Source: CHN NEBRASKA submitted to NRP
NTAE 2.0: BUILDING ON SUCCESS FROM NTAE 1.0 TO STRENGTHEN GUSNIP FOR ALL AUDIENCES
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
ACTIVE
Funding Source
OTHER GRANTS
Reporting Frequency
Annual
Accession No.
1031111
Grant No.
2023-70414-40461
Cumulative Award Amt.
$14,000,000.00
Proposal No.
2023-05827
Multistate No.
(N/A)
Project Start Date
Sep 1, 2023
Project End Date
Aug 31, 2027
Grant Year
2024
Program Code
[NTAE]- Nutrition Training Assistance and Evaluation
Recipient Organization
CHN NEBRASKA
8401 WEST DODGE RD SUITE 100
OMAHA,NE 681143494
Performing Department
(N/A)
Non Technical Summary
The Nutrition Incentive Program Training, Technical Assistance, Evaluation, and Information (NTAE) Center supports potential applicants, grantees, and the Gus Schumacher Nutrition Incentive Program (GusNIP) as a whole. GusNIP brings together partners from food, healthcare, and research sectors to improve the health and nutrition of participating households, facilitate growth in underrepresented communities and geographies (UCGs), and collect and compile data to identify best program practices. The first NTAE Center (NTAE 1.0) was authorized from 2019-2023. NTAE 1.0 was led by the Gretchen Swanson Center for Nutrition (GSCN), the prime awardee, in partnership with Fair Food Network (FFN). GSCN and FFN assembled partners and resources, known collectively as the Nutrition Incentive Hub (Hub).The proposed work for 2.0 will provide training and technical assistance (T&TA), evaluation, and informational support services to potential applicants, nutrition incentive (NI) and produce prescription (PPR) projects, and GusNIP as a whole. NTAE 2.0 will be led by GSCN, in partnership with FFN and University of California San Francisco (UCSF). The NTAE and Hub will continue to inform efforts that maximize the effectiveness and efficiency of GusNIP projects in meeting GusNIP priorities, increase fruit and vegetable purchases, and improve the nutrition of participating households. Specifically, 2.0 will:1.Engage GusNIP audiences to improve and sustain GusNIP NI/PPR projects, with an emphasis on reaching underrepresented communities and geographies (UCGs). To achieve this, we integrate meaningful engagement of GusNIP audiences into 2.0 governance.2.Provide and continuously improve T&TA services that optimize the experience of GusNIP audiences. To achieve this, we assemble robust partnerships and technologies to maximize USDA NIFA's return on investment in NI/PPR projects.3.Conduct a rigorous evaluation of NI/PPR projects centered on diversity, equity, inclusion, and accessibility (DEIA) principles. To achieve this, we advance the evidence for NI/PPR with continued scientific rigor, while centering DEIA.Ultimately, these efforts are intended to meet the long-term goal of making safe, nutritious food available to all Americans, which is a strategic goal of the U.S. Department of Agriculture.
Animal Health Component
25%
Research Effort Categories
Basic
25%
Applied
25%
Developmental
50%
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
70460991010100%
Knowledge Area
704 - Nutrition and Hunger in the Population;

Subject Of Investigation
6099 - People and communities, general/other;

Field Of Science
1010 - Nutrition and metabolism;
Goals / Objectives
Building upon the work of the Gus Schumacher Nutrition Incentive Program (GusNIP) Nutrition Incentive Program Training, Technical Assistance, Evaluation, and Information (NTAE) Center from 2019-2023 (NTAE 1.0), the goal of NTAE 2.0 (hereafter 2.0) is to create an integrated system of efficient and streamlined implementation and evaluation support services directly informed by the communities and geographies we serve. To achieve this goal in 2.0, the NTAE will carry out the following objectives:1.Engage GusNIP audiences to improve and sustain GusNIP nutrition incentive (NI)/produce prescription (PPR) Programs, with an emphasis on reaching underrepresented communities and geographies (UCGs). Objective 1 integrates meaningful engagement of GusNIP audiences into 2.0 governance.2.Provide and continuously improve training and technical assistance (T&TA) services that optimize the experience of GusNIP audiences. Objective 2 assembles robust partnerships and technologies to maximize USDA NIFA's return on investment in NI/PPR projects.3.Conduct a rigorous evaluation of NI/PPR projects centered on diversity, equity, inclusion, and accessibility (DEIA) principles. Objective 3 advances the evidence for NI/PPR with continued scientific rigor, while centering DEIA.In 2.0, the NTAE will contribute to the long-term goal of making safe, nutritious food available to all Americans (USDA's Strategic Goal 4).
Project Methods
Methods for Objective 1Objective 1 engages GusNIP audiences to improve and sustain GusNIP NI/PPR programs, with an emphasis on reaching UCGs. Activities to achieve Objective 1 involve forming and implementing a GLC, implementing CBIF and CBIF awards annually, and conducting targeted outreach to UCGs, including tailored resources, webinars, and 1:1 and group T&TA. Field visits with outreach teams will be conducted to inform the development of tailored resources to UCGs. Milestones to create the GLC will be achieved, and outputs will be measured each year.Methods for Objective 2Objective 2 provides and continuously improves T&TA services that optimize the experience of GusNIP audiences. NTAE 2.0 will develop integrated technology systems to enhance access to all T&TA services through a "single point of entry" and enhance access to evaluation results through dashboards and data visualizations. Activities also include maintaining and refining Hub website and portal with new resources and developing and offering DEIA-focused and tailored training throughout the grant lifecycle. Resources such as Communities of Practice virtual groups and culturally competent trainings will be informed by the GLC during biannual meetings and feedback from GusNIP audiences through a T&TA annual survey.To ensure seamless data deposition of core metrics, including making data publicly available and transferable at the end of the project period, we will build upon systems, infrastructure, and resources developed in 1.0. A team of advisors will help grantees to use NTAE core and optional data metrics to submit firm-level reports and to develop and deploy participant-level surveys, and we will survey grantees annually about their experience with the advisor model and T&TA broadly. In 2.0, grantees and applicants will continue to receive tailored IRB assistance and support for intellectual property protections, from the pre-application stage throughout the lifecycle of their grant. IRB resources will emphasize the unique needs of human subjects protections among grantees, including PPR grantees and data sovereignty for Tribes, and we will compile a list of public and private IRBs to help connect grantees without IRB access.Methods for Objective 3Objective 3 conducts a rigorous evaluation of NI/PPR projects centered on DEIA principles. In 2.0, evaluation will be guided by lessons learned from 1.0 (e.g., cultural appropriateness of dietary questions), diverse community experiences, and rigorous, feasible, and community engaged evaluation approaches. We will work with Praxis Project and the GLC on a core metrics review and pilot process to consider potential refinements to update the core metrics.We will ensure surveys are culturally competent and centered on DEIA principles by leveraging resources such as the National Culturally and Linguistically Appropriate Services Standards from the U.S. Department of Health and Human Services. Strategies may include using more culturally sensitive language and visual aids (e.g., pictures), incorporating Indigenous Traditional Ecological Knowledge, and including constructs relevant to specific sub-populations. Culturally specific adaptations will be piloted in Y2 with broader implementation and resource deployment in Y3 and Y4.In 2.0, we will leverage the evaluation systems we developed to compile project data from grantees and evaluate project performance that complements individual project evaluation teams. We will generate an annual report to Congress on grantees' project outcomes, including project results and grant funds used. We will enhance our secure data management systems and work with our data management and analysis team to compile GusNIP data to produce annual aggregate reporting (i.e., Congressional Report, public facing reports), individual grantee data sets and reports, substudies, and manuscripts. In-depth mixed method substudies will augment core metrics data and aggregate findings to fill specific knowledge gaps.NTAE Project Coordinators will produce monthly progress dashboards reflecting the status of Objectives 1-3 and their associated outputs and outcomes. These reports will be provided to GLC members, partners, and staff quarterly to identify quality improvement opportunities. Annual grantee surveys will inform NTAE implementation and ensure we are meeting both our objectives and GusNIP audiences' needs.

