COMPREHENSIVE AND INTEGRATED CENTER FOR NUTRITION INCENTIVE PROGRAM TRAINING, TECHNICAL ASSISTANCE, EVALUATION AND REPORTING

• Sponsoring Institution: National Institute of Food and Agriculture
• Project Status: COMPLETE
• Funding Source: OTHER GRANTS
• Reporting Frequency: Annual
• Accession No.: 1020863
• Grant No.: 2019-70030-30415
• Cumulative Award Amt.: $31,000,000.00
• Proposal No.: 2019-04687
• Project Start Date: Sep 1, 2019
• Project End Date: Aug 31, 2024
• Grant Year: 2022
• 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
Healthy food incentive providers (i.e., GusNIP Grantees) have varying capacity and resources to carry out comprehensive evaluation and reporting and often face barriers to implementation. The NTAE aims to maximize the effectiveness and efficiency of GusNIP projects in meeting GusNIP priorities, increasing fruit and vegetable purchases, and improving the nutrition of participating households. The collective group of partners forming the NTAE include a broad and deep cross-section of experts in the area of healthy food access, food insecurity, food incentives, and evaluation and reporting. The NTAE will yield a streamlined and integrative clearinghouse for training and technical assistance (T&TA), and reporting and evaluation (R&E), to support GusNIP grantees over the next four years toward the intended impact of improving health outcomes of SNAP households and decreasing associated health care costs.The proposed NTAE Center has two key goals: (1) Develop systems, infrastructure, and collaborative relationships using a community-informed approach to support GusNIP grantees R&E while building sustainability and capacity; and (2) Maximize effectiveness and efficiency of GusNIP projects in meeting GusNIP priorities, increasing fruit and vegetable purchases, and improving the nutrition of participating households. Strategies for the NTAE will be rooted in a collaborative format with USDA and other stakeholders, using a bottom-up approach informed by needs and capacity of prospective GusNIP grantees as well as existing and yet to be developed technology that will provide infrastructure for collecting key information related to T&TA and R&E. The overarching benefit of the NTAE will be increased capacity of GusNIP Grantees and reporting of process and outcome metrics that will help inform the continued efforts of healthy food incentive programs.

Animal Health Component

33%

Research Effort Categories

Basic

33%

Applied

33%

Developmental

34%

Classification

Knowledge Area (KA)	Subject of Investigation (SOI)	Field of Science (FOS)	Percent
704	6099	3030	100%

Knowledge Area
704 - Nutrition and Hunger in the Population;

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

Field Of Science
3030 - Information and communication;

Keywords

evaluation

food insecurity

nutrition incentives

reporting

technical assistance

training

Goals / Objectives
The following outlines key goals and associated objectives the NTAE. For clarity and ease of review, these plans have been divided intotwo overarching sections: Reporting and Evaluation (R&E) and Training and Technical Assistance (T&TA).?Goals and Objectives for R&EGOAL 1: To develop systems, infrastructure, and collaborative relationships using a community-informed approach to support Grantees R&E while building sustainability and capacity.OBJECTIVES1. Identify and describe best practice R&E processes that are feasible and meaningful for all Grantees through formative assessments.2. Develop robust protocols and a clearinghouse of information to guide Grantees and build their capacity in R&E and inform the field on progress made with GusNIP programming.3. Augment Grantee self-evaluation to address discrete knowledge gaps by deploying NTAE team to conduct quantitative and qualitative data collection with a subset of Grantees.4. Develop an online reporting system to collect and compile data and outcomes from Grantees.5. Develop and manage a public website for compiling Grantee data, outcomes, and key metrics.6. Evaluate T&TA to determine effectiveness (e.g., impact of amount, type, mode, etc.).Goals and Objectives for T&TAGOAL 2: To maximize the effectiveness and efficiency of GusNIP projects in meeting GusNIP priorities, increasing FV purchases, and improving the nutrition of participating households.OBJECTIVES1. Increase % of and total GusNIP funds used for Nis to participants by developing, collecting, and deploying best practice tools, templates, and trainings in communications, direct-to-consumer marketing, nutrition education, incentive instrument development, integration of PoS systems, recordkeeping, and reporting.2. Leverage collective demand and purchasing power of Grantees and retailers to develop new technology-enabled solutions for SI and PPR benefit redemption in B&M and FD retail.3. Help Grantees benchmark, standardize, and improve local and regional produce sourcing in B&M retail.4. Develop and support a Grantee network to cultivate shared learning and best practices.5. Strengthen communication and collaboration among key NI stakeholders to leverage capacity and align resources. Stakeholders include Grantees, retailers, produce distributors, regional food system practitioners, health care and insurance providers, nutrition education programs, PoS companies, cooperative extensions, funders, legislators, evaluators/researchers, USDA, and applicable state agencies.6. Include the diverse perspectives of served communities and Grantees in shaping the delivery and content of culturally appropriate T&TA.7. Build capacity in high-need communities and foster innovation in communications, PoS integration, and supplemental services, including online ordering, transportation between home and store, and delivery.

Project Methods
The following outlines key methods by objective for the NTAE. For clarity and ease of review, these plans have been divided intotwo overarching sections: Reporting and Evaluation (R&E) and Training and Technical Assistance (T&TA).Methods for R&E OBJECTIVE 1Methods:Review existing reports/literature from NI programs to inform evidence-based R&E approaches.Conduct site visits (and key informant interviews) with a subsample of Grantees (~10-15 Grantees each year) to inform evaluation.Conduct online survey with all Grantees to confirm findings from site visits among broader sample.OBJECTIVE 2 Methods:Identify/define metrics for core minimum dataset (and optional metrics), and develop sampling strategy across Grantees to ensure adequate sample sizes. Certain metrics and core minimum dataset will be dependent on grantee type.Educate/train Grantees on R&E completion within RVS (i.e., instructional videos, TA interactions).Develop clearinghouse of all metrics Grantees will incorporate into evaluation plans; assemble other resources to promote resource sharing and peerlearning.Conduct electronic survey among Grantees to assess knowledge, self-efficacy, and capacity.OBJECTIVE 3 Methods:Identify knowledge gaps in literature and develop additional evaluation strategies, such as best practices for rural settings, longitudinal analysis, and changes in local food procurement.Carry out mixed-methods data collection (surveys and interviews) to fill specific knowledge gaps as case studies (Sites: N=3-5 in Y1; N=5-7 in Y2; N=1-3 in Y3-4).Develop reports incase-study format to be disseminated among multiple stakeholders (USDA, Grantees, Congress) rapidly and develop peer-reviewed manuscripts to advance the NI field.OBJECTIVE 4Methods:Develop templates for GusNIP core minimum dataset and optional metrics in RVS system.Develop reports to transfer data to GSCN and other partners fromRVS system.CFFM and GSCN to provide T&TA to Grantees on use of RVS and outcome-based reporting.Develop GusNIP report formats in RVS to allow NTAE & USDA quick report-generation.OBJECTIVE 5Methods:Identify metrics/data to be publicly accessible with input from core partners, AC, and USDA.Develop interfaces, report generation, searchable databases, and data visualization for Grantees to access data; aggregate data for USDA and other key stakeholders to retrieve relevant information.Educate and train end users of publicly accessible data how to access and use relevant information from RVS (end users may include Grantees, advisory committee, USDA, advocates, other stakeholders).Develop congressional reports (beginning in FY 2020) with key results and funds used.OBJECTIVE 6 Methods:Site visits with FFN, NGA, and FMC to identify how T&TA is being delivered.Build model that summarizes provision and receipt of T&TA (process outcomes fordeliveryof T&TA and effectiveness outcomes forrecipients).Collect relevant data to conduct multilevel analyses on core functions of T&TA model.Develop iterative reporting and feedback loops to T&TA providers to improve potential impact.Methods for T&TA OBJECTIVE 1Methods:Conduct 1:1 phone calls with each Grantee, develop relationships and assess T&TA needs.Research, select, and build out web-based T&TA hub to house resources and comprehensively serve needs of Grantees.Maintain and manage hub, staff help desk, spur conversation and provide consultation in online forum, and categorize inquiries to improve accessibility and reduce redundancy.Develop tools and templates and assist Grantees with tailoring and adapting to specific needs (e.g., signage, communications, recordkeeping).Develop training modules, tutorials, documentation, and workshops for cashiers, produce managers, store managers, farmers market staff, and health care staff.Schedule, design, and deliver monthly webinars on timely and relevant topics featuring content area experts and best-in-class Grantees (e.g., local sourcing, shopper engagement, point-of-sale (PoS)).Develop menu of T&TA consultation services in conjunction with core partners and content-area consultants.Coordinate and deliver site visits and consultations. Track and manage services usedto inform future contracts and expectations with core partners.Design, develop, and launch consumer-facing website to promote GusNIP opportunities to SNAP shoppers and other potential participants, and easily connect them with participating sites.OBJECTIVE 2 Methods:Inventory existing technology-enabled systems and solutions used by participating retailers. Document pros and cons and package effective solutions so that they can be replicated.Create turnkey integrated solutions for 2 brick and mortar (B&M) PoS systems and 1 farm-direct technology-enabled systems.OBJECTIVE 3Methods:Work with produce suppliers, regional food system experts, and B&M retailers to develop a variety of templates (tailored to context and seasonality) to track and report local and regional sourcing.Design and deploy local and regional sourcing learning track for regional convenings to co-create and share best practice tools and documentation.Develop and facilitate local and regional sourcing community of practice to design and share best practice tools and documentation.OBJECTIVE 4 Methods:Maintain and manage online T&TA hub, cultivate exchanges among Grantees through email listserv and digital forum, and tag/archive threads of conversation for accessibility and reduced redundancy.Plan and facilitate annual national T&TA Grantee conference.Develop, convene, and maintain communities of practice for farmers market managers, B&M retailers, health care staff, local produce suppliers, farm-direct incentive practitioners, B&M incentive practitioners, and produce prescription practitioners to design and share best practice tools and documentation.OBJECTIVE 5 Methods:Plan, coordinate, and execute five regional convenings per for Grantees, retailers, produce distributors, regional food system practitioners, state agencies, health care providers, insurance agencies, nutrition education programs, funders, legislators, and cooperative extension services.Leverage NTAE Advisory Committee, core partners, and content-area consultants to build relationships between Grantees and applicable state agencies to ensure sustainable projects.Collaborate with USDA to provide clarity on rules and regulations for GusNIP and SNAP. Field questions from Grantees and provide to USDA in a structured way.Coordinate and deliver strategic presence at 10-20 relevant industry conferences annually.Coordinate and implement annual Nutrition Incentives Conference to attract key stakeholders and industry experts to the field.Convene annual funders conference to create network effect and spur greater investment.OBJECTIVE 6 Methods:Convene Grantee & Participant Advisory Group (GPAG) twice per year. Once in person (during national or regional convening) and once virtually.Identify cross-cultural gaps and challenges of outreach and training materials (i.e., language barriers, graphic representation, etc.) and adapt materials for inclusiveness as needed.Work with advisory committee and GPAG to review and adapt T&TA hub, trainings, convenings and materials for cultural inclusivity, appropriateness, and relevance.OBJECTIVE 7 Methods:Dictate parameters for Start-up and Innovation Fund microgrants, including priorities, timeline, and scoring rubric with input from GPAG and core partners.Review proposals with GPAG and core partners; administer 5-15 awards of $50k-$100k each year.Document/highlight use of funds and innovation of best practices through white papers, case studies, newsletters, and webinars.

