Perceived impact and feasibility of strategies to improve access to healthy foods in Washington State, USA.
OBJECTIVE
The present study measured the perceived impact and political and implementation feasibility of state-level policy strategies related to increasing access to healthy foods and limiting unhealthy foods.


METHODS
Potential state-level policy strategies to improve access to healthy foods were identified through a review of evidence-based literature and policy recommendations. Respondents rated the perceived impact and political and implementation feasibility of each policy on a five-point scale using online surveys.


METHODS
Washington State policy process.


METHODS
Forty-nine content experts (national researchers and subject experts), forty policy experts (state elected officials or their staff, gubernatorial or legislative policy analysts) and forty-five other stakeholders (state-level advocates, programme administrators, food producers).


RESULTS
In aggregate, respondents rated policy impact and implementation feasibility higher than political feasibility. Policy experts rated policy strategies as less politically feasible compared with content experts (P < 0·02) or other stakeholders (P < 0·001). Eight policy strategies were rated above the median for impact and political and implementation feasibility. These included policies related to nutrition standards in schools and child-care facilities, food distribution systems, urban planning projects, water availability, joint use agreements and breast-feeding supports.


CONCLUSIONS
Although they may be perceived as potentially impactful, some policies will be more difficult to enact than others. Information about the potential feasibility of policies to improve access to healthy foods can be used to focus limited policy process resources on strategies with the highest potential for enactment, implementation and impact.
1 Center for Public Health Nutrition, University of Washington, Box 353410, Seattle, WA 98195 USA.
Donna B
DB
Johnson
Emilee L
EL
Quinn
Mary
M
Podrabsky
Nadia
N
Beckwith-Stanley
Nadine
N
Chan
Amy
A
Ellings
Tricia
T
Kovacs
Claire
C
Lane
D002648:Child; D003625:Data Collection; D004032:Diet; D005522:Food Services; D005523:Food Supply; D006293:Health Promotion; D006801:Humans; D018673:Nutrition Policy; D009753:Nutritive Value; D009765:Obesity / Q000517:prevention & control; D010465:Perception; D011057:Politics; D015397:Program Evaluation; D012574:Schools; D014861:Washington