Nutrition: Strategies and Resources
Increase Access to Healthy Foods and Beverages
Initiatives to increase access to healthier foods and beverages in retail venues can improve existing stores, encourage placement of new stores, improve transportation access to healthier food retailers and/or implement comprehensive in-store markets and promotion.
Provide access to healthier food retail (grocery stores, small stores, farmers markets, bodegas, and mobile food retail)
Healthier food retail (HFR) initiatives can help increase peoples’ access to places that sell healthier foods and beverages in underserved areas, including grocery stores, small stores, farmers markets, bodegas, or mobile food retail. Initiatives can involve creating new food retail outlets that sell healthier foods; improving the quality, variety, and amount of healthier foods and beverages at existing stores; or promoting and marketing healthier foods and beverages to the consumer.
Resources
- Healthier Food Retail: An Action Guide for Public Health Practitioners
This resource provides guidance for public health practitioners on how to develop, implement, and partner on initiatives and activities around food retail to improve access, availability, and affordability of healthier foods and beverages. With this guide, public health practitioners can begin or enhance their work in healthier food retail. - Healthier Food Retail: Beginning the Assessment Process in Your State or Community[PDF-7.7MB]
This tool provides public health practitioners with an overview of how to develop an assessment of their state’s or community’s food retail environment. - State Initiatives Supporting Healthier Food Retail: An Overview of the National Landscape[PDF-2.4MB]
This overview provides public health practitioners, their partners, community members, and policy makers with useful information on the rationale for – and characteristics of – state-based healthier food retail legislation enacted in the last decade. It includes action steps that public health practitioners can use to inform, educate, and support improved fruit and vegetable access through Heathier Food Retail initiatives. - Making the Business Case for Prevention (Videos)
Two videos from CDC’s Division of Community Health, Healthy Corner Stores and A Grocery Store’s Healthy Options, provide store owner perspectives on how making changes to their stores has made healthy living easier for customers and improved profits.
Program Highlights
- Alabama’s Healthy Vending Machine Program Improving Lives One Worksite at a Time[PDF-410KB]
- Kentucky Farmers’ Markets Improve Access to Fresh Produce in Poor Neighborhoods[PDF-475KB]
- Corner Stores in Missouri Make Healthy Food Options Easier to Buy[PDF-1.13MB]
- Corner Stores in Rural Wisconsin Provide Residents with Fresh Produce[PDF-387KB]
- Current Practices in Healthy Food Retail: Small Stores[PDF-2.49MB]
The practices highlighted in this document demonstrate ways to increase the availability of healthy foods and beverages by using public health strategies that focus on small stores. - Improving Retail Access for Fruits and Vegetables[PDF-241KB]
Food can be sold at a variety of retail venues in a community. To increase fruit and vegetable consumption by community members, it is important to improve access to these venues and to increase the availability of high-quality, affordable fruits and vegetables sold at these locations. This document highlights a few states’ work in this area.
Intervention Examples
- Baltimore Healthy Stores
Baltimore Healthy Stores (BHS) uses a store’s existing facilities to improve access to healthier food and to increase consumers’ knowledge, self-efficacy, and behavioral intentions about healthier food choices and food preparation. This is done through health education and point-of-purchase marketing strategies - Healthy Cornerstore Initiative Produce Distribution System
The Healthy Cornerstore Initiative increases access to fresh fruits and vegetables in corner stores by linking small stores with produce distributors on a year-round basis. - Pennsylvania Fresh Food Financing Initiative (FFFI)
The Pennsylvania Fresh Food Financing Initiative (FFFI) is a policy-level intervention designed to increase access to affordable, quality healthful foods in underserved areas of the state. The program provides critical one-time loans and grants for the development, expansion, or renovation of fresh food retail establishments, such as supermarkets or grocery stores. The FFFI also creates steady jobs for community members living in economically distressed areas.