Progress 09/01/24 to 08/31/25

Outputs
Target Audience:Target audiences are GusNIP applicants, grantees, practitioners, residents (i.e., NI/PPR participants), farmers, grocers, health professionals, healthcare and insurance providers, researchers, and evaluators. In addition, the NTAE engages with several groups to help achieve program goals and objectives, including produce distributors, regional food system practitioners, nutrition education providers, point-of-sale (POS) companies, cooperative extensions, funders, USDA NIFA and FNS, and applicable state agencies. Changes/Problems:As reflected in the project title, Building on Success from NTAE 1.0 to Strengthen GusNIP for All Audiences, the NTAE continued to carry out its mission to serve all GusNIP audiences with responsive technical assistance and evaluation support to meet USDA NIFA goals. This approach did not result in problems, delays, adverse conditions or impacts to the cumulative budget, ability to meet milestones, or the current objectives of the award. For example, in an effort to meet the needs of all GusNIP audiences, the NTAE launched the GusNIP GCV and engaged directly with grantees and residents to inform evaluation strategies and program support services, which will allow for an understanding of broader impacts of GusNIP in future years. The NTAE also enhanced its approach to T&TA by expanding its support tools and resources, such as the GusNIP Site Map and Capacity Building and Innovation Fund, to benefit all GusNIP participants. Further, the NTAE is developing updated materials, guidance on regulatory requirements, and strategies for improved digital systems to streamline efforts and increase efficiency. As such, permissible budget changes included internal reallocations, without changes to cumulative federal funding or a need for prior approval, to ensure the NTAE remains compliant and aligned with our cooperative agreement. CNHI and the NTAE are committed to transparency, continuous improvement, and a strong collaboration with USDA NIFA to enhance the reach and effectiveness of the GusNIP program nationwide. What opportunities for training and professional development has the project provided?During Y6, staff and consultants enhanced their work-related skills and knowledge by completing professional development and learning opportunities. The majority of CNHI staff members attended a Center-wide summit focused on connecting with other staff members and incorporating a variety of 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, research scientists, and registered dietitian nutritionists. 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 range of professional conferences. Topic areas covered by these webinars/seminars and conferences included implementation science, nutrition policy, rural health in America, food security and breastfeeding, nutrition labeling, food systems, storytelling with ArcGIS, and urban agriculture. The list below includes professional development and learning activities that the broader Nutrition Incentive Hub engaged in throughout this reporting period. In-person Courses Civic Saturday Fellowship (Akron, OH) Workshops National Collaborative on Childhood Obesity Research, Obesity-Related Policy, Systems, and Environment Research in the U.S. (NCCOR OPUS) II Workshop (virtual) Center-wide Summit: Center for Nutrition & Health Impact (virtual) Conferences/Meetings Connecticut Data Collaborative Conference (Southbury, CT) American Public Health Association Meeting (Minneapolis, MN) Healthy Eating Research (HER) Annual Meeting (Durham, NC) NOPREN Annual Meeting (Durham, NC) Society of Behavioral Medicine (SBM) Conference (San Francisco, CA) Consumer Food Data System Grantee Final Conference (Washington, DC.) Nutrition Obesity Research Center Conference (Birmingham, AL) Webinars and Seminars Change the Tray: Carceral Nutrition and Public Health Nutrition and Obesity Policy Research and Evaluation Network (NOPREN) September State of the Science: Implementation Science & Implications for Policy Research NOPREN November State of the Science: NIH Office of Nutrition Research Updates and Priorities NOPREN December State of the Science: Updates in Global Nutrition Policy NOPREN January State of the Science: FDA Office of Nutrition Updates and Priorities NOPREN March State of the Science: Four Ways to Think About Policy in Implementation Science Research Advancing Nutrition ArcGIS StoryMap Webinar Finding the Effectiveness of Implementation Strategies: Discussion of a Systematic Review Rural America at a Glance, 2024 Edition The Influence of Food Security Status on Breastfeeding Outcomes: A Mixed-Methods Study Front of Package Nutrition Labeling: Front & Center Food Insecurity and Food Safety: Important Policy and Legislative Actions HER NOPREN Resilient Food Systems and Nutrition Work Group Meeting - Scaling Up Urban Agriculture to Transform Food Systems Professional Development Groups: Consultant Program Advisors Project Managers 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), 1-on-1 and cohort calls, website resources and information, numerous topical discussion boards, and media relations. In addition, the NTAE: Published 6 peer-reviewed manuscripts to disseminate original GusNIP research. Delivered presentations for several GusNIP and USDA webinars and at several conferences and national meetings, including 4 presentations (poster and speaking) at the American Public Health Association Annual Meeting in Minneapolis, MN. Disseminated information on the biweekly digest Nutrition Incentive Hub Newsletter (2,000+ recipients), Facebook and LinkedIn 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 7 grantees, partners, and farmers on the Nutrition Incentive Hub social media platforms, including Facebook and LinkedIn to elevate grantee stories. Introduced LinkedIn long-form articles to share grantee successes and stories with a broader audience. Posted over 49 social media posts across 2 social media platforms about industry news, learnings, and work conducted by the NTAE. Planned for the 2025 Nutrition Incentive Hub National Convening that took place May 20-22, 2025 in Minneapolis, MN. During the performance period, the NTAE had an open call of session proposals from the GusNIP community and received 90+ applications. From those submitted, 32 proposals were accepted. Presenters shared information about various aspects of GusNIP program implementation and evaluation to an audience of 300+ attendees. As a result of exemplary work related to GusNIP, the NTAE was awarded the prestigious International Society of Behavioral Nutrition and Physical Activity (ISBNPA) MS Nanney Award, recognizing its significant impact on behavioral health. This commendation follows a competitive selection process involving community nominations and review by a panel of esteemed experts. The award will be formally presented at the 2025 ISBNPA Annual Meeting in Auckland, sharing the NTAE's achievements with an even wider audience of research and practice professionals. What do you plan to do during the next reporting period to accomplish the goals?In Y7, the NTAE will continue enhancing firm- and participant-level data collection while disseminating results through high-quality products. We will build grantees' capacity to document success and improve programming by