Policy change is an effective population health approach to make healthy choices the easiest choices. This type of broad change happened when Congress passed the Agriculture Act of 2014, also known as the Farm Bill. Congress allocated $100 million to fund the Food Insecurity Nutrition Incentive program (FINI)
to increase affordable access to fruits and vegetables for the more than 40 million Americans receiving Supplemental Nutrition Assistance Program (SNAP) benefits. These incentives can be used at any food retailer, including the growing number of farmers’ markets across the US.
While there is strong evidence1
that incentive programs provide an effective nudge to encourage dietary improvements, challenges arise as communities seek to implement these complex-to-track programs. This challenge created a research opportunity for Darcy Freedman, PhD, Associate Director of the PRCHN at Case Western Reserve University in Cleveland, Ohio. Cleveland became a natural incubation space for creating healthy food incentive evaluation technology because the city and surrounding area has been committed to making wide-spread access to farmers’ markets a priority for improving community health. This farmers’ market-rich environment is the context of FreshLink,
the core research of the CDC-funded PRCHN at Case Western. As a researcher, Freedman knew the value of having standardized, easy-to-use tools to support evaluation of healthy food incentive interventions not only in Cleveland but also nationally.
Working in partnership with nonprofit organization Wholesome Wave
, Freedman and her team created a mobile app and website that simplifies the evaluation process for farmers’ markets, mobile markets, and community-supported agriculture offering healthy food incentives. Called FM Tracks, this novel technology supports farmers’ market managers’ collection of sales data, customer data, market day information, and health, economic, and community impacts of their markets.
Initially released by the PRCHN as a pilot project, FM Tracks was adopted by nearly 300 markets in 18 states and Washington, DC, during a nine-month feasibility testing timeframe. These markets recorded more than 40,000 sales transactions using the evaluation technology, providing the start to the largest standardized database to support evaluation of the national FINI program. Fast forward to July 2017, just two years after the release of the pilot technology, and FM Tracks’ growth is exponential. The technology is:
• Used at more than 400 markets across the United States,
• Has captured more than 200,000 sales transactions over a two-year period,
• Offers national-level insights into SNAP customer purchases of fresh fruits and vegetables at farmers’ markets.
Future expansion is expected as large networks such as the California-based Ecology Center
integrate FM Tracks technology into their healthy food incentive program operations beginning in 2018.
Freedman notes, “The real-time information captured through FM Tracks is designed to foster data-driven decisions to improve market access for low-income customers.” To advance this goal, the national SNAP-Ed program incorporated FM Tracks into its evaluation framework in 2016, offering potential for cross-sector collaboration for evidence activation. Public health departments are also integrating FM Tracks into local and statewide healthy food incentive programming.
Researchers at the Prevention Research Center for Healthy Neighborhoods are beginning to draw insights from FM Tracks data to understand the implications of healthy food incentive programs operated in local communities, across states, and nationwide. “Whether using the data to evaluate an outreach intervention or to target programming in communities with high rates of chronic disease, FM Tracks is providing real-time access to information necessary to improve the reach and impact of these interventions on population health,” Freedman said.
- The New York Department of Health and Mental Hygiene began using the technology as a part of a FINI grant aimed at evaluating the impact of different monetary incentive amounts on diet.
- Ohio Department of Health is leveraging the capacity of FM Tracks to support the development of a statewide healthy food incentive program called Produce Perks.
The PRCHN and Wholesome Wave are collaborators on a Food Insecurity Nutrition Incentive (FINI) grant that Wholesome Wave received from the United States Department of Agriculture (USDA). As a result of the success of FM Tracks, the USDA has asked Dr. Freedman to consult with them. Learn more about Dr. Freedman's work with the USDA in the PRCHN Connection.
1o Afshin, A., Peñalvo, J. L., Del Gobbo, L., Silva, J., Michaelson, M., O'Flaherty, M., . . . Mozaffarian, D. (2017). The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis. PLoS One, 12(3), e0172277. doi:10.1371/journal.pone.0172277. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172277 o Pearson-Stuttard, J., Bandosz, P., Rehm, C. D., Penalvo, J., Whitsel, L., Gaziano, T., . . . O’Flaherty, M. (2017). Reducing US cardiovascular disease burden and disparities through national and targeted dietary policies: A modelling study. PLOS Medicine, 14(6), e1002311. doi:10.1371/journal.pmed.1002311. http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002311