Progress 09/01/19 to 08/31/24

Outputs
Target Audience:Current and prospective GusNIP grantees are the primary audience. Other key audiences broadly include NI and PPR practitioners (including past FINI grantees) and other partners and/or policymakers (members of Congress/House of Representatives via annual report to Congress). The NTAE also engaged with several audiences to achieve program goals and objectives, including retailers, produce distributors, regional food system practitioners, health care and insurance providers, nutrition education providers, point-of-sale (POS) companies, Cooperative Extension, funders, evaluators/researchers, USDA NIFA and FNS, as well as applicable state agencies. Changes/Problems:In Y1 of GusNIP there were two major problems that impacted both expenditure of funds and the research schedule. First, funding from USDA NIFA for all GusNIP grantees (including the NTAE) was delayed. Subsequently, this delayed the planned activities of the NTAE lead (CNHI) and subrecipient organizations, including contract initiation, hiring, and implementation of planned project activities to varying degrees. Similarly, GusNIP grantees funded through the GusNIP 2019 RFA (n=22) faced significant delays in GusNIP project work, including hiring, data collection, and collaborative work with community organizations. Second, the COVID-19 pandemic unfolded during the Y1 reporting period. Due to travel restrictions and risk associated with in-person events, the NTAE canceled the in-person GusNIP national convening scheduled for March 2020 in Salt Lake City and instead held that and other meetings remotely (GusNIP core partner and advisory committee meetings). Similarly, assistance with data collection and overall program evaluation support was conducted virtually or postponed. Due to these unanticipated issues associated with the COVID-19 pandemic, the NTAE determined that the Y1 evaluation was best accomplished through the utilization of qualitative methods to better assess the challenges and opportunities faced by grantees this year. Additionally, most grantees halted or greatly reduced participant-level and firm-level data collection. While some grantees continued to manage existing projects through the funding and COVID-19 delays, many new projects had to push back their start date significantly. In Y2, the pandemic continued to present challenges for the NTAE and across GusNIP grantees. Although COVID-19 safety protocols were better understood and strategies to mitigate the spread in the context of NI/PPR projects and society in general were implemented, resulting interruptions were long-standing and challenged GusNIP program implementation, reporting, and evaluation. Despite vaccines being rolled out in many communities across the U.S., social distancing and business closures continued. In conjunction, variants of COVID-19 emerged during this reporting period, which reinforced the need to continue efforts to limit contact. Throughout this time, the NTAE has remained patient and flexible with grantee data collection and reporting, particularly around the participant-level surveys. Several activities were affected by social distancing practices including site visits with grantees, the Nutrition Incentive Hub National Convening, and participant-level data collection. In Y3, the changing nature of the COVID-19 pandemic continued to present challenges for the NTAE and across all GusNIP grantees. Despite new safety protocols in place, rapidly changing circumstances in the number of cases and respective guideline updates continued to impact GusNIP project implementation, leading to some reporting and evaluation challenges. During this time, the NTAE could not conduct field visits with grantees for a portion of the reporting period (September - March 2022) as originally planned. Field visits resumed April 2022 in accordance with public health recommendations. To help manage onboarding of new grantees to GusNIP in the absence of in-person field visits, virtual onboarding calls were conducted between the NTAE and grantees. For the third year in a row, the NTAE forwent in-person convenings and virtually conducted the Nutrition Incentive Hub National Convening. PPR projects were particularly impacted by COVID-19. Many of the collaborating clinical partners were overwhelmed with COVID-19 testing, caring for patients with COVID-19, and vaccine distribution which inhibited their ability to enroll participants and collect survey or clinical data. Finally, with the addition of GusNIP COVID-19 Relief and Response (GusCRR) funding, an influx of new projects and add-ons to existing projects required additional R&E and TA&I support. The NTAE and Nutrition Incentive Hub addressed emerging issues through planning webinars, disseminating resources, and hiring staff to support the rise in need. In Y4, with the addition of GusCRR and ARPA funding mechanisms to the GusNIP portfolio of awards, the NTAE had to remain flexible and adapt in the following ways: 1) Adapted support services to maintain excellent service to applicants, grantees, partners, and participants with an increasing number of projects funded by GusNIP, GusCRR, and ARPA; 2) Enhanced the portal data collection processes to capture funding sources and accurately report core firm-level metrics; 3) Adapted and advanced 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; 4) Supported and accommodated the large influx of new PPR grantees and awards funded through ARPA and GusCRR; and 5) Sourced and developed methodologies to map firm locations with various base layers to report on reach and representativeness of GusNIP/GusCRR/ARPA projects. In Y5, 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 the project period, GusNIP NTAE staff enhanced work-related skills and knowledge through professional development and learning opportunities. Online courses focused on software skill-building, project management, and cultural sensitivity training. DEI workshops included "Racism and Other Macrosocial Determinants of Health: Moving from Explanation to Action", "Equity in Communications Workshop," and "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 (program advisors, supervisors, project managers, research associates, and research scientists) also led and/or participated in several CNHI professional development groups to foster information sharing, mentoring, and team building across roles. NTAE staff sought further education across a broad span of topic areas by attending virtual and in-person seminars and traveling to professional conferences. Topic areas included population-specific data disaggregation, nutrition for various non-communicable diseases, agricultural policy, enhancing food systems/food security, and weight stigma. The list below highlights significant professional development and learning activities that the broader Nutrition Incentive Hub engaged in throughout the award period. Online Courses SPSS Masterclass: Learn SPSS From Scratch to Advanced Fundamentals of Statistical Literacy, Colorado School of Public Health Project Management Essentials with Certified Associate Project Manager Prep Spatial Data Science: The New Frontier in Analytics (Esri course) Smartsheet-Control Center Training; Building Effective Dashboards; Dashboard in a Day Causal Diagrams: Draw Your Assumptions Before Your Conclusions Being an Ally in Indian Country Workshops GusNIP Theory of Change Workshops Indigenous Food Sovereignty and Health Symposium Taking Flight: DiSC Assessment Training Racism and Other Macrosocial Determinants of Health: Moving from Explanation to Action Equity in Communications Workshop Being Who We Say We Are: Negotiating Power and Building Relationships in Food Systems Research Conferences/Meetings American Public Health Association Annual Meeting & Expo, 2020, 2021, 2024 International Society for Pediatric and Adolescent Diabetes, 2020 NOPREN & HER Annual Meeting, 2020, 2023, 2024 Racial Equity Leadership: Building Multi-Racial Movements for Equity and Justice in the New Advancing Food Is Medicine Approaches Summit 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 Inaugural Symposium: Cultivating Health in a Changing World - Cardiovascular Health and Wellness National Institutes of Health (NIH) Advancing Health Equity Through Culture-Centered Dietary Interventions to Address Chronic Diseases First Americans Land Grant Consortium 18th Annual Conference, October 2021 Health and Human Services (HHS) Inaugural Food is Medicine Summit: Building a Dynamic Future Webinars and Seminars Building America's Nutrition Security Infrastructure Weight Stigma, graduate seminar, University of Georgia Dept of Nutrition Sciences Nutrition and Obesity Policy Research and Evaluation Network (NOPREN) State of the Science - Food is Medicine in 2023 Food Justice, Equity, Diversity, and Inclusion (JEDI) in Nutrition Incentives Summer Webinar Series - Sessions 1-4 SOIL Carving Out Space for BIPOC Farming National Academies-Advancing a Food Systems Approach to Prioritize Healthy People and a Healthy Planet Question Wording and Response Sets for Disaggregated Racial/Ethnic Data Disparity to Parity: Environmental Resilience through Agriculture Policy SNEB Fall Journal Club: Impact of a Prescription Produce Program on Diabetes and Cardiovascular Risk Outcomes Webinar Food Literacy for All 2022 Lecture Series (Freedom, Food, & Fat; The Role of Weight Bias on Health Outcomes) USDA Programs, Investments, and Innovations to Prevent and Reduce Food Loss and Waste Risk to Resilience: Encouraging Girls' Physical and Mental Health Through Nutrition 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 Professional Development Groups Consultant Program Advisors Project Managers & Project Coordinators Research Associates Registered Dietitian Nutritionists Research Scientists Supervisors How have the results been disseminated to communities of interest?A comprehensive and multifaceted communication strategy was used to disseminate GusNIP NTAE results to diverse audiences using various formats. Each year, a detailed communication plan was developed to deliver intentional messages to key audiences. This included highlighting grantee and project achievements tied to specific observations relevant to their work. Press releases, crafted in collaboration with various departments and organizations, were shared on the Nutrition Incentive Hub website and distributed to broader media contacts. Additionally, manuscripts and other publications were actively promoted on NTAE social media platforms to engage a wider audience. A biweekly newsletter was distributed, featuring upcoming events, key accomplishments, and inspiring stories and learnings from the GusNIP community. These efforts ensured that the research findings and associated activities were effectively communicated to, and engaged with, the broader community. Lastly, the yearly Impact Findings report was widely shared via email, press releases, website promotions, and social media. Each year, these findings were translated into a digestible executive summary and infographic to be distributed to various audiences. What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

Impacts
What was accomplished under these goals? Accomplishments during the NTAE grant period, including the provision of TA support to GusNIP NI/PPR grantees for project planning and implementation, and advising and evaluation related to the collection of core measures used to understand the impact of GusNIP on NI/PPR participants, firms, and communities, led to changes in knowledge, action, and condition. The NTAE processes resulted in notable learnings that advanced the science and practice of GusNIP NI/PPR projects and their impact on communities. NTAE support provided to grantees led to actionable changes for efficient and effective NI/PPR project planning and implementation. As a result, the NTAE demonstrated improvements to participant outcomes, NI/PPR project growth across the U.S., and the substantial influence of GusNIP on local economies. GOAL 1: OBJ 1: Pioneered an NTAE advisor model to support grantees (1:1 and group cohorts) through the lifecycle of their award Standardized internal grantee tracking systems and NTAE advisor training protocols Prepared and disseminated 231 individualized impact reports for grantees Funded 186 GusNIP awards with stipends to support participant data collection Conducted 50+ formal and informal grantee field visits to build relationships, provide implementation, reporting/evaluation support, and support substudies Created the External Evaluators Community of Practice (CofP), hosting 14 meetings OBJ 2: Assembled NTAE Master Contact List of GusNIP collaborators Created core minimum datasets and optional participant metrics Participant surveys available in 10 languages (Arabic, English, French, Korean, Russian, Simplified Chinese, Somali, Spanish, Traditional Chinese, Vietnamese) Created the Searchable Resource Library, a searchable database of gray literature and GusNIP resources Developed 500+ instructional and supplementary resources for GusNIP applicants and grantees on a wide range of topics Created/refined the GusNIP NTAE Style Guide OBJ 3: Published Congressional/Impact Findings Reports and public-facing companion pieces for Y1-Y4 Published 23 peer-reviewed manuscripts Delivered 100+ presentations at national/regional conferences Developed data use agreement for PPR projects Finalized grantee resources with content experts (e.g., Theory of Change for PPR, Healthcare Provider Survey, Healthcare Utilization Pilot Survey, letter templates to IRBs) Developed an Economic Impact Calculator tailored to NI projects Implemented a healthcare utilization pilot survey with 19 grantees to assess self-reported healthcare utilization Initiated 12 substudies (e.g., Electronic Health Records [EHR], DEI, farmers, FV intake assessment), with some leveraging GusNIP funding to secure external awards (i.e., Bloomberg Philanthropies/UIC, ADA, RWJF, and AHA) OBJ 4: Established a secure, online portal for grantees' monthly and yearly data (119,708 monthly reports and 321 grantee/11,483 firm annual reports) Optimized portal use through standardized grantee onboarding, dashboards with reporting requirements, refined filters/data exports, trainings, 1:1 meetings, and support materials Developed individualized impact report templates Developed project reach timelapse video and interactive GusNIP site map for NI/PPR projects layered with data on poverty thresholds, low-income low access, race/ethnicity, and veteran status OBJ 5: Launched a public website with periodic new features, such as searchable resource library, discussion groups, Grantee Projects Interactive Map, the GusNIP Site Map, the Nutrition Incentive Economic Impact Calculator, events/webinars page, and a GusNIP Impact Findings Report landing page OBJ 6: Established a TA tracking system through Zendesk with add-on data visualization features Disseminated quarterly TA reports for core partners Collected grantee feedback (n=158) through the TA Annual Survey Conducted quality improvement interviews with TA providers and recipients to inform TA services OBJ 7: Integrated GusCRR grantees into existing systems, while ensuring separate tracking capabilities Enhanced the advising consultant team to meet increased demand of GusCRR grantees Provided TA support (1:1 and group) for GusCRR proposals and grantees Determined participants reached and incentives distributed/redeemed among GusCRR grantees GOAL 2: OBJ 1: Resolved 6,200+ TA requests, 2750+ hours of support to 1300+ practitioners Provided 322 hours of direct TA for RFA support through virtual meetings to 1370+ individuals among 836 organizations Developed/hosted 89 webinars including 32 GusNIP RFA support webinars Launched a Farm Direct Nutrition Incentives Guide the Grocer Resource for Nutrition Incentives website Archived 435 resources on the Nutrition Incentive Hub website across 10+ content areas OBJ 2: Coordinated GusNIP grantees and industry experts to agree upon and publish point of sale (POS) functionality requirements for NI/PPR Led sign-on letter with 1000+ signatures to streamline POS data for retailers Provided TA support to states implementing EBT integration (e.g., CA, RI, WA), and hosted EBT Integration Work Group meeting (45 attendees from 10 states) Hosted monthly EBT integration and Farm Direct CofP Collaborated with FNS SEMTAC team to help grantees implement online SNAP Clarified policies with USDA FNS to resolve requests for online SNAP for non-traditional retailers (e.g., food hubs) OBJ 3: Launched a 7-week-long local sourcing learning cohort with 11 grantees Published national case study on how food hubs support NI/PPR projects Interviewed grantees (n=37) and reported about local & regional sourcing models Supported GusNIP applicants to incorporate local sourcing into applications Supported NGAF student case study competition focused on local sourcing OBJ 4: Maintained set of online tools/platforms to grow virtual community (Zendesk: 500+ organizations, Mailchimp: 2,400+ subscribers) Provided 100+ scholarships for grantees to attend national conferences and convenings Contracted with specialists to lead 8 CofPs, 3 learning cohorts, webinars, & resource creation related to NI/PPR work OBJ 5: Hosted 4 National Convenings (One hybrid, 3 virtual) Facilitated communication among grantees, USDA, NIFA, FNS (e.g., SNAP policy guidelines, online SNAP, Last 4 digits of EBT number, GusNIP RFA resource feedback) Sponsored multiple conferences to expand presence Hosted 5 mini convenings to increase peer-to-peer learning (PPR, scaling programs, working with healthcare partners, land/food/culture) Developed sessions for 2 NGA Shows Facilitated Rural Grocery Summit conference session hosted at at the University of Nebraska-Lincoln OBJ 6: Launched Participant Engagement Learning Cohort where 9 grantees developed community engagement projects and received $66,400 in mini grants Hosted a 4-part Food Justice, Equity, Diversity, and Inclusion (JEDI) summer webinar series and DEI podcast Offered DEI tracks and learning sessions at National Convenings in 2020-2023 Supported GusNIP applicants working with Tribes by including NTAE program advisors with experience working with Native communities in required 1:1 sessions Provided TA to 2 NI awardees in Puerto Rico, increased knowledge of NAP policy and operations, and successfully advocated for the GusNIP RFA and webinars to be available in Spanish OBJ 7: Awarded $3.75M to 171 grantees through the Capacity Building and Innovation Fund Developed RFA resources to support lower capacity organizations in GusNIP applications Leveraged guidance for meeting GusNIP administrative requirements based on 2022-2023 USDA NIFA administrative review feedback Hosted COVID-specific coffee hours/sessions at National Convening, and awarded $300K in mini-grants to 31 organizations to support innovations/adaptations in response to COVID Hosted webinar with the Indigenous Food and Agriculture Initiative to share information about GusNIP, and hosted webinar highlighting GusNIP grantees work in Tribal communities

Publications

• Type: Other Status: Submitted 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
• Type: Other Status: Submitted Year Published: 2024 Citation: GusNIP NTAE. Gus Schumacher Nutrition Incentive Program (GusNIP): Year 4 Impact Findings: 2022 to August 31, 2023. Prepared for U.S. Department of Agriculture, National Institute of Food and Agriculture; 2024. https://www.nutritionincentivehub.org/media/ev5aet4n/year-4-gusnip-impact-findings-report-2024.pdf
• Type: Peer Reviewed Journal Articles Status: Published 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: Published 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: Published Year Published: 2024 Citation: Long C, Yaroch A, Byker Shanks C, 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: Published 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: Published 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: Published Year Published: 2024 Citation: Houghtaling B, Zhang N, Yaroch A, et al. 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: Peer Reviewed Journal Articles Status: Published Year Published: 2024 Citation: Banerjee T, Levi R, Basu S, et al. Preferences for food vouchers among adults with low incomes. J Hunger Environ Nutr. 2024;112. doi:10.1080/19320248.2024.2383753
• Type: Other Journal Articles Status: Under Review Year Published: 2024 Citation: Byker Shanks C, Izumi B, Eastman J, et al. 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: Reynolds M, Byker Shanks C, Yaroch A, et al. 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: Other Journal Articles Status: Under Review Year Published: 2024 Citation: 1. 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: Other Journal Articles Status: Under Review Year Published: 2024 Citation: Byker Shanks C, Fung Uy, Zhang N, et al. Nutrition incentives improve participant outcomes: 2020-2023 results from the United States Gus Schumacher Nutrition Incentive Program (GusNIP). Under Review. AJPM Focus. 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. 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: 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.

