Introduction
Food systems incorporate a myriad of actors and activities spanning food production, processing, distribution, consumption and waste. These activities are interlinked with the social, economic and environmental contexts in which they are situated(1). Food systems are within urban and rural or remote contexts, the latter encompassing areas beyond metropolitan or major cities(2). Current food systems in high-income countries are fraught with issues including a lack of resiliency, resulting in fluctuations in food availability and price issues, issues which are exacerbated during crises(Reference Godrich, Macau and Kent3), challenges associated with climate change, such as natural resource degradation(4), and inequitable food access, whereby a greater density of energy-dense, nutrient-poor foods exists in lower socio-economic areas(Reference Trapp, Hooper and Thornton5). When challenges with food access and supply occur in high-income countries, there is often a reliance on providing short-term, suboptimal food relief that often fails to meet nutritional needs and individual agency(Reference Oldroyd, Eskandari and Pratt6). In addition, limited access to comprehensive nutrition knowledge and cooking skills programmes can prevent optimal food utilisation in populations at high risk of food insecurity in high-income countries(Reference Butcher, Platts and Le7,Reference Begley, Paynter and Butcher8) .
Effective solutions to food system issues across urban and rural areas of high-income countries includes prioritising local or regional food systems to increase food system resiliency(Reference Godrich, Macau and Kent3,Reference Godrich, Lo and Kent9) . While there is no commonly agreed definition of locally grown or regionally grown food, often the terms relate to food grown close to consumer residences, or grown within the country of consumption(Reference Kent, Godrich and Murray10). Other solutions proposed include increasing equitable access to nutritious food through alternative food relief models(Reference Lo and Delwiche11,12) ; supporting increased economic development of regional communities through increased job opportunities or local food sales; environmental sustainability activities including reducing food industry or hospitality sector food waste; and increasing access to healthy food through successful policy advocacy (e.g. retail zoning)(Reference Hills and Jones13–Reference Schiff, Levkoe and Wilkinson15).
Food Policy Groups (FPGs) have emerged as an effective mechanism to facilitate these food system solutions. FPGs refer to the diverse range of cross sector organisations also known as food policy councils, coalitions, collaboratives, networks, partnerships, boards or steering committees(Reference Bassarab, Santo and Palmer16). FPGs have proliferated across high-income countries including Europe, the USA, Canada, the UK, New Zealand and Australia, engaging multi-sectorial stakeholders from government, agriculture (i.e. food producers), social services, economic development, public health, hunger relief organisations and advocacy groups in identifying issues and facilitating effective solutions across the food system(Reference Calancie, Allen and Weiner17). FPGs can operate at varying levels including municipal/local government, provincial/state, rural or First Nations levels(Reference Bassarab, Santo and Palmer16). Depending on regional needs, FPGs are involved in a diverse range of activities including advocacy to influence local or state policy, such as preserving agricultural land(Reference Calancie, Allen and Weiner17,Reference Calancie, Cooksey-Stowers and Palmer18) ; network or partnership facilitation; local food procurement to build local or regional food systems; or direct program delivery, such as cooking, gardening skills or school meals(Reference Calancie, Cooksey-Stowers and Palmer18). Research shows that school meal programmes can provide both educational and health benefits to children and can influence food security at the household level(19). In addition, a nutritionally balanced lunch may significantly contribute to the diets of children and young people(Reference Cook, Altman and Jacoby20). School lunch programmes also have the potential to be extended to incorporate food literacy education, and have resulted in improved attendance, educational engagement and behaviour(Reference Sarlio-Lähteenkorva and Manninen21,Reference Saxena and Tornaghi22) . Evidence has shown that increasing food literacy is linked to better dietary practices(Reference Butcher, Platts and Le7,72) . Among adolescents, increased preparation of meals has been related to healthier diets(Reference McCartan and Palermo73), while among adults, food literacy has been related to intention to prepare healthy meals(Reference Palmer and Calancie74). However, evidence from within some high-income countries suggests that food literacy education is not widely prioritised by schools(Reference Knowles, Nicol, Pitt and Williams75,Reference Moragues-Faus and Marceau76) . A survey of teachers found that one quarter (27%) disagreed that food and nutrition education was prioritised in their schools, and almost half (43%) disagreed that their school adopted a ‘whole of school’ approach to food and nutrition education(Reference Knowles, Nicol, Pitt and Williams75,Reference Lange, Calancie and Onufrak77) . FPGs have also implemented activities that increased awareness of local food poverty, resource dissemination to emergency relief or local service providers. However, these activities are less likely to positively influence the food security of a region in the longer term(Reference Loopstra23). The COVID-19 pandemic required FPGs to ‘step up’ and respond to local food needs within their communities, extending current activities or creating new ones, for example, utilising their substantial partner network to redistribute food destined for waste to new markets, delivering targeted food boxes to priority populations, and advocating that food sources such as farmers’ markets be deemed essential business during mandated lockdowns(Reference Palmer, Atoloye and Bassarab24).
