What are ways that communities can ensure accessibility to food for all people?

Engaging the community to understand food needs

• Understanding the environments in which community members make food decisions as well as the availability of resource to meet daily food needs is critical to effectively address diet-related wellness conditions.
• Beyond satisfying customs do good requirements, there are a number of benefits to conducting a robust mural assessment of existing customs food resources and engaging community members during the community health needs assessment (CHNA) and health improvement planning process.
  • Leads to a more detailed understanding of community needs
  • Identifies potential partners in order to establish or strengthen relationships to improve attain, impact and long-term sustainability of efforts
• There are number of ways that community organizations that address food issues tin participate in the CHNA process:
  • Participate in inventorying nutrient-related customs resources
  • Participate in interviews, surveys, and focus groups
  • Participate in customs health data review and health needs prioritization
  • Serve on the CHNA steering/advisory committee.

This guidance brief complements the guidance cursory on data sources regarding nutrient access, food environments, and food behaviors to assist facilities in understanding good for you food access needs and opportunities in their CHNAs.

Understanding the built, social, and economic environments in which community members brand nutrient decisions as well every bit the availability of resources to meet daily food needs is critical to effectively address ascent rates of diet-related health conditions. Efforts to improve healthy food access and promote healthier community nutrient environments can have a significant impact on population health outcomes.

For these reasons, understanding the customs food environment and landscape of community food resources is an essential component of any customs health needs assessment and health comeback planning process.

Community do good regulations specify that a hospital's written customs wellness needs assessment (CHNA) report must include a description of the community resources potentially bachelor to address the pregnant health needs identified.

Community benefit regulations also instruct hospitals to take customs input into account when identifying and prioritizing significant health needs and identifying resource potentially available to accost those needs.

Later on completing the needs assessment, hospitals are required to develop an "implementation strategy" that describes how the hospital volition use its resources and avails of the local community to address prioritized health needs.

Conducting a robust assessment of existing community food system resource and engaging community stakeholders in this process, likewise equally in needs identification and prioritization and in implementation strategy evolution, provides an opportunity to satisfy multiple community benefit obligations.

According to 2016 national survey findings, obesity was identified as a priority wellness need in more 70 percent of CHNAs, while food insecurity or healthy food access was identified as a health need in 13 percent of CHNAs. Identifying existing community resource that address food access, good for you eating, food insecurity, healthy food product and distribution, and other food system-related matters is critical for the bulk of hospitals to fulfill community benefit requirements.

Beyond satisfying community benefit requirements, at that place are a number of benefits to conducting a robust landscape cess of existing community food organizations and resource and engaging community nutrient system stakeholders in the CHNA procedure, such as:

• Leads to a more detailed agreement of community needs and underlying determinants of wellness
• Increases likelihood of success by engaging community as partners in assessment and strategy development process thereby increasing sense of buy-in and buying
• Increases knowledge of existing community food resources
• Helps avert duplication or re-creating programs and services
• Reveals gaps, areas of need, and opportunities to strengthen current assets
• Identifies potential allies and partners in order to institute or strengthen relationships to help improve accomplish, affect and long-term sustainability of efforts
• Illuminates opportunities to align with existing community efforts or bring groups and organizations together for greater synergy
• Strengthens health improvement efforts through increased alignment, coordination or collaboration
• Develops more effective and appropriate strategies and approaches by consulting experts in the field with years of experience addressing food organization issues

Recommended practices

Getting to know what'southward out at that place: Conducting a robust mural assessment

Various strategies and techniques exist for conducting a landscape assessment of existing community food resources. Inventorying customs resources could exist equally simple as a group of stakeholders gathering to talk over and list community nutrient assets including programs, services, and resources, as well equally identifying gaps or weaknesses.

Seeking out local groups or agencies with expertise such as county extension services, a local food policy quango or food coalition, the local public health department, a university partner, city planners and sustainability managers, or others can be valuable to identify if a nutrient system assessment or mapping attempt already exists, or to consider partnering to conduct or commission a robust community nutrient assessment.

Community food assessments can be scaled up to become valuable as a standalone tool and resource for the community. Assessments may use formal instruments to compile specific food surroundings and food security-related data to provide a comprehensive view of the nutrient arrangement relative to customs wellness.

From Subcontract to Tabular array: A Kansas Guide to Community Nutrient Assessment provides a detailed list of common community food-related assets and indicators to consider when inventorying food system resources, too as data resources, cess tools, and examples.

