Progress 11/01/23 to 10/31/24

Outputs
Target Audience:GusNIP, GusCRR, and APRA grantees and associated partners are the primary audience. The NTAE will effectively support all aspects of R&E and TA&I needs of grantees. GusCRR/APRA enhanced activities will align with overall GusNIP priorities, and the long-term goals: (1) ensure that all grantees and applicants have access to TA&I resources to support program implementation and development and (2) articulate impact through robust and comprehensive R&E. Disseminating findings and other relevant project updates will be targeted to various audiences, depending on roles and needs for aggregate data and outcomes. Dissemination activities will include reporting to Congress and disseminating program impacts to the broader public. The target audience of the public-facing Impact Findings report includes GusNIP, GusCRR, and APRA grantees, NI and PPR practitioners, researchers, policymakers, and others. We are also developing strategies to report public-facing findings in diverse formats (e.g., briefs, infographics, videos) for participants of NI and PPR projects and other invested parties.? Changes/Problems:No major changes or problems were encountered in carrying out the project plan, approach, methods, timeline, or objectives. What opportunities for training and professional development has the project provided?During year 2 of ARPA, staff and consultants enhanced their work-related skills and knowledge by completing professional development and learning opportunities. Online courses completed by NTAE staff primarily focused on skill-building, including data analysis (PowerBI and ArcGIS) and project management. The majority of CNHI staff members attended a workshop titled "An Equity Centered Approach to Research and Evaluation" as part of an ongoing series focused on recognizing implicit biases, awareness of personal privilege, and incorporating diverse perspectives in research/projects. NTAE staff and consultants led and/or participated in several CNHI professional development groups to foster information sharing, mentoring, and team building across roles, including program advisors, supervisors, project managers, research associates, and research scientists. Throughout the year, NTAE staff sought further education across a broad span of topic areas by attending virtual and in-person seminars and traveling to a wide range of professional conferences. Topic areas covered by these webinars/seminars and conferences included technological innovation, food systems, food sovereignty, reducing environmental impacts, DEIA, food policy, malnutrition, Cooperative Extension, and state-specific nutrition incentive projects. The list below includes professional development and learning activities that the broader Nutrition Incentive Hub engaged in throughout this reporting period. Online Courses Spatial Data Science: The New Frontier in Analytics (Esri course) Project Management Essentials with Certified Associate in Project Management (CAPM) Prep Workshops Being Who We Say We Are: Negotiating Power and Building Relationships in Food Systems Research An Equity Centered Approach to Research and Evaluation Racial Equity Workshop American Diabetes Association Grantee Workshop Changing Narratives and Shifting Power for Health Equity Training Obesity-Related Policy, Systems, and Environmental Research in the US Workshop Conferences/Meetings Food and Nutrition Conference & Expo Annual Meeting (Denver, CO) PPR Mini Convening (Chicago, IL) New to GusNIP Mini-Convening (New York, NY) Growing Produce Prescriptions Programs in Rhode Island Summit (Providence, RI) 2023 Milken Institute Future of Health Summit (Washington, DC) 2024 American Public Health Association (APHA) Annual Meeting (Atlanta, GA) Food As Medicine Policy Summit (Washington DC) 2023 USDA NIFA Community Nutrition Project Directors Meeting (New Orleans, LA) Health and Human Services (HHS) Inaugural Food is Medicine Summit: Building a Dynamic Future (Washington, DC) Food is Medicine Midwest Convening (Topeka, KS) Food is Medicine: Data and Metrics (Washington, DC) 2024 Healthy Eating Research (HER) Grantee Meeting (Denver, CO) 45th Annual Meeting & Scientific Sessions for Society of Behavioral Medicine (SBM) (Philadelphia, PA) Convening on Understanding, Measuring, and Addressing Racism in the Food System: Applying an Anti-Racist Praxis to Improve Sovereignty, Community Resilience, Well-Being, and Justice (Chicago, IL) Inaugural Symposium: Cultivating Health in a Changing World - Cardiovascular Health and Wellness (Arizona) White House Minority Health Forum (Washington, DC) Association for International Agricultural and Extension Education (AIAEE) Annual conference (Orlando, FL) National Institutes of Health (NIH) Advancing Health Equity Through Culture-Centered Dietary Interventions to Address Chronic Diseases (Virtual) Farmers Market Pros InTents Conference (San Diego, CA) National Grocers Association Show (Las Vegas, NV) Rural Grocery Summit (Mobile, AL) Mobile Market Summit (Virtual) 2024 Virginia Food is Medicine Summit (Richmond, VA) 2024 International Society of Behavioral Nutrition and Physical Activity (Omaha, NE) 2024 Agriculture, Food & Human Values Society and the Association for the Study of Food and Society (Virtual) American Diabetes Association 84th Scientific Sessions (Virtual) Webinars and Seminars USDA Programs, Investments, and Innovations to Prevent and Reduce Food Loss and Waste New Frontiers to Prevent Diabetes and Malnutrition Health Affairs Briefing: Tacking Structural Racism in Health National Heart, Lung, and Blood Institute (NHLBI): New directions in Community-Based Interventions to Improve Food Access in Baltimore Risk to Resilience: Encouraging Girls' Physical and Mental Health Through Nutrition Academy of Nutrition and Dietetics Food Security Affinity Group Measuring Diet Quality Across the Lifespan: Introducing the New Healthy Eating Index-Toddlers-2020 and Healthy Eating Index-2020 National Institutes of Health (NIH) - Culture-Centered Dietary Interventions to Address Chronic Diseases NIFA Food and Nutrition Security Webinar Series: Promoting Indigenous Food Sovereignty Centers for Disease Control and Prevention (CDC) Moving Forward: What it Means for the Future of Health Communication Food Insecurity Among Veterans: Resources to Screen and Intervene A Supermarket-Research Partnership: Origins, Lessons Learned, and Future Directions HER NOPREN Resilient Food Systems and Nutrition Work Group Inter-Institutional Network for Food, Agriculture, and Sustainability (INFAS) Annual Summit Racism and Other Macrosocial Determinants of Health: Moving from Explanation to Action Using Ag Data Commons to Share USDA-funded Work Talking Data Equity with Dr. Joanna Redden on Data Harms Family Nutrition Program Professional Development Webinar Series - Food Insecurity and Eating Disorders Nutrition and Obesity Policy Research and Evaluation Network State of the Science - Food is Medicine in 2023 Nutrition and Obesity Policy Research and Evaluation Network State of the Science Monthly Webinar Series - Pathophysiology or Obesity Our Food Is Medicine - Can Community Research and Data Sovereignty Co-Exist? Study Groups Professional Development Groups: