Products, Publications, and Presentations - Center for Health Promotion and Disease Prevention

Products

Community Voice

Centering community voice is an equity imperative when partnering and implementing community-based programs, especially for those communities most affected by systemic inequities. In an effort to learn about the experiences of partners and participants working engaged in local programs, during the summer of 2023, the FFORC Team adapted two Community-based participatory research (CBPR) qualitative approaches, Most Significant Change and the Sort and Sift, Think and Shift qualitative data analysis, with the objective to understand the most significant or meaningful aspects of the programs personally and in their communities. The following projects participated, and links to the findings are provided in English & Spanish.

Coharie Community Garden ( ENG | SPA )
REMMSCO Community Garden ( ENG | SPA )
Fairview Communities on the Move ( ENG | SPA )
Golden Journeys ( ENG | SPA )

Community Investment One-Pagers

Grocery basket with vegetables in it on top of a scale

These snapshots are powerful education tools showing the investment FFORC and the SNAP-Ed Nutrition Education and Obesity Prevention Program at UNC-Chapel Hill have made in communities across North Carolina.

Activate Fairview Active Living Plan

Sign that reads "Welcome to Fairview" in the grass along the street

In the Fairview Youth in Action program, a program sponsored by the Fairview Community Watch (FCW), the UNC Food, Fitness and Opportunity Research Collaborative (UNC FFORC), Habitat for Humanity of Orange County (Habitat), and with support from Mobycon, have worked to promote active living in their neighborhood. Over the past four summers, high-schooled-aged Fairview residents assessed neighborhood barriers to healthier lifestyles through a series of mapping and assessment exercises, interviewed community stakeholders, and gained input from the wider community through outreach and advocacy events. The Fairview Youth in Action interns applied what they learned to create the Activate: Fairview Active Living Plan 2022-2027 (“Activate”). This youth-driven, community-engaged plan outlines goals, objectives, and recommendations to improve the neighborhood.

Read the Activate Fairview Active Living Plan

Orange County Community Food Access Assessment

This Community Food Access Report summarizes an assessment process that began late in 2021 and finished in July 2022.

The purpose of this assessment was to focus on the expertise and experiences of those most impacted by food insecurity. We intentionally avoided more traditional assessment practices such as surveys or an over-reliance on quantitative data. Instead, our focus was on listening to the community and honoring their experiences as subject-matter expertise.

Publications

NEW! Lu, I., Sheppard, B., Chapman, L., Barnes, L., & De Marco, M. (2024). Evaluation of a Sparkling Water Promotion Intervention on Sales at Convenience Stores in the Southeastern US. Journal of Nutrition Education and Behavior. Advance online publication. https://doi.org/10.1016/j.jneb.2024.01.010

Alvarado, J. S., Perez-Velazco, X., Gregorio, V., Newton Ward, M., & De Marco, M. (2022). Using Formative Research to Develop a Social Marketing Campaign to Understand Food Shopping Behaviors in Young Mothers. Social Marketing Quarterly. https://doi.org/10.1177/15245004211073187

Chauvenet, C. Sheppard, B, Siddique, N., Gallagher, B., Kearney, W. & De Marco, M. (2021) A Qualitative Study of Rural Low-Wealth Participants’ Experiences with Community Gardens. Journal of Hunger & Environmental Nutrition. 10.1080/19320248.2021.1907641

McGuire, C. M., Gollust, S. E., De Marco, M., Durfee, T., Wolfson, J., & Caspi, C. E. (2021). Equity at the Ballot Box: Health as a Resource for Political Participation Among Low-Income Workers in Two United States Cities. Frontiers in Political Science, 2. https://doi.org/10.3389/fpos.2020.601323

Shanafelt, A., Sadeghzadeh, C., Chapman, L., Jackson, M., Gust, S., Harnack, L., De Marco, M., Caspi, C. (2020). Recruitment of low-wage workers for a time-sensitive natural experiment to evaluate a minimum wage policy: Challenges and lessons learned. SAGE Field Methods. 2021; 33(3). https://doi.org/10.1177/1525822X20985966

Gilbert, J., Chauvenet, C., Sheppard, B., & De Marco, M. (2020). “Don’t Just Come for Yourself”: Understanding Leadership Approaches and Volunteer Engagement in Community Gardens. Journal of Agriculture, Food Systems, and Community Development, 9(4), 259–273. https://doi.org/10.5304/jafscd.2020.094.019

Sadeghzadeh C, Sheppard B, de Groot J, De Marco M. Evaluating the Benefits of a SNAP-Ed-Funded Community Garden Intervention Using Ripple Effect Mapping. Health Education & Behavior. 2022;49(1):141-149. doi:10.1177/10901981211058075

Additional Ripple Effect Mapping (REM) Resources:

Chapman LE, Sadeghzadeh C, Koutlas M, Zimmer C, and De Marco M. (2019). Evaluation of three behavioral economics ‘nudges’ on grocery and convenience store sales of promoted nutritious foods. Public Health Nutrition. doi: 10.1017/S1368980019001794.

