Potential Public Health Impact
Reach: IATP reported that the produce distributors currently make the "right-sized" fresh produce items available to roughly 500 small stores, including 200 small stores that are WIC-authorized Data are not currently available regarding the number and characteristics of shoppers in participating stores making it difficult to conclude much about whether the stores are reaching the full range of customers. Potentially, this intervention could have significant reach if replicated across the country. It is likely that small stores in other regions are struggling with the challenge of selling produce.
Effectiveness: The primary outcome for this intervention was at the store level: to help small WIC stores succeed in implementing the produce component of the new WIC package. The evaluation presented suggests that this intervention was effective in promoting the availability of fresh fruits and vegetables and making a reliable source of year-round, right-sized, culturally appropriate produce items available to roughly 500 stores. The in-store observations suggested that about two-thirds of participating stores had the required number of produce items available. As an emerging intervention, data are not currently available regarding adoption levels among the stores or the impact on produce access relative to stores not receiving the intervention. We also don't know, at this point, how effective this intervention was at the individual level; in other words, if the diets of the WIC participants who frequent the intervention stores include more fruits and vegetables than WIC participants who frequent non-intervention stores. However, it is likely that produce availability is a necessary first step in achieving dietary change among WIC participants.
Adoption: The information available did not provide detail about the proportion or characteristics of participating stores among those that were eligible. Thus it is difficult to predict whether stores in other regions would be willing to make these changes. Qualitative data suggested that small stores located close to a large grocery store were less positive about carrying produce because they felt that people preferred to buy produce at the large stores. This is helpful information for those considering this intervention in other regions..
Implementation: The information provided suggests that the intervention was implemented effectively. The intervention developers suggested several key factors that were important to successful implementation, such as essential characteristics of their produce distributor: ability to meet the WIC minimum requirements for year round fresh produce, interest in exploring new markets and willingness to develop a "right-sized" product line appropriate for smaller stores.
Maintenance: IATP reported that the program and relationships between allied businesses have been sustained with minimal facilitation by IATP and without the infusion of additional outside funding.