Consultant Program Advisors Project Managers & Project Coordinators Supervisors Research Scientists Research Associates Registered Dietitian Nutritionists How have the results been disseminated to communities of interest?Program results have been disseminated to GusNIP audiences and other communities of interest through webinars (see question 8 "Other Products" for a complete list), mini convenings (see question 8 "Other Products"), 1-on-1 and cohort calls, website resources and information, biweekly newsletters for GusNIP, GusCRR, and ARPA practitioners and grantees, numerous topical discussion boards, and media relations. In addition, the NTAE: Hosted an EBT Integration Working Group Kickoff Meeting in Boston, MA with 26 attendees from 10 different states. Programs gathered to learn from incentive programs in Massachusetts and Rhode Island on how to add incentive benefits to the EBT card at brick-and-mortar and farm direct locations. Planned and scheduled a mini convening in Hawaii in August 2024, which will be focused on the connections GusNIP grantee projects have with food, land, and culture. 21 grantees are attending with 16 receiving scholarships. Attendees will be hosted by Kokua Kalihi Valley Comprehensive Family Services, Waianae District Comprehensive Health and Human Services Board, The Food Basket, and the Hawaii Good Food Alliance. Grantee hosts will share how their GusNIP projects have been informed by their participants and community elders, invest in local agriculture, highlight cultural foods, and support resilient communities. Published 7 peer-reviewed manuscripts to move the state of the GusNIP science and practice fields forward. Delivered presentations for several GusNIP and USDA webinars and at several conferences and national meetings. Disseminated information on the biweekly Nutrition Incentive Hub Newsletter (2,000+ recipients), Facebook, LinkedIn, and X/Twitter channels, bringing together the public, practitioners, grocers, farmers markets, produce wholesalers, industry technology, and USDA to facilitate information sharing and communications around Nutrition Incentive Hub events, webinars, and updates about GusNIP. Highlighted 11 grantees, partners, and farmers on the Nutrition Incentive Hub social media platforms, including Facebook, LinkedIn, and X/Twitter, to elevate grantee stories. Posted over 60 social media posts across 3 social media platforms about industry news, learnings, and work conducted by the NTAE. Drafted and disseminated 4 press releases about the GusNIP Site Map launch, round 5 of the CBIF, USDA NIFA's $52 million investment in GusNIP, and the public-facing Impact Findings Report. Collaborated with Nutrition Incentive Hub partners to promote GusNIP and GusCRR results on various social media platforms and newsletters. Developed and disseminated the Y4 Congressional Report which included GusCRR- and ARPA-specific results. Developed, launched, and disseminated the GusNIP Y4 Impact Findings Report along with several companion pieces including an executive summary, infographic, and social media toolkit. What do you plan to do during the next reporting period to accomplish the goals?In year 3 of ARPA, the NTAE will continue supporting and building the capacity of grantees to track both firm- and participant-level metrics for each award type (GusNIP, GusCRR, and ARPA). The NTAE will continue collecting, cleaning, and analyzing grantee data by project and award type and will apply processes and learnings from managing GusCRR data to the ARPA awardees' data. The following bullets summarize planned year 3 activities and products organized by objective: GOAL 1: OBJ 1: Describe the extent to which GusCRR/ARPA expanded the reach of GusNIP NI and PPR projects to new geographic locations and individuals. Continue collecting data through the Nutrition Incentive Hub portal submission system to capture participating firms, dollar value of incentives distributed, dollar value of incentives redeemed, transactions, and unique participants (where possible) associated with each award type (GusNIP, GusCRR, ARPA). Apply the proxy estimate approach to extrapolate the average number of unique NI project participants reached monthly that is associated with each award type (GusNIP, GusCRR, ARPA). Determine the total reach of PPR projects in GusNIP year 5 that is associated with each award type (GusNIP, GusCRR, ARPA). OBJ 2: Determine how GusCRR/ARPA NI and PPR projects improved access to fruits and vegetables for participants and underrepresented communities. Continue reporting expanded reach via firm-level data specific to NI and PPR projects for GusNIP, GusCRR, and ARPA awards. Update the GusNIP firm locations maps (newly developed in year 4 of GusNIP) twice annually with updated firm locations and add additional layers of interest. OBJ 3: Document the dollar value of additional incentives issued and redeemed to GusCRR/ARPA participants and the associated economic impact. Apply the methodology used to determine the dollar value of incentives issued and redeemed to ARPA funded projects. Report additional incentives issued and redeemed attributed to GusCRR funding and ARPA funding in a report to Congress and a public-facing Impact Findings report. OBJ 4: Develop responsive and expanded reporting and evaluation (R&E) and technical assistance and innovation (TA&I) services to support GusNIP, GusCRR, and ARPA funded grantees in project implementation and meeting firm- and participant-level core metrics requirements. Promote and facilitate peer-learning opportunities, such as discussion boards, communities of practice, and coffee hours. Consolidate and organize all resources on the Nutrition Incentive Hub website for increased navigability for applicants, practitioners, and grantees. Transition to the new technology vendor, and work closely with the vendor, NTAE staff, and core partners to develop and deploy the integrated technology system. Provide ongoing evaluation-focused support via 1:1 and grantee cohorts through program, firm-level, and survey advising models. Provide ongoing implementation-focused support via 1:1 and group advising. Provide timely technical assistance support through evaluation@nutritionincentivehub.org and ta@nutritionincentivehub.org general inboxes, website helpdesk, and new integrated technology system. Refine and maintain a centralized firm-level reporting model. Refine and maintain a centralized participant-level survey advising model. Offer mini awards to fund participant-level stipends and provide technical assistance on administering stipends. Solicit feedback from GusNIP, GusCRR, and ARPA grantees on advising model and in-person support for continuous quality improvement. Continue to develop internal and external resources to help PPR grantees navigate the healthcare outcomes, cost, and utilization data requirement. Conduct field visits with ARPA and GusCRR grantees on an as-needed basis. Host at least 1 mini convening for GusNIP, GusCRR, and ARPA grantees focused on emergent grantee needs. Host the National Convening in Spring 2025. Continue offering Capacity Building and Innovation Fund Awards in the Spring of 2025. Continue facilitating a bi-monthly PPR Community of Practice and coffee hours.