While there are ample FPG annual reports and websites documenting the plethora of food system activities undertaken by FPGs, there is currently no synthesis of these activities or an appraisal of the impact of these activities across high-income countries. Evaluation within each country would provide useful place-based application, though some countries have a dearth of evidence regarding successful FPG activities. Therefore, the cross-country synthesis would provide a wide range of activity exemplars that could potentially be transferrable to other locations, for example, policy advocacy or community/citizen activities(Reference Kwon, Cameron and Hammond25). The lack of evaluation evidence limits our understanding of the effectiveness of these groups on local food system issues, such as through policy, systems and environmental change, including an understanding of the impacts in urban and rural communities(Reference Schiff, Levkoe and Wilkinson15,Reference Calancie, Cooksey-Stowers and Palmer18) . Therefore, this scoping review aimed to synthesize the literature describing the impact of FPGs, for improving food system action, in urban and rural regions of high-income countries. To provide a comprehensive overview of the available evidence, the question guiding this scoping review was ‘What evidence is available on the impact of FPGs on local food systems, in urban and rural regions of high-income countries?’
Methods
Protocol and registration
The protocol for this scoping review is registered with Open Science Framework register (https://osf.io/zj7a6). The protocol for this review was determined a priori to beginning the review, including the research question, inclusion and exclusion criteria, data sources and search strategy, and the process for selection of the evidence, data-charting and synthesis. The structure and reporting of this review was guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist(Reference Tricco, Lillie and Zarin26).
Search strategy for identifying studies
A database search for peer-reviewed literature was conducted in Scopus, Medline, Proquest and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases using the following search terms: ‘local food partnership’ OR ‘food policy council’ OR ‘food policy coalition’ OR ‘food policy alliance’ OR ‘food system coalitions’ AND ‘impact OR outcome’ OR ‘policy output’ OR ‘evaluation’. All results were exported into an EndNote database(27). A three-step grey literature search was also conducted. Firstly, a Google Scholar search using the search terms was undertaken, with the first fifty pages of results scanned for relevancy. Secondly, the resource Johns Hopkins ‘Annotated Bibliography on Existing, Emerging, and Needed Research on Food Policy Groups’(Reference Santo, Bassarab and Kessler28) was reviewed, with individual references retrieved. Thirdly, individual FPG websites from Europe, Canada, the USA, New Zealand and Australia were reviewed(29–31), and reports referring to impact or evaluation were identified(Reference Calancie, Allen and Weiner17,Reference Kornacki32–Reference Hamel, McCabe, Page and Zaldonis34) . Potentially relevant grey literature was identified by the title or synopsis/abstract including the terms ‘local food partnership’ OR ‘food policy council OR food policy coalition OR food policy alliance OR food system coalition’ AND ‘impact OR outcome OR policy output OR evaluation’. References were then collated in an Endnote library with peer-reviewed literature, then imported into Covidence software for screening(35).
Screening and selection of included studies
For the purposes of this scoping review, FPGs were defined as collective groups of stakeholders who worked collaboratively to create food system reform through policies and programmes, with a focus on health, economic, environmental and social outcomes(Reference Santo, Bassarab and Kessler28). Documents were included in this scoping review if they were published between 2002 and 2022, to align with the proliferation of FPGs in the past two decades(Reference Schiff, Levkoe and Wilkinson15). Documents from FPGs in Europe, the USA, Canada, the UK, New Zealand and Australia were considered for inclusion, based on documents published in English, and that they are defined high-income Organisation for Economic Co-operation and Development (OECD) countries(36). Further, documents were included if they were online reports, journal articles, theses or book chapters. Documents were excluded if they were conference proceedings; magazine articles or opinion pieces; published before 2002; published in a language other than English, or if the FPGs operated in low- or middle-income countries.
Documents were initially screened for relevance by title, executive summaries, or table of contents by two authors (J.D. and S.G.) with conflicts resolved by a third reviewer (K.K.). Documents were included if they discussed the impact and/or evaluation of activities by an FPG (or synonyms). Limited documents demonstrating evaluation evidence were initially found, therefore the search strategy was broadened and repeated to include documents that listed activities and/or programmes that contributed to impact on food systems. Full-text documents were reviewed by two authors (J.D. and S.G.), