Examples of National Program Evaluation Models:

EFNEP (Expanded Food and Nutrition Education Program): The USDA provides the core assessment tools for EFNEP, to measure behavior change related to diet and physical activity after participation in education programs. They offer tools for adult, youth, and community-level assessment. The USDA also provides tools for training and assessing core competencies of program staff and volunteers. EFNEP is run by the extension programs at Land Grant universities, some of which have done their own research and complementary tool development. The resources used by UVM’s program are available on their webpage. Samples from other Extension services are collected on the EFNEP Digital Resources page.

SNAP-ED Evaluation Framework: The SNAP-Ed evaluation framework includes indicators across individual change, environmental settings, and “sectors of influence” including social, policy, and health care. The SNAP-Ed site also provides examples of using the evaluation framework, and it links to other evaluation tools. Information about Vermont SNAP-Ed evaluations is found at the Vermont Department of Health website.

GusNIP Produce Prescriptions: The publicly available Nutrition Incentive Hub provides comprehensive grant evaluation materials used with both Nutrition Incentives and Produce Prescriptions, along with opportunities to join peer learning groups for evaluation. One thing to note is that the technical assistance and evaluation center running these programs works on both program evaluation and research to publish findings related to produce prescription efficacy, so not all elements will be applicable to a more narrowly define program evaluation.

Accountable Health Communities: The Centers for Medicaid & Medicare Innovation (CMMI) runs the Accountable Health Communities demonstration program (not to be confused with Accountable Communities for Health - the CMMI project refers to a specific set of grant funded pilot projects). This program studies best practices for screening and referring patients and coordinating with community partners to address a range of health-related social needs, such as food insecurity. It connects the results back to health care outcomes.

Healthy Rural Hometown Initiative: As part of a Federal Office of Rural Health Policy grant for using food to reduce the risk of cardiovascular disease in rural communities, Bi-State Primary Care Association built an evaluation model for using FQHC EHR (electronic health record) systems to track program impact. This model combines recommended best practices for food insecurity screening (using the Hunger Vital Sign as screen), evaluating impact of SDOH programs in a primary care practice, and monitoring risk factors for CVD (note: the ASCVD risk estimator tool linked here is not designed for lifestyle interventions, the background source material provided the clinical dashboard elements for the Bi-State model). The goal of data collection for this grant was to build structures for evaluating food access program performance in identifying and addressing health-related social needs in a way that integrates clinical and non-clinical work. This review would allow us to evaluate impact on health outcomes and the business model for sustaining programs. The grant does not have the scope of an intensive program like the Accountable Health Communities Model profiled above. We address that limitation by placing our work in the context of broader Vermont Food Access and Health Care Consortium strategic planning, mapping the specific interventions to possible future phases, and approaching some of the data elements as “observational” - not something we are attempting to directly influence at this time.

The initial grant description of a plan to build reliable data collection systems is found here. The updated Cost Savings Estimation (CSE) Model (October, 2022) provides a detailed review of plans for understanding program impact and connecting evidence-based program structures to funding opportunities - the CSE Model Narrative summarizes our review of cost savings, Appendix A situates the model in an overview of best practices and previous VT FAHC strategic planning, and Appendix B provides details on project progress towards data tracking & dashboard development.