updating our website and secure portal technologies. We will generate learnings from our newly implemented GCV work and apply them to a pilot process for collecting/refining new core metrics and updating evaluation/dissemination strategies. We will improve data visualization and storytelling through data dashboards. We will support new and existing grantees through our centralized advising model where grantees receive implementation, reporting, and evaluation support through a simplified interface. We will continue to facilitate CofPs, office hours, and networking opportunities to foster peer support and shared learning among grantees. Finally, we will disseminate GusNIP results through peer-reviewed manuscripts and evaluation reports. The following summarizes Y7 activities and products organized by objective/goal: OBJ 1: To build capacity and promote program growth and sustainability, the NTAE will: Collect feedback related to outgoing and incoming NI/PPR RFAs during the post-consultation process and share overall trends with USDA NIFA. Streamline RFA resources and consultation support to NI/PPR applicants during the FY25 and FY26 RFA seasons. Offer additional rounds of CBIF. Gather feedback from GusNIP residents to complete GCV activities. Finalize findings with core partners, grantees, and other GusNIP community members to iteratively refine core metrics. OBJ 2: To collect and provide best practices for NI/PPR projects, the NTAE will: Maintain web portal and technology support to ensure smooth grantee data entry and construction of a quality core metrics dataset. Continue to engage SEAT committee to prioritize technology enhancements and work with technology vendor to implement new features. Streamline TA System to be used by all core partners and TA teams. Enhance grantee profile page/management and improve firm reporting processes and instructions for portal users. To disseminate information and assist w/collaboration across GusNIP audiences and Coordinate communication between NTAE & all GusNIP audiences, the NTAE will: Continue integrated support to NI/PPR grantees through the updated advising model. Continue to refine GusNIP applicant support, with emphasis on first-time applicants and organizations to help pass the USDA Administrative Review and submit applications through Grants.gov. Consolidate/organize all resources on the Nutrition Incentive Hub website for optimized navigability for applicants, practitioners, and grantees. Develop new resources that are responsive to grantees' needs. Continue facilitating 8 virtual CofPs and 4 office hours and introduce new CofPs responsive to grantees' needs. Host and provide scholarships to mini convenings tailored to specific grantee categories (e.g., PPR, NI, farm direct, brick-and-mortar, program size, experience level) including one to help grantees explore tools/financial resources needed to scale up or scale back projects. Re-launch online discussion boards to increase communication between specialists, grantees, and practitioners. To ensure seamless data deposition of core metrics, the NTAE will: Continue integrated support to NI/PPR grantees through the updated advising model. Formally integrate Award Health Checkup process as annual grantee touchpoint. Provide up to $50,000 in stipend funding to support grantees in meeting participant-level surveying requirements. Establish a formal award closeout process to ensure grantees have met NTAE requirements at the end of their award. Conduct a satisfaction survey among grantees to assess NTAE advising support. To receive, maintain, and transition via a warm hand-off a publicly accessible on-line site, the NTAE will: Develop 4-8 new external resources (including 2 on-demand videos) and 2-5 internal resources based on emerging needs. Update external- and internal-facing resources through annual review. Review IRB resources with an emphasis on unique needs of PPR grantees and Tribes. Maintain and enhance existing website and portal. To work with grantees on human subjects and intellectual property protections, the NTAE will: Develop and deploy an integrated technology system solution to inventory and display IRB determination(s) and renewal requirement(s) for individual awards. Through updating resources and training NTAE advising/consultant staff, continue to guide grantees to meet requirements of 7 CFR Part 1c Human Subjects Research Protections including documenting IRB approval with USDA NIFA, submitting modifications and continuing reviews of existing IRB protocols as necessary, and communicating with for-profit IRBs. OBJ 3: To compile project data from grantees, the NTAE will: Host informational kickoff webinars on firm-level and participant-level reporting and evaluation requirements. Offer ongoing support to grantees through firm-level reporting and survey advising help desks. Publish results for multiple ongoing studies of GusNIP PPR projects' impact on healthcare cost and utilization, including findings showing a reduction in child participants' emergency room utilization, results of a study measuring the short-term cost effectiveness of GusNIP PPR projects for improving diabetes management, and in 2027, report a microsimulation modeling study of the long-term health and economic impacts and cost effectiveness of GusNIP PPR participation. Revise firm-level reporting structure and content in portal to allow for more streamlined data collection from grantees. To maintain and improve instrument design and mechanism for reporting core data sets, the NTAE will: Use GCV findings to identify new core metrics and to adapt original metrics as needed with consideration for Farm Bill, USDA, grantee, and scientific priorities. Refine policies, analysis criteria, and reporting methods for new core metrics. To ensure data surveying is centered on all GusNIP audiences, the NTAE will: Begin a pilot process to collect and refine new core metrics that align with grantees' projects and all communities' needs. Develop methods and approaches for evaluation based on core metric revision pilot to provide grantees with structured guidance and support for more tailored evaluations. Compile new core metrics dataset that will be used to produce annual aggregate reports, sub-studies, and manuscripts. To generate an annual report to Congress on grantees' project outcomes, the NTAE will: Develop a Congressional Report that is responsive to Congressional needs and a Y6 Impact Findings Report that communicates comprehensive results to all audiences. Develop the Y6 Impact Findings infographic, social marketing toolkit, and other companion pieces to optimize accessibility and reach all audiences. Develop and distribute individual grantee reports to all Y6 grantees. To use evaluation data to inform NTAE 2.0 implementation, the NTAE will: Conduct annual TA survey with GusNIP grantees and NI/PPR practitioners to inform advising strategy and offerings. Conduct post-RFA consultation survey with GusNIP applicants to inform FY26 RFA offerings. Make recommendations and gather partner feedback on guiding implementation science framework(s) for self-evaluation. Engage with technology partners to understand internal TA tracking capabilities and outline needs. Develop and implement self-evaluation survey for grantees. Engage with core partners to better understand data dashboard KPIs.

