Objectives: To identify facilitating factors that guide local health departments (LHDs) in their transition from direct clinical service provision to population-level interventions addressing the social determinants of health. Design: Key informant interviews with LHD leaders and their staff were conducted using a semistructured interview guide. Thematic qualitative analysis was used to identify common characteristics and strategies among the LHD leaders and staff. Participants: LHDs represented both rural and urban communities with population sizes from 9746 to 919 628 and agencies in Illinois,
The Farmers Market (FM) Food Navigator program was designed over 3 years and follows a social ecological framework to increase vulnerable populations’ access to local foods and build confidence to shop in a FM supporting local food systems while promoting fruit and vegetable consumption. Food Navigators followed a program Playbook, though unlike many similar programs, the program did not offer incentives to subsidize FM purchases. To inform program design and understand outcomes, data were collected from Food Navigators, shoppers, FM managers, and FM vendors. Food Navigators supported five to seven FMs each season (May through October), spending 590 days in FMs over three seasons. Due to their interaction with Food Navigators, shoppers in Season 3 ( n = 689) indicated that they would: shop more at the FM (80%); eat more vegetables (52%); and purchase more vegetables (50%). Of shoppers who interacted with Food Navigators more than once ( n = 55), 26% reported a higher frequency of vegetable consumption on their last survey compared with their first. In Season 3, at least half of FM managers ( n = 4, 50%) and vendors ( n = 68, 57%) agreed that food navigators helped increase overall market fruit and vegetables sales. Findings indicated the program did influence multiple levels of a social ecological framework as intended. FM nutrition programs can have success at increasing market sales and improving health-related behaviors without offering incentives. As a result, programs could operate with smaller budgets and be more likely to have increased shopper fruit and vegetable consumption sustainably beyond the direct subsidy of purchases.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.