Impacts
What was accomplished under these goals? In year 2 of ARPA, the NTAE continued to use novel systems to support ARPA grantees, many of whom have multiple funding sources for their project. Grantees supported by ARPA continued to collect both participant- and firm-level data for the NTAE to analyze and use in future reports. Further, grantees supported by GusCRR continued collecting and reporting both firm- and participant-level data, which the NTAE cleaned, merged, and analyzed to showcase the reach and impact of each award type (GusNIP, GusCRR, and ARPA). Highlighted results and products include unique participants reached, incentives redeemed and distributed, and economic impact. A GusNIP site map also shows the aggregated impact of different award types, regarding the reach of projects across the United States. The NTAE helped GusNIP, GusCRR, and ARPA grantees develop tools and systems to meet reporting requirements. The bullets under each of the below objectives detail activities, products, and results accomplished by NI and PPR grantees and the NTAE during year 2. GOAL: Tailor previously developed systems, infrastructure, and collaborative relationships to support, monitor, and evaluate NI and PPR projects funded with GusCRR/ARPA awards. OBJ 1: Describe the extent to which GusCRR/ARPA expanded the reach of GusNIP NI and PPR projects to new geographic locations and individuals. Collected data on participating firms, dollar value of incentives distributed, dollar value of incentives redeemed, transactions, and unique participants (where possible) associated with each award type (GusNIP, GusCRR, ARPA) via the Nutrition Incentive Hub portal data submission system. Across active NI/PPR projects in GusNIP year 4, a total of 4,612 firms received GusNIP/GusCRR/ARPA funding (of these, 1,796 utilized GusCRR funding and 347 used ARPA funding). Used a proxy estimation to extrapolate the average number of unique NI project participants reached monthly by award type. On average, 234,571 NI participants were reached each month during GusNIP year 4. Of those, 146,745 participants redeemed incentives funded by GusNIP awards, and 87,826 participants redeemed incentives funded by GusCRR awards. Determined the total reach of PPR projects in GusNIP year 4 by award type. In total, 22,571 PPR participants were enrolled during GusNIP year 4 (9,251 in GusNIP projects, 6,608 in ARPA projects, and 6,712 in GusCRR projects). Engineered and disseminated the GusNIP Site Map, a geographic information system (GIS) map designed to display GusNIP NI and PPR sites alongside demographic base layers (e.g., poverty status, race and Hispanic origin, low income, low access areas) to better understand GusNIP's reach. OBJ 2: Determine how GusCRR/ARPA NI and PPR projects improved access to fruits and vegetables for participants and underrepresented communities. Measured and reported expanded reach to participants and firms in the year 4 GusNIP Congressional Report specific to NI and PPR projects and GusNIP/GusCRR/ARPA award types. Developed NI and PPR maps representing firm locations by other layers of interest: race and ethnicity, veteran status, population density, low-income and low-access areas, urban and rural areas. Provided education and instruction for how GusNIP communities can utilize the site map via webinars and documentation. OBJ 3: Document the dollar value of additional incentives issued and redeemed to GusCRR/ARPA participants and associated economic impact generated. Determined the dollar value of additional incentives issued and redeemed attributed to GusCRR grant funding for both the year 4 GusNIP Report to Congress and the year 4 GusNIP Impact Findings Report. Out of $69,313,547 total incentives distributed by NI projects in GusNIP year 4, GusCRR supported $11,333,385 in NI incentives distributed. Out of $6,019,701 total incentives distributed by PPR projects in GusNIP year 4, GusCRR supported $1,359,097 in PPR incentives distributed and ARPA supported $987,495 in PPR incentives distributed. Of the total dollar amount of incentives redeemed ($52,142,189), GusCRR supported $13,367,534 and ARPA supported $826,548, which generated an estimated economic impact of $29,239,809 among communities across the country. Promoted the economic impact calculator (available at www.nutritionincentivehub.org) that is tailored to NI projects using state groupings based on similar agricultural and food economies. OBJ 4: Develop responsive and expanded reporting and evaluation (R&E) and technical assistance and innovation (TA&I) services to support GusNIP, GusCRR, and ARPA funded grantees in meeting project implementation and firm- and participant-level core metrics requirements. Provided peer-learning opportunities through discussion boards and communities of practice. Provided ongoing support approximately monthly via 1:1 and R&E TA based on the advising model (i.e., program, firm-level, and survey advising). Refined and maintained a centralized firm-level reporting model ("helpdesk"). Launched a centralized participant-level data collection and survey advising model ("helpdesk"). Approved $70,100 in mini awards to 35 ARPA grantees to fund participant-level stipends. Approved $7,140 in mini awards to 8 GusCRR grantees to fund participant-level stipends. Continued to develop internal and external resources to help PPR grantees navigate the healthcare outcomes, cost, and utilization data requirement. Conducted informal field visits with 2 ARPA or GusCRR grantees. Hosted 2 mini convenings with ARPA and GusCRR grantees: One in October 2023 held in Chicago that focused on PPR partnerships with healthcare organizations and nonprofits, and one in June 2024 held in New York City that included PPR and NI grantees new to GusNIP or new to their role within GusNIP. Hosted 6 meetings of the PPR Community of Practice and 4 coffee hours for GusNIP, GusCRR, and ARPA grantees. Released a final set of operating standards for point-of-sale technology for PPR transactions that was co-developed with ARPA, GusCRR, and GusNIP grantees.

Publications

• Type: Peer Reviewed Journal Articles Status: Accepted Year Published: 2024 Citation: Banerjee T, Levi R, Basu S, Carroll MM, Seligman H. Preferences for Food Vouchers Among Adults with Low Incomes. J Hunger Environ Nutr. 2024; 112. doi:10.1080/19320248.2024.2383753
• Type: Peer Reviewed Journal Articles Status: Accepted Year Published: 2023 Citation: Parks C, Mitchell E, Byker Shanks C, et al. Which program implementation factors lead to more fruit and vegetable purchases? An exploratory analysis of nutrition incentive programs across the United States. Curr Dev Nutr. 2023;7(12):102040-102040. doi:10.1016/j.cdnut.2023.102040
• Type: Peer Reviewed Journal Articles Status: Accepted Year Published: 2024 Citation: Stotz S, Fricke H, Byker Shanks C, et al. Strengthening nutrition incentive and produce prescription projects: An examination of a capacity building and innovation fund. J Agric Food Syst Community Dev. 2024;13(2):161-174. doi:10.5304/jafscd.2024.132.016.
• Type: Peer Reviewed Journal Articles Status: Accepted Year Published: 2024 Citation: Long C, Yaroch A, Byker Shanks C, Short E, et al. Leveraging electronic health record data within food is medicine program evaluation: Considerations and potential paths forward. Adv Nutr. 2024;15(4):100192. doi:10.1016/j.advnut.2024.100192
• Type: Peer Reviewed Journal Articles Status: Accepted Year Published: 2024 Citation: Figueroa R, Houghtaling B. Food is medicine and implementation science: A recipe for health equity. Transl Behav Med. 2024;14(4):234-240. doi:10.1093/tbm/ibae005
• Type: Peer Reviewed Journal Articles Status: Accepted Year Published: 2024 Citation: Houghtaling B, Short E, Byker Shanks C, et al. Implementation of food is medicine programs in healthcare settings: A narrative review. J Gen Intern Med. 2024. doi:10.1007/s11606-024-08768-w
• Type: Peer Reviewed Journal Articles Status: Accepted Year Published: 2024 Citation: Houghtaling B, Zhang N, Yaroch A, Milburn Atkinson C, Byker Shanks C. How does eligibility for GusNIP produce prescriptions relate to fruit and vegetable purchases and what factors shape the relationship? A protocol for a secondary analysis of nationally representative data in the United States. BMJ Open. 2024;14:e085322. doi:10.1136/bmjopen-2024-085322
• Type: Other Journal Articles Status: Under Review Year Published: 2024 Citation: Byker Shanks C, Izumi B, Eastman J, Hartenfeld M, Jilcott Pitts S. Application and adaptation of the Veggie Meter� in community-based settings: Perspectives from a national initiative aimed to increase fruit and vegetable intake. Under Review: J Acad Nutr Diet. 2024.
• Type: Other Journal Articles Status: Under Review Year Published: 2024 Citation: Stotz S, Seligman H, Yaroch A, et al. The realities of data derived from electronic health records to evaluate health outcomes, utilization, and cost of produce prescription programs: A multiple case study evaluation. Under Review: J Public Health Res. 2024.
• Type: Other Journal Articles Status: Under Review Year Published: 2024 Citation: Byker Shanks C, Houghtaling B, Yaroch A. Implications of a United States food policy on food systems transformation. Under Review: NPJ Sci Food. 2024.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Buckingham-Schutt L, Byrd L, Groves G, Stotz S. Food and nutrition security in action: The role of the RDN in nutrition incentive programs. Presented at: 2023 Food and Nutrition Conference and Expo; October 9, 2023; Denver, CO.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Houghtaling B. Evaluation of Gus Schumacher Nutrition Incentive Program (GusNIP) nutrition incentive projects. Presented at: SNAP Healthy Eating Incentives Workshop; October 11-12, 2023; Auburn, AL.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Houghtaling B. Implementation of food is medicine programs in healthcare settings: A narrative review. Presented at: Virginia Tech Human Nutrition, Food, and Exercise 5204 course; November 11, 2023; Blacksburg, VA.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Byker Shanks C, Smith A, Hesterman O. A cross-sector approach to nutrition security. Presented at: Come to the Table Mountain Plains Region; November 14, 2023; Virtual.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Houghtaling B. Barriers and facilitators to nutrition incentive and produce prescription program implementation in brick-and-mortar retail settings using the Exploration, Implementation, Preparation, Sustainment (EPIS) framework. Presented at: Healthy Food Retail Working Group, Nutrition and Obesity Policy Research and Evaluation (NOPREN) network; November 28, 2023; Virtual.