Impacts
What was accomplished under these goals? The GusNIP NTAEcontinued to provide key support, guidance, and evaluation to GusNIP audiences. The following specifies activities and deliverables accomplished under each objective during Year 6 (Y6). OBJ 1: To build capacity and promote program growth and sustainability, the NTAE: Awarded $1.2M to 39 organizations through the Capacity Building and Innovation Fund (CBIF) to support potential applicants and current GusNIP awardees. Hosted a 3-part webinar tailored to first-time applicants and attended by 23 organizations that covered overview/general information about the GusNIP RFA and tips for preparing to apply through grants.gov. Began updating GusNIP evaluation core metrics using a GusNIP Community Voices (GCV) approach. Maintained the GusNIP Indigenous Rural Learning Circle for PPR projects to build capacity among Indigenous/rural communities. OBJ 2: To collect and provide best practices for NI/PPR projects, the NTAE: Established NTAE Software Enhancement Advisory Team (SEAT) with representation from all core partners to provide ongoing feedback and prioritization of technology enhancements. Engaged technology vendor to implement prioritized enhancements including organization/user list exports and document library component for two-way document sharing with grantees. Researched key performance indicators (KPIs) for new dashboard pages. Developed/disseminated 7 internal resources and 62 external, public facing resources via the Searchable Resource Library. To disseminate information and assist w/collaboration across GusNIP audiences and Coordinate communication between NTAE & all GusNIP audiences, the NTAE: Developed 5 new resources and updated 16 to support the FY25 RFA release. Provided 105 scholarships to GusNIP grantees to attend the 2025 Nutrition Incentive Hub National Convening and Project Directors Meeting. Responded to 300+ technical assistance (TA) requests from GusNIP grantees covering a wide range of topics, including grant administration, program design, implementation, and evaluation. Hosted 8 communities of practice (CofP) meetings monthly or bi-monthly. Hosted 4 office hours for open-ended TA support including 1 new topic area (electronic benefit transfer [EBT] integration). Hosted webinar series about Medicaid reimbursement for PPR in partnership with Center for Health Law Policy & Innovation (CHLPI). Offered scholarships to 10+ PPR grantees to receive expert consultation from CHLPI staff on Medicaid reimbursement and data sharing/privacy issues. Hosted 3-part webinar focused on non-Federal fundraising strategies for NI/PPR programs. Developed and launched web-based PPR incentive technology provider directory and associated decision tree to assist grantees with identifying PPR-related technology platforms. Facilitated meetings focused on elements of local sourcing for each CofP (e.g., ways to support local sourcing with Brick-and-Mortar and Corner Stores). To ensure seamless data deposition of core metrics, the NTAE: Continued advising model that provides integrated implementation, reporting, and evaluation support to all active grantees. Provided $63,411 in funding to 50 grantees for participant-level survey stipends. Established new Award Health Checkup process that provides proactive TA to help grantees meet approved goals and spend all award funds. 78 out of 105 invited grantees completed screening form, and TA teams conducted 40+ meetings with grantees. Ensured continuing education for Program Advisors, NI Advisors, and PPR Advisors through biweekly/monthly meetings. Developed 4 new resources about ensuring data privacy and security standards when sharing data. To receive, maintain, and transition via a warm hand-off a publicly accessible on-line site, the NTAE: Maintained the Nutrition Incentive Hub website and portal with technology consultant to include enhanced features (e.g., document upload section, user list exports) and upload new/updated resources. To work with grantees on human subjects and intellectual property protections, the NTAE: Guided grantees through documenting Institutional Review Board (IRB) approval with USDA NIFA and completing human subjects research training (e.g., CITI). Assisted grantees with existing IRB protocol modifications/continuing reviews. Served as liaison between grantees and for-profit IRBs to submit review packages and negotiate fees. OBJ 3: To compile project data from grantees, the NTAE: Analyzed electronic health records from 1,489 participants from 5 GusNIP PPR projects to estimate the impact of PPR participation. Results showed clinically and statistically significant improvements in HbA1c and blood pressure. From pre-enrollment to follow-up, participants' HbA1c decreased by 0.5 units (8.2% to 7.7%). Improvements were more pronounced among participants with HbA1c greater than 9% at baseline, decreasing by 1.9 units (11.1% to 9.2%). From pre-enrollment to follow-up, systolic blood pressure (SBP) decreased by 1.8 mmHg (from 131 to 129.2) and diastolic blood pressure (DBP) decreased by 2 mmHg (78.8 to 76.8). Improvements were notable among participants with stage 2 hypertension, with decreases in SBP by 10.7 mmHg (148.5 to 137.8) and DBP by 5.7 mmHg (85.6 to 79.9). The magnitude of these improvements is similar to assumptions used in an influential produce prescription microsimulation study by Tufts University and the Rockefeller Foundation (True Cost of Food: Food is Medicine Case Study), which showed that if health and diet improvements (including HbA1c decrease of 0.6 units) held up at scale and over time, they would result in healthcare savings of approximately $40 billion dollars. Completed follow-up data collection for SNAPI sub-study (Bloomberg Philanthropies) to determine impact of NIs on fruit and vegetable intake, total dietary quality, and food security. Hosted informational kickoff webinars for firm- and participant-level data collection. Provided ongoing firm-level reporting and participant-level data collection support through centralized advising help desks. Published 6 peer-reviewed manuscripts. To maintain and improve instrument design and mechanism for reporting core data sets, the NTAE: Continued updating core metrics and guidance to grantees by discussing at partner meetings, soliciting feedback from grantees, conducting GCV focus groups, and collaboratively generating ideas for updated metrics to align grantee interests, Farm Bill priorities, USDA needs, and scientific progress. Collected core metrics data from all active NI/PPR awards. To ensure data surveying is centered on all GusNIP audiences the NTAE: Began core metrics revisions to serve all communities using findings from GCV focus groups/interviews, and planned core metrics pilot process. To generate an annual report to Congress on grantees' project outcomes, the NTAE: Developed Congressional Report responsive to Congressional needs, and drafted the Y5 Impact Findings Report that communicates comprehensive results. Drafted Y5 Impact Findings infographics, social marketing toolkit, press release, and downloadable pdfs of report sections to reach all audiences. Developed/distributed 178 Y5 individual grantee reports. To use evaluation data to inform NTAE 2.0 implementation, the NTAE: Developed TA survey to inform upcoming TA offerings through CofPs, webinars, resources, and in-person mini convenings. Utilized feedback from 101 applicant organizations during a FY24 post-RFA consultation survey to inform/streamline FY25 RFA consultation services. Conducted a satisfaction survey with NTAE personnel to boost morale and productivity. Updated/maintained the GusNIP Site Map to include additional pages to better display the map, layer options, data table, and dashboard elements. Produced workflow process to review data dashboard pages with partners, GCV members, and USDA.