Chauvenet, C., De Marco, M., Leone, L. A., Haynes-Maslow, L., & Ammerman, A. S. (2019). The Role of Food Retailers in the Promotion of Healthful, Low-Cost Products to WIC Recipients. Journal of hunger & environmental nutrition, 1–15.

Sadeghzadeh, C., Soldavini, J., Uslan, D., & De Marco, M. (2018). Novel sales tracking method to evaluate a healthy corner store intervention. Health Promotion Practice, published online July 24, 2018. https://doi.org/10.1177/1524839918789379

De Marco, M., Chapman, L., McGee, C., Calancie, L., Burnham, L., & Ammerman, A. (2017). Merging opposing viewpoints: Analysis of the development of a state-wide Sustainable Local Food Advisory Council in a traditional agricultural state. Journal of Agriculture, Food Systems, and Community Development, 7(3), 197-210. https://doi.org/10.5304/jafscd.2017.073.018

Ammerman A, Hartman TS, De Marco M. (2017). Behavioral Economics and SNAP – Making the Healthy Choice the Easy Choice. American Journal of Preventative Medicine, S145-S150. https://doi.org/10.1093/qjmed/hcw190.

De Marco, M, Smith, T., Kearney, W., Ammerman, A. (2016). Harvest of Hope: The impact of a church garden project on African American youth and adults in the rural American South. Journal of Hunger & Environmental Nutrition, 11(3), 317-327. https://doi.org/10.1080/19320248.2016.1146193.

Skinner, H., Calancie, L., Vu, M., Garcia, B., De Marco, M., Ammerman, A., & Schisler, J. (2015). Using Community-Based Participatory Research Principles to Develop More Understandable Recruitment and Informed Consent Documents in Genomic Research. PLoS ONE, 10(5) e0125466. https://doi.org/10.1371/journal.pone.0125466.

De Marco, A., De Marco, M, Biggers, A, West, M., Young, J., & Levy, R. (2015). Can People Experiencing Homelessness Acquire Financial Assets? Journal of Sociology and Social Welfare, 42(4), 55-78.

De Marco, M., Gustafson, A., Gizlice, Z., Ammerman, A. (2014). Locally-Grown Fruit and Vegetable Purchasing Habits and the Association with Children’s Diet. Journal of Hunger and Environmental Nutrition, 9(3), 372-387. https://doi.org/10.1080/19320248.2014.929545.

De Marco, M., Smith, T., Kearney, W., Jones, C. Kearney-Powell, A., & Ammerman, A. (2014). Growing Partners: Building a community-academic partnership to address health disparities in rural North Carolina. Progress in Community Health Partnerships, 8(2), 181-186. doi: 10.1353/cpr.2014.0021

Black, K. Z., Hardy, C. Y., De Marco, M., Ammerman, A., Corbie-Smith, G., Council, B., Ellis, D., Eng, E., Harris, B., Jackson, M., Jean-Baptiste, J., Kearney, W., Legerton, M., Parker, D., Wynn, M. & Lightfoot, A. (2013). Beyond Incentives for Involvement to Compensation for Consultants: Increasing Equity in CBPR Approaches. Progress in Community Health Partnerships: Research, Education, and Action, 7(3), 263-270. doi: 10.1353/cpr.2013.0040.

Lightfoot, A., De Marco, M., Dendas, R., Jackson, M., & Meehan, E. (2014). Engaging Underserved Populations in ACA-required Needs Assessments: A Report from the Field. Special Issue of the Journal for Health Care for the Poor and Underserved, (JHCPU) 25th Anniversary Edition, 25(1), 11-18. doi: 10.1353/hpu.2014.0060.

Jones, B., Lightfoot, A., De Marco, M., Roman Isler, M., Ammerman, A., Nelson, D., Harrison, L., Motsinger, B., Melvin, C., Corbie-Smith, G. (2012). Community Responsive Research Priorities: Transforming Health Research Infrastructure. Progress in Community Health Partnerships: Research, Education, and Action, special issue on “The Science of Community Engagement,” 6(3), 339-348. doi: 10.1353/cpr.2012.0045.

