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A novel approach to measuring potential for health equity impact in community health interventions

  • Program: Community Health Planning and Policy Development
  • The education arm of the Supplemental Nutrition Assistance Program (SNAP-Ed) is the largest nutrition education and obesity prevention program in the United States. It aims to improve health behaviors among SNAP-eligible individuals through education and changes in policies, systems, and environments that increase access to healthy foods and physical activity opportunities in low-income communities. There is tremendous potential for SNAP-Ed programs to advance health equity in our most under-resourced communities; however, these programs must be planned and implemented with care and intent to achieve and sustain equity gains. Additionally, to address the incredible diversity of SNAP-eligible populations, program implementation varies greatly according to the needs, opportunities, and capacity of each community. This heterogeneity contributes to the challenge of evaluating SNAP-Ed interventions. Meaningful metrics to evaluate the health equity impact of community health interventions are sorely needed. Nationwide, nearly 40 states use the Program Evaluation and Reporting System (PEARS) for federally-required SNAP-Ed reporting and other monitoring and evaluation, providing standardization in data collected about SNAP-Ed program delivery. Using annual PEARS data reported by 60 California local health departments, we present a novel measure of the potential for SNAP-Ed programs to advance health equity based on the Getting to Equity (GTE) framework, developed by Shiriki Kumanyika. The GTE framework uses an equity lens to assess obesity prevention strategies according to four inter-related dimensions. These dimensions (increase healthy options, reduce deterrents, improve social and economic resources, build on community capacity) go beyond addressing nutrition and exercise to also include upstream factors like affordability, discrimination, economic development, strategic partnerships, and more. We created a metric for Health Equity Impact Potential by coding existing PEARS data into each GTE dimension with scoring based on the number and combination of dimensions to account for the importance of synergy as described by the GTE framework. We also identified gaps in data collection and alternate data sources. We will share scoring methodology so that agencies can adopt or modify this metric to fit their data sources, along with examples of how the score can be used to analyze equity impact. Having a measure of health equity potential makes it possible for organizations to assess where improvements can be made in community health policy and program planning to ensure that priority populations are reached, interventions are implemented equitably, and root causes of health disparities are addressed.
Janice Kao
University of California, Division of Agriculture and Natural Resources Nutrition Policy Institute
Academic Coordinator
  • Linked Session ID: 947608
  • Authors: Janice Kao, MPH, Gail Woodward-Lopez, MPH, RD, Christina Becker, BA, Carolyn Rider, MA, Erin Esaryk, MPH, Evan Talmage, BA
    UCANR Nutrition Policy Institute
  • Learning Outcome 1: Describe and explain a new methodology for assessing the potential of community health interventions to impact health equity.
  • Learning Outcome 2: Discuss how to implement and interpret health equity metrics to drive program planning to advance health equity.
  • Linked Session Title: CHPPD POSTER SESSION 7