Publications

  • Type: Peer Reviewed Journal Articles Status: Accepted Year Published: 2025 Citation: Akin J, Stotz S, Sanville L, Yaroch AL, Byker Shanks C. Nutrition education across Gus Schumacher Nutrition Incentive Programs: A landscape analysis. J Nutr Educ Behav. 2025;57(5):425-434. doi:10.1016/j.jneb.2025.01.009
  • Type: Peer Reviewed Journal Articles Status: Accepted Year Published: 2025 Citation: Byker Shanks C, Izumi B, Eastman J, Alvord TW, Yaroch AL. Improving public health data collection approaches across populations: Findings from a national evaluation of fruit and vegetable incentives. Public Health Nutr. 2025;28(1):e67. doi:10.1017/S1368980025000084
  • Type: Peer Reviewed Journal Articles Status: Accepted Year Published: 2025 Citation: Byker Shanks C, Fung Uy W, Zhang, N, et al. Nutrition incentives associated with improved outcomes: 2020-2023 results from the United States Gus Schumacher Nutrition Incentive Program (GusNIP). AJPM Focus. Published online April 2025:100348. doi:10.1016/j.focus.2025.100348
  • Type: Peer Reviewed Journal Articles Status: Accepted Year Published: 2025 Citation: Byker Shanks C, Park MS, Yaroch AL, Short E, Seligman HK. Health outcomes of produce prescription programs associated with Gus Schumacher Nutrition Incentive Program funding. Annu Rev Nutr. Published online May 12, 2025. doi:10.1146/annurev-nutr-111124-092627
  • Type: Peer Reviewed Journal Articles Status: Accepted Year Published: 2025 Citation: Stotz SA, Seligman H, Yaroch AL, 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. J Public Health Res. 2025;14(2):22799036251329452. doi:10.1177/22799036251329452
  • Type: Peer Reviewed Journal Articles Status: Accepted Year Published: 2025 Citation: Ridberg RA, Maitin-Shepard M, Garfield K, et al. Food is Medicine National Summit: Transforming Health Care. Am J Clin Nutr. December 2024;120(6):1441-1456. doi:10.1016/j.ajcnut.2024.09.027
  • Type: Other Journal Articles Status: Submitted Year Published: 2025 Citation: Byker Shanks C, Zigmont V, Quattro R, et al. Who participates in produce prescriptions? Characteristics of the people and communities served by the Gus Schumacher Nutrition Incentive Program (GusNIP) from 2020-2024. Am J Public Health. Submitted for publication April 2025.
  • Type: Other Journal Articles Status: Submitted Year Published: 2025 Citation: Byker Shanks C, Izumi, B, Eastman J, Hartenfeld M, Jilcott Pitts S. Application and adaptation of the Veggie Meter in community-based settings: A mixed methods study. J Acad Nutr Diet. Submitted for publication November 2024.
  • Type: Other Journal Articles Status: Submitted Year Published: 2025 Citation: Byker Shanks C, Houghtaling B, Yaroch A. Implications of a United States food policy on food systems transformation. NPJ Sci Food. Submitted for publication July 2024.
  • Type: Other Journal Articles Status: Submitted Year Published: 2025 Citation: Fung Uy W, Houghtaling B, Fricke H, et al. Quantitative measures used to evaluate nutrition incentive programs in the United States: A scoping review. Nutr Rev. Submitted for publication October 2024.
  • Type: Other Journal Articles Status: Submitted Year Published: 2025 Citation: Parks C, Yaroch A. Exploring qualitative insights into nutrition incentive and produce prescription programs: A scoping review. Nutr Rev. Submitted for publication March 2025.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2024 Citation: Long CR. Evaluating food Is medicine interventions: Making sense of the menu of metrics. Presented at: Nutrition Obesity Research Center at the University of Alabama at Birmingham; Sept 10, 2024; Birmingham, AL.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Long CR. The importance of food is medicine in the southern U.S.: Disparities, communities, and opportunities. Presented at: Forge AHEAD Center, Heersink School of Medicine at the University of Alabama at Birmingham; Sept 11, 2024; Birmingham, AL.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Houghtaling B. Implementation of food is medicine in the United States. Presented at: HNFE 5204: Translational Science in Human Nutrition, Foods, and Exercise; September 17, 2024; Blacksburg, VA.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2025 Citation: Houghtaling B, Zhang N, Yaroch A, Milburn Atkinson C, Byker Shanks C. Understanding limitations of a produce prescription policy restricting incentive redemptions for lower-income Americans to fresh fruits and vegetables. Presented at: Consumer Food Data System Grantee Final Conference; February 7, 2025; Washington, DC.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Zigmont VA, Seligman H, Yaroch A, et al. How can produce prescription operators measure changes in healthcare utilization? Challenges and a potential way forward. Poster presented at the American Public Health Association; October 27, 2024; Minneapolis, MN.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Short E, Zigmont VA, Marriott J, Houghtaling H, Yaroch A. What health outcomes do produce prescription projects evaluate? Results of a scoping review. Poster presented at: American Public Health Association Annual Meeting; October 27, 2024; Minneapolis, MN.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Yaroch AL. Centering Communities in GusNIP: Where we have gone, and where we are going next in GusNIP 2.0. Presented at American Public Health Association; October 2024; Minneapolis, MN.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Zigmont VA, Quattro R, Levi R, Yaroch A. Who is reached by GusNIP produce prescription projects? A description of participants and their communities. Poster presented at: American Public Health Association; October 29, 2024; Minneapolis, MN.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2024 Citation: Byker Shanks C, Her K, Yaroch A. GusNIP community voices: Re-envisioning GusNIP evaluation. Presented at; GusNIP Project Director Meeting; December 2, 2024; Virtual.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2025 Citation: Fung Uy W, Houghtaling B, Parks CA, et al. Quantitative measures used to evaluate nutrition incentive programs in the United States: A scoping review. Presented at: 2025 Robert Wood Johnson Foundation's Healthy Eating Research Annual Meeting; March 13, 2025; Durham, NC.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2025 Citation: Houghtaling B. Implementation of nutrition incentive and food is medicine programs. Presented at: Cornell University; March 21, 2025; Virtual.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2025 Citation: Houghtaling B, Marriott J, Yaroch A, et al. Retail implementation of the CalFresh fruit & vegetable EBT pilot project. Presented at: NOPREN Healthy Food Retail Working Group; January 21, 2025; Virtual.