Progress 09/01/22 to 08/31/23

Outputs
Target Audience:Current and prospective GusNIP grantees are the primary audience for the GusNIP NTAE. Other key audiences include NI and PPR practitioners more broadly (including past FINI grantees) and other partners and/or policymakers (members of Congress/House of Representatives via annual report to Congress). In addition, the NTAE engages with several groups to help achieve program goals and objectives, including retailers, produce distributors, regional food system practitioners, health care and insurance providers, nutrition education providers, point-of-sale (POS) companies, cooperative extensions, funders, evaluators/researchers, USDA NIFA and FNS, and applicable state agencies. 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 so many grantees, 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 the process 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 4 of GusNIP, 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 scientists. 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) International Conference on Diet and Activity Methods (Limerick, Ireland) International Society of Behavioral Nutrition and Physical Activity (Uppsala, Sweden) 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. Offered a data walk during the Annual Convening-a unique and interactive way to share data with participants, originally developed by the Urban Institute. Data from the 2023 Technical Assistance (TA) Annual Survey were presented on the walls between panel locations to encourage discussion among attendees. As part of the data walk, attendees voted on TA priorities in 2024 based on challenges identified in 2023 TA Annual Survey. 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 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 5 (Y5), the NTAE will continue promoting and 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 maintaining our website and secure portal and promoting the new Economic Impact Calculator for NI projects. We will continue to improve data visualization and storytelling through PowerBI dashboards, ArcGIS maps and StoryMaps, and grantee dashboards. We will support new and existing grantees through 1-on-1 advising and centralized, broader-reach offerings. We will continue to offer networking opportunities to foster peer support and shared learning among grantees. Finally, we will continue to disseminate GusNIP results through peer-reviewed manuscripts and evaluation reports. The following summarizes Y5 activities/products organized by goal/objective: GOAL 1: OBJ 1: Identify, develop, implement, and promote feasible and meaningful best practices for R&E Continue to refine and implement PA model for ongoing/new GusNIP/GusCRR/ARPA projects to guide grantees in meeting R&E requirements Provide individualized TA for R&E with new GusNIP applicants as needed Help grantees meet annual sample size for participant survey completion for FY19-23 GusNIP/GusCRR/ARPA projects Conduct statistical analyses for FY19-23 GusNIP, GusCRR and ARPA projects pertaining to firm/participant-level outcomes Disseminate individualized reports for FY19-23 GusNIP, GusCRR, and ARPA grantees Continue stipend funding to support participant survey collection Conduct evaluation-focused mini convenings and/or group field visits OBJ 2: Develop clearinghouse of resources to build grantee R&E capacity and inform the field Continue to promote the core minimum dataset to assess impact across NI/PPR projects at firm/participant levels, with minor refinements to firm-level reporting structure Continue to refine/promote optional participant-level metrics in response to grantee evaluation goals Continue to promote non-English translations of the core participant-level surveys Modify and pilot existing measurement tools for program partners (e.g., farm direct, grocery store, health care providers) Continue to develop, update, and disseminate tools and resources through public website (www.nutritionincentivehub.org) OBJ 3: Augment grantee self-evaluation to address knowledge gaps Interpret/disseminate Y4 (2022-2023) impact/process results in annual Congressional Report and a public-facing Impact Findings Report Continue to identify knowledge gaps in NI/PPR literature and develop/implement additional evaluation strategies, such as: 2 quasi-experimental sub-studies (as funds permit) using a control group and more rigorous measures to provide robust NI/PPR impact results 1-2 case studies focused on novel methodologies or priority population groups Peer-reviewed manuscripts on the impact of GusNIP to advance NI/PPR fields Additional research approaches to explore non-hypothesis-driven research (e.g., scoping literature reviews, exploratory qualitative studies) OBJ 4: Develop and manage online reporting systems for grantees and firms Continue refinement of secure portal to support all aspects of project, meet NTAE and USDA goals, and meet needs of various audiences (e.g., grantees, external partners, practitioners, clinicians, funders, policymakers) Continue to enhance reporting tools and associated resources for ease of use Continue to improve upon data visualization solutions via PowerBI dashboards, ArcGIS maps and StoryMaps, and grantee dashboards Continue to offer training sessions, demonstrations, and support materials for partners, grantees, firms, and TA providers to maximize portal utilization Develop comprehensive maintenance procedures for managing the portal OBJ 5: Develop and manage public website for dissemination and community engagement Continue updating public-facing website with GusNIP program information, results, and a wide range of resources Disseminate/promote Nutrition Incentive Hub webinars/events Publish partner/grantee data sharing agreement and request process Maintain/enhance resources toolkit and the Searchable Resource Library Update website pages with new design, widgets, and content Train partners, grantees, firms, and TA providers on new website feature OBJ 6: Evaluate TA&I by maintaining a feedback loop with partners Activities for this objective were achieved during years 1-4 of the GusNIP NTAE and no additional activities are proposed for Y5. OBJ 7: IntegrateGusCRR granteesintoexisting processesfor R&E Continue to support GusCRR and ARPA grantees within existing systems and processes while ensuring separate tracking mechanisms for GusNIP, GusCRR, and ARPA cohorts Provide GusCRR- and ARPA-specific findings within annual reports Provide individual grantee reports for GusCRR and ARPA projects based on grantees' preferences GOAL 2: OBJ 1: Increase funds used to deploying best practice tools and resources Continue providing high-touch one-on-one TA support responding to an average of 250 requests per quarter Develop new resources with a particular focus on EBT integration/eHIP, mobile markets, local sourcing, and online SNAP OBJ 2: Leverage collective demand to develop new technology-enabled solutions Finalize the technical requirements developed by the PPR Standards Workgroup and disseminate to the field Finalize PPR technology resources OBJ 3: Support local and regional produce sourcing in B&M retail Finalize local sourcing report and food hub case study Modify and relaunch Local Sourcing Learning Cohort OBJ 4: Support a grantee shared learning Disseminate 2024 TA survey to grantees to inform and shape TA resources and strategies for the coming year Continue facilitating 4 communities of practice (Produce Prescription; Nutrition Education; Incentives in Corner Stores; Brick-and-Mortar) Launch Farm Direct Technology Community of Practice and facilitate an existing EBT Integration Community of Practice (initially developed outside the Nutrition Incentive Hub) Continue facilitating State Funding Learning Cohort Onboard FY24 GusNIP grantees (co-facilitate Nutrition Incentive Hub kick-off webinar; conduct TA-specific onboarding webinars in the areas of produce prescriptions, farm direct, and brick-and-mortar retail) OBJ 5: Strengthen collaboration among key stakeholders to leverage capacity and align resources Coordinate 1-2 regional mini convenings Continue to facilitate communication among grantees, USDA, NIFA, and FNS OBJ 6: Include the diverse perspectives to shape culturally appropriate T&TA Based on feedback from grantees, relaunch Participant Engagement Learning Cohort as a shortened "design sprint" to wrap up the DEIA-focused learning cohort, "Self and System Change" OBJ 7: Build capacity in high-need communities and foster innovation Provide high-touch support to recipients of the Capacity Building and Innovation Fund grants aimed at building capacity to apply for the 2024 GusNIP application Continue refining and expanding RFA support for 2024

Impacts
What was accomplished under these goals? In year 4 (Y4) of GusNIP, the NTAE implemented novel systems to support additional grantees with new and multiple funding sources. 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 and project objectives, effectiveness, and reach. GOAL 1: To develop systems, infrastructure, and collaborative relationships using a community-informed approach to support grantees' R&E efforts while building sustainability and capacity. Y4 R&E focused on improving systems to support grantees. Highlights included: engaged grantees in a new cohort advising model; improved firm/participant datasets; published 4 manuscripts; launched and promoted the Economic Impact Calculator for NI projects. OBJ 1: Identify, develop, implement, and promote feasible and meaningful best practices for R&E Implemented/improved NTAE advisor model (e.g., grantee onboarding, IRB assistance, survey tailoring, centralized firm-level advising) Standardized internal grantee tracking systems (via Smartsheet) and NTAE advisor training protocols Distributed individualized impact reports for projects that opted in to receiving a report (N=58) Funded 33 GusNIP grantees to support participant data collection via stipends Developed in-person field visit request protocol Maintained External Evaluators Community of Practice Provided 230 RFA consultations to 2023 GusNIP applicants OBJ 2: Develop clearinghouse of resources to build grantee R&E capacity and inform the field Maintained NTAE Master Contact List of GusNIP collaborators Refined/promoted core minimum datasets Developed resources to guide grantee data collection (e.g., Common Survey Modifications) Promoted participant surveys in 10 languages Conducted annual grantee reporting compliance review Refined optional participant metrics Expanded Searchable Resource Library on public website Provided R&E-focused support to NI and PPR applicants OBJ 3: Augment grantee self-evaluation to address knowledge gaps Published Y3 Congressional/Impact Findings Reports and public-facing companion pieces (i.e., executive summary, infographics, press release, social media toolkit) Developed 4 peer-reviewed manuscripts (see Products) Presented at 16 national/regional conferences (see Products) Developed a data use agreement for PPR projects Finalized grantee resources with content experts including, Theory of Change for PPR; Healthcare Provider Survey; Healthcare Utilization Pilot Survey Finalized the Economic Impact Calculator tailored to NI projects Implemented a healthcare utilization pilot survey with 19 grantees to assess self-reported healthcare utilization OBJ 4: Develop and manage online reporting systems for grantees and firms Improved individualized impact report templates in PowerBI Developed GIS maps using Y3 firm locations and the ACS poverty base layer Developed a grantee project timelapse video to showcase GusNIP reach Optimized portal use through standardized grantee onboarding, improved dashboards with overview of reporting requirements, improved functionality of filters/data exports, trainings, 1:1 meetings, and support materials (e.g., Portal Pro Tips) Created and shared PowerBI reports for NIFA and core partners OBJ 5: Develop and manage public website for dissemination and community engagement Developed new website features (e.g., reporting dashboard features) Disseminated resources, trainings, webinars, and events to grantees/practitioners Updated grantee projects interactive map to include funding streams Deployed communications to promote website utilization (e.g., newsletters, social media) Provided trainings, demos, and support materials to optimize website use Developed a dedicated webpage to house the Y3 GusNIP Impact Findings report and companion pieces Monitored and maintained user feedback (n=462 submissions) OBJ 6: Evaluate TA&I by maintaining a feedback loop with partners Continued TA tracking in Zendesk with add-on data visualization features Adapted quarterly TA reports for TA&I partners Redesigned and administered the TA Annual Survey OBJ 7: IntegrateGusCRR granteesintoexisting processesfor R&E Updated portal to capture firm-level metrics by award type Determined average number of NI participants reached monthly (estimated) during Y4 by award type Determined total PPR participants reached during Y4 by award type Determined additional incentives attributed to GusCRR grantees GOAL 2: To maximize the effectiveness and efficiency of GusNIP projects in meeting GusNIP priorities, increasing FV purchases, and improving the nutrition of participating households. Y4 TA&I focused on meeting grantee needs while continuing to build support systems, tools, and curricula for broad-reach and centralized support/information sharing. OBJ 1: Increase funds used to deploying best practice tools and resources Resolved 1,500+ TA requests, 600+ hours of support to 400+ practitioners GusNIP RFA support: Provided 148 hours of direct TA through virtual meetings to 431 unique individuals representing 390 organizations Developed/hosted 19 webinars including 11 GusNIP RFA webinars OBJ 2: Leverage collective demand to develop new technology-enabled solutions Began a PPR Standards Workgroup to develop a uniform set of standards for grocery retail point-of-sale (POS) technology Continued participation in California Electronic Benefit Transfer (EBT) integration calls Started planning TA offerings around EBT integration and Electronic Healthy Incentives Pilot (eHIP) Responded to emergent requests around online SNAP for non-traditional retailers (e.g., food hubs) and clarified policy with USDA FNS OBJ 3: Support local and regional produce sourcing in B&M retail Began a case study on how food hubs support NI and PPR projects Launched a 7-week-long local sourcing learning cohort with 11 grantees OBJ 4: Support a grantee shared learning Maintained set of online tools/platforms to grow virtual community (Zendesk: 500+ organizations, Mailchimp: 2,000+ subscribers) Continued operating 7 communities of practice Provided scholarships for grantees to attend the National Convening (N=65), 2 mini convenings (N=40), and the NGA Show (N=9) Farm Direct team contracted with FairShare CSA Coalition for CSA-specific TA Began planning for mobile market-specific TA offerings OBJ 5: Strengthen collaboration among key stakeholders to leverage capacity and align resources Hosted 3rd National Convening in hybrid format in Arlington, VA (see question 3 for details) Hosted 2 mini convenings (one for NI and one for PPR grantees) to increase peer-to-peer learning Facilitated communication among grantees, USDA, NIFA, FNS (e.g., SNAP policy guidelines, online SNAP, FY23 RFA resource feedback) Developed sessions for NGA Show (e.g., Retailer Experiences, Being Incentive Ready) Conveyed GusNIP TA available to National Produce Prescription Policy Collaborative OBJ 6: Include the diverse perspectives to shape culturally appropriate T&TA Launched the Participant Engagement Learning Cohort (PELC) where 9 grantees developed community engagement projects and received mini grants Launched a 4-part series learning cohort, "Self and System Change", to continue DEIA training and deepen community collaborations Disseminated the 2023 TA survey to inform TA offerings (N=88 across 86 unique organizations and 36 States) Engaged grantees in resource review to ensure alignment and relevance with their needs OBJ 7: Build capacity in high-need communities and foster innovation Awarded $900k to 45 grantees in round 5 of the Capacity Building and Innovation Fund (focused on building capacity among prospective GusNIP applicants) Developed RFA resources to support lower capacity organizations in GusNIP applications Worked with a consultant to provide specific support for meeting GusNIP administrative requirements

Publications

• Type: Journal Articles Status: Published 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 Programs (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: Published 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: Published 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: Published 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