• Type: Other Journal Articles Status: Under Review Year Published: 2024 Citation: Reynolds M, Byker Shanks C, Yaroch A, Szczepaniak M, Lasswell T, Richert Brown M, Parks C. The role of weight stigma in research and evaluation: Reflections from a national healthy food incentive initiative. Under Review: Am J Prev Med. 2024.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Long C. Using a social drivers of health lens for metrics and evaluation. Presented at: The Root Cause Coalition National Summit; December 12, 2023; Kansas City, MO.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Yaroch A, Byker Shanks C. GusNIP NTAE. Presented at: USDA Project Directors Meeting; December 5, 2023; New Orleans, LA.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Byker Shanks C, Ammerman A, Alenstrof K, Harvey S. Food is medicine programs in deeply frontier communities. Presented at: Food is Medicine Midwest Convening; Aspen Institute and Sunflower Foundation; January 25, 2024; Topeka, KS.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Long CR, Yaroch A. What are we learning from GusNIP produce prescription projects? Presented at: Food is Medicine Midwest Convening; Aspen Institute and Sunflower Foundation; January 26, 2024; Topeka, KS.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Mitchell E. PRx in the wider food is medicine context. Panelist at: RI Food Policy Council's Summit: Growing Produce Prescription Programs in Rhode Island; February 28, 2024; Providence, RI.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Houghtaling B. Using implementation science to advance nutrition programs and policies. Research office hours led at: 2024 Healthy Eating Research Annual Meeting; March 6-8, 2024; Denver, CO.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Houghtaling B. Barriers and facilitators to the implementation of food is medicine programs. Presented at: 2024 Virginia Food is Medicine Summit; March 20-21, 2024; Richmond, VA.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Byker Shanks C. Pillars 1&3 of Biden's strategy on hunger, nutrition, and health. Speaker. Presented at: Nutrition Leadership Network: Western MCH; April 11, 2024; Oakland, CA.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Reynolds M. Centering a national evaluation on diversity, equity, inclusion, and accessibility: Perspectives on weight bias. Poster presented at: International Society of Behavioral Nutrition and Physical Activity 2024 Annual Meeting; May 22, 2024; Omaha, NE.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Mitchell E, Stotz S, Seligman H, Yaroch A, Long C, Akers M, Zigmont V, Nugent N, Byker Shanks C. Measuring healthcare outcomes, utilization, and costs within produce prescription projects across the United States: A multiple case study evaluation. Presented at: International Society of Behavioral Nutrition and Physical Activity 2024 Annual Meeting; May 22, 2024; Omaha, NE.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Reynolds M. Strengthening nutrition incentive and produce prescription projects: An examination of a capacity building and innovation fund. Presented at: International Society of Behavioral Nutrition and Physical Activity 2024 Annual Meeting; May 23, 2024; Omaha, NE.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Byker Shanks C, Izumi B, Eastman J, Alvord T, Yaroch A. Equitable evaluation approaches for assessment of fruit and vegetable intake: A case study from a USA fruit and vegetable intervention. Presented at: International Society of Behavioral Nutrition and Physical Activity 2024 Annual Meeting; May 2024; Omaha, NE.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Fricke H, Groves G, Her K, Byker Shanks C, Houghtaling B, Yaroch A. Lessons learned and future directions for technical assistance within financial incentive programs designed to increase fruit and vegetable intake in the United States. Presented at: International Society of Behavioral Nutrition and Physical Activity 2024 Annual Meeting; May 2024; Omaha, NE.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Fung Uy W, Byker Shanks C, Houghtaling B, Shilen A, Eastman J, Yaroch A. Towards sustainable food systems: Perspectives of farmers participating in United States nutrition incentive projects. Presented at: International Society of Behavioral Nutrition and Physical Activity 2024 Annual Meeting; May 2024; Omaha, NE.
• Type: Other Status: Accepted Year Published: 2024 Citation: GusNIP NTAE. Gus Schumacher Nutrition Incentive Program (GusNIP): Impact Findings Y4: September 1, 2022 to August 31, 2023. Prepared for U.S. Department of Agriculture, National Institute of Food and Agriculture; 2024. Accessed [date] https://www.nutritionincentivehub.org/ gusnip-ntae-impact-findings
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Mitchell E, Byker Shanks C, Stotz S, Long C, Marriott J, Nugent N. Produce prescription as intervention method for achieving sustainable impact on individual and community. Presented at: American Diabetes Association 84th Scientific Sessions; June 23, 2024; Orlando, FL.
• Type: Other Status: Accepted Year Published: 2023 Citation: GusNIP NTAE. Gus Schumacher Nutrition Incentive Program Training, Technical Assistance, Evaluation and Information Center (GusNIP NTAE): Progress Report to Congress, Year 4: September 1, 2022 to August 31, 2023. 2023

Progress 11/01/22 to 10/31/23

Outputs
Target Audience:GusNIP, GusCRR, and APRA grantees and associated partners are the primary audience. The NTAE will effectively support all aspects of R&E and TA&I needs of grantees. GusCRR/APRA enhanced activities will align with overall GusNIP priorities, and the long-term goals (1) ensure that all grantees and applicants have access to TA&I resources to support program implementation and development and (2) articulate impact through robust and comprehensive R&E. Disseminating findings and other relevant project updates will be targeted to various audiences, depending on roles and needs for aggregate data and outcomes. Dissemination activities will include reporting to Congress and disseminating program impacts to the broader public. The target audience of the public-facing Impact Findings report includes GusNIP, GusCRR, and APRA grantees, NI and PPR practitioners, researchers, policymakers, and others. We are also developing strategies to report public-facing findings in diverse formats (e.g., briefs, infographics, videos) for participants of NI and PPR projects and other invested parties.? Changes/Problems:With the addition of GusCRR and ARPA funding mechanisms to the GusNIP family of awards, the NTAE had to remain flexible and adapt in the following 5 foundational ways described below. Adapting support services to maintain excellent service to applicants, grantees, partners, and participants with an increasing number of projects funded by GusNIP, GusCRR, and ARPA. Whereas previous GusNIP and GusCRR grantees were served in a 1:1 capacity through assigned program advisors (PAs), reporting advisors (RAs), and survey advisors (SAs), given the influx of awards, ARPA grantees were placed into cohorts of 4-8 grantees, with R&E core services provided through a combination of group and 1:1 activities. The cohort model proved beneficial in terms of increasing efficiency for the NTAE PA/RA/SA advising model and providing an opportunity for peer-to-peer networking and learning among grantees. This model will be carried forward with all new grantees given its initial success and the growing number of GusNIP/GusCRR/ARPA awards. Specific to firm-level reporting, a centralized (vs. 1:1) helpdesk was launched, refined, and maintained to better support the growing number of grantees and increase NTAE efficiency. Additionally, grantee onboarding, regularly occurring interactions (e.g., webinars, check-in calls), needed supports (e.g., IRB), and field visits (e.g., mini convening or group visits) were refined for greater efficiency. Finally, existing advising resources and timelines were modified to accommodate the various funding mechanisms and grantees that were operating multiple simultaneous awards. Enhancing the portal data collection processes to capture funding sources and accurately report core firm-level metrics. Some grantees operate both NI and PPR GusNIP projects with additional funds from GusCRR and/or ARPA to support increased reach to new populations and/or specific firms. Therefore, the NTAE team developed a solution to attribute funds spent at each firm to each respective grant funding source. Some projects implemented models that could differentiate firms supported by GusNIP and/or GusCRR awards (approximately one third), and grantees were trained to accurately report data