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Meaningful, Measurable, and Manageable Approaches to Evaluating Healthy Food Financing Initiatives: An Overview of Resources and Approaches

Fleischhacker, Sheila E. PhD, JD; Flournoy, Rebecca MPH; Moore, Latetia V. PhD

Journal of Public Health Management and Practice: November/December 2013 - Volume 19 - Issue 6 - p 541–549
doi: 10.1097/PHH.0b013e318271c6eb
Original Articles

More than 23 million Americans have limited access to grocery stores. Healthy food financing initiatives have been emerging at local, state, and federal levels to address grocery gaps. Through public-private partnerships, retailers have been awarded funding to open or renovate a variety of food outlets. Preliminary findings have reported increased access to healthy foods, as well as improved community and economic development. As policy makers continue to consider enacting or expanding these initiatives and as all program stakeholders increasingly seek information on program impacts, this article provides guidance on using meaningful, measurable, and manageable methods to evaluate program's multifaceted outcomes.

This article provides an overview of healthy food financing initiatives. It describes a range of resources and approaches to quantify program effectiveness in the short and long term by capitalizing on existing data sources, maximizing application and reporting processes, and conducting longer-term multilevel studies.

NIH Division of Nutrition Research Coordination, National Institutes of Health, US Department of Health and Human Services, Bethesda, Maryland (Dr Fleischhacker); Alameda County Public Health Department, Oakland, California (Ms Flournoy); and Nutrition Branch, Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Moore).

Correspondence: Sheila E. Fleischhacker, PhD, JD, NIH Division of Nutrition Research Coordination, National Institutes of Health, US Department of Health and Human Services, Two Democracy Plaza, Room 635, 6707 Democracy Blvd, MSC 5461, Bethesda, MD 20892 (

This article was commissioned by the Robert Wood Johnson Foundation through its Healthy Eating Research program. We are indebted to the insights and contributions of the Food Access Working Group of the Healthy Eating Research program. In addition, we are grateful for the time and thought provided during the development of the manuscript to Tatiana Andreyeva, Amy Hillier, Allison Karpyn, Lance Loethen, Mary Lee, Diego Rose, Victor Rubin, the late Sarah Samuels, and the Division of Nutrition, Physical Activity, and Obesity at the Centers for Disease Prevention and Control. We also garnered invaluable insights from a memo developed for the federal agencies working to implement and evaluate the federal Healthy Food Financing Initiative developed by Judith Bell, Rebecca Flournoy, and Allison Hagey of PolicyLink; Pat Smith, Cathy Califano, and Lance Loethen of The Reinvestment Fund; and John Weidman and Allison Karpyn, and Tracey Giang of The Food Trust.

Disclosure: The authors declare no conflicts of interest.

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.