Progress 09/01/21 to 08/31/22

Outputs
Target Audience:Current and prospective GusNIP grantees are the primary audience for the GusNIP NTAE. Other key audiences include NI and PPR practitioners more broadly (including past FINI grantees) and other partners and/or policymakers (members of Congress/House of Representatives via annual report to Congress). In addition, the NTAE engages with several groups to help achieve program goals and objectives, including retailers, produce distributors, regional food system practitioners, health care and insurance providers, nutrition education providers, point-of-sale (POS) companies, cooperative extensions, funders, evaluators/researchers, USDA NIFA and FNS, and applicable state agencies. Changes/Problems:In Y3, the changing nature of the coronavirus pandemic continued to present challenges for the NTAE and across all GusNIP grantees. Although COVID-19 safety protocols were in place during Y3, rapidly changing circumstances in the number of cases and respective guideline updates impacted GusNIP program implementation, leading to some reporting and evaluation challenges. Throughout this time, the NTAE has needed to remain patient and flexible with grantee data collection and reporting. Several activities were affected: The NTAE could not conduct field visits for a portion of the reporting period (September - March 2022) with grantees as originally planned. Field visits resumed April 2022 in accordance with public health recommendations. To help manage onboarding of new grantees to GusNIP in the absence of in-person field visits, onboarding calls via Zoom or telephone were conducted between the NTAE (specifically PAs) and grantees. The NTAE applied an adaptive model, where PAs worked with grantees to meet R&E requirements and to help build capacity through regular check-in calls. The NTAE made the necessary decision to conduct the Annual Nutrition Incentive Hub Convening virtually for the third year. The convening was held January 18-20, 2022 with 41 sessions, 120 speakers, and approximately 1,172 attendees. National and regional convenings were virtual until March 2022 and, following, resumed to in-person or hybrid format. Participant-level data collection was conducted in Y3, but has been intermittent for some grantees due to COVID-19 continuing to impact project implementation and data collection. PAs worked with each grantee to tailor the participant survey and develop strategies to help grantees meet evaluation goals and requirements. Many GusNIP projects operate primarily throughout the summer and early fall months (seasonality of locally grown produce) and as such, many grantees do not necessarily complete the full participant-level survey sample by August 31 of the reporting year. The NTAE plans to analyze and report on outcomes from all participant-level surveys, regardless of when the data were collected (e.g., roll over into Y4 reporting). The NTAE has planned for oversampling among grantees that have higher levels of capacity. PPR projects are particularly impacted by COVID-19 as many of the collaborating clinical partners are overwhelmed with COVID-19 testing, caring for patients with COVID-19, and vaccine distribution. Therefore, several clinical partners have been stymied in their ability to enroll participants and collect survey or clinical data. Some PPR projects have experienced delays in collecting data (e.g., Electronic Health Record, healthcare use, clinical measures) due to internal organizational impediments with data sharing. The NTAE partnered with external researchers to develop a Health Insurance Portability and Accountability Act (HIPAA) guide to help grantees navigate some of the associated challenges. With the addition of GusNIP COVID-19 Relief and Response (GusCRR) funding from the recent stimulus package, an influx of new projects and add-ons to existing projects required additional R&E and TA&I support. The NTAE and Nutrition Incentive Hub addressed emerging needs through planning webinars, disseminating resources, and hiring staff to support the rise in need. Updates to Objectives As GusNIP reporting and evaluation (R&E) processes and activities have developed during the first three years of the grant, we have updated our objectives and associated work to meet the needs of grantees and the field at large. The following table includes revised language for each of the objectives and an explanation of the updated language: Objective 1 Revised language Continue to identify, develop, implement, and promote current best practices and processes for reporting and evaluation (R&E) that are feasible, meaningful, and demonstrate impact across a variety of GusNIP audiences and collaborators (e.g., grantees, participants, farmers, grocers, healthcare providers). Updates Originally, objective 1 covered the formative evaluation work of identifying and describing current best practices in reporting and evaluation of NI and PPR projects using a "bottom up" approach. Since Y1, the R&E team has expanded this objective to include training grantees and collaborators on how to plan and conduct evaluations of GusNIP projects. To accomplish this objective, the R&E team created a program advisor (PA) model whereby PAs promote current best practices, build evaluation capacity, and offer tailored R&E guidance. The R&E team formalized the PA role through a detailed PA training/onboarding process and accompanying PA manual. Objective 2 Revised language Develop a clearinghouse of resources (e.g., protocols, guides, training videos) to guide grantees and build their capacity in R&E and inform the field on progress made with GusNIP projects. Updates We have modified this objective by expanding the focus around identifying and defining core and optional metrics to include promoting the use of core and optional metrics among grantees and continuously developing and refining the suite of R&E resources available. Training grantees how to access and use the portal has moved under objective 4. Work related to determining grantees' participant-level survey sample size has moved under objective 1. Objective 3 Revised language Augment grantee self-evaluation to address discrete knowledge gaps by producing scientific reports and peer-reviewed literature through quantitative and qualitative data collection with a subset of grantees. Updates We are clarifying this objective to include any activities and deliverables advancing the science of NI and PPR. We are including the development of the Congressional Report and the public-facing GusNIP Impact Findings Report under the work of this objective. Thus, data analysis and interpretation of our core metrics datasets will fall under the methods of this objective. Objective 4 Revised language Develop and manage an online reporting system to collect and compile data and outcomes from grantees and their firms displaying aggregate grantee outcomes. Updates We are updating the name of our online reporting system from the previous "RVS" to the current "web portal" since partners and plans have changed since pre-award. We are expanding this objective beyond developing the online web portal to managing the web portal and training grantees and relevant partners on how to use and maintain accurate reporting during and after the current NTAE grant cycle. Objective 5 Revised language Develop and manage a public website that disseminates aggregated grantee data, fosters community engagement, and provides resources. Updates We are expanding this objective to include additional features developed for our website which will foster peer-to-peer information sharing and resource dissemination such as discussion boards and the Searchable Resource Library. We are specifying that aggregate data are shared via the public-facing GusNIP Impact Findings Reports on the website in addition to other aggregate data displays such as grantee maps. We are moving methods/outputs related to developing the Congressional Reports under objective 3. Objective 6 Revised language Evaluate TA&I by identifying gaps in TA services provided and creating/maintaining a feedback loop with TA&I partners for continuous improvement. Updates We are expanding this objective to include continuous quality improvement resulting from TA&I evaluation. Objective 7 (NEW) Original Integrate GusCRR grantees into existing processes established for GusNIP grantees, including collecting, monitoring, and reporting core minimum firm-level and participant-level metrics, while completing separate reporting and evaluation for each distinct grant program, as capacity and funding allow. What opportunities for training and professional development has the project provided?During Y3, NTAE staff and consultants sought professional development and learning opportunities to enhance knowledge and skills related to their work. This list includes professional development and learning activities that the broader Nutrition Incentive Hub engaged in. Some key examples of online courses completed included those covering study designs and statistics. The Executive Director completed a 5-week media training course. Another team member initiated self-study on scrum meetings and received a Certified Scrum Master (CSM) certification. As part of the Gretchen Swanson Center for Nutrition employee development system, many senior staff mentored junior team members on a variety of topics, including data collection, manuscript development, consulting with grantees, and other R&E activities. Also, during this reporting period, staff participated in a variety of virtual conferences, seminars, workshops, and webinars for ongoing learning and networking in relevant topic areas. A detailed list of all training and professional development opportunities is provided below: Online Courses: -Study Designs course at Colorado School of Public Health -Fundamentals of Statistical Literacy at Colorado School of Public Health -Media Training (5 week session) Self-Study -Completed workshop and took test to successfully receive Certified Scrum Master (CSM) Certification Workshops -Reporting in Qualtrics -Tips and Tricks for writing NIH Proposals -Indigenous Food Sovereignty and Health Symposium -NIH Workshop: Food Insecurity, Neighborhood Food Environment, and Nutrition Health Disparities: State of the Science - 3 day workshop - 9/21/21 - 9/23/21 -Advancing Health Equity Through Data Disaggregation - 2/9/22 Conferences -American Public Health Association Annual Meeting and Expo, October 2021 -Adobe Max Conference: DEI and 508/Accessibility Sessions, October 2021 -First Americans Land Grant Consortium 18th Annual Conference, October 2021 -Food & Ag Data Convening Day 1 - Nutrition Research and Assistance Programs, November 10, 2021 -Food & Ag Data Convening Day 2 - Nutrition Research and Assistance Programs, November 16, 2021 -Nutrition Incentive Hub 2022 National Convening, January 2022 -National Grocers Association Show, February 2022 -England Food System and Beyond, February 2022 -National Anti-Hunger Policy Conference, March 2022 -Society for Behavioral Medicine Annual Convening, April 2022 -PBH 2022 Consumer Connection Conference, April 2022 -Racial Equity Leadership: Building Multi-Racial Movements for Equity and Justice in the New Webinars and Seminars -National Institutes of Health (NIH) Virtual Seminar on Program Funding and Grants Administration -Society of Nutrition Education & Behavior (SNEB) Fall Journal Club: Impact of Food Insecurity Nutrition Incentives on Household Fruit and Vegetable Expenditures -SNEB Fall Journal Club: Impact of a Prescription Produce Program on Diabetes and Cardiovascular Risk Outcomes Webinar -NIH Rural Health Day -Comparison of the Potential to Use Automated Self-Administered Recall System (ASA24) to Replace the Nutrition Data System for Research (NDSR) Dietary Assessment Tool in Estimating Added Sugar Intake -The Role of Racial Equity in SNAP-Ed Part 2: Authentic Resident Engagement as a model to advance equity -Food Literacy for All 2022 Lecture Series (Freedom, Food, & Fat; The Role of Weight Bias on Health Outcomes) -Food Policy Networks conference (Johns Hopkins University) -Food Is Medicine Research Action Plan Launch -Weight Stigma, graduate seminar, University of Georgia Dept of Nutrition Sciences -Honoring and Celebrating Black History Month: The Role of Registered Dietitian Nutritionists and Other Allied Health Professionals. -Doctoral Dissertation Defense: The Utilization of Sensory Eval Methodology to Examine the Acceptability of Recipes within Federal Nutrition Education Programs, UGA/Dept of Nutrition -Secretary's release of the USDA's Blueprint for Nutrition Security -Research Designs to Account for Diversity and Inclusiveness and Impact Food Guidance Policy -Many Voices, One Goal: Next Steps in Advancing Health Equity -Doctoral Thesis Defense: Improving the Healthfulness of SNAP: Assessing The Impact Of Fruit and Vegetable Incentives on Retailers and Customers across Diverse Retail Environments -MPH Thesis Defense (Yaroch, Preceptor): Nutrition Incentive Hub Local and Regional Sourcing -Smartsheet Webinar Series: Project Management, Sheets Recording, Collaboration, Intro to Salesforce Connector, Essential Formulas, and Intro to Control Center -Food Justice, Equity, Diversity, and Inclusion (JEDI) in Nutrition Incentives Summer Webinar Series - Sessions 1-4 -The New Normal: How Local and Regional Food Systems are Leveraging Lessons of COVID for Current and Future Disruptions -Brick & Mortar Team Onboarding Webinar for 2021 GusNIP Grantees -Farm Direct Team Onboarding Webinar for 2021 GusNIP Grantees -2021 GusNIP Grantee Onboarding: Produce Prescription Projects -GusNIP Listening Session -Considerations for Incorporating Stakeholder Values into Nutrition Incentive Program Local & Regional Sourcing Efforts -USDA - Strengthening Partnerships across the Food and Healthcare System to Improve Food and Nutrition Security -Potential Technology Solutions for Implementing Produce Prescription Programs -Building Effective Partnerships for Produce Prescription Programs -Addressing Nutrition and Food Access in Medicaid -Leading with Empathy, Developing Managers with Compassion -Making lemonade out of local lemons: Innovative multi-sector strategies for leveraging emergency supply chain funds -SOIL Carving Out Space for BIPOC Farming -Just Sustainabilities in Policy, Planning and Practice -Disparity to Parity: Environmental Resilience through Agriculture Policy -Cultivating Food Justice Panel Series at the American Association of Geographers -County Health Rankings and Roadmaps 2022 Release How have the results been disseminated to communities of interest?Program results have been disseminated to communities of interest through webinars (See Section 8 "Other Products" for a complete list), convenings (See "Other Products"), 1-on-1 calls, website resources and information, biweekly digest emails for NI and PPR practitioners and grantees, numerous topical and interest groups on a NTAE-hosted Slack communications platform (transitioned to discussion boards during this reporting period), and media relations. In addition, we: -Virtually hosted the 3-day National Nutrition Incentive Hub Convening with robust participation from 1,172 participants across 10 tracks, 41 sessions, and featuring 120 speakers. -Participated in the Food is Medicine Expert Panel sponsored by the Centers for Disease Control and Prevention and RTI International. -Delivered oral presentations at the National Institute of Health Virtual Workshop, Grantmakers in Health Nutrition Incentives Webinar, Produce for Better Health Webinar, Society of Behavioral Medicine Annual Meeting, Consumer Connection Annual Conference, and several GusNIP RFA Webinars. -Represented the NTAE at the National Grocers Association Show. There were 4 sessions on nutrition incentives. -Disseminated information on the Nutrition Incentive Hub 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. Social media serves as a virtual space for the public to learn about our network of local practitioners and national experts across the fields of NI (including SNAP incentives) and PPR. -Conducted media pitching and participated in media interviews with a nutrition security op-ed in The Hill, a produce prescription interview in Civil Eats and GusNIP Year 2 Impact Findings in Food Environment and Reporting Network's Ag Insider, Successful Farming, and Politco's Weekly Ag Newsletter. What do you plan to do during the next reporting period to accomplish the goals?In Year 4, the NTAE will continue promoting and 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 through refinement of our new website and secure portal. We will support potential, new, and existing grantees through 1-on-1 advising and centralized, broader-reach offerings. We will continue to offer networking opportunities to foster peer support and shared learning among grantees. Finally, we will apply for the next NTAE award, submit an NCE for Y5, prepare for a warm hand-off of NTAE products/learnings if needed, and prepare for a cumulative year 1-4 evaluation report during the NCE period. The following summarizes Y4 activities/products organized by goal/objective: GOAL 1: OBJ 1 -Continue to refine and implement PA model for ongoing/new GusNIP/GusCRR projects to guide grantees in meeting R&E requirements -Provide individualized TA for R&E with new GusNIP applicants as needed -Help grantees meet annual sample size for participant survey completion for FY 2019-2022 GusNIP/GusCRR projects -Conduct statistical analyses for FY 2019-2022 GusNIP and GusCRR projects pertaining to firm/participant-level outcomes -Disseminate individualized reports for FY 2019-2022 GusNIP and GusCRR grantees -Continue in-person field visits and stipend funding to support participant survey collection OBJ 2 -Continue to refine/promote the core minimum dataset to assess impact across NI/PPR projects at firm/participant levels -Continue to refine/promote optional participant-level metrics in response to grantee evaluation goals -Continue to refine/promote non-English translations of the core participant-level surveys -Modify and pilot existing measurement tools for program partners (e.g., farm direct, grocery store, health care providers) -Continue to develop, update, and disseminate tools and resources through public website (www.nutritionincentivehub.org) OBJ 3 -Interpret/disseminate FY 2019-2022 impact/process results in annual Congressional Report and a public-facing Impact Findings Report -Continue to identify knowledge gaps in NI/PPR literature and develop/implement additional evaluation strategies, such as: 2 quasi-experimental substudies as funds permit (using a control group and more rigorous measures) to provide robust NI/PPR impact results 3-5 case studies focused on novel methodologies or priority population groups Peer-reviewed manuscripts on interim impact of GusNIP to advance NI/PPR fields Additional research approaches to explore non-hypothesis-driven research (e.g., scoping literature reviews, exploratory qualitative studies, evaluation of Capacity Building Innovation Fund grant proposals questions) OBJ 4 -Continue refinement of secure portal to support all aspects of project, meet NTAE and USDA goals, and meet needs of various audiences (e.g., grantees, external partners, practitioners, clinicians, funders, policymakers) -Continue to enhance reporting tools and associated resources for ease of use -Continue to improve upon data visualization solutions via PowerBI and grantee dashboards -Continue to offer training sessions, demonstrations, and support materials for partners, grantees, firms, and TA providers to maximize portal utilization -Develop comprehensive maintenance procedures for managing the portal OBJ 5 -Continue updating public-facing website with GusNIP program information, results, and a wide range of resources -Disseminate/promote Nutrition Incentive Hub webinars/events -Publish partner/grantee data sharing agreement and request process -Maintain/enhance resources toolkit and the Searchable Resource Library -Update website pages with new design, widgets, and content -Enhance Grantee Project Map functionality -Create features for events management (e.g., webinar registration) -Train partners, grantees, firms, and TA providers on new website features OBJ 6 -Continue quarterly TA reports and discuss reports with TA&I partners as needed. Quarterly reports include data from 1:1 TA request and completion from Zendesk, and other forms of TA not captured in Zendesk (e.g., webinars, convenings, peer-to-peer engagement, communities of practice) -Conduct interviews with TA recipients and potential TA recipients to inform TA efforts -Collaborate with FFN to conduct the TA annual survey with GusNIP/non-GusNIP practitioners -Develop Zendesk dashboards through the "explore" feature to inform TA reach and best practices OBJ 7 -Continue to support GusCRR grantees within existing systems and processes while ensuring separate tracking mechanisms for GusNIP and GusCRR cohorts -Provide GusCRR specific findings within annual reports -Provide individual grantee reports for GusCRR projects based on grantees' preferences GOAL 2: OBJ 1 -Continue providing high-touch one-on-one TA support responding to an average of 250 requests per quarter -Develop new resources with a particular focus on fundraising, mobile markets, local sourcing, and online SNAP -Host new webinars OBJ 2 -Build on technology work in Y3 to distribute funds to develop turnkey solutions OBJ 3 -Identify and onboard new local sourcing partner to assist with local sourcing benchmarking goals -Reconfigure local sourcing community of practice OBJ 4 -Disseminate 2022 TA survey to grantees to inform and shape TA resources and strategies for the coming year -Coordinate regional convenings (4 planned covering a range of topics: PPR, rural incentive programs) -Continue facilitating 6 communities of practice (Produce Prescription; Nutrition Education; Incentives in Corner Stores; Local and Regional Sourcing; Diversity, Equity, and Inclusion; Brick and Mortar) -Continue facilitating 3 Learning Cohorts (State Funding for Nutrition Incentives; EToken; CSAs) -Onboard FY2022 GusNIP grantees (Co-facilitate Hub kick-off webinar; Conduct TA specific onboarding webinars in the areas of Produce Prescriptions, Farm Direct, and Brick and Mortar Retail) OBJ 5 -June 2023 - Annual convening - hybrid event -Sponsor 5 events towards strategic presence goals -Facilitate communication among grantees, USDA, NIFA, and FNS OBJ 6 -Implement Participant Engagement Learning Cohort - group meetings, grantee projects, and resources will take place and be completed by June 2023 -Reorganize DEI subcommittee and community of practice with new partner -Develop specific resources for Tribal communities and communities using NAP (e.g., Puerto Rico) OBJ 7 -Award $1 million through the 5th round of the Capacity Building and Innovation Fund -If approved by Office of General Council, provide Capacity and Building and Innovation Fund to organizations preparing to apply for GusNIP -Conduct outreach to potential GusNIP applicants in under-represented communities and geographies (e.g., tribal communities, specific states and territories) -Identify new strategies and supports for established organizations focused on sustaining and scaling their projects