in the portal. Reporting is more streamlined for grantees that are able to treat GusCRR-funded work as a distinct project. For example, grantees may have developed a new tender issued to a specific population that allows GusCRR activity to be tracked and reported separately at firms. In this case, grantees report these data in separate reports on their GusCRR dashboard. Other grantees use GusCRR funds to completely fund newly onboarded firms, in which case, these firms report incentive distribution/redemption data directly under the GusCRR dashboard, and no budgetary split is required. When surveyed in August of 2021, approximately one third of GusCRR awardees planned to use their funds concurrently with GusNIP funding at specific firms. In response, the NTAE enhanced the portal to accommodate data entry of funds from multiple awards distributed or redeemed at the same firm. If a firm is funded by more than one source (e.g., GusNIP and GusCRR), a field on the GusNIP monthly firm report prompts a grantee to report the approximate proportion of dollars attributed to GusNIP. The remaining proportion is automatically attributed to the GusCRR award. For example, if the grantee reports 80% of the report dollars are attributed to GusNIP at a specific firm, then 80% of incentives redeemed at this firm will be attributed to their GusNIP award, and 20% of incentives redeemed at this firm will be attributed to their GusCRR award. This, and other portal enhancements, reduced grantee reporting burden and expedited the data checking and approval process. The NTAE will apply the enhanced data collection processes to ARPA grantees moving forward. Adapting and advancing participant-level data collection, processing, cleaning, and analysis to accommodate a growing number of grantees and awards and to alleviate challenges associated with merging data from different survey platforms. Given the heterogeneity across GusNIP projects, certain core participant-level metrics have become irrelevant over the course of the GusNIP program and others have required minor changes. To track and monitor these changes for each grantee, a tracking document was developed to instruct the statistical team how to code missing or modified variables. To accommodate the influx of new grantees, the NTAE updated processes for checking, cleaning, and merging participant-level datasets across all grantees, projects, and awards. First, the NATE established quarterly data checkpoints leading up to the August 31st participant-level data submission deadline. These checkpoints allow NTAE SAs to review data and request edits or clarification from grantees so that data cleaning may conclude in a timely manner. Additionally, a new data review process and companion checklist were created to use during data checkpoints to ensure consistent/complete data cleaning. Supporting and accommodating the large influx of new PPR grantees and awards funded through ARPA and GusCRR. PPR projects tend to require more support from R&E and TA&I staff than NI projects due to the complexity of both program implementation and evaluation methods associated with PPR projects. For example, PPR projects tend to have more complicated IRB protocols (e.g., EHR and HIPAA implications). Therefore, the NTAE offered resources, templates, and 1:1 help to support grantees in securing IRB approval. Similarly, the NTAE developed resources, templates, and 1:1 support specific to reporting healthcare outcomes, cost, and utilization data for PPR projects that are required to collect these data as a condition of funding. Furthermore, PPR projects are required to collect longitudinal data to comply with the core metrics comprehensive evaluation. To alleviate challenges associated with longitudinal data collection (e.g., linking pre and post surveys, merging datasets from multiple projects), the NTAE began encouraging grantees to use Qualtrics and provided additional support and guidance to PPR grantees. Specifically, the NTAE increased TA focused on PPR projects and developed learning groups focused on PPR projects (e.g., additional peer-meetings and communities of practice). Sourcing and developing methodologies to map firm locations with various base layers to report on reach and representativeness of GusNIP/GusCRR/ARPA projects. To develop maps of GusNIP/GusCRR/ARPA site locations layered with variables of interest, the NTAE first identified a valid and robust source of data to include in these maps. Sourcing appropriate and accurate base-layer variables can be challenging. Geographic Information System (GIS) maps rely on accurate and current data to provide meaningful insights. However, acquiring up-to-date data can be a complex process due to varying data formats, incompatible file structures, and data inconsistencies across different sources. This requires expertise in data integration and cleaning techniques to ensure the accuracy and reliability of the base-layer variables used in GIS map creation. During this reporting year, the NTAE created new maps starting with two variables of interest: poverty and low-income and low-access areas (i.e., food desert). Poverty data and shape files exist from the American Community Survey, and the NTAE selected the 2020 vintage with 5-year estimates. Low-income and low-access areas are defined by the USDA Economic Research Service in the food environment atlas with data that can be imported into ArcGIS. Identifying and sourcing these two datasets and learning how to implement them appropriately was a challenge for NTAE team members, but the NTAE is now poised to develop maps with other variable layers of interest in the future. What opportunities for training and professional development has the project provided?During year 1 of ARPA, NTAE staff and consultants enhanced their work-related skills and knowledge by completing professional development and learning opportunities. The list below includes professional development and learning activities that the broader Nutrition Incentive Hub engaged in throughout this reporting period. Online courses completed by NTAE staff included those focusing on technological systems (SmartSheet, Institutional Review Board training, electronic health record data), developing project management skills, and diversity, equity, inclusion, and accessibility (DEIA)-focused content. Multiple staff members joined an Equity in Communications workshop to learn how to incorporate a DEIA lens while writing for various audiences, while all full-time GusNIP staff attended two DEIA trainings at the Gretchen Swanson Center for Nutrition annual retreat. NTAE staff and consultants led and/or participated in several GSCN professional development groups to foster information sharing and mentoring across roles, such as program advising, supervising, project management, and research. Throughout the year, the NTAE sought further education and knowledge across a broad span of topic areas by attending both virtual and in-person seminars, as well as traveling to a wide range of professional conferences. Topic areas covered by these webinars/seminars and conferences included technological innovation, implementation science, DEIA, health law, RFA learning sessions, and grant budgeting. For more details, see the list below: Online Courses Smartsheet-Control Center Training Smartsheet-Building Effective Dashboards Smartsheet-Dashboard in a Day Smartsheet-Winter 2023 Updates CITI-Biomedical Research (Basic Course) Coursera-Agriculture, Economics and Nature (University of Western Australia) ThinkHuman People Development-Delegation & Accountability Being an Ally in Indian Country Project Management Essentials with Certified Associate Project Manager Prep Fundamentals of EHR Data Short Course Workshops Equity in Communications Workshop Wallace Center-Finding Your Leverage Point for Making Change The Batsheva de Rothschild Food Security Workshop-Avoiding the coming food security crisis: novel solutions at the intersection of agriculture, environment and health International Food Acquisition Research and Methods (iFARM) Workshop International Society of Behavioral Nutrition and Physical Activity-Cognitive interviewing for improved measurement Indigenous Environmental Health Research workshop Taking Flight: DiSC Assessment Training Critical Research and Quantitative Analysis The Art of Letting Go Conferences Western Maternal and Child Health Nutrition Leadership Network Annual Meeting (virtual) 2022 Produce Prescription Mini Convening (California) Healthy Food Community of Practice Convening (Santa Ana Pueblo, NM) USDA Nutrition Security and Healthcare Summit (Washington, D.C.) The Root Cause Coalition Conference (Kansas City, MO) NI Projects