Adrienne harvesting sage as a part of the Healthy Roots Collaborative programming in rural Vermont. (Northwestern Medical Center)

Physically putting community assets on a map provides a visual help that can increase insight and identify patterns regarding the availability of resources. This may atomic number 82 to focusing on a item neighborhood, or tailoring the intervention approach to adjust specific environments and circumstances.

The Maryland Food System Mapping Resource is one example of incorporating information on the nutrient system, public health, and environment to amend understand geographic patterns and community trends to inform planning, interventions, advocacy, funding, policies, and enquiry. This food system information mapping informed an array of valuable projects, resources, and reports including a robust food environment cess for Baltimore City. Johns Hopkins Infirmary used the Mapping Baltimore Urban center's Food Environs report in their 2016 CHNA and to inform implementation strategies.

The following resources discuss methods, tools and example assessments, all of which hospitals can draw on to incorporate community nutrient assessment components into a community health needs cess (CHNA):

• The Community Food Security Assessment Toolkit, produced past the U. S. Department of Agriculture (USDA), includes a guide and series of standardized measurement tools for assessing various aspects of community food security, including components of the customs food environment, community food resources, and household nutrient security. Data collection tools include secondary information sources, focus group guides, and a nutrient store survey instrument.
• Facilitator'due south Guidebook Customs-Based Food System Assessment and Planning provides facilitator tools and instructions for activities including developing a steering committee, defining goals, inventorying community assets, creating a baseline report, engaging a wide range of community stakeholders, hosting customs meetings and more than. Certain components may be useful to draw on as standalone exercises or to contain every bit elements in a CHNA. The section on "Taking Stock of Your Community Nutrient Organization Assets" (pgs 21-32) could help guide an inventory of community food assets.
• What'south Cooking in Your Nutrient System? A Guide to Community Food Assessment provides context for the emerging field of Customs Nutrient Assessments (CFA), including an overview of the U.South. nutrient organization and community nutrient security approach. This resource defines CFAs and benefits, presents brief case studies, outlines basic steps of an assessment, and provides detailed guidance on the CFA process from developing goals and research questions to putting the cess to work in your community.
• Healthier Food Retail: Beginning the Assessment Process in Your State or Community is a report from the Centers for Disease Control (CDC) that provides a detailed overview of how to behave an assessment of the nutrient retail environment at the country or local level. Information technology contains a number of useful resources and data sources, guidance on collaboration and methodology, and information on developing a successful implementation strategy after conducting the assessment.
• Whole Measures for Community Food Systems (Whole Measures CFS) is a values-based customs-oriented tool for evaluation, planning, and dialogue geared toward organizational and customs change.
• This Customs Food Assessments resource from LiveWell Colorado provides guidance and resources for getting started, navigating information drove, besides as a variety of tools to support CFA activities.

Whatever strategy or approach a infirmary may have to identify and inventory stakeholder groups, organizations, and existing customs nutrient organization resources, cardinal questions to consider include:

• Which organizations are working on food access, healthy eating, and food insecurity bug in your community?
• Which groups or neighborhoods experience disproportionate rates of nutrient insecurity and/or lack access to healthy foods, and which agencies or organizations work closely with these communities?
• Which organizations are involved with local nutrient promotion or customs development through nutrient initiatives?

Types of organizations to consider when conducting a food system mural assessment are listed below. Come across Making Nutrient Systems Part of Your Customs Health Needs Assessment: Practical Guidance for a more comprehensive review of organizations to consider as well as examples of how they partner with local hospitals.

The following types of organizations can be considered potential partners when conducting a CHNA and/or conducting an inventory of community nutrient system assets and resource:

• Programs that link food-insecure people to food resources (e.one thousand. Supplemental Nutrition Assistance Program [SNAP], Women, Infants, and Children [WIC] Food and Diet Service, fruit and vegetable incentive programs, etc.)
• Food banks and pantries
• Soup kitchens and congregate repast programs
• Supplemental meal provision programs (east.m. summer, afterschool, and weekend meal and supplemental food "backpack" programs)
• Home-delivered repast programs (e.m. Meals on Wheels)
• Food system advancement groups (e.g. local nutrient policy councils, food justice coalitions)
• Community organizations involved with farmers markets, healthy food retail/store initiatives, programming that doubles the value of SNAP dollars for utilize on fresh foods at farmers markets
• Agencies that serve low-income and vulnerable communities who commonly face up food insecurity and food admission issues (e.g. WIC providers, social service agencies, faith-based outreach/support groups, section of aging, department of wellness and human services, local public wellness department)
• Community agriculture groups and organizations (eastward.yard. community gardening, urban farming programs, community supported agronomics)
• Food product or value-added processing community development program (e.yard. community kitchens, food business organisation incubators, nutrient hubs)
• Farm-to-school networks
• Colleges, universities, and agriculture extension agencies
• Regime agencies (U.Due south. Department of Agriculture [USDA], USDA Nutrient and Nutrition Services [USDA-FNS])
• City (authorities) planners and sustainability managers
• Local wellness foundations
  