Provide access to farmers markets
A farmers market is a recurring gathering of farmers selling their food products directly to consumers. Other produce markets may include wholesalers and retailers, rather than just farmers. These markets can be held on public or private land, in temporary or permanent structures, or may even be mobile. They may be set up in community locations, health clinics, places of worship, schools, hospitals, and workplaces; and can include locally or regionally grown items and fresh produce.
Program Highlights
- CDC Study Shows State Health Departments’ Role in Supporting Farmers Markets[PDF-1.49MB]
This fact sheet highlights common activities used by CDC funded state health departments to support farmers markets across three cooperative agreements. CDC grantees and public health practitioners can use this document when developing state-level farmers market strategies. - Current Practices in Developing and Supporting Farmers’ Markets[PDF-2.53MB]
This document highlights efforts by five state health departments to increase access to healthy foods through farmers’ markets. - Farm-To-Where-You-Are[PDF-225KB]
Farm-to-where-you-are programs promote the delivery of regionally grown farm produce to community institutions, farmers markets, and individuals. - Texas: Connecting Farmers and Workplaces[PDF-848KB]
The Texas Farm-to- Work program increases access to fresh fruits and vegetables in the work environment by providing a weekly opportunity for purchase and delivery of fresh produce from local farmers. The program’s primary focus is to promote individual and group behavior change by modifying the work environment to increase access, availability, purchases, and use of healthy fruits and vegetables from local farms.
Intervention Examples
- Cleveland-Cuyahoga Food Policy Council
The Cleveland-Cuyahoga County Food Policy Coalition was formed to help support public and private policy-based changes that foster a healthier food system in Cleveland and surrounding Cuyahoga County, Ohio. - Health Bucks
The Health Bucks program helps residents of low-income neighborhoods increase their opportunity to purchase fresh fruits and vegetables by providing a financial incentive for use at participating farmers markets. - Health Bucks Evaluation Toolkit[PDF-8MB]
A Health Bucks evaluation toolkit was created to assist farmers’ market incentive programs in designing and implementing evaluations. The tools can be adapted for incentive programs of various sizes, and can be scaled to guide both small and large evaluations depending on available resources.
Promote Adoption of the Food Service Guidelines or Other Nutrition Standards
The Food Service Guidelines (FSG) or nutrition standards are guidelines for organizations or programs to create healthy eating and drinking environments in government-managed cafeterias, snack bars, and vending machines. The guidelines can be applied to non-government settings as well, including universities, hospitals, or worksite cafeteria or vending settings. Use of pricing incentives, promotional materials, or food placement strategies is important for guideline implementation.
Implement nutrition standards/food services guidelines in priority settings (Early Care and Education, Workplaces, Communities)
Resources
- Philadelphia Hospitals Offer Healthier Options with Good Food, Healthy Hospitals[PDF-547KB]
This document highlights the Philadelphia Department of Public Health’s initiative to promote healthy foods and beverages for patients, staff, and visitors of Philadelphia hospitals. - Study Assesses Policies for State-Level Food Service Guidelines[PDF-3.56MB]
This fact sheet highlights the results of a study that assessed the landscape of state-level food service guidelines across the United States. Health departments and other stakeholders can use the baseline data offered in this study for future FSG policy assessments. - Tips for Offering Healthier Options and Physical Activity at Workplace Meetings and Events[PDF-586KB]
This document includes tips and resources for increasing healthier food and beverage options at worksite meetings, parties, conferences, and events and for offering physical activity opportunities for employees throughout the work day. - Smart Food Choices: How to Implement Food Service Guidelines in Public Facilities[PDF-1.8MB]
This guide includes action steps to help you implement food service guidelines in your government work site or other public facility to increase the availability of healthier food and beverage options at food service venues, including cafeterias, concession stands, snack bars, and vending machines. - Improving the Food Environment through Nutrition Standards: A Guide for Government Procurement[PDF-650KB]
This document provides practical guidance to states and localities for use when developing, adopting, implementing and evaluating a food procurement policy. - Healthier Vending Machine Initiatives in State Settings[PDF-154KB]
This vending toolkit describes actions taken, key considerations, and lessons learned by state health departments already implementing healthy vending machine initiatives in buildings owned or operated by the state. It provides examples and links to resources, tools, and guidance related to healthy vending machine initiatives. - NAP SACC Module (Username and password required)
This training is designed for those interested in adopting the Nutrition and Physical Activity Self-Assessment in Child Care (NAP SACC) intervention in a state or community. The training provides step-by-step instructions and materials on fully implementing the NAP SACC program.
Program Highlights
- Better Bites Program Offers Kentucky Employees Healthier Meal Options[PDF-126KB]
This document highlights the Kentucky Department of Public Health (KDPH) worksite wellness committee to address employee health issues and set up Better Bites pilot programs at three state department cafeterias. - Food Service Guidelines Highlights[PDF-421KB]
These highlights focus on state health departments’ coordinated efforts to implement strategies that encourage improved food service guidelines in worksites. - Food Service Guidelines: Case Studies from States and Communities[PDF-1.8MB]
This document highlights five case studies of food and beverage guidelines developed to improve the food environment. The case studies provide information on the implementation and evaluation of food service guidelines, along with descriptions of site-specific successes and challenges.
Intervention Examples
- Healthy Food Procurement in the County of Los Angeles
This is a practice-tested institutional policy for creating model healthy food environments in county venues and programs. - Eat Well Play Hard in Child Care Settings
This multi-component intervention focuses on improving the nutrition and physical activity behaviors of pre-school age children and their parents/caregivers and influencing food and activity practices in child care settings. - Out of School Nutrition and Physical Activity (OSNAP) Initiative
This initiative is a research-tested intervention designed to increase healthy nutrition for children, including the frequency with which water is served during snack at afterschool programs. - North Carolina Prevention Partners Healthy Food Environment Pricing Incentives
This policy intervention was developed to increase availability, visibility and affordability of healthy foods and beverages for employees, volunteers, and visitors on hospital campuses. - Kaiser Permanente Cafeteria Menu Labeling
This is a practice-tested intervention developed to help patrons make informed decisions about their purchases with the goal of shifting purchasing to lower calorie and healthier options. - Healthy Iowa Vending
This intervention was designed to evaluate and improve the worksite vending machine environment
Food Service Guidelines
Every day, millions of Americans buy or are served food and beverages at their workplaces, or in other community settings such as hospitals, parks and recreation areas. Making changes to the types of food and beverages available in these settings can improve the diets of people who eat there. Food service guidelines are used to create a food environment in which healthier choices are made easier for consumers. These guidelines are used to increase the availability of healthier food and beverages, and to display them more prominently, to increase the likelihood that healthier options are selected by customers.
Healthy Hospital Environments
DNPAO works with partners across the country to promote improvements in hospital environments, and ensure that the healthier choice is the easier choice. DNPAO has developed tools to assist hospitals in conducting food, beverage, and physical activity environment assessments for prioritizing and implementing change. Hospitals reach a large population of employees, patients and visitors and can have an impact on neighboring communities. This makes them an important setting for obesity-prevention efforts.
Salad Bars to Schools
Salad Bars to Schools is a unique public-private partnership to mobilize and engage stakeholders at the local, state and national level to promote and sponsor salad bars in schools. School children eat more fruits and vegetables when they have a variety of choices, such as those provided in a self-serve salad bar. By supporting Let’s Move Salad Bars to Schools’ mission to increase the prevalence of salad bars in schools across the country, CDC aims to ensure every child has the choice of healthy fruits and vegetables each day at school.
General Nutrition Resources
Links to non-federal government organizations found in this document are provided solely as a service to the reader. These links do not constitute an endorsement of these organizations or their programs by CDC or the federal government, and none should be inferred. CDC is not responsible for the content of the individual organization sites listed on this website.
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