 10 studies) of evidence-based interventions. Findings were mixed for interventions’ effects on practitioners’ capacity or intervention planning behaviors. Both the type and structure of capacity-building strategies may have influenced effectiveness. The review also identified contextual factors that may require variations in the ways capacity-building interventions are designed. Conclusions Based on review findings, refinements are suggested to the EBSIS. The refined framework moves the field towards a more comprehensive and standardized approach to conceptualizing the types and structures of capacity-building strategies. This standardization will assist with synthesizing findings across studies and guide capacity-building practice and research

    What strategies are used to build practitioners’ capacity to implement community-based interventions and are they effective?: a systematic review

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    Background Numerous agencies are providing training, technical assistance, and other support to build community-based practitioners’ capacity to adopt and implement evidence-based prevention interventions. Yet, little is known about how best to design capacity-building interventions to optimize their effectiveness. Wandersman et al. (Am J Community Psychol.50:445–59, 2102) proposed the Evidence-Based System of Innovation Support (EBSIS) as a framework to guide research and thereby strengthen the evidence base for building practitioners’ capacity. The purpose of this review was to contribute to further development of the EBSIS by systematically reviewing empirical studies of capacity-building interventions to identify (1) the range of strategies used, (2) variations in the way they were structured, and (3) evidence for their effectiveness at increasing practitioners’ capacity to use evidence-based prevention interventions. Methods PubMed, EMBASE, and CINAHL were searched for English-language articles reporting findings of empirical studies of capacity-building interventions that were published between January 2000 and January 2014 and were intended to increase use of evidence-based prevention interventions in non-clinical settings. To maximize review data, studies were not excluded a priori based on design or methodological quality. Using the EBSIS as a guide, two researchers independently extracted data from included studies. Vote counting and meta-summary methods were used to summarize findings. Results The review included 42 publications reporting findings from 29 studies. In addition to confirming the strategies and structures described in the EBSIS, the review identified two new strategies and two variations in structure. Capacity-building interventions were found to be effective at increasing practitioners’ adoption (n = 10 of 12 studies) and implementation (n = 9 of 10 studies) of evidence-based interventions. Findings were mixed for interventions’ effects on practitioners’ capacity or intervention planning behaviors. Both the type and structure of capacity-building strategies may have influenced effectiveness. The review also identified contextual factors that may require variations in the ways capacity-building interventions are designed. Conclusions Based on review findings, refinements are suggested to the EBSIS. The refined framework moves the field towards a more comprehensive and standardized approach to conceptualizing the types and structures of capacity-building strategies. This standardization will assist with synthesizing findings across studies and guide capacity-building practice and research

    Supplementary Tables for "TAS2R38 predisposition to bitter taste associated with differential changes in vegetable intake in response to a community-based dietary intervention".

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    <p>Table S1: Comparison of the coverage of reference panels used for SNP imputation; Table S2: SNP imputation results; Table S3: Allele frequencies of TA2R38 SNPs by each ancestral group and time point; Table S4: Linkage disequilibrium analysis of TAS2R38 SNPs at each time point of the intervention; Table S5: Haplotype distribution of TAS2R38 alleles at each time point of the intervention; Table S6: T2R gene family member SNPs used in multivariate analysis; Table S7: Full factor loadings of the principal components analysis; Table S8: Selected factor loadings of the principal components analysis; Table S9: T2R gene family member SNPs used in multivariate analysis.<br></p><p></p

    Merging Opposing Viewpoints: Analysis of the Development of a Statewide Sustainable Local Food Advisory Council in a Traditional Agricultural State

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    Food policy councils (FPCs) are a useful way for interested groups to work together to create mutually beneficial change within the food system. Often formed through grassroots organizing or commissioned by governmental entities, FPCs have been successful at tackling challenges within food systems by creating forums to address issues whose roots ordinarily are in disparate parts of these systems. Little peer-reviewed research exists, however, examining the formation of state-level FPCs, particularly among states known for their conventional production practices. In this case study, we explored the process of forming a statewide FPC in North Carolina from 2007 to 2009. The objectives were to (a) qualitatively exam­ine the two-year process of forming a statewide FPC in a traditional agriculture state, and (b) iden­tify the factors that led to its formation. To do so, we developed an in-depth interview guide for inter­viewing eight individuals, including government stakeholders, conventional agricultural producers, sustainable agricultural producers, philanthropists, and legal representatives. We used qualitative analy­sis methods to analyze the transcripts, drawing on John Kingdon’s agenda-setting and policy-formation theory to guide analysis. Results indi­cated that four factors drove the formation of the North Carolina state-level FPC: (1) stakeholder involvement, (2) diverse partnerships, (3) stake­holder ability to compromise, and (4) a conducive political setting. While the small sample size pre­vents us from causally interpreting our results and generalizing our findings, this preliminary research may provide insight for other states, especially those with a predominately traditional agriculture system, that are interested in forming state-level FPCs
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