Engaging customs-based food organizations and customs stakeholders

After identifying existing community nutrient system resources besides as key stakeholders, including organizations that work on food-related problems and with low-income and minority communities, key questions include:

• Who is already at the tabular array for your CHNA procedure? What food organization stakeholder group or community is not represented?
• What community nutrient assessments already be?
• Who would you like to exist at the tabular array to provide insight, expertise and on-the-ground feel?
• At what point(due south) in the CHNA process would their input and expertise be almost valuable? And how would yous ideally like to accept them participate?

There are a multifariousness of means that community food organizations and stakeholders can participate in the CHNA process, each of which is discussed beneath.

1. Participate in data collection
2. Participate in community health data review and health needs prioritization
3. Serve on the CHNA steering committee

These forms of appointment are non mutually exclusive and it is valuable to incorporate whatsoever number of the practices described below. Generally, the greater the level of customs engagement, the greater the benefit. What is "best" or "right" is situation-specific and depends on the overall goals, priorities, and resources bachelor. The wide range of strategies means there are multiple opportunities to increase community participation.

Information collection

Community-based organizations and stakeholders that work on healthy food access, food insecurity, or other food system related initiatives can be a great resource to help develop relevant, advisable, and constructive information collection strategies. Well established customs-based agencies with strong client networks can too be incredibly valuable partners for implementing a range of data drove activities.

Yet, information technology is important to ensure a respectful and ethical approach to information extraction. Some communities may be studied frequently by universities, regime agencies, hospitals, and other institutions. It is disquisitional to utilize existing analyses in society to avoid duplication of efforts and over-burdening customs members, particularly if at that place is niggling or no bounty for their vital contribution to data collection. Customs members besides should accept access to and an agile function in stewardship over this information.

Common ways to engage community stakeholders in CHNA data collection activities include:

• Partner with a community coalition or agency to deport a robust mural assessment of customs food system resources or a local food environment assessment
• Partner with community stakeholders to host focus groups at neutral, known, and comfortable customs locations; leverage the network and reputation of community organizations to recruit participants
• Ask community members to review customs survey, focus group, or interview guides to provide feedback on questions and indicators incorporated, as well equally appropriateness of language utilized
• Partner with community organizations to disseminate surveys; leverage existing networks of an system or coalition to help increase participation and representation of low-income, minority, and historically underserved populations
• Inquire customs stakeholders with food system or food access expertise to participate in a primal informant interview
• Seek input from community partners working on food arrangement bug regarding indicators commonly used in their field to include in the CHNA, besides as recommendations regarding reputable data sources and existing datasets (national, regional and local - including a previously conducted local food surround cess or asset mapping)

Causes and multipliers of health conditions are nuanced. Including community organizations and stakeholders that work on food issues in data collection tin aid ensure the right questions are being asked in order to capture what is happening in the customs, and help ensure the data collection strategies utilized will elicit robust participation from populations of involvement (e.g. depression-income, minority, vulnerable).

Information review and prioritization

Including community stakeholders in the process of identifying and prioritizing health needs can help ensure accurate understanding of needs and priorities for unlike groups and neighborhoods in the assessment area. In addition, ensuring community stakeholders participate in needs identification and prioritization will help build community trust and buy-in, while establishing new connections and cultivating relationships that could be fruitful for implementation strategies.

Common opportunities to include food-related community organizations in the data review and prioritization process include:

• Partner with a customs-based nutrient organization to host a community event to engage central stakeholders, organizations and community members in data review, interpretation and needs prioritization. Work with the organisation to identify key stakeholder groups for participation to ensure representation of the entire food organization, central actors, and community.
• Initiate or utilize an existing cross-sector community wellness coalition, workgroup or committee that includes food system stakeholders to interpret data and identify priority health needs.
• Administer a survey to get together community input on needs prioritization. Partner with community food organizations and agencies that work on food issues to disseminate through their networks.

Fresh produce and good for you living education opportunities are available for participants of the Nutritional Options for Health (NOW) program, which was founded by Spectrum Health and administered by Access of West Michigan.  (Admission of W Michigan)

Steering/advisory commission

Inviting food system stakeholders to serve on the CHNA steering or advisory committee provides the opportunity for community experts to lend insight at various steps in CHNA process.