Progress 09/01/23 to 08/31/24

Outputs
Target Audience:Target audiences are applicants, grantees, practitioners, Tribes, residents (i.e., NI/PPR participants), farmers, grocers, health professionals, healthcare and insurance providers, researchers and evaluators, and members of underrepresented communities and geographies (UCGs). In addition, the NTAE engages with several groups to help achieve program goals and objectives, including produce distributors, regional food system practitioners, nutrition education providers, point-of-sale (POS) companies, cooperative extensions, funders, USDA NIFA and FNS, and applicable state agencies. Changes/Problems:In the first year of this cooperative agreement, the NTAE has not encountered any major problems or delays in the proposed plan. However, the NTAE has made slight adjustments to the timeline proposed in the grant application to accommodate more time needed for formative efforts. Planning for all tasks and deliverables under each objective has begun, but the timeline for launch and completion has been modified for some deliverables. For example: Field visits, focused outreach, and resources specifically for UCGs will be completed in Y2 through Y4 rather than Y1 to ensure the NTAE has time to plan these efforts and is well positioned to support UCGs. New data visualization pages, peer-reviewed literature, and revised resources will be uploaded to the website beginning in Y2 rather than Y1 to accommodate the transition to a new technology vendor. Core metrics refinements and adaptations will extend into Y2 and Y3. Implementing the new TA annual survey and NTAE self-evaluation will start in Y2 rather than Y1 to accommodate integrated technology system planning procedures to inform the self-evaluation focus. The objectives and activities with a modified timeline are noted below: Objective 1 Activities, Outputs, Outcomes, and Milestones Build capacity and promote program growth and sustainability in UCGs. Form and implement a GLC 30 GLC members (including 4 residents) reflecting GusNIP audiences: Previously Y1, modified to Y1-Y4 Select GLC members & work on core metrics: Added to Y1 Conduct targeted outreach to UCGs Identify 3-6 experts and organizations annually representing UCGs: Previously Y1-Y4, modified to Y2-Y4 Focused outreach strategies tailored to UCGs annually, including resources (n=5-20), 2-3 UCG specific webinars, 1:1 and group T&TA: Previously Y1-Y4, modified to Y2-Y4 2 field visits with UCG states and/or Territories and associated resources (n=6-10): Previously Y1-Y3, modified to Y2-Y4 Increase number of GusNIP applications from UCGs annually: Previously Y2-Y4, modified to Y1-Y4 Objective 2 Activities, Outputs, Outcomes, and Milestones Collect and provide best practices for NI/PPR projects. Maintain and refine Hub website and portal Relevant NI/PPR peer-reviewed literature catalogued in Searchable Resource Library: Previously Y1-Y2, modified to Y2 New and existing resources updated with new information and DEIA best practices (n=10-20 annually): Previously Y1-Y4, modified to Y2-Y4 Ensure training is culturally competent and centered on DEIA principles. Develop and offer DEIA trainings DEIA strategic plan developed and implemented: Previously Y1-Y4, modified to end of Y1-Y4 Work with grantees on human subjects and intellectual property protections. Provide tailored IRB support throughout the grant lifecycle IRB resources with an emphasis on unique needs of PPR grantees and Tribes: Previously Y1-Y4, modified to end of Y1-Y4 Support intellectual property protections Intellectual property resources, including Indigenous Traditional Ecological Knowledge: Previously Y1-Y4, modified to end of Y1-Y4 Objective 3 Activities, Outputs, Outcomes, and Milestones Maintain and improve instrument design and mechanism for reporting core data sets. Update core metrics through a community engaged approach Needed adaptions and metric additions identified with GLC: Previously Y1, modified to Y1-Y2 Culturally sensitive metrics are piloted and refined: Previously Y2, modified to Y2-Y3 Ensure data surveying is culturally competent and centered on DEIA principles. Develop culturally tailored metrics for participant survey DEIA study findings review with GLC: Previously Y1, modified to Y1-Y2 Resources and pilot of new culturally tailored scales: Previously Y2-Y3, modified to Y2-Y4 Use evaluation data to inform NTAE 2.0 implementation. Develop and implement internal NTAE quality improvement strategies Monthly review sessions of dashboards with NTAE leadership: Previously Y1-Y4, modified to Y2-Y4 TA annual survey collected among GusNIP audiences to inform overall strategy and TA offerings: Previously Y1-Y4, modified to Y2-Y4 Dashboards to monitor and facilitate NTAE progress toward objectives, outputs, and outcomes: Previously Y1-Y4, modified to Y2-Y4 What opportunities for training and professional development has the project provided?During Y1 of NTAE 2.0, 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 Family Nutrition Program Professional Development Webinar Series - Food Insecurity and Eating Disorders Nutrition and Obesity Policy Research and Evaluation Network (NOPREN) State of the Science - Food is Medicine in 2023 An Equity Centered Approach to Research and Evaluation Racial Equity Workshop American Diabetes Association Grantee Workshop Conferences/Meetings Food and Nutrition Conference & Expo Annual Meeting (Denver, CO) PPR Mini Convening (Chicago, IL) 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) 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 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 digest emails 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 (mini convening) 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. Published 6 peer-reviewed manuscripts to disseminate original GusNIP research. Delivered presentations for several GusNIP and USDA webinars and at several conferences and national meetings. Disseminated information on the biweekly digest 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 3 press releases about the GusNIP Site Map launch, round 5 of the CBIF, and USDA NIFA's $52 million investment in 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 Y2, the NTAE will continue promoting and enhancing firm- and participant-level data collection while disseminating results through high-quality products. We will continue to build grantees' capacity to document success and improve programming by updating our website and secure portal and launching a new integrated system for all GusNIP audiences. We will enhance services to underrepresented communities and geographies through establishment of a robust GusNIP Learning Circle and a DEIA strategic plan. We will continue to improve data visualization and storytelling through data dashboards. We will support new and existing grantees through a centralized advising model where grantees receive implementation, reporting, and evaluation support through a simplified interface. We