Balvanz, P., Barlow, M. De Marco, M., Samuel, K., Crowder, R., & Ammerman, A. (2011). “The Next Generation, That’s Why We Continue To Do What We Do”: Experiences with land loss among African-American farmers in North Carolina. Journal of Agriculture, Food Systems, and Community Development, 1(3), 67-88. https://doi.org/10.5304/jafscd.2011.013.011

De Marco, M., Weiner, B., Meade, S., Hadley, M., Goldmon, M., Boyd, C., Green, M., Manning, M., Godley, P., Howard, D., & Corbie-Smith, G. (2011). Assessing the readiness of Black churches to engage in health disparities research. Journal of the National Medical Association, 103(9-10), 960-7.

De Marco, M., Cykert, S., Coad, N., Doost, K., Schaal, J., White, B., Young, D., Isler, M. R., & Corbie-Smith, G. (2010). Views on personalized medicine: do the attitudes of African American and white prescription drug consumers differ?
Public Health Genomics, 13(5), 276-83. doi: 10.1159/000242199.

De Marco, A. & De Marco, M. (2010). Conceptualization and Measurement of the Neighborhood in Rural Settings: A Systematic Review of the Literature. Journal of Community Psychology, 38 (1), 99-114. doi: 10.1002/jcop.20354.

De Marco, M. & Thorburn, S. (2009). The Relationship between Income and Food Insecurity among Oregon Residents: Does Social Support Matter? Public Health Nutrition, 12(11), 2104-2112. doi: 10.1017/S1368980009990243.

De Marco, M., Thorburn, S., & Kue, J. (2009). “In a country as affluent as America, people should be eating:” Qualitative findings from research to explore food insecurity among rural and urban Oregonians. Qualitative Health Research, 19, 1010 – 1024. doi: 10.1177/1049732309338868.

De Marco, M. & De Marco, A. (2009). Welcome to the neighborhood: Does where you live affect nutrition, health, and welfare program utilization? Journal of Sociology & Social Welfare, 36(1), 141-166.

De Marco, M. & Thorburn, S. (2008). The association between sociodemographic factors, participation in assistance programs and food insecurity among Oregon residents. Journal of Hunger & Environmental Nutrition, 3(1), 36-50. https://doi.org/10.1080/19320240802163506.

Presentations

Sadeghzadeh, C., Guge Cozon, L., Bishop, J., Hernandez, E., Bradley, M., Dearth Wesley, T., & De Marco, M. (2021, September). Human-Centered Design Methods to Advance Healthy Food Retail Strategies. Presented at the NIH Food Insecurity, Neighborhood Food Environment and Nutrition Health Disparities Conference.

Alvarado, J., Perez-Velazco, X., Gregorio, V., Ward, M., & De Marco, M. (2021, September). Using Formative Research to Develop a Social Marketing Campaign to Understand Food Shopping Behaviors in Young Mothers. Presented at the NIH Food Insecurity, Neighborhood Food Environment and Nutrition Health Disparities Conference.

Sheppard, B., Perez Velazco, X., & De Marco, M. Food Insecurity Among College Students: Addressing the Wellbeing of an Overlooked Population to Reduce Disparities. Presented at the NIH Food Insecurity, Neighborhood Food Environment and Nutrition Health Disparities Conference.

Sadeghzadeh, C., Bishop, J., Bradley, M., Panicelli, J., Hernandez, E., Dearth-Wesley, T., & De Marco, M. (2021, February 2). Using an Equity Lens within Human Centered Design: Methods and Tools to Put SNAP-Ed Participants at the Center of Effective Program Design and Implementation. ASNNA Annual Meeting.

Parker, S., De Marco, M., Mata, S., & Kearney, W. (2020, February 5). Looking within SNAP-Ed Cultures: Community-based and Organizational Structure with Anti-Racist and Anti-Oppressive Lenses. Presented at the Association of SNAP Nutrition Education Administrators Winter 2020 Conference.

de Groot, J., De Marco, M., & Kearney, W. (2020, March 5). Digging deep on our shared racial history: Building an anti-racist lens to conduct community-based research to strengthen the community food system in rural communities of color. Presented at the Paul A. Godley Health Equity Symposium

LaJeunesse, S., De Marco, M., Katz, J., Alvarado, J., & Sadeghzadeh, C. (2019, November 5). Communities on the move: Mobilizing coalitions to afford active living for all. Presented at the American Public Health Association’s 2019 Annual Meeting And Expo.

Sheppard, B., Sadeghzadeh, C., de Groot, J., & De Marco, M. (2019, November 5). A Novel Approach to Evaluating Impacts of Complex Community-based Health Intervention Settings: Ripple Effect Mapping in Rural, Community Gardens. Presented at the American Public Health Association’s 2019 Meeting And Expo.

de Groot, J., Windley, T., Kearney, W., & De Marco, M. (2019, November 4). Lift Every Voice: Implementation and Evaluation of a Dialogue-to-Promote Change Intervention in Rural North Carolina . Presented at the American Public Health Association’s 2019 Annual Meeting And Expo.

