Update: April 2019. The ESHE Index has moved to the CARES Network. Please read the great work that went into creating the index and what has come from it below. We think you will be impressed!
The Environments Supporting Healthy Eating (ESHE) Tool on has provided a platform for community engagement planning and pilot projects to assess the broad potential uses of the ESHE Index Score in the field. You may have read our last post about the ESHE Hub, which described the ESHE Index benchmarking tool and comprehensive report in depth. This article will focus on the recent success of three ESHE community action projects and the resulting insights about how ESHE can be used for local-level healthy food environment advocacy activities.
The ESHE team at the national office of the African American Collaborative Obesity Research Network (AACORN), in Philadelphia, PA identified three partners in urban and rural communities to pilot the use of ESHE for community action. The pilot sites included Philadelphia, PA, Chicago, IL and Vance County, NC. Each site used the ESHE Index tools on the Commons to generate County and State-level ESHE Index scores and a full EHSE report to obtain an overview of food environment variables in their area. Since food environments often vary greatly within a city or county, they then used the ESHE Community Measures Toolkit to help with assessments and planning for advocacy at the local level. Read the highlights of each pilot below and follow the links to read the full case studies. The case studies serve as examples of community engagement efforts; show the potential for positive impact from collecting data at the neighborhood level to understand variations in food environments between small geographies; and how to use the findings to advocate for change.
ESHE partners in Chicago were members of a community-academic partnership, the Healthy Corner Store Project (HCSP). HCSP launched in 2013 as a way for Chicago residents to influence their food environments. Their objective was to find ways to increase healthy food options and improve product placement in corner/convenience stores—oftentimes the most accessible places to buy food in many Chicago neighborhoods, but unlikely to carry fresh fruits and vegetables or other healthy food options. Results are being disseminated in various ways throughout the community and a toolkit to train store operators on topics including nutrition, community engagement, sustainable sourcing, bookkeeping, marketing, product placement, and advertising.
Vance County, NC
Located in north-central North Carolina, Vance County is a rural county that lacks access to healthy food. The Granville Vance District Health Department’s comprehensive Community Health Needs Assessment (CHNA) identified the availability of food retail outlets among the main barriers to healthy eating in Vance County. For the pilot project, the ESHE Index Tools were used to raise awareness among community residents and, in collaboration with a researcher from the University of North Carolina (UNC), the department of health staff trained community members to be store auditors. This pilot study adapted the CX3 Market Quality Scorecard, one of the tools recommended in the ESHE Community Measures Toolkit, for data collection in a rural area. Findings supported receipt of funding and technical assistance through a Centers for Disease Control and Prevention grant to the UNC partner. The findings from the pilot are being incorporated into several community engagement activities.
The pilot study in Philadelphia focused on community supported agriculture to improve healthy food access. The partner, Neighborhood Gardens Trust (NGT), is Philadelphia’s largest nonprofit land trust. NGT works with community residents to preserve their gardens by securing ownership or long-term leases, so that these spaces cannot be sold or developed. This pilot involved a garden acquisition study to strategically identify gardens for future preservation. The standardized ESHE Index was utilized with NGT’s stakeholders to describe factors impacting healthy food environments and the need for increased access to healthy foods in low-to-moderate income communities. A tailored garden assessment survey (community measure) was also used to analyze how well a garden was meeting its goals on a range of issues. The findings from this study are helping NGT in pursuing preservation of nearly 30 community gardens.
The ESHE community measures pilot projects provide several insights into healthy food environment advocacy. Some of the main lessons learned include:
- The standardized ESHE Index is a helpful tool to create an evidence base for community initiatives and to start a conversation about food environments at the neighborhood level.
- Recruiting members of the community to collect data creates an important dimension of community ownership of the food environment issue you wish to change.
- Community-level data collection is feasible for small-project teams and the data collected can be useful to a broad array of stakeholders on multiple levels.
- Data collection tools designed for urban environments can be modified for local contexts or rural communities with support from an evaluator/researcher.
The case studies conducted by the ESHE team and local partners illustrate how the ESHE Index tools and complementary community measures can be used for case-making on the ground. Creating an ESHE Index score and report can provide a starting point to stimulate changes in food quality, access, and policy landscapes that are conducive to high dietary quality. The ESHE team is committed to helping individuals and groups maximize their potential use of the index.