Focused on Statewide Scaling Mini Convening (Philadelphia, PA) 2023 Society of Behavioral Medicine Annual Meeting (Phoenix, AZ) Healthy Eating Research Annual Meeting (Durham, NC) Tribal Public Health Conference (Durant, OK) Nutrition Incentive Hub 2023 National Convening (virtual and in-person; Arlington, VA) Advancing Food Is Medicine Approaches Summit (Boston, MA) 2023 Esri User Conference (virtual) American Diabetes Association Scientific Sessions 2023 (San Diego, CA) Webinars and Seminars Network for Public Health Law-Collecting and Disseminating Public Health Data Disaggregated by Race and Ethnicity to Advance Health Equity: Navigating the Legal Issues Union of Concerned Scientist-Opportunity for climate action on farm bill Healthy Eating Research, Nutrition and Obesity Research Policy and Evaluation Network (HER NOPREN)-Early Childhood Working Group Presentation - Overview of AAP Guidelines for Childhood Overweight and Obesity HER NOPREN-Exploration, Preparation, Implementation, and Sustainment (EPIS) Framework to advance the science and practice of healthy food retail Rockefeller Foundation and Kaiser Permanente-Serving up Solutions: Building the evidence on Produce Rx Programs National Institutes of Health (NIH)-2022 NIH Rural Health Day Seminar: Improving Rural Health through Research Dissemination and Implementation Food as Medicine National Summit National Collaborative on Childhood Obesity Research (NCCOR)-Cooperative Extension's National Framework for Health Equity and Well-Being: Implementation and Intersections with NCCOR Partners Society of Nutrition Education & Behavior-Addressing Nutrition Insecurity with Cultural Humility National Academies-Advancing a Food Systems Approach to Prioritize Healthy People and a Healthy Planet Center for Health Law and Policy Innovation, Harvard law School-Policy Applied: Addressing Nutrition through Produce Prescriptions in Medicaid Managed Care Tufts-Advancing Food is Medicine Approaches University of Tennessee-Mapping Our Course: Strategies to Achieve Hunger, Nutrition, and Health Goals in the US NIH-The Challenge and Promise of Food is Medicine Dialogue4Health-Cutting Through the Chaos: Reframing Public Health Other Senate Ag Hearing on the 2023 Farm Bill Professional Development Groups: Consultant Program Advisors Project Managers & Project Coordinators Supervisors Research Scientists How have the results been disseminated to communities of interest?Program results have been disseminated to communities of interest through webinars (see question 8 "Other Products" for a complete list), mini convenings (see question 8 "Other Products"), 1-on-1 and cohort calls, website resources and information, biweekly digest emails for GusNIP, GusCRR, and ARPA practitioners and grantees, numerous topical discussion boards, and media relations. In addition, the NTAE: Hosted a hybrid (virtual and in-person) 3-day Nutrition Incentive Hub Annual Convening in Arlington, VA, with 600+ participants across 6 tracks, 37 sessions, and featuring 100+ speakers. Published the Year 3 Impact Findings Report (includes separate results from GusNIP and GusCRR projects) and companion pieces (i.e., executive summary, press release, 2 infographics, and a social media toolkit). Published 4 peer-reviewed manuscripts to disseminate original GusNIP research. Delivered presentations for several GusNIP and USDA webinars and at several conferences, including: The Root Cause Coalition The Batsheva de Rothschild Workshop Mini Symposium on Science and Measurement in Food Security Policy The Taub Center Annual Conference Healthy Eating Research Annual Grantee Meeting Food is Medicine Spring 2023 Learning Collaborative Society of Behavioral Medicine International Society of Behavioral Nutrition and Physical Activity International Conference on Diet and Activity Methods Disseminated information on the Nutrition Incentive Hub Newsletter (2,000+ recipients), Facebook, LinkedIn, and Twitter channels, bringing together the public, practitioners, grocers, farmers markets, produce wholesalers, industry technology, and USDA to facilitate information sharing and communications around Nutrition Incentive Hub events, webinars, and updates about GusNIP. Collaborated with Nutrition Incentive Hub partners to promote GusNIP and GusCRR results on various social media platforms and newsletters. What do you plan to do during the next reporting period to accomplish the goals?In year 2 of ARPA, the NTAE will continue supporting grantees and building their capacity to track both firm- and participant-level metrics for each award type (GusNIP, GusCRR, and ARPA). The NTAE will continue collecting, cleaning, and analyzing grantee data by project and award type and will apply processes and learnings from managing GusCRR data to the ARPA awardees' data. The following bullets summarize year 2 activities and products organized by objective: GOAL 1: OBJ 1: Describe the extent to which GusCRR/ARPA expanded the reach of GusNIP NI and PPR projects to new geographic locations and individuals. Continue collecting data through the Nutrition Incentive Hub portal submission system to capture participating firms, dollar value of incentives distributed, dollar value of incentives redeemed, transactions, and unique participants (where possible) associated with each award type (GusNIP, GusCRR, ARPA). Apply the proxy estimate approach to extrapolate the average number of unique NI project participants reached monthly among ARPA grantees (in addition to GusNIP and GusCRR grantees). Determine the total reach of PPR projects in GusNIP year 4 among ARPA grantees (in addition to GusNIP and GusCRR grantees). Refine the GusNIP firm locations maps (newly developed in year 4 of GusNIP) to include symbols representing each award type. OBJ 2: Determine how GusCRR/ARPA NI and PPR projects improved access to fruits and vegetables for participants and underrepresented communities. Continue reporting expanded reach via firm-level data specific to NI and PPR projects for GusNIP and GusCRR awards and incorporate ARPA firm-level data. Create maps with firm locations layered on top of low-income, low-access and Tribal base layers to determine the reach of ARPA firm locations. Disseminate publicly available interactive maps using ArcGIS StoryMap and ArcGIS. Dashboards: these interactive maps will be made available on the Nutrition Incentive Hub website as appropriate based on data sharing guidelines. OBJ 3: Document the dollar value of additional incentives issued and redeemed to GusCRR/ARPA participants and associated economic impact generated. Apply the methodology used to determine the dollar value of incentives issued and redeemed to ARPA funded projects. Report additional incentives issued and redeemed attributed to GusCRR funding and ARPA funding in a report to Congress and a public-facing Impact Findings report. OBJ 4: Develop responsive and expanded reporting and evaluation (R&E) and technical assistance and innovation (TA&I) services to support GusNIP, GusCRR, and ARPA funded grantees in project implementation and meeting firm- and participant-level core metrics requirements. Promote and facilitate peer-learning opportunities, such as discussion boards, communities of practice, and coffee hours. Provide ongoing support via 1:1 and cohort-based R&E TA through advising model (i.e., program, firm-level, and survey advising). Provide ongoing TA&I support via 1:1 and group advising. Provide timely technical assistance support through evaluation@nutritionincentivehub.org and ta@nutritionincentivehub.org general inboxes and the website helpdesk. Refine and maintain a centralized firm-level reporting model (firm-level reporting helpdesk). Launch, refine, and maintain a centralized participant-level survey advising model. Offer mini awards to fund participant-level stipends and provide technical assistance on administering stipends. Solicit feedback from GusNIP, GusCRR, and ARPA grantees on advising model and in-person support for continuous quality improvement. Continue to develop internal and external resources to help PPR grantees navigate the healthcare outcomes, cost, and utilization data requirement. Conduct field visits with ARPA and GusCRR grantees on an as-needed basis. Host a mini convening for GusNIP, GusCRR, and ARPA grantees focused on PPR projects. Finalize the results of the PPR workgroup recommendations led by the National Grocers Association Foundation and supported by Fair Food Network and Michigan Farmers Market Association. The results will summarize the difference between paper and technology-based solutions, list suggested questions to use with technology vendors, and provide a list of current PPR transaction options.