will continue to offer networking opportunities to foster peer support and shared learning among grantees. Finally, we will disseminate GusNIP results through peer-reviewed manuscripts and evaluation reports. The following summarizes Y2 activities and products organized by objective/goal: OBJ 1: Engage GusNIP audiences to improve and sustain GusNIP NI/PPR Programs, with an emphasis on reaching underrepresented communities and geographies (UCGs). To build capacity and promote program growth and sustainability in UCGs, the NTAE will: Collate feedback related to outgoing and incoming NI and PPR RFAs to USDA NIFA. Provide 1:1 and group support to NI and PPR applicants during the FY25 RFA season. Develop self-assessment/readiness tool for prospective NI/PPR applicants to determine fit with GusNIP. Offer additional rounds of CBIF in FY24, including one round supporting capacity building efforts amongst grantees and another round supporting first-time applicants for GusNIP. Host a webinar series and 1:1 consultation for CBIF awardees that are first-time GusNIP applicants to prepare applicants for administrative review and ensure understanding of the FY25 RFA. Increase NTAE knowledge of Tribal food security through training for NTAE staff, partners and specialists. Continue to tailor outreach materials to UCGs and Tribal communities. Present and attend conferences and meetings featuring UCGs. Continue new GusNIP Indigenous Rural Learning Circle for PPR serving indigenous and rural communities. Recruit all members of the GLC and launch meetings to inform and guide NTAE services. OBJ 2: Provide and continuously improve T&TA services that optimize the experience of GusNIP audiences. To collect and provide best practices for NI/PPR projects, the NTAE will: Maintain web portal and technology support to ensure smooth grantee data entry and construction of a quality core metrics dataset. 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. To disseminate information and assist w/collaboration across GusNIP audiences and Coordinate communication between NTAE & all GusNIP audiences, the NTAE will: Continue integrated support to NI and PPR grantees through the updated advising model. Refine GusNIP applicant support, with an emphasis on first-time applicants and organizations to pass the USDA Administrative Review and submit applications through Grants.gov. Consolidate and organize all resources on the Nutrition Incentive Hub website for increased navigability for applicants, practitioners, and grantees. Introduce new communities of practices led by NTAE specialists, responsive to the programmatic needs of grantees. Host and provide scholarships to mini convenings tailored to specific grantee categories (e.g., PPR, NI, farm direct, brick-and-mortar, program size, experience level) including one in New York City (June 2024) to support both NI and PPR grantees that are new to GusNIP and one in Hawaii (August 2024) focused on how GusNIP NI and PPR projects are supporting community resilience and local food systems. Re-launch the online discussion board to increase communication between specialists, grantees, and practitioners. To ensure training is culturally competent and centered on DEIA principles, the NTAE will: Collaborate with a DEIA consultant and NTAE core partners to develop DEIA strategic plan. To ensure seamless data deposition of core metrics, the NTAE will: Continue integrated support to NI and PPR grantees through the updated advising model. Determine integration of TA specialists into advising model. Provide up to $50,000 in stipend funding to support grantees in meeting participant-level surveying requirements. Conduct a satisfaction survey among grantees to assess advising support provided by the NTAE. Collect healthcare metrics from a subset of PPR grantees. To receive, maintain, and transition via a warm hand-off a publicly accessible on-line site, the NTAE will: Review new and existing resources updated with new information and DEIA best practices. Review 4-8 new external resources (including 2 on-demand videos) and 2-5 internal resources annually based on emerging needs. Maintain external- and internal-facing resources through annual review. Review IRB resources with an emphasis on unique needs of PPR grantees and Tribes. Review intellectual property resources, including indigenous traditional ecological knowledge. Maintain and enhance existing website and portal. To work with grantees on human subjects and intellectual property protections, the NTAE will: Continue to guide grantees through documenting IRB approval with USDA NIFA, modifications and continuing reviews of existing IRB protocols, and communications with for-profit-IRBs. Work with the Indigenous Food and Agriculture Initiative and other partners to develop plan for creating indigenous traditional ecological knowledge resources. OBJ 3: Conduct a rigorous evaluation of NI and PPR projects centered on DEIA principles. To compile project data from grantees, the NTAE will: Host informational kickoff webinars on firm-level and participant-level reporting and evaluation requirements in FY25. Offer ongoing support to grantees through firm-level reporting and survey advising help desks. To maintain and improve instrument design and mechanism for reporting core data sets, the NTAE will: Begin a pilot process to collect and refine culturally sensitive metrics. Work with the GLC to identify new core metrics and to adapt original metrics as needed. Refine policies, inclusion criteria, and exclusion criteria around analysis methods for core metrics. Compile core metrics data that will be used to produce annual aggregate reports, sub-studies, and manuscripts. To ensure data surveying is culturally competent and centered on DEIA principles, the NTAE will: Begin a pilot process to collect and refine culturally sensitive metrics. Work with the GLC to identify new core metrics and to adapt original metrics as needed. To generate an annual report to Congress on grantees' project outcomes, the NTAE will: Develop a Congressional Report that is responsive to Congressional needs and the Y1 Impact Findings Report that communicates comprehensive results in a culturally appropriate and community-informed manner. Develop the NTAE 2.0 Y1 Impact Findings infographic, social marketing toolkit, and other companion pieces to optimize accessibility and reach diverse audiences. Develop and distribute individual grantee reports to all Y1 grantees. To use evaluation data to inform NTAE 2.0 implementation, the NTAE will: Make recommendations and gather partner feedback on guiding implementation science framework(s) for self-evaluation. Engage with technology partners to understand internal technical assistance tracking capabilities and outline needs. Develop and implement self-evaluation survey for grantees. Engage with core partners to better understand data dashboard KPIs. Produce a workflow process to review data dashboard pages with partners, GLC members, and funders.