Impacts
What was accomplished under these goals? In Y3, the NTAE worked with grantees to adapt operations due to continued COVID-19 challenges. Grantees worked to meet increased demand for their programs and tailored their approach to evolving systems level changes (e.g., food supply, health care, technology). One area of support for both Technical Assistance and Innovation (TA&I) and Reporting and Evaluation (R&E) was helping GusNIP and GusCRR grantees develop tools and systems to meet reporting requirements. GOAL 1: To develop systems, infrastructure, and collaborative relationships using a community-informed approach to support grantees' R&E efforts while building sustainability and capacity. Y3 R&E focused on improving systems to support grantees. Highlights included: firm- and participant-level data collection, analysis, and reporting; 9 published manuscripts; creation of new resources; public website and web portal updates. OBJ 1 - Implemented/improved program advisor (PA) model (e.g., IRB assistance, survey tailoring/automation, firm-level reporting) - Developed internal grantee tracking systems (via Smartsheet) and PA training protocols for standardization - Distributed individualized impact reports of participant/firm outputs for all active projects (N=45) - Funded grantees to support participant data collection (stipends) and reporting healthcare utilization/costs (PPR small grants) - Developed in-person field visit request protocol - Launched External Evaluators Community of Practice and External Evaluators Working Group OBJ 2 - Maintained NTAE Master Contact List of GusNIP collaborators - Refined/promoted core minimum datasets - Developed resources to guide grantee data collection (e.g., Portal Pro Tips, Rybbon Set-Up) - Translated participant surveys into 8 languages - Developed 'quick guides' for scoring/analyzing core metrics - Developed internal grantee reporting compliance protocols - Refined 'optional' participant metrics - Launched Searchable Resource Library on public website - Implemented data sharing agreements (TA&I partners, grantees) OBJ 3 - Published Y2 Congressional and Impact Findings Reports with firm/participant-level outcomes - Developed several case studies, reviews, and manuscripts (see "Products") - Presented at 10 national conferences (see "Products") - Added template interview guides to qualitative methods resource - Finalized grantee resources developed in tandem with content experts: Theory of Change for NI; Commentary on EHR abstraction; 5 briefs on Navigating Patient Privacy Information/HIPAA - Managed new/ongoing contracts for grantee resource development (e.g., utilizing EHR data, economic impact) OBJ 4 - Developed individualized impact report templates in PowerBI - Enhanced data collection (i.e., portal, Qualtrics) and data visualization systems (i.e., PowerBI) - Optimized portal use with a communication plan, trainings, 1:1 meetings, and support materials (e.g., Portal Pro Tips) - Convened grantee panel for feedback on portal and reporting improvements - Built data visualization tools for USDA-NIFA and partners OBJ 5 - Developed/implemented new website features (e.g., discussion groups, Searchable Resource Library - Disseminated resources, trainings, webinars, and events to grantees/practitioners - Refined Grantee Projects interactive map - Deployed communications to encourage website utilization across audiences - Provided training, demos, and support materials for optimized website use - Monitored and maintained user feedback (n=462 submissions) OBJ 6 - Continued TA tracking in Zendesk with add-on data visualization features - Developed dashboards within Zendesk - Developed/adapted quarterly TA reports for TA&I partners - Redesigned TA Annual Survey (to be administered summer 2022) OBJ 7 - Presented three onboarding webinars for GusCRR grantees (see "Other Products") - Co-hosted drop-in sessions with FFN to help separate GusCRR reporting - Determined participant survey sample sizes for GusCRR projects - Integrated GusCRR grantees into NTAE systems while differentiating GusCRR reporting GOAL 2: To maximize the effectiveness and efficiency of GusNIP projects in meeting GusNIP priorities, increasing FV purchases, and improving the nutrition of participating households. Y3 TA&I focused on meeting grantee needs while continuing to build support systems, tools, and curricula for broad-reach and centralized support/information-sharing. OBJ 1 - Resolved 1000+ TA requests, 550+ hours of support to 200+ practitioners (including prospective grantees to fulfill NTAE consultation requirements) - Developed/hosted 19 webinars - Developed resources across multiple categories (see "Products") - Launched a Farm Direct Nutrition Incentives Guide Site: www.farmdirectincentives.guide OBJ 2 - NGAF coordinated GusNIP grantees and industry experts to reach consensus on point of sale (POS) functionality requirements - Continued participation in California Electronic Benefit Transfer (EBT) integration calls - Organized 2021 NGA Show booth highlighting NI and PPR project and POS solutions - TFT/NGAF researching loyalty-driven NI project technologies (AppCard, ECRS) - TFT/NGAF exploring coupon/card-based PPR models (Snap2Save, INCOMM) - PPR TA team surveyed PPR Community of Practice on technology successes/challenges to inform resource/webinar development and facilitated technology provider meetings (Healthiby, Epic, INCOMM, Fresh Connect) - Farm Direct team researched e-token solutions, launched e-token learning cohort - FMC hosted 7 technology conversations with farm direct managers, state agencies, leaders (key areas identified: e-tokens, data, scale-appropriate tech services) OBJ 3 - NGAF/MSU CRFS interviewed grantees (N=37) about local & regional sourcing and report, model, readiness tool are in development - NGAF facilitated local sourcing community of practice - Case study under development on how food hubs support NI and PPR projects OBJ 4 - Conducted TA-specific onboarding calls with GusCRR/GusNIP grantees -Maintained set of online tools/platforms to grow virtual community (Zendesk: 500+ organizations, Mailchimp: 950 subscribers) -Helped transition Slack to Discussion Groups in secure portal -Operating 7 communities of practice including newly created Brick & Mortar Retail group -Launched 3 new "Learning Cohorts:" State Funding for Incentive Programs, E-Tokens, CSAs -Provided scholarships for grantees to attend 2 NGA Shows (N=11 grantees) and 5th Native American Nutrition Conference (N=8 grantees) -Farm Direct team contracted with FairShare CSA Coalition for CSA-specific TA OBJ 5 -Hosted 3rd National Convening (1172 attendees, 41 sessions, 120 speakers) -Facilitated communication among grantees, USDA, NIFA, FNS (e.g., align with SNAP policy guidelines, collated FY21 RFA input, RFA resource feedback) -Sponsored conferences to expand presence (Virtual Food Policy Networks Conference, Rural Grocery Summit, Native American Nutrition Conference) -Developed sessions for NGA Show (e.g., retailer experiences, being incentive ready) OBJ 6 -FFN launching TA opportunity (June 2022): Participant Engagement Learning Cohort -MSU CRFS and DEI subcommittee created 4-part Food Justice, Equity, Diversity, and Inclusion summer webinar series (see "Products") -MSU CRFS created a DEI podcast, "Reaching for Equity in All Lives (REAL) Talks" -The Corner Store Community of Practice highlighted perspectives of small store owner community engagement -FFN used RFP processes to select 2 DEI consultants to develop trainings and inform communications OBJ 7 -Awarded $400k to 9 grantees in Round 3 of the Capacity Building and Innovation Fund -Developed RFA resources to support lower capacity organizations in GusNIP applications -Hosted webinar with the Indigenous Food and Agriculture Initiative to share information about GusNIP -Hosted webinar highlighting GusNIP grantees working in tribal communities

Publications

• Type: Journal Articles Status: Accepted Year Published: 2022 Citation: Ridberg, R., Nugent, N.B., Seligman, H., Byker Shanks, C., Yaroch, A. (In Press). A Case for Using Electronic Health Record Data in the Evaluation of Produce Prescription Programs. Journal of Primary Care and Community Health.
• Type: Journal Articles Status: Accepted Year Published: 2022 Citation: Yaroch, A.L., Byker Shanks, C., Fricke, H.E., Parks, C.A., Budd Nugent, N. (In Press). Financial incentives: potential of a policy innovation to promote fruits and vegetables intake and support food security. UN Nutrition.
• Type: Journal Articles Status: Published Year Published: 2022 Citation: Leng, K., Yaroch, A., Budd Nugent, N., Stotz, S., Krieger, J. (2022). How does the Gus Schumacher Nutrition Incentive Program Work? A Theory of Change. Nutrients, 14(10).
• Type: Journal Articles Status: Published Year Published: 2022 Citation: Stotz, S. A., Fricke, H., Perra, C., Byker-Shanks, C., & Yaroch, A. L. (2022). Successful Community Nutrition Incentive Program Data Collection during the COVID-19 Pandemic: A Case Study. Current developments in nutrition, 6(3), nzac025. https://doi.org/10.1093/cdn/nzac025
• Type: Journal Articles Status: Published Year Published: 2022 Citation: Shanks, C. B., Parks, C. A., Izumi, B., Andress, L., & Yaroch, A. L. (2022). The Need to Incorporate Diversity, Equity, and Inclusion: Reflections from a National Initiative Measuring Fruit and Vegetable Intake. Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j.jand.2022.01.011
• Type: Other Status: Published Year Published: 2021 Citation: GusNIP NTAE. (2021). Report to Congress, Gus Schumacher Nutrition Incentive Program Training, Technical Assistance, Evaluation and Information Center (GusNIP NTAE): Progress Report to Congress, Year 2: September 1, 2020 to August 31, 2021.
• Type: Other Status: Published Year Published: 2022 Citation: GusNIP NTAE. (2022). Year 2 GusNIP Impact Findings Report. A more detailed and public-facing version of the Year 2 Report to Congress.
• Type: Journal Articles Status: Accepted Year Published: 2022 Citation: Budd Nugent, N., Byker Shanks, C., Fricke, H., Stotz, S., Seligman, H., Ridberg, R., Akers, M., Yaroch, A. (In Press). Strengthening food sovereignty and health with produce prescription programs: A case study in two rural tribal communities participating in GusNIP. Journal of Agriculture, Food Systems, and Community Development.
• Type: Journal Articles Status: Published Year Published: 2022 Citation: Byker Shanks, C., Izumi, B., Parks, C. A., & Yaroch, A. L. (2022). Measurement of Fruit and Vegetable Intake Incorporating a Diversity, Equity, and Inclusion Lens. Comment on Di Noia, J.; Gellermann, W. Use of the Spectroscopy-Based Veggie Meter� to Objectively Assess Fruit and Vegetable Intake in Low-Income Adults. Nutrients 2021, 13, 2270. Nutrients, 14(4), 809. https://doi.org/10.3390/nu14040809
• Type: Journal Articles Status: Published Year Published: 2021 Citation: Parks, C. A., Mitchell, E., Byker Shanks, C., Nugent, N. B., Fricke, H. E., & Yaroch, A. L. (2021). Descriptive Characteristics of Nutrition Incentive Projects Across the U.S.: A Comparison Between Farm Direct and Brick and Mortar Settings. Inquiry : a journal of medical care organization, provision and financing, 58, 469580211064131. https://doi.org/10.1177/00469580211064131
• Type: Journal Articles Status: Published Year Published: 2021 Citation: Budd Nugent, N., Byker Shanks, C., Seligman, H. K., Fricke, H., Parks, C. A., Stotz, S., & Yaroch, A. L. (2021). Accelerating Evaluation of Financial Incentives for Fruits and Vegetables: A Case for Shared Measures. International journal of environmental research and public health, 18(22), 12140. https://doi.org/10.3390/ijerph182212140
• Type: Journal Articles Status: Submitted Year Published: 2023 Citation: Stotz, S., Nugent, N.B., Byker Shanks, C., Her, K., Yaroch, A. (Under Review). Produce Prescription Programs: Health Care Provider Experiences and Perspectives. Preventing Chronic Disease.
• Type: Conference Papers and Presentations Status: Other Year Published: 2022 Citation: Yaroch, A., OConnor, A., Pellegrin, E., Dhyberg, M., Khoo, C., Voreades, N. (2022, May 25). What Are The Different Approaches and Trends in Food as Medicine, Nutrition, Health & Wellness? Panel discussion with open Q&A at Food as Medicine Summit.
• Type: Conference Papers and Presentations Status: Other Year Published: 2022 Citation: Yaroch, A., Shanks, C., Powell, L. (2022, May 20). Carrot or Stick?: Incentives Versus Disincentives to improve dietary Behaviors in the United States. Debate at the ISBNPA annual meeting. ? Shanks, C. (2022, May 20). Incentives to Improve Dietary Behaviors: The Case for Financial Incentives for Fruits and Vegetables. Presented at the ISBNPA annual meeting.
• Type: Conference Papers and Presentations Status: Other Year Published: 2022 Citation: Kapsak, W., Wood, W., Yaroch, Y., Webster, M., Delaney, A., (2022, April 19). The Power of Habit: Something to Nosh On. Keynote panel presentation at PBH The Consumer Connection Annual Conference in Scottsdale AZ.
• Type: Conference Papers and Presentations Status: Other Year Published: 2022 Citation: Mason, T. (2021, November 9). How Retailers Can Get Involved in Nutrition Incentive Projects. Presentation during a meeting of the Food Industry Association Executives.
• Type: Conference Papers and Presentations Status: Other Year Published: 2022 Citation: Yaroch, A. (2022, February 15). Participated in the Food is Medicine Expert Panel meeting with CDC and RTI.
• Type: Conference Papers and Presentations Status: Other Year Published: 2022 Citation: Farmers Market Coalition. (2022, February 18). History of SNAP and Nutrition Incentives. Presented at Pick Tennessee Conference: SNAP Incentives Update.
• Type: Journal Articles Status: Other Year Published: 2022 Citation: Ecology Center. (2022, February 27 - March 3). SNAP and EBT and How to Grow Your Nutrition Incentive Program. Presented at California Small Farms Conference.
• Type: Journal Articles Status: Other Year Published: 2022 Citation: Farmers Market Coalition. (2022, February 28). Best Practices of EBT and Nutrition Incentives for Markets. Presented at Missouri Farmers Market Association Conference.
• Type: Conference Papers and Presentations Status: Other Year Published: 2022 Citation: Nutrition Incentive Hub 2022 National Convening (3rd annual) was hosted virtually 01/18/22 - 01/20/22 and included 41 sessions, 120 speakers, and 1,110 attendees. Attendees included current and past FINI / GusNIP grantees, their partners, funders, and other stakeholders. Selected presentations below: - Fulmer, N., Nutrition Incentives 101. - Bleich, S., Byker Shanks, C., Yaroch, A., Parks, C., Koenings, M. Leveraging Reporting and Evaluation to Elevate Impact: Welcome Remarks from the GusNIP NTAE, USDA NIFA and Keynote from Dr. Sara Bleich. - Parks, C. Scaling Up Produce Prescription Projects: How Implementation Science Can Inform Reporting and Evaluation. - Parks, C., Kone, A. Increasing Engagement with Food Retail using Data Visualization and Communication. - Kaminsky, T., Matzen, C., Hoh, R., McQuown, N.B., Garcia, H. New and Novel: Discover Interactive Resources for Nutrition Incentive and Produce Prescription Projects. - Byker Shanks, C., Mitchell, E. Demystifying the GusNIP Grantee Journey: Reporting and Evaluation Details for Potential Applicants. - Nugent, D., Landauer, R., Ridberg, R., Seligman, H. Navigating Electronic Health Records (EHR), Personal Health Information (PHI), and HIPAA Compliance in PPR Programmatic Evaluations. - Stotz. S., Seligman, H., Virudachalam, S., Kim, L., Berkowitz, S. Roundtable Discussion with the Experts: Utilizing Health Outcomes and Healthcare Cost. - Parker, H., Castille, C., Chitnis, P., Stluka, S., Zeng, S., Koenings, M., Kornegay, R., Morriss, S., Kerling, B., Smith, S., Hoh, R. Welcome Remarks from USDA NIFA Director, Dr. Carrie Castille & Open Discussion with NIFA Panel.
• Type: Conference Papers and Presentations Status: Other Year Published: 2022 Citation: Virudachalam, S., Kim, L., Seligman, H. (2022, April 28). Moving Beyond Food Insecurity: Produce Prescription Programs, Food is Medicine, and a Path to Food Equity. Presented at Pediatric Academic Societies Annual Meeting.