Impacts
What was accomplished under these goals? In year 1 of ARPA, the NTAE planned and implemented new systems to support additional grantees with new and multiple funding sources for their projects. Grantees supported by ARPA began collecting both participant- and firm-level data which the NTAE will analyze and include in future reports. Grantees supported by GusCRR continued collecting and began reporting both firm- and participant-level data, which the NTAE cleaned, merged, and analyzed to showcase the reach and impact of GusNIP and GusCRR funding. Highlighted results and products include unique participants reached, incentives redeemed and distributed, and economic impact by award type, as well as new maps displaying firm locations by project type and overlayed by poverty level. Both Technical Assistance and Innovation (TA&I) and Reporting and Evaluation (R&E) teams helped GusNIP, GusCRR, and ARPA grantees develop tools and systems to meet reporting requirements. Most year 1 accomplishments involve GusNIP and GusCRR grantees. More ARPA-related activities and results will be included in the year 2 progress report once the NTAE has received and analyzed data from ARPA grantees. The bullets under each objective detail activities, products, and results from year 1. GOAL: Tailor previously developed systems, infrastructure, and collaborative relationships to support, monitor, and evaluate NI and PPR projects funded with GusCRR/ARPA awards. OBJ 1: Describe the extent to which GusCRR/ARPA expanded the reach of GusNIP NI and PPR projects to new geographic locations and individuals. Updated the Nutrition Incentive Hub portal data submission system to capture participating firms, dollar value of incentives distributed, dollar value of incentives redeemed, transactions, and unique participants (where possible) associated with each award type (GusNIP, GusCRR, ARPA). Across active NI projects in GusNIP year 3, a total of 2,928 firms received GusNIP/GusCRR funding (of these, 1,179 utilized GusCRR funding). Across active PPR projects in GusNIP year 3, a total of 913 firms received GusNIP/GusCRR funding (of these, 43 utilized GusCRR funding). Developed a proxy estimate approach to extrapolate the average number of unique NI project participants reached monthly by award type. On average, 146,146 NI participants were reached each month during GusNIP year 3. Of those, 104,122 participants redeemed incentives funded by GusNIP awards, and 42,024 participants redeemed incentives funded by GusCRR awards. Determined the total reach of PPR projects in GusNIP year 3 by award type. In total, 23,832 PPR participants were enrolled during GusNIP year 3 (19,305 in GusNIP projects and 4,527 in GusCRR projects). Generated 10 new maps of firm locations for the year 3 GusNIP Impact Findings report: NI firm locations across the U.S., PPR firm locations across the U.S., 4 regional NI maps, and 4 regional PPR maps. OBJ 2: Determine how GusCRR/ARPA NI and PPR projects improved access to fruits and vegetables for participants and underrepresented communities. Measured and reported expanded reach and firm-level data in the year 3 GusNIP Impact Findings Report specific to NI and PPR projects and GusNIP and GusCRR award types. Developed NI and PPR maps representing firm locations by poverty threshold levels in ArcGIS to begin measuring access to fruits and vegetables by GusNIP and GusCRR projects and to determine gaps in coverage. In aggregate during GusNIP year 3, NI and PPR firms funded by GusNIP and GusCRR were located in communities where, on average, 14.1% and 14.8% respectively of the community members have incomes below the federal poverty level, compared to 11.4% nationally. Included poverty threshold maps in the year 3 Impact Findings Report along with county level data summarizing the poverty levels where GusNIP/GusCRR firms are located. Began background work (e.g., researched variables and secondary data options) on other map layer categories including low-income and low-access areas, communities of color (% non-white); disability status; veteran status; LGBTQIA+ status; population density (rural, urban, tribal, frontier); insular areas; and frontier and remote areas. OBJ 3: Document the dollar value of additional incentives issued and redeemed to GusCRR/ARPA participants and associated economic impact generated. Determined the dollar value of additional incentives issued and redeemed attributed to GusCRR grant funding for both the year 3 GusNIP Report to Congress and the year 3 GusNIP Impact Findings Report. Out of $65,024,589 total incentives distributed by NI projects in GusNIP year 3, GusCRR supported $17,015,218 in NI incentives distributed. Out of $3,591,599 total incentives distributed by PPR projects in GusNIP year 3, GusCRR supported $298,244 in PPR incentives distributed. Of the total dollar amount of incentives redeemed ($41,557,249), GusCRR supported $13,549,258, which generated an estimated economic impact of $27,911,471 among communities across the country. Launched an economic impact calculator (available at www.nutritionincentivehub.org) tailored to NI projects using state groupings based on similar agricultural and food economies. OBJ 4: Develop responsive and expanded reporting and evaluation (R&E) and technical assistance and innovation (TA&I) services to support GusNIP, GusCRR, and ARPA funded grantees in project implementation and meeting firm- and participant-level core metrics requirements. Conducted tailored onboarding activities for 71 ARPA awards (12 enhancement, 17 meritorious, 42 regular) relative to award type and expressed grantee needs, including: a kickoff and core services webinar, a 1:1 onboarding call with grantees' respective program advisor, IRB onboarding and assistance, firm- and participant-level onboarding (e.g., portal setup, survey build-out, etc.), and introduction to peer-learning opportunities such as discussion boards and communities of practice. Provided ongoing support via 1:1 and cohort-based R&E TA approximately monthly through the advising model (i.e., program, firm-level, and survey advising). Launched, refined, and maintained a centralized firm-level reporting model ("helpdesk"). Approved $60,181 in mini awards to 33 ARPA grantees to fund participant-level stipends. Approved $11,880 in mini awards to 12 GusCRR grantees to fund participant-level stipends. Solicited feedback on in-person support (e.g., field visits, mini convenings) to guide future peer-to-peer engagement opportunities. Developed internal and external resources to help grantees navigate the healthcare outcomes, cost, and utilization data requirement. Conducted field visits with 3 ARPA or GusCRR grantees and 2 mini convenings with ARPA and GusCRR grantees. Began planning a PPR-focused mini convening scheduled to take place in October 2023. Hosted 4 meetings of the PPR Community of Practice and 2 coffee hours for GusNIP, GusCRR, and ARPA grantees. Launched a PPR Incentive Technology Workgroup with 16 grantees and practitioners that meet weekly. Hosted the National Convening in June 2023. The event featured: 36 sessions across 6 tracks and 3 days 5 field visits for attendees 340 in-person attendees 296 virtual attendees

Publications

• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Kaminsky T, Koné A. Leveraging Nutrition Incentive Hub Website Tools to Strengthen Your Program. Presentation at: Nutrition Incentive Hub National Convening; June 6-8, 2023; Arlington, VA.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Hoh R, Byker Shanks C. Closing Session: GusNIP National Convening. Presentation at: Nutrition Incentive Hub National Convening; June 6-8, 2023; Arlington, VA.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Yaroch A. Opening Remarks: GusNIP National Convening. Presentation at: Nutrition Incentive Hub National Convening; June 6-8, 2023; Arlington, VA.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Long CR, Yaroch A. Learning Session: Evolving the GusNIP Produce Prescription Evaluation. Presentation at: Nutrition Incentive Hub National Convening; June 6-8, 2023; Arlington, VA.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Parks CA, Rodriguez Espinosa P, Chen W, Martinez E, Thompson-Lastad A, Reynolds M, Yaroch AL, Rosas LG. A qualitative exploration of the scalability of produce prescription programs using the Consolidated Framework for Implementation Research (CFIR). Virtual Presentation at: Nutrition Incentive Hub National Convening; June 6-8, 2023; Arlington, VA.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Quattro R, Marriott JP, Mitchell E, Koprak J. Data Visualization & Storytelling Through Maps. Presentation at: Nutrition Incentive Hub National Convening; June 6-8, 2023; Arlington, VA.