Windley, T., de Groot, J., & De Marco, M. (2019, June 19). Lift Every Voice: Pilot Results of a Dialogue to Promote Change Intervention in Rural North Carolina. Presented at the 12th Annual National Conference on Health Disparities.

Chapman, L., Koultas, M., Sadeghzadeh, C., Zimmer, C., & De Marco, M. (2019, June 10). Evaluation of Three Behavioral Economics “Nudges” on Grocery and Convenience Store Sales of Promoted Nutritious Foods. Presented at the American Society for Nutrition.

FNV (Fruits & Veggies) Social Marketing Campaign in Wisconsin: Strategies for Multi-Sector Collaboration. Amber Canto, MPH, RDN¹, Alice Ammerman, DrPH², Molly M. De Marco, PhD, MPH² and Erin Aagesen, MS, MPH³, (1)University of Wisconsin-Extension, Cooperative Extension, Madison, WI, (2)University of North Carolina at Chapel Hill, Chapel Hill, NC, (3)University of Wisconsin Extension, Cooperative Extension, Madison, WI. American Public Health Association Annual Meeting, San Diego, November 13, 2018.

Integrating Concepts from Behavioral Economics into Low-Cost Healthy Retail Interventions: Methods and Results from Rural North Carolina. Leah Chapman, MPH¹, Claire Sadeghzadeh^2, Molly M. De Marco, PhD, MPH², Daniella Uslan, MPH², Dwayne Campbell, Ed.D.² and Bill Kearney³, (1)The University of North Carolina at Chapel Hill, Chapel Hill, NC, (2)University of North Carolina at Chapel Hill, Chapel Hill, NC, (3)UNC Center for Health Promotion and Disease Prevention, Chapel Hill, NC. American Public Health Association Annual Meeting, San Diego, November 13, 2018.

Communities on the move: A participatory approach to health equity via enhancing groups’ physical activity in North Carolina communities of color. Seth LaJeunesse, CAGS, MCRP, Daniella Uslan, MPH, Judit Alvarado and Molly M. De Marco, PhD, MPH, University of North Carolina at Chapel Hill, Chapel Hill, NC. American Public Health Association Annual Meeting, San Diego, November 13, 2018.

Community Circle Dialogue to Address Food Insecurity, Poverty and Racism in North Carolina. Juliana de Groot¹, Jessie Phillips¹, Tiki Windley, MPA², Molly De Marco, PhD, MPH², Bill Kearney², (1)The University of North Carolina at Chapel Hill, Chapel Hill, NC, (2)UNC Center for Health Promotion and Disease Prevention, Chapel Hill, NC. Graduate Association of Food Studies Annual Conference, Chapel Hill, NC, October 4th, 2018.

Integrating Concepts from Behavioral Economics into Low-Cost Healthy Retail Interventions: Methods and Results from Rural North Carolina. Leah Chapman, MPH^1,2, Maria Koutlas², Claire Sadeghzadeh, MPH², Catherine Zimmer, PhD³, Molly M. De Marco, PhD, MPH², (1) The University of North Carolina at Chapel Hill Department of Nutrition, Chapel Hill, NC, (2) UNC Center for Health Promotion and Disease Prevention, Chapel Hill, NC, (3) UNC Odum Institute, Chapel Hill, NC. National Rural Grocery Summit, Manhattan, Kansas, June 25, 2018.

Beyond the Health Benefits of Fresh Fruits and Vegetables: Rural Community Gardens as Catalysts of Community Invigoration, New Socio-Economic Pathways, and Reclamation of Tradition and Food Sovereignty. Brett Sheppard, MA, Christina Chauvenet, PhD candidate and Molly M. De Marco, PhD, MPH, University of North Carolina at Chapel Hill, Chapel Hill, NC. AFHVS/ASFS Conference, Madison, June 16, 2018.

Beyond the Health Benefits of Fresh Fruits and Vegetables: Utilizing Qualitative Research to Understand the Broader Impacts of a Community Gardens Project in Low-Income, Rural Communities. Brett Sheppard, MA, Christina Chauvenet, PhD candidate, Dwayne Campbell, PhD, Nasir Siddique, Bridget Gallagher, and Molly M. De Marco, PhD, MPH, University of North Carolina at Chapel Hill, Chapel Hill, NC. Minority Health Conference, Chapel Hill, February 23, 2018.