Having a customs stakeholder with food system experience on the steering committee amplifies the impact of hospital investment by making connections to existing efforts, coalitions, and potential partners.

Infirmary charitable grants and community do good resources alone, while critically important, are not enough to fundamentally transform key determinants of health. A better, more sustainable opportunity is to collaborate with community partners to leverage all available resources to integrate community benefit into the fabric of the community and implement real, lasting change.

Participation of customs food organizations on the CHNA committee has significant implications for community wellness improvement efforts. In a 2016 national survey, 45 percent of hospitals reported including at least one food-related arrangement on their CHNA committee. Having a food-related organization on the CHNA committee was strongly correlated with having a community benefit program that targeted healthy food access or food insecurity.

Robust community partnerships

Deeper and ongoing engagement of the customs in the CHNA procedure is more common as hospitals increasingly realize the value in cultivating robust community partnerships and relationships — not only to better serve their community, but to advance hospital mission and goals.

Beyond more effective interventions and use of community benefit and charitable resource, hospitals can apply insights gained from conducting a robust mural assessment and having stiff community participation in the CHNA to amend aspects of their business concern model, operations, and strategic approach to population health. Customs engagement is valuable to identify ripe opportunities for health care facilities to address social and environmental determinants of health through a range of "anchor institution strategies" such every bit local purchasing, hiring, and other strategic investments.

Below are examples of how hospitals today are actively partnering with their community food organizations and stakeholders throughout the CHNA procedure.

Facility and staff of Orlando Health showcase plants and decorative building materials in the Healthy Living Garden space (Orlando Health)

Acquire more

• Participatory Asset Mapping is an instructional toolkit that introduces basic concepts and methods for using and applying participatory nugget mapping. Stakeholders and organizations can employ the tools provided, such as the Customs-Engaged Mapping Facilitation Guide and Guide to Planning a Community-Engaged Mapping Event to host an activity that collects cognition and experiences from customs members about local assets.
• The Customs Food System (CFS) tool is designed to help community nutrient system stakeholders reach their goals and create resilient community nutrient systems through collaborations. This short tool includes an exercise on mapping a community food system, essential strategies for building constructive partnerships, and tips for engaging diverse stakeholders.
• Conversations Across the Nutrient Organization: A Guide to Coordinating Grassroots Community Nutrient Assessments provides a background and overview of the process involved in coordinating a grassroots customs nutrient assessment (CFA). As opposed to more data-driven assessments, this arroyo focuses on conversations, asset mapping and engaging the customs in a participatory process that builds capacity to help ensure efforts initiated through the CFA go on into the futurity.
• A team of regional food system specialists from across the country adult the Economics of the Local Food Arrangement: a Toolkit to Guide Community Discussion, Assessments and Choices, comprised of nutrient system assessment principles, economic indicators, real-world projection examples and applied advice. This toolkit provides guidance on conducting a customs food organization assessment that engages farmers, incorporates the local food product arrangement, and helps evaluate and communicate economic impacts of local food system initiatives.
• Local and Regional Nutrient Systems: Community/Regional Development is an index of resources and initiatives related to local and regional food systems from Cornell Academy. The index includes resource related to food system assessments, spatial analysis and mapping of food systems, and more than.
• Oregon Food Banking concern partners with local organizations to complete community food assessments in counties throughout the country. Their website provides more than 35 examples of community food cess reports, each of which is unique and describes their process, methods, indicators, results, tools, and resources.
• The Center for a Livable Hereafter created a Community Food Cess (CFA) tool and conducted CFAs in neighborhoods of Baltimore to gather data on local nutrient environments, resident experiences and behaviors, customs avails and areas of need. The results are used by partners to straight customs efforts, inform policymakers interested in improving good for you food admission, and abet for programs and policies. This website includes examples of CFAs conducted utilizing their tool and links to the original assessment and tool utilized.
• The written report Opportunities for Increasing Access to Healthy Foods in Washington is the result of a collaborative multi-sector cess of systems and factors that touch access to salubrious foods in Washington State. The report details assessment methods, maps of primal food and health indicators, community assets and barriers, promising strategies, opportunities and recommendations to improve healthy food admission. Each component of the report provides useful examples to draw on to comprise community nutrient cess elements into a customs health needs cess.

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Source: https://foodcommunitybenefit.noharm.org/resources/community-health-needs-assessment/engaging-community-understand-food-needs

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