Impacts
What was accomplished under these goals? In Year 1 (Y1) of NTAE 2.0, the NTAE began development of an updated and integrated support system to provide efficient and streamlined implementation and support services for the communities and geographies GusNIP serves. The NTAE continued to provide Training and Technical Assistance (T&TA) in both implementation and evaluation to a growing number of Nutrition Incentive (NI) and Produce Prescription (PPR) grantees. In addition, core partners of NTAE 2.0 including Center for Nutrition and Health Impact (CNHI; formerly the Gretchen Swanson Center for Nutrition), Fair Food Network (FFN), and University of California San Francisco (UCSF) piloted a new program advising model where implementation, reporting, and evaluation support were streamlined across partners and simplified for new grantees. Program advisors were trained in the new model and onboarded grantees according to the new 2.0 protocols. As a result, many grantees launched their projects and started submitting both firm- and participant-level data, with plans in place to clean, aggregate, analyze, and report results during Year 2 (Y2). During this formative year of NTAE 2.0, staff laid the foundation for streamlined and efficient work to be accomplished in future years. We planned and initiated many cross-partnership meetings to facilitate communication and collaboration between core partners and Nutrition Incentive Hub specialists. CNHI created 9 work groups, each with their own NTAE 2.0 statements of work and official work plans. We established and convened an Indigenous Rural Learning Circle to enhance service to Tribal communities. Finally, we engaged 56 applicant organizations from underrepresented communities and geographies (UCGs) for the FY24 grant cycle and awarded $900,000 through the Capacity Building and Innovation Fund (CBIF) to support GusNIP applicants from UCGs. OBJ 1: Engage GusNIP audiences to improve and sustain GusNIP NI/PPR Programs, with an emphasis on reaching underrepresented communities and geographies (UCGs). To build capacity and promote program growth and sustainability in UCGs, the NTAE: Engaged with 6 applicant organizations from 18 different UCGs for the FY24 NI grant and 50 applicant organizations from 19 different UCGs for the FY24 PPR grant. Awarded $900,000 to 41 organizations across 23 states, Washington D.C., and Puerto Rico through the CBIF to provide capacity building support for organizations preparing to apply for a GusNIP award in FY24. Selected and began working with a consultant that will guide and implement the GusNIP Learning Circle (GLC). Facilitated a new GusNIP Indigenous Rural Learning Circle for PPR projects to build capacity among Indigenous and rural communities. OBJ 2: Provide and continuously improve T&TA services that optimize the experience of GusNIP audiences. To collect and provide best practices for NI/PPR projects, the NTAE: Developed an interview guide and completed 12 interviews with NTAE scientists, Project Director, Co-Project Director, project managers, research associates, and program advisors to evaluate team understanding and needs for an integrated system. Conducted 6 focus groups with NTAE staff and core partners (33 participants representing 3 organizations) to further envision an integrated technology system. Used results from interviews and focus groups for technology work group to develop a list of requirements and a request for proposals (RFP) to develop an integrated technology system. A review committee with representatives from all NTAE core partners (CNHI, FFN, UCSF) reviewed 7 vendor applications, received presentations from 3 vendors, and selected 1 vendor to move forward with development. Conducted a data visualization page audit for existing pages to better understand KPIs for new dashboard pages. Developed and disseminated 7 internal resources and 62 external, public facing resources via the Searchable Resource Library. To disseminate information and assist w/collaboration across GusNIP audiences and Coordinate communication between NTAE & all GusNIP audiences, the NTAE: Conducted 155 consultations with PPR applicants and 31 consultations with NI applicants during the FY24 PPR RFA through 1:1s, group sessions, and webinars. Developed 13 new resources associated with FY24 RFA support. Provided 31 scholarships to GusNIP grantees to attend the annual Project Directors Meeting in New Orleans, 6 scholarships to GusNIP grantees to attend the National Grocers Association Show in Las Vegas, and 8 scholarships to GusNIP grantees to attend the Mobile Market Summit in Phoenix. Hosted an EBT Integration Working Group Kickoff Meeting in Boston 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. Hosted 8 communities of practice, each meeting monthly or bi-monthly, including 2 new communities of practice focused on farmers market incentive technology and communications/marketing. Hosted 4 learning cohorts on participant engagement, state funding, and local sourcing. Hosted 9 GusNIP RFA-specific webinars (See "Webinars" in "Other Products" below). To ensure training is culturally competent and centered on DEIA principles, the NTAE: Convened partners and GusNIP Learning Circle (GLC) consultant in April 2024 to begin developing DEIA strategic plan and trainings. To ensure seamless data deposition of core metrics, the NTAE: Piloted a modified advising model to provide integrated implementation, reporting, and evaluation support to FY24 grantees (e.g., kickoff webinar, onboarding calls, recurring check-in meetings, ad-hoc support). Provided $14,000 total in funding to 8 grantees for participant-level survey stipends. Ensured continuing education for Program Advisors through biweekly meetings. To receive, maintain, and transition via a warm hand-off a publicly accessible on-line site, the NTAE: Maintained the website and portal with the NTAE 1.0 technology consultant with minor updates and fixes that arose (e.g., adding Territories to grantee map). Updated 19 resources in the Nutrition Incentive Hub website. Extended existing technology contract and coordinated efforts between new technology consultant and previous technology consultant to transition materials and knowledge. To work with grantees on human subjects and intellectual property protections, the NTAE: Guided FY24 grantees through documenting Institutional Review Board (IRB) approval with USDA NIFA and completing human subjects research training (e.g., CITI). Assisted grantees with existing IRB protocol modifications and continuing reviews. Served as liaison between grantees and for-profit IRBs to advocate for expedited review, IRB fees control, and translation of requested edits to submitted IRB packages. OBJ 3: Conduct a rigorous evaluation of NI and PPR projects centered on DEIA principles. To compile project data from grantees, the NTAE: Hosted informational kickoff webinars for firm-level and participant-level data collection. Provided ongoing firm-level reporting and participant-level data collection support through centralized advising help desks. To maintain and improve instrument design and mechanism for reporting core data sets, the NTAE: Began planning a process to update core metrics and guidance to grantees by discussing at partner meetings and mini convenings and soliciting feedback from the External Evaluators Community of Practice. To use evaluation data to inform NTAE 2.0 implementation, the NTAE 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 (i.e. poverty status, race and Hispanic origin, low income, low access areas, etc.) to better understand GusNIP's reach.

Publications

  • Type: Journal Articles Status: Accepted Year Published: 2023 Citation: Parks CA, 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:https://doi.org/10.1016/j.cdnut.2023.102040.
  • Type: 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:https://doi.org/10.5304/jafscd.2024.132.016.
  • Type: Journal Articles Status: Accepted Year Published: 2024 Citation: Long CR, Yaroch A, Byker Shanks C, et al. Perspective: leveraging electronic health record data within food is medicine program evaluation: considerations and potential paths forward. Adv Nutr. Published online February 1, 2024. doi:https://doi.org/10.1016/j.advnut.2024.100192.
  • Type: 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. Published online February 16, 2024. doi:https://doi.org/10.1093/tbm/ibae005.
  • Type: Journal Articles Status: Accepted Year Published: 2024 Citation: Houghtaling B, Short E, Shanks C, et al. Implementation of food is medicine programs in healthcare settings: A narrative review. J Gen Intern Med. 2024. https://doi.org/10.1007/s11606-024-08768-w.
  • Type: 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: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Fung Uy W, Her K. NTAE considerations for optional metrics: Focus on sociodemograhic items. PowerPoint presented at: GusNIP External Evaluators Community of Practice; September 23, 2023; Virtual.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Akin J, Quattro R. GusNIP Y4 impact findings and Y1-4 cumulative reports. Presented at: GusNIP Partners Meeting; September 30, 2023; Chicago, IL.
  • 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: Mitchell E, et al. Food security round table. Presented at: Tufts Community Union Food Security Panel; October 11, 2023; Boston, MA.
  • 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. Paper 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: Conference Papers and Presentations Status: Accepted Year Published: 2023 Citation: Long CR. 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 AL. 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 hour 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.