Progress 09/01/20 to 08/31/21

Outputs
Target Audience:Current and prospective GusNIP grantees are the primary audience for the GusNIP NTAE. Other key audiences include NI and PPR practitioners more broadly (including past FINI grantees) and other partners and/or policymakers (members of Congress/House of Representatives via annual report to Congress). In addition, the NTAE engages with several groups to help achieve program goals and objectives, including retailers, produce distributors, regional food system practitioners, health care and insurance providers, nutrition education providers, point-of-sale (POS) companies, cooperative extensions, funders, evaluators/researchers, USDA, and applicable state agencies. Changes/Problems:In year 2, the coronavirus pandemic continued to present challenges for the NTAE and across all GusNIP grantees. Although COVID-19 safety protocols were better understood during year 2, and strategies to mitigate the spread in the context of incentive programs and society in general were implemented, this unprecedented pandemic made the GusNIP program implementation, as well as reporting and evaluation challenging. Despite vaccines being rolled out in many communities across the U.S., social distancing and business closures continue to persist. In conjunction, variants of COVID-19 emerged during this reporting period, which reinforced the need to continue efforts to limit contact. Throughout this time, the NTAE has needed to remain patient and flexible with grantee data collection and reporting, in particular around the collection of the participant-level surveys. Since in-person activities remained postponed several activities were affected: The NTAE could not conduct site visits with grantees as originally planned. To help manage onboarding of new grantees to GusNIP in the absence of in-person site visits, onboarding calls were conducted between the NTAE (specifically PAs) with grantees, and relevant TA core partners. Hands-on assistance with data collection and overall program evaluation support was intended to take place during in-person site visits, and as such, the NTAE transitioned to a more adaptive model where PAs worked with grantees to inform and build capacity to help grantees meet R&E requirements through regular check-in calls. In-person site visits will not resume until it is safe to do so. Also, as noted in the "Other Products" section, the NTAE made the necessary decision to conduct the Annual Nutrition Incentive Hub Convening virtually for the second year. The convening was held March 10-11, 2021 with 40 sessions, 125 speakers, and approximately 1,000 attendees. National and regional convenings will continue to be virtual until they are safe to resume in an in-person or hybrid format. Participant-level data collection has been conducted in year 2, but has been slow due to COVID-19 continuing to impact program implementation as well as the ability to safely collect participant-level surveys. PAs worked with each grantee to tailor the participant survey. Currently, more than half of grantees are collecting surveys. To adapt to COVID-19 and social distancing requirements, grantees have used alternative methods of data collection; PAs have worked with grantees to establish protocols that allow for electronic, telephone, and other methods of survey data collection. Again, due to these delays, we anticipate having somewhat limited participant survey responses before the end of the program year. In addition, many GusNIP projects operate primarily throughout the summer and early fall months and as such, may not be able to complete the full survey sample by August 31, 2021 (i.e., cut off date for NTAE to obtain, clean, analyze and synthesize results for Y2 Report to Congress, due at the end of the calendar year). The NTAE still plans to analyze and report on outcomes from the participant-level survey, with some caveats on sample size, which will roll over into Y3 reporting. In addition, in order to achieve an adequate sample size for reporting the impact of GusNIP projects, the NTAE has been planning for some oversampling among grantees that have higher levels of capacity. PPR programs are particularly impacted by COVID-19 as many of the collaborating clinical partners are overwhelmed with COVID-19 testing, caring for patients with COVID-19, and vaccine distribution. Because of this, in several cases, clinical partners are stymied in their ability to enroll participants and collect survey or clinical data. With the addition of GusNIP COVID-19 Relief and Response (GusCRR) funding from the recent stimulus package, there will be an influx of new projects and add-ons to existing projects that will require additional R&E and TA support. The NTAE and Nutrition Incentive Hub are addressing this anticipated rise in need through planning for additional staff requirements (e.g., Program Advisor, reporting systems) with start dates for GusCRR grants occurring on or before August, 2021. What opportunities for training and professional development has the project provided?During Y2, NTAE staff and consultants continued to seek professional development and learning opportunities to enhance knowledge and skills related to their work. For example, several NTAE staff completed online courses covering data management and analysis software. Many team members initiated self-studies related to 508 compliance, and one team member participated in an online media training course. As part of the Gretchen Swanson Center for Nutrition employee development system, many senior staff mentored more junior team members on a variety of topics including data management, manuscript development, and other scientific activities. Also, during this reporting period, staff participated in a variety of virtual conferences, seminars, workshops, and webinars for ongoing learning and networking in relevant topic areas. A detailed list of all training and professional development opportunities is provided below: Online Courses: SPSS Masterclass: Learn SPSS From Scratch to Advanced Atlas.ti Intermediate Short Course at University of Colorado Causal Diagrams: Draw Your Assumptions Before Your Conclusions Smartsheet Learning Series Media Training Series Self-Study USDA's 508 Compliance Videos/Guide documents Workshops Aspen Institute Food Is Medicine (1st working session and follow up meeting on evaluation) GusNIP Theory of Change Workshops (consultant building NI Theory of Change model) Attendify Speaker Training Session Effective Writing for Scientific and Media Audiences Conferences American Public Health Association Annual Meeting & Expo, 2020 International Society for Pediatric and Adolescent Diabetes, 2020 NOPREN & HER Annual Meeting, 2020 Tufts Research and Data Symposium for Food and Nutrition, 2021 Harkin on Wellness, Food is Medicine Symposium, 2021 Chobani's Child Hunger Summit, 2021 Seminars University of Colorado Department of Pediatrics, monthly Nutrition Webinar Series Writing for Publication Information Series: Part I: Introduction to Publishing Your Work Question Wording and Response Sets for Disaggregated Racial/Ethnic Data NOPREN Monthly Meetings and NOPREN Food Security Working Group Academy of Nutrition and Dietetics Nutrition Education Taskforce Monthly Meeting Webinars Mainstreaming Produce Prescriptions: A Policy Strategy Report Building America's Nutrition Security Infrastructure USDA ART Hunger/Nutrition Listening Session GusNIP Supplemental Stimulus Funding Policy Forum GusNIP RFA webinar GusCRR RFA webinar How have the results been disseminated to communities of interest?Program results have been disseminated to communities of interest through webinars (See"Other Products" for a complete list), convenings (See "Other Products"), 1-on-1 calls, website resources and information, biweekly digest emails for NI practitioners and grantees, and numerous topical and interest groups on a NTAE-hosted Slack communications platform. In addition, we: Virtually hosted the 2-day National Nutrition Incentive Hub Convening with robust participation from 979 participants across 5 tracks, 40 sessions, and featuring 125 speakers(see agenda here for presentation specifics). Presented on the NTAE to the Centers for Disease Control and Prevention. Delivered oral presentations at the National Grocers Association Show, American Public Health Association Annual Meeting & Expo, the Nutrition & Obesity Policy Research & Evaluation Network annual meeting, the Healthy Eating Research annual meeting, Farmers Market InTents Conference, the GusNIP Core Partners Meeting, and several GusNIP RFA Webinars. Launched social media channels for the Nutrition Incentive Hub on Facebook and LinkedIn, bringing together the public, practitioners, grocers, farmers markets, produce wholesalers, industry technology, and USDA to facilitate information sharing and communication around Nutrition Incentive Hub events, webinars, and updates about GusNIP. Social media serves as a virtual space for the public to learn about our network of local practitioners and national experts across the fields of NI (including SNAP incentives) and PPR. What do you plan to do during the next reporting period to accomplish the goals?In Year 3, the NTAE will continue promoting and 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 through the launch and refinement of our new website and secure portal. We will support potential, new, and existing grantees through one-on-one advising and centralized, broader reach offerings. Finally, we will foster greater connectivity between grantees to build peer support networks and shared learning through networking opportunities. The following summarizes Y3 activities/products organized by goal/objective: GOAL 1: OBJ 1 Enhance Program Advisor (PA) model for ongoing GusNIP and new GusNIPCRR (GusCRR) and 2021 GusNIP projects. Calculate new sample sizes needed for GusCRR PRX and NI projects, as well as FY 2021 projects. Conduct statistical analyses for 2019-2021 GusNIP and GusCRR projects (n=~112) firm- and participant-level outcomes. Interpret and disseminate aforementioned results in the Year 2 Congressional Report, a public-facing technical report, and a public-facing summary brief. Create individualized reports for 2019-2021 grantees showcasing each project's progress, accomplishments, Y2 firm-level outcomes, and participant outcomes, where applicable. OBJ 2 Continue to refine and promote the core minimum dataset developed in Y1 to assess impact across NI and PPR projects, at both firm- and participant-levels. Translate the core participant-level surveys (NI, baseline and post PPR) into additional languages based on grantees' needs. Develop standardized surveys for various farm direct staff, grocery store staff, and health care providers, assessing the impact and feasibility of GusNIP projects among different partners. Continue to develop and disseminate tools and resources through the public website (www.nutritionincentivehub.org) to assist grantees in R&E processes and address expressed needs, e.g., navigating federal grants, firm-level data collection and reporting, project implementation. OBJ 3 Continue to identify knowledge gaps in NI and PPR literature and as a response, develop and implement additional evaluation strategies, including: Development of 3 -5 case studies focused on novel methodologies or priority population groups Development of peer-reviewed manuscripts to advance the NI and PPR fields more broadly Increased use of qualitative research methods to complement quantitative data OBJ 4 The fully operational secure portal will; 1.) support all aspects of the project, 2.) meet NTAE and USDA goals, and 3.) undergo refinement, informed by a panel of collaborators, to meet the needs of various audiences, e.g., grantees, external partners, practitioners, clinicians, funders, policymakers. Develop new reporting resources and update existing resources to accompany the web portal. Through automation, improve many data system functions including report verifications, data cleaning, and analysis. Incorporate data visualization and enhanced data analysis of GusNIP-wide aggregate data through PowerBI. Develop grantee- and firm-level dashboards. Offer training sessions, demonstrations, and support materials for partners, grantees, firms, and TA providers for smooth transition and utilization of the new secure portal. OBJ 5 Continue updating public-facing website with GusNIP program information, resources, and core partners. Disseminate and promote Nutrition Incentive Hub webinars/events for practitioners and grantees. Integrate the new Resource Library into the new website. Build and refine grantees interactive map. Create and promote peer-to-peer learning through online website/portal discussion groups. Train partners, grantees, firms, and TA providers on new website features. Implement strategic communications plan to launch, promote, and encourage utilization of the new website across all key audiences. OBJ 6 Continue quaterly TA reports and discuss reports at standing TA services subcommittee meetings. Evaluate other forms of TA not captured in Zendesk, e.g., webinars, convenings, peer-to-peer engagement, communities of practice. Conduct interviews with TA recipients and other non-recipients identified through communities of practice to learn how we can reach non-recipients through TA efforts. Continue monitoring feedback and engagement from core partners through a yearly survey. Conduct the TA annual survey with GusNIP and non-GusNIP practitioners. OBJ 7 Continue to integrate GusCRR grantees into existing systems and processes while ensuring separate tracking mechanisms for GusNIP and GusCRR cohorts. Hire additional R&E consultants as needed to meet the demand of onboarding GusCRR grantees and assisting GusCRR grantees in completing R&E requirements. GOAL 2: OBJ 1 Build capacity of GusNIP and GusCRR grantees through 1-1 intensive support Based upon findings from the annual TA survey, 1-1 calls and community of practice meetings: Develop calendar of webinars Create new tools, guides, templates and resources Create new opportunities for peer learning OBJ 2 Leverage foundational roadmap and call to action from Y2 to develop POS solutions that streamline the distribution, redemption, reporting, and reimbursing of incentives. Catalog and analyze PPR technology solutions. NGAF and PPR consultant will convene grantees and retailers around PPR POS solution development. OBJ 3 NGAF and CRFS will continue to develop a set of standards based on interviews held with grantees and their retail partners in Y2. Continue local sourcing community of practice. Develop new tools to support grantees and their retail partners in identifying local sourcing opportunities through food hubs and value chain coordinators. OBJ 4 Conduct onboarding calls with 2021 grantees to inform TA. Continue to refine Zendesk to streamline and track TA. Continue facilitating existing communities of practice, and launch new ones as needed. Analyze and disseminate 2020 annual survey results to increase grantee connectivity and advance the field. Conduct 2021 annual survey as an ongoing measure of group needs, and adapt based on lessons learned. Foster greater connectivity, learning and sharing amongst grantees through: In-person site visits and regional convenings Group discussion channels Monthly community of practice meetings Direct connections made by TA partners OBJ 5 Plan, grow, and launch 2022 National Nutrition Incentive Hub Convening. Explore hybrid in-person and virtual format to maximize participation and engagement. Plan and launch strategic presence at the 2021 NGA Show to attract and engage new retailers, POS companies, and produce distributors. Strategic presence includes a POS technology demonstration area and booth. Develop an internal facing strategy rubric to help assess and prioritize different opportunities amongst key stakeholders. Use rubric to select at least 5 conferences to attend. Share feedback with NIFA regarding any overarching grantee challenges or concerns regarding program implementation or RFA process. OBJ 6 Launch the Grantee Participant Advisory Council with leadership from the DEI subcommittee. Update the annual survey utilizing a DEI lens. Continue to facilitate DEI community of practice. OBJ 7 Grow and strengthen the FY22 GusNIP applicant pool: Conduct outreach to organizations who have not participated in GusNIP with a specific focus on Tribal communities. Identify opportunities to foster creative partnership development. Develop new resources/tools to support lower-capacity organizations to develop/implement successful applications. Facilitate the delivery of $1.02M in grants to build the capacity of high-need organizations. Develop resources/trainings to support grantees as they work to build retailer relationships.