• Type: Other Status: Accepted Year Published: 2022 Citation: GusNIP NTAE. 2022. Report to Congress, "Gus Schumacher Nutrition Incentive Program Training, Technical Assistance, Evaluation and Information Center (GusNIP NTAE): Progress Report to Congress, Year 3: September 1, 2021 to August 31, 2022."
• Type: Other Status: Accepted Year Published: 2022 Citation: GusNIP NTAE. Gus Schumacher Nutrition Incentive Program (GusNIP): Impact Findings Y3: September 1, 2021 to August 31, 2022. Prepared for U.S. Department of Agriculture, National Institute of Food and Agriculture; 2023. Accessed [date] https:// nutritionincentivehub.org/gusnip-ntae-y3-impact-findings
• Type: Other Status: Accepted Year Published: 2023 Citation: GusNIP NTAE. Gus Schumacher Nutrition Incentive Program (GusNIP): Impact Findings Y3: September 1, 2021 to August 31, 2022. [Executive Summary] Prepared for U.S. Department of Agriculture, National Institute of Food and Agriculture; 2023. Accessed [date] https://nutritionincentivehub.org/gusnip-ntae-y3-impact-findings
• Type: Journal Articles Status: Accepted Year Published: 2023 Citation: Byker Shanks C, Parks CA, Izumi B, Andress L, Yaroch AL. The United States Department of Agriculture Gus Schumacher Nutrition Incentive Program⿿s (GusNIP) National Training, Technical Assistance, Evaluation, and Information Center reply to ⿿The diversity, equity and inclusion lens is incomplete when disabilities are excluded⿿. J Acad Nutr Diet. 2023; S2212-2672. doi:10.1016/j.jand.2023.03.008
• Type: Journal Articles Status: Accepted Year Published: 2023 Citation: Houghtaling B, Misyak S, Serrano E, Dombrowski RD, Holston D, Singleton CR, Harden SM. Using the exploration, preparation, implementation, and sustainment (EPIS) framework to advance the science and practice of healthy food retail. J Nutr Educ Behav. 2023;55(3):245-251. doi:10.1016/j.jneb.2022.10.002
• Type: Journal Articles Status: Accepted Year Published: 2023 Citation: Stotz SA, Mitchell E, Szczepaniak M, Akin J, Fricke H, Byker Shanks C. A qualitative exploration of approaches applied by nutrition educators within nutrition incentive programs. J Nutr Educ Behav. 2023;55(3):224-234. doi:10.1016/j.jneb.2022.11.007
• Type: Journal Articles Status: Accepted Year Published: 2023 Citation: Stotz SA, Nugent N, Akers M, Leng K, Byker Shanks C, Yaroch AL, Krieger J, Szczepaniak M, Seligman H. How the Gus Schumacher Produce Prescription Program Works: An Adaptation of a Nutrition Incentive Theory of Change. Nutrients. 2023;15(15):3352. https://doi.org/10.3390/nu15153352
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2022 Citation: Yaroch A. Nutritional security, science and semantics [Workshop Presentation]. The Batsheva de Rothschild Workshop. November 8, 2022. Jerusalem, Israel.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2022 Citation: Yaroch A. Nutrition security and financial incentives: Can these interventions be applied in Israel? [Symposium Presentation]. Mini Symposium on Science and Measurement in Food Security Policy, November 10, 2022. Jerusalem, Israel.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2022 Citation: Yaroch A. Financial incentives to promote nutrition security: Examples from the United States and application to Israel [Conference presentation]. The Taub Center Annual Conference - Inequality in Health: Defining Challenges, Developing Solutions. November 17, 2022. Jerusalem, Israel.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2022 Citation: Parks C. Implementation Science: The Role of Program Evaluation [NCCOR Workshop]. Implementation Science & Childhood Obesity - Sparking Conversations and Actions to Advance Equity. November 30, 2022. Online.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Houghtaling B. Using the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework to advance the science and practice of healthy food retail [Speaker for Rural Food Access Working Group]. Nutrition and Obesity Policy Research and Evaluation (NOPREN) network. February 16, 2023. Online.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Stotz S. Nutrition educators support nutrition incentives for food and nutrition security programs to promote increased intake of fruit and vegetables [Podcast]. JNEB. March 7, 2023. Online.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Szczepaniak M. Training NMFMA Firms on Reporting in the Portal [Workshop]. NMFMA Annual Conference. March 8, 2023. Santa Fe, NM.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Yaroch A. Nutrition and health care: Opportunities for more integration [Annual meeting presentation]. 2023 Healthy Eating Research (HER) Annual Grantee Meeting; March 15-17, 2023; Durham, NC.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Byker Shanks C. Social Determinants of Health & GusNIP Produce Prescription Program [Workshop]. ICEP Professional Development Committee. March 16, 2023. Online.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Shanks CB, Long CR. Produce prescriptions and Food as Medicine across the U.S.: Where does your clinic fit in? [Food is Medicine Spring 2023 Learning Collaborative]. Sunflower Foundation. March 30, 2023. Topeka, KS.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Long CR, Shanks CB. Produce prescriptions and Food as Medicine across the U.S.: Where does Kansas fit in? [Food is Medicine Spring 2023 Learning Collaborative]. Sunflower Foundation. March 31, 2023. Topeka, KS.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Byker Shanks C. Leveraging Food and Nutrition to Center Health Equity in Healthcare [Webinar]. Vizient. April 7, 2023. Online.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Szczepaniak M, Parks C, Shreve A. Data Management Systems and Scaling [Convening Presentation]. Nutrition Incentive Mini-Convening. April 13, 2023. Philadelphia, PA.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Stotz S. A Qualitative Exploration of Approaches Applied by Nutrition Educators Within Nutrition Incentive Programs [Community of Practice Presentation]. Nutrition Education and Nutrition Incentive Community of Practice. April 17, 2023. Online.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Houghtaling B, Short E, Byker Shanks C, Stotz S, Seligman H, Marriott J, Long C. The Exploration, Preparation, Implementation, and Sustainment (EPIS) Framework: Application to Produce Prescription Programs [Symposium: Scaling Up Produce Prescription Programs for Impact]. Symposium presented at: Society of Behavioral Medicine; April 26-29, 2023; Phoenix, AZ.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Parks CA, Rodriguez Espinosa P, Chen W, Martinez E, Thompson-Lastad A, Reynolds M, Yaroch AL, Rosas LG. A qualitative exploration of the scalability of produce prescription programs using the Consolidated Framework for Implementation Research (CFIR). Conference presented at: Society of Behavioral Medicine; April 26-29, 2023; Phoenix, AZ.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Stotz S, Groves G. 2023 RFA Learning Session ⿿ IRB Requirements for GusNIP Grants [Webinar]. RFA support for potential GusNIP applicants. April 27, 2023. Online.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Fricke HE, Byker Shanks C. Learning Session: Evolving the GusNIP Nutrition Incentive Evaluation. Session at: Nutrition Incentive Hub National Convening; June 6-8, 2023; Arlington, VA.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Parks CA, Akin J, Fricke HE. Deep Dive into the Year 3 GusNIP Impact Findings Report. Presentation at: Nutrition Incentive Hub National Convening; June 6-8, 2023; Arlington, VA.