Reports

How Healthy Helping Supported North Carolinians: Key Preliminary Findings by Shu Wen Ng, Molly DeMarco, Richard Henderson, Isabel Lu, Brett Sheppard, Neal Curran, and Sam Hoeffler.

Adapting Design Thinking Methods and Best Practices to a Virtual Environment: Lessons Learned and Future Considerations by Jared Bishop, Claire Sadeghzadeh, Eduardo Hernandez, Liz Chen, Alice Ammerman, Tracy Dearth- Wesley, and Molly De Marco.

Research on Behavioral Economics-Based Promotion of Healthy Food Choice in a Retail Setting: Can Results Inform SNAP-Ed Practice? by Molly De Marco, Jessica Soldavini, Tracy Wesley, and Alice Ammerman. This brief describes strategies for communicating research findings to program managers and practitioners in USDA’s SNAP-Ed program, potentially leading to new intervention approaches that could impact the well-being of the many Americans reached by the SNAP-Ed program.

A Researcher’s Checklist for Working with Sales Data to Evaluate Healthy Retail Interventions by Molly De Marco, Christina Chauvenet, Leah Chapman, and Danton Noriega-Goodwin. This brief aims to provide an overview of key considerations for researchers who wish to use sales data to evaluate the effectiveness of healthy retail interventions. This brief discusses key considerations for identifying the research question, forming a partnership with retailers, and data collection and analysis.

What’s in it for Retailers? Establishing Partnerships with Food Retailers to Conduct Healthy Food Choice Research by Molly De Marco, Leah Chapman, and Nasir Siddique. Food retailers can and should be seen as vital partners as we work to improve nutrition. This brief provides insights and strategies for establishing research partnerships with food retailers. This brief represents accumulated insights from researchers working with the following programs and projects: SNAP-Ed, BECR, NC Growing Together, and the RNECE-South, who have conducted healthy food retail interventions for 5 years with over 20 different corporate and family-owned retailers.

Uses of Behavioral Economics Nudges within Healthy Retail Interventions in the SNAP-Ed Program: Research Opportunities by Daniella Uslan, Jessica Soldavini, Molly De Marco, Terry Hartman, and Alice Ammerman. In collaboration with the UNC Center for Health Promotion and Disease Prevention, the BECR Center drafted a brief to discuss the potential research opportunities for using behavioral economics strategies within the SNAP-Ed Program. This brief highlights text from the 2017 SNAP Education Plan Guidance.

Choosing Foods and Beverages to Promote in Healthy Retail Research by Terry Hartman, Molly De Marco, Megan Lott, Jessica Soldavini, Madelaine Katz, Alice Ammerman, and Mary Story. Purchasing a healthy mix of food items is a key step toward improving diet and health. Researchers are increasingly focusing on this step, investigating strategies to promote healthy food purchasing. However, in a retail setting that encompasses thousands of items, choosing products to promote that are most likely to have a positive impact on consumers’ diets may require consideration. The purpose of this brief is to provide behavioral researchers with a quick reference to help determine which types of products to promote.

Behavioral Economics in the Healthy Retail Environment: Working Within the SNAP-Ed Context by Alice Ammerman, Molly De Marco, and Daniella Uslan. The Regional Nutrition Education and Obesity Prevention Centers of Excellence (RNECE) Southern Region at UNC- Chapel Hill recently presented a webinar on behavioral economics within the SNAP-Ed context. The field of Behavioral Economics provides valuable insight in understanding people’s behaviors and decision-making processes. This webinar will introduce key concepts from Behavioral Economics and discuss how SNAP-Ed agencies can leverage these concepts to “nudge” consumers to make healthier food choices in a retail setting.

Buying Wisely and Well: Managing WIC Food Costs While Improving the WIC Customer’s Shopping Experience by Alice Ammerman, Molly De Marco, Matthew Harding, Terry Hartman, and Jewels Rhode. In July 2015, the BECR Center hosted a roundtable to discuss exploratory and innovative behavioral economics strategies that might be useful in helping the WIC Program manage food costs without adversely impacting participant redemptions, program satisfaction, and participation. This brief provides a summary of the discussion that took place during the meeting, based on five white papers funded by the BECR Center as well as the accompanying discussion.

Review of the Literature on Use of Behavioral Economic Nudges in Farmers’ Markets and More Traditional Retail Settings by Hannah Pettus, a master’s student from the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, Behavioral Economic nudges offer a range of techniques for influencing food-choice related behaviors in retail settings, including convenience stores, grocery stores and farmers’ markets. We summarize the research to date that has used behavioral economic techniques to nudge consumers to make healthier choices in places where we shop for food.