Impacts
What was accomplished under these goals? In Y2, the NTAE worked with grantees to adapt operations in response to COVID-19, specifically helping grantees adjust to enormous spikes in demand for incentives and navigate reporting & evaluation (R&E). Beyond emergent needs, the NTAE continued to develop/launch systems/tools to support grantees in maximizing program effectiveness. GOAL 1: To develop systems, infrastructure, and collaborative relationships using a community-informed approach to support grantees' reporting and evaluation efforts while building sustainability and capacity. Y2 R&E activities focused on developing systems to support GusNIP grantees. Highlights include: development of a Program Advisor (PA) model; creation of resources; evaluation of technical assistance (TA); interim online reporting; and development of website and secure web portal (launch: Summer 2021). OBJ 1 Developed a Resource Library, searchable database of grey literature. Created/implemented a PA model (grantees assigned to R&E staff). PAs advise grantees on R&E processes. For standardization, manual of procedures was developed and trainings occurred. Conducted sample size calculations; developed individual sampling strategies with grantees. Conducted statistical analyses for 2019 grantees (n=19) firm-level outcomes (reported in Congressional/public-facing reports). Created individualized reports for 2019 grantees, showcasing outcomes. OBJ 2 Refined/promoted core minimum datasets (firm/participant-levels for NI and PPR). Developed/promoted Spanish-language versions (NI, PPR) of participant surveys. Developed surveys for youth/parent-child dyad focus and associated instructional document. Developed/disseminated tools/resources (e.g., training videos, protocols) through public website. Added COVID-19 core metrics (firm/participant-levels). Developed 'optional' metrics of relevant constructs. Developed resource, "GusNIP and the Benefits of Financial Incentives for Fruits and Vegetables." Developed resource, "GusNIP NTAE Style Guide" to ensure consistent language/branding. OBJ 3 Published one case study on implications of COVID-19 and online SNAP. Conducted two case studies (rural tribal programs, Electronic Health Records), under review. Developed 4 case studies (in process). Published one commentary, submitted another (under review) on GusNIP-related topics. Presented research results at national conferences (see "Other Products"). Developed qualitative methods guidelines with template interview guides and case study guidelines resource. Established contracts to develop grantee resources: Dr. Jim Kreiger, Healthy Food America, Dr. Ronit Ridberg, University of California Davis, Dr. Seth Berkowitz (consultant), Center for Health Law and Policy Innovation, Harvard Law School (CHLPI). OBJ 4 Continued to collect firm-level core metrics from grantees/firms using Smartsheet (interim system). Created trainings and provided 1:1 support. Created data visualization for grantees. Developed a streamlined system to export, securely store, and clean data prior to analysis. Developed data migration protocols to transfer data/content from Smartsheet to secure portal. Tailored Qualtrics participant surveys for grantees. Continued to develop/manage interim solutions for TA/R&E (e.g., Smartsheet, Zendesk, Qualtrics) and used learnings to inform new website. OBJ 5 Continued to manage existing website with added functionality (e.g., resources, trainings, events). Finalized scope of work with RBA, Inc. (10/1/21) for development of new public website and secure portal. Participated in over 50 meetings (discovery, design, testing) with RBA and Core Partners to inform final product. Initiated communications plan for new website and secure portal. Completed content migration (current to new website). Developed/oversaw processes to maintain 508 compliance. OBJ 6 Formalized TA tracking within Zendesk to capture characteristics of TA. Developed quarterly TA reports for core partners. Conducted key informant interviews with sample of TA providers/recipients. Findings presented to partners. Conducted TA Annual Survey (N=86) capturing project characteristics and needs for TA. Shared data with partners. OBJ 7 Attended/presented on USDA's GusCRR RFA Webinar (4/20/21). Reviewed GusCRR RFA, FAQs, and other communications. Began planning for integration of GusCRR grantees into existing systems, ensuring separate tracking for GusNIP/GusCRR cohorts. Hired R&E consultants to serve as PAs to meet demand of GusCRR grantees in completing R&E requirements. Provided R&E TA support for GusCRR proposals. GOAL 2: To maximize the effectiveness and efficiency of GusNIP projects in meeting GusNIP priorities, increasing FV purchases, and improving the nutrition of participating households. Y2 TA focused on meeting grantee needs as they adjusted to COVID-19 demands while continuing to build support systems. Tools and curricula for broad-reach, centralized support and information-sharing were developed and paired with 1-1 meetings with current/potential GusNIP grantees. OBJ 1 Resolved 1,000+ TA requests, provided 500+ hours of support to 200+ practitioners, including 60+ hours of GusNIP/GusCRR application support to 70+ organizations. Developed/hosted 8 webinars. Built/launched resource toolkit and TA offerings in 10 content areas. National Grocers Association Foundation (NGAF) launched a grocer-facing website with resources to support grocers/grantees implementing NI/PPR programs. OBJ 2 Farmers Market Coalition (FMC) and NGAF inventoried incentive technology solutions. Findings incorporated into resources to help grantees navigate point of sale (POS) technology. Selected industry expert to convene grantees and POS developers to co-create consensus-based functionality and reporting requirements for BM retail. The final product will be a roadmap to streamline distribution/redemption/reporting/reimbursement of incentives. NGAF led sign-on letter about streamlining POS data for retailers (over 1,000 signatures). OBJ 3 Developed local sourcing materials/resources. Conducted 25+ interviews to learn how practitioners are tracking/defining local sourcing. NGAF 2021 student case study competition focused on local sourcing, which will yield additional research on local procurement in BM. OBJ 4 Conducted TA onboarding calls with 2020 grantees. Completed 2020 annual survey (86 responses), first comprehensive national database of NI/PPR practitioners. Results analyzed/categorized/disseminated to increase connectivity and advance field. Created set of online tools/platforms to grow virtual community of practitioners: Grew Zendesk database (400+ organizations, 1,000+ individuals) Grew Mailchimp audience (500+ subscribers, Biweekly Digest) Grew Slack chat platform (200+ members, 15+ channels) Launched 5 communities of practice. OBJ 5 Drew 979 attendees to 2nd National Convening (40 sessions, 125 speakers). Facilitated communication among grantees, USDA, NIFA, and FNS. Facilitated discussion among grantees to identify considerations regarding GusCRR, submitted letter to USDA. Collected input from practitioners to identify key challenges with the FY21 RFA. Synthesized feedback to NIFA for consideration. Streamlined communication between FNS and grantees to clarify MOU processes. Sponsored/presented at Intents Farmers Market Conference. OBJ 6 Launched Diversity, Equity and Inclusion (DEI) subcommittee with all-partner representation. Developing DEI training for core partners and DEI-specific materials for grantee resource toolkit. OBJ 7 Awarded $850k to 28 grantees through Capacity Building and Innovation Fund (CBIF). Round 1focused on adapting programs during COVID-19. Round 2 focused on initiatives to expand program reach/community engagement/strengthen long-term sustainability.

Publications

• Type: Conference Papers and Presentations Status: Other Year Published: 2020 Citation: Parks, C.A., Stern, K. Nutrition Incentive and Produce Prescription Evaluation and Reporting. Oral presentation at the annual convening of the National Grocers Association, Feb 2020.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2021 Citation: Stotz SA, Nugent D, Castro D, Pinon R, Alvarez J. Community Health Workers and Promotoras as Nutrition Educators for USDAs Gus Schumacher Nutrition Incentive Programs (GusNIP). Program presentation accepted for 80-minute oral presentation at 2021 Society for Nutrition Education and Behavior Annual Conference, August 2021.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2021 Citation: Descriptive Characteristics of Nutrition Incentive and Produce Prescription Projects Across the United States Authors: Parks, C.A., Zhai, Y., Xu, T., Han, P., Mitchell, E., Kon�, A., Nugent, N., Fricke, H.E., Yaroch, A.L. accepted for oral presentation at 2021 International Society of Behavioral Nutrition and Physical Activity (ISBNPA) Conference, June 2021.
• Type: Conference Papers and Presentations Status: Other Year Published: 2021 Citation: Yaroch, A.L., Parks, C.A., Strengthening Access to Fruits and Vegetables: Improving Nutrition Incentive and Produce Prescription Projects through Training, Technical Assistance, Reporting, and Evaluation. Discussion Salon presented at the annual convening of Health Eating Research, March 2021.
• Type: Journal Articles Status: Published Year Published: 2020 Citation: Hingle MD, Shanks CB, Parks C, Prickitt J, Rhee KE, Wright J, Hiller-Venegas S, Yaroch AL. Examining Equitable Online Federal Food Assistance during the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Case Study in 2 Regions. Curr Dev Nutr. 2020 Sep 25;4(10):nzaa154. doi: 10.1093/cdn/nzaa154. PMID: 33073163; PMCID: PMC7543249.
• Type: Journal Articles Status: Published Year Published: 2020 Citation: Parks CA, Nugent NB, Fleischhacker SE, Yaroch AL. Food system workers are the unexpected but under protected COVID heroes. The Journal of Nutrition. 2020 Aug 1;150(8):2006-8.
• Type: Journal Articles Status: Under Review Year Published: 2021 Citation: Yaroch AL, Byker Shanks C, Nugent NB, Fricke H, Parks CA. Financial incentives: a key strategy to promote food and nutrition security. (under review, Am J of Prev Med).
• Type: Journal Articles Status: Under Review Year Published: 2021 Citation: Nugent NB, Byker Shanks C, Fricke H, Parks CA, Stotz S, Seligman H, Yaroch A. Accelerating evaluation of financial incentive programs: a case for shared metrics. (under review Health Affairs)
• Type: Conference Papers and Presentations Status: Other Year Published: 2020 Citation: Parks, C.A., Nugent, N., Fricke, H.E., Yaroch, A.L. Challenges and successes in developing common metrics and evaluation methods across grantees implementing nutrition incentive produce prescription projects. American Public Health Association (APHA) Annual Meeting, October 2020.
• Type: Conference Papers and Presentations Status: Other Year Published: 2020 Citation: Kimmelman, N., Hoh, R., Warren, A., Parker, H., Fulmer, N. Technical assistance & innovation by coalition  how diverse stakeholders are collaborating to help nutrition incentive programs maximize impact. American Public Health Association (APHA) Annual Meeting, October 2020.
• Type: Conference Papers and Presentations Status: Other Year Published: 2020 Citation: Chen, S., Tester, J., Goldman-Rosas, L., Emmert-Aronson, B., Chen, X., Ben-Moshe, K., Markle, E. Launching a data collaboration to support scaling and sustainability of a produce prescription project in Alameda County, California. American Public Health Association (APHA) Annual Meeting, October 2020.
• Type: Conference Papers and Presentations Status: Other Year Published: 2020 Citation: Smith, E., Kon�, A. How Mississippi can lead the charge for establishing redemption technologies across multiple point of sale systems. American Public Health Association (APHA) Annual Meeting, October 2020.

Progress 09/01/19 to 08/31/20

Outputs
Target Audience:GusNIP grantees are the primary audience for the GusNIP NTAE. Other key audiences include nutrition incentive practitioners in general (including past FINI grantees) and policymakers (via annual report to Congress). In addition, the NTAE engages with several groups to help achieve program goals and objectives, including retailers, produce distributors, regional food system practitioners, health care and insurance providers, nutrition education providers, point-of-sale (PoS) companies, cooperative extensions, funders, evaluators/researchers, USDA, and applicable state agencies. Changes/Problems:The NTAE experienced and adapted to the following changes and challenges during Y1: Funding from USDA NIFA for the NTAE was delayed. The period of performance is 9/1/2019 through 8/31/2020; funds were not received by GSCN until March 18, 2020. This delayed activities of the performing organization (GSCN) and subrecipient organizations, including contract initiation, hiring, and implementation of planned project activities to varying degrees among the organizations involved with the NTAE. Similarly, GusNIP grantees funded through the GusNIP 2019 RFA (n=22) faced significant delays in funding through USDA NIFA. All grantees were slated to have received their funding in late spring 2020. This has resulted in delays in GusNIP project work for the 22 grantees, including hiring, data collection, collaborative work with community organizations, etc. In early December 2019, one of the core partners included in the original project proposal, the University of Minnesota Center for Farm Financial Management (CFFM), notified GSCN that they were unable to follow through on the commitment to work as part of the GusNIP NTAE. The CFFM was slated to co-lead work to develop and implement the online reporting site to collect and compile data and outcomes for all grantees, as well as administer associated training and ongoing technical support to grantees. In the months after the CFFM withdrew from the project, the NTAE has pivoted to broaden and enhance its concept for a comprehensive web portal and public-facing website. During this reporting period, the NTAE formed a web portal/website working group to guide the project, engaged a technical consultant to assist with articulating and prioritizing project requirements and drafting a competitive RFP on which software design and architecture vendors could bid, solicited and reviewed proposals for the Discovery phase (requirements and solution definition and roadmap creation) of this project, and as of June 2020 selected a vendor, RBA Consulting, to carry out Discovery phase work. Web portal/website project work will begin in July 2020. Investments in incentive technology will likely not happen until 2021, after we have inventoried existing solutions, defined a vision for future technologies, prioritized areas for investment, and systematically selected appropriate vendors. Benchmarks associated with TA&I objectives 1-3 will likely be pushed back to 2021, when we have a solid data infrastructure in place. A consumer-facing website to connect SNAP shoppers with NI sites has also been delayed in service of the larger Hub web platform, which will be rolled out in 2021. The global coronavirus pandemic unfolded during the current reporting period. As COVID-19 has altered every aspect of life in society, reverberations have been felt throughout GusNIP NTAE project work. The NTAE has risen to the challenge, pivoting rapidly in March 2020 to begin to assess the experiences and needs of GusNIP grantees and other NI practitioners, develop a CoP and new communications channels to foster engagement and information sharing among and between GusNIP grantees and the NTAE. As noted in #1 above, the NTAE conducted site visits with several grantee organizations in Y1 before COVID-19 preempted further travel. Assistance with data collection and overall program evaluation support that was intended to take place during in-person site visits has moved to virtual or postponed until further notice. Because of these unanticipated issues, we determined that Y1 evaluation was best accomplished through the utilization of qualitative methods to better assess the challenges and opportunities faced by grantees this year, in light of funding delays and COVID-19. Also, as noted in #8 above, the NTAE made the necessary decision to cancel the in-person GusNIP meetings scheduled for March 2020, in Salt Lake City. The NTAE quickly re-tooled the GusNIP Core Partner and Advisory Committee meetings and NI Practitioner Convening to be held virtually via Zoom. In the face of the challenges and uncertainties all were facing due to COVID-19, the NTAE was able to provide a valuable service to GusNIP grantees and the larger NI practitioner community by convening 165 unique participants over four days of virtual meetings focused on GusNIP work and facilitating conversations to begin to understand and chart a path forward through the challenging new landscape we face. Additional in-person national and regional convenings and grantee site visits will not happen until it is safe to do so. Since a majority of grantees are either just now beginning (or still have yet to begin) participant-level data collection due to funding delays and COVID-19, we anticipate having much less participant-level data at the end of Y1 (this was communicated to USDA NIFA). Grantees will need additional time over summer and fall 2020 to continue collecting data in ways that are safe and appropriate for the various populations they serve and current social distancing restrictions in their communities. In particular, for PPR grantees, these delays have meant a later program start date, and in many cases, while they may be able to collect baseline data on participants, post-program data will not be able to be collected until after the end of Y1, as program rounds last several months at minimum. We will need to reach a certain sample size of participants in order to power the sample on a 0.25 cup increase in fruit and vegetable consumption as intended. This sample size will not be reached by the end of Y1 and we anticipate needing through December 2020 to reach this milestone. Similarly, institutional- and firm-level data will be delayed. While some grantees continued to manage existing programs through the funding delays and COVID-19, many new programs had to push back their start date significantly. It will require additional time both to collect historical data from existing programs as well as onboard both new and existing programs to our data entry system (Smartsheet). Our aim is to have enough data to report on before doing so; as such, we anticipate needing through December 2020 (at the earliest) to complete the collection of Y1 institutional and firm level data. What opportunities for training and professional development has the project provided?During this first reporting period of Y1 NTAE activities, staff and consultants joined the project and work tools and processes were selected and implemented. As relevant to work roles and individual staff needs, individuals were trained on software tools for use in NTAE collaboration and project activities, including the Google Suite, Zendesk, Qualtrics, Slack, and Smartsheet. NTAE staff members from GSCN and FFN attended the National Grocers Association (NGA) Show, which took place in San Diego, CA, in Feb 2020. This tradeshow for the independent supermarket industry included more than 60 educational sessions and more than 100 speakers covering issues facing the food retail industry. The coronavirus pandemic has limited all in-person travel from March 2020 to present. On March 19-20, 2020, the GusNIP NTAE hosted the annual NI Practitioner Convening, which due to COVID was held virtually. This event was geared toward organizations implementing SI and PPR programs and included 25 presenters across eight sessions and reached 165 participants. Content focused on best practices, common challenges, and innovative ideas to drive the field forward. NTAE staff are participating in virtual convenings for ongoing learning and networking in areas of relevance, such as the Food is Medicine virtual convening held June 16-17, 2020, which two GSCN team members attended. How have the results been disseminated to communities of interest?Program results have been disseminated to communities of interest through webinars (see list in #8 below), convenings (described in #2 above), 1-on-1 calls, website resources and information, weekly digest emails for NI practitioners and grantees, and numerous topical and interest groups on a NTAE-hosted Slack communications platform. In addition, we: Presented on the NTAE at Health Datapalooza, National Good Food Network Annual Conference, Healthy Food Access Portal Webinar, Nutrition & Obesity Policy Research and Evaluation Network (NOPREN), National Direct Ag Summit, National Grocers Association (NGA) Information Technology Share Group, and the Food Industry Association Executives. Launched the first regional convening with a half-day session at the NGA Show bringing together practitioners, grocers, produce wholesalers, industry technology, and USDA FNS leadership to discuss topics germane to conducting SI programs in brick and mortar retail. Throughout the NGA Show, there were 3 meetings and education sessions, each with 100+ stakeholders from across the food industry. Virtually hosted the 2-day annual NI Practitioner Convening with robust participation across 165 participants, 25 presenters, and 8 sessions. What do you plan to do during the next reporting period to accomplish the goals?Year 2 work plans for the NTAE will include carry over tasks from Y1 that were impacted due to funding delays and COVID-19. The following high-level tasks are organized by Reporting and Evaluation, led by Gretchen Swanson Center for Nutrition (GSCN), and Technical Assistance and Innovation (formerly T&TA), led by Fair Food Network (FFN). Key overarching tasks, such as the development of the comprehensive web portal, convening partners and dissemination of information are also included. Web portal and Public-Facing Website (Led by GSCN) In June 2020, the RFP and selection phase for the web portal was concluded with the selection of RBA Consulting to complete this work. The Discovery Phase kicked off on July 21, 2020. Throughout Y2, we will work with technical solution partners, consultants, and vendors as needed, and move through all stages of product development with input from key stakeholders throughout. Our target launch date for the web portal is mid-2021. An interim public website (www.nutritionincentivehub.org) was launched in March 2020, with functionality limited to outward sharing of information and resources. During Y2, a redesigned public website with more robust functionality for interfacing with key program audiences will be developed and connected to the web portal. The website will be launched in tandem with the web portal, with a target date of mid-2021. Reporting and Evaluation (Led by GSCN) Complete Y1 data collection efforts for 2019 grantees (which has been shifted due to funding delays and COVID-19), move into analysis phase, and continue to support 2019 grantees and 2020 grantees who will be awarded in fall 2020. Participant level data: Grantees will need additional time in fall 2020 to continue collecting data in ways that are safe and appropriate for the various populations they serve and current social distancing restrictions in their communities. We will need to reach a certain sample size of participants in order to power the sample on a 0.25 cup increase in fruit and vegetable consumption as intended. This sample size will be reached by December 2020 (at the earliest). Institutional- and firm-level data: Historical data from existing programs will be collected, as well as the onboarding of both new and existing programs to our current data entry system, Smartsheet. Build the most efficient and effective strategy for onboarding 2020 grantees. This may include: Development of a webinar series to introduce metrics In-person and virtual site visits Provision of technical assistance (TA) as needed on the required metrics and data collection methods New quantitative and qualitative tools for evaluation with other key audiences will be developed, tested, and implemented in the field. These audiences include vendors, grocers, clinics, farmers market managers. Dissemination of findings will continue with a third case study, focusing on the economic impact of nutrition incentive programs. Another 3-5 case studies will be developed. Additionally, a foundational paper based on a systematic literature review on best practices in evaluation for Food Insecurity Nutrition Incentive (FINI) programs will be completed. Evaluation of technical assistance tasks will also be a focus of Y2. Key stakeholder interviews will be conducted with those involved in the provision of technical assistance A TA tracking platform, Zendesk (currently in use) or similar tool, will be incorporated into web portal. Data from Zendesk will be analyzed and new tools and resources will be developed to proactively answer the most frequently reported TA requests. Technical Assistance and Innovation (Led by FFN): Inventory existing incentive technology solutions, define a vision for future technologies, prioritize areas for investment, and invest $815k in user-centric solutions that streamline the distribution, redemption, reporting, and reimbursing of nutrition incentives. Host annual convening (virtually) to bring together over 150 nutrition incentive (NI) practitioners for two days of learning and sharing of promising practices. Host three regional convenings (in-person or virtually as needed) to strengthen partnerships among NI practitioners and key stakeholders. Build consumer-facing website functionality to connect SNAP shoppers with their nearest SI retailer. Coordinate strategic presence at up 10 relevant conferences to attract industry experts and key stakeholders to help advance the field (depending on safety of travel due to COVID). Develop up to 10 papers capturing and elevating promising practices in areas important to practitioners, such as communications, point of sale technology, and supplemental services. Benchmark percentage of GusNIP funds used directly on incentives. Develop roadmap for 2.5% increase per year. Benchmark percentage of incentives redeemed through streamlined, appropriate, and accurate technologies. Develop roadmap for 2.5% increase per year. Benchmark percentage of local and regional sourcing in brick-and-mortar retail. Develop roadmap for 1.25% increase per year. Award up to $1M in Capacity Building and Innovation Fund grants (through FFN award funds) to provide critical capacity-building support in underserved communities and states with low participation and to foster innovative solutions to common challenges with implications and lessons for the field. ($300k carried forward from Y1 that will be disbursed in September 2020 through the Y1 Round 2 of funding; funds to be awarded just after the close of Y1). Convening and Dissemination (Led by GSCN in partnership with FFN) Coordinate and host two convenings of core partners and advisors. Submit all required annual reporting to USDA and Congress. Disseminate findings in peer-review publications and though presentations at national conferences.

Impacts
What was accomplished under these goals? GOAL 1: To develop systems, infrastructure, and collaborative relationships using a community-informed approach to support grantees' reporting and evaluation efforts while building sustainability and capacity Obj 1 Systematic literature review outlining how nutrition incentive programs have historically reported/evaluated programs and potential gaps and areas of opportunity (in process) Conducted in-person & virtual site visits w/7 grantees: Yukon-Kuskokwim Health Corporation (AK); DC Greens (DC); The Food Basket (HI); The Food Trust (PA); Hunger Task Force (WI); Alameda County (CA); COPE (NM) Administered an electronic survey to grantees to gather information about key questions and concerns around core metrics, including institutional (firm) level and participant levels Delivered presentation at virtual grantee/practitioner convening to outline core metrics in greater detail and provided tailored TA sessions Conducted follow-up 1:1 calls with all grantees to gather information on status of their programs given delay in GusNIP funding and COVID, and impact on program implementation and evaluation activities Ongoing conversations and correspondence w/all grantees to help identify their measurement and evaluation needs & capacity. Based on grantee input, we tailored core metrics and data collection approach Obj 2 Developed core shared metrics to assess impact across SI & PPR programs Conducted sample size calculations & developed overall sampling strategy Worked with SI & PPR grantees on research study design, IRB processes, impacts on data collection during COVID, & online nutrition education resources Developed an IRB resource toolkit Provided curbside consulting & virtual office hours for grantees Launched PPR & SI communities of practice (CoP) Disseminated resources through program website Obj 3 Developed list of "recommended" metrics for SI & PPR grantees to be made available in coming months for programs to select survey items of interest. Required core metrics were kept brief to reduce burden for grantees, participants, and firms. Initiated 3 case studies on use of online SNAP/EBT & incentive redemption, program adaptations & unique challenges/facilitators for projects serving rural tribal communities, & assessing the local economic impact of a SI program Conducted semi-structured interviews w/all grantees to better understand readiness for program implementation in light of funding delays & COVID Obj 4 Following withdrawal of core partner CFFM (see question #9) who would have co-led development and implementation of online reporting site to collect and compile data and outcomes for all grantees, as well as administer associated training and ongoing technical support to grantees, the NTAE refined its concept for a comprehensive, integrated web portal & public website. In January 2020, the NTAE formed a web portal/website working group, sought input from key stakeholders, and engaged technical consultants to assist with defining and prioritizing project requirements and drafting competitive RFP for software design/architecture vendors. The RFP was issued in May; proposal review/selection process occurred in June. RBA, Inc. was selected as vendor for this project beginning July 2020. Interim solutions for TA, data collection, reporting, & evaluation (Smartsheet, Zendesk, Qualtrics) have been implemented. Developed Qualtrics surveys for grantees to collect participant level data online and lent GSCN-owned iPad Minis to grantees to help facilitate data collection. Surveys are tailored for each grantee. Given delays in grantee participant and firm level data collection, the NTAE is facing delays in compiling and reporting on data and outcomes from grantees. See question #9. Obj 5 In March 2020, launched public website for NTAE: www.nutritionincentivehub.org In April 2020, information about core metrics for SI & PPR grantees was uploaded to the public website, including core metrics currently required of GusNIP projects at the participant & firm levels. The online resources contain lists of metrics & rationale explaining each of the required metrics. Obj 6 Developed TA tracking strategy and methods Implemented an interim Excel spreadsheet tracking solution, followed by online system (Zendesk) to manage TA&I requests, delivery, & reporting GOAL 2: To maximize the effectiveness and efficiency of GusNIP projects in meeting GusNIP priorities, increasing FV purchases, and improving the nutrition of participating households Obj 1 Launched resource toolkit on GusNIP Program Administration & RFA resources Developed comprehensive TA tracking Hosted 9 webinars and 4 coffee chats Conducted site visits with 6 grantees Launched communications/marketing TA for NI programs Obj 2 Hosted session at the 2020 NI Practitioner Convening on incentive technology in grocery settings Contracted with core partner National Grocers Association Foundation (NGAF) to recruit incentive program, food industry, & USDA-FNS regulatory experts to provide advice and consulting services to the project, and began collecting information from participating retailers on incentive programs in their stores NGAF engaged 31 practitioners & 34 food industry groups in 1:1 sessions to enhance understanding of existing technology & opportunities Obj 3 Contracted with Michigan State University (MSU), Center for Regional Food Systems (CRFS) to lead 1 CoP, 1 webinar, & 2 reports on local & regional sourcing in grocery Obj 4 Conducted calls with grantees to inventory project scopes, needs, successes/challenges to inform TA Developed email listserv & launched Slack communications platform Operationalized 15 CoPs w/average of 23 members Virtually hosted 2-day annual NI Practitioner Convening Contracted with core partner Farmers Market Coalition (FMC) to lead CoP, 4 webinars, & resource creation related to NI work in FD retail Contracted with Food Trust, Michigan Farmers Market Association (MIFMA), & Reinvestment Partners to lead CoPs, webinars, & resource creation related to NI work in small-scale retail as well as nutrition education and SNAP-Ed, PPR work in farm-direct retail, & PPR work in brick & mortar retail, respectively Obj 5 Developed roles, responsibilities, & collaborative relationships among core partners & consultants Launched first regional convening with session at NGA Show in Feb 2020 bringing together multiple stakeholders to discuss topics germane to conducting NI in B&M retail Worked with GSCN to correspond with NIFA to reinstate the 2019 RFA amendment for the 2020 RFA Presented on the NTAE & NIs in multiple national forums Reinvestment Partners is in process to lead a CoP, webinar, & resource creation related to attracting healthcare providers and payors to PPR programs Obj 6 Developed a Diversity, Equity, and Inclusion (DEI) subcommittee w/representation across 9 organizations. Hosted DEI keynote sessions during annual NI Practitioner Convening. MSU CRFS is leading a CoP, a webinar, & 2 reports on DEI in the food system Obj 7 Developed subcommittee, systems, & processes for Capacity Building and Innovation Fund. Round 1 grants awarded May 2020, w/mini-grants totaling $300K awarded to 31 organizations to support SI & PPR innovations/adaptations in response to COVID Hosted COVID rapid-response session during NI Practitioner Convening Hosted follow-up COVID virtual coffee house chats biweekly for grantees & practitioners FMC provided resources & support for sustaining NI programs in FD retail during COVID NGAF hosted the university challenge at NGA Show (opportunity for students to present ideas on how to do effective outreach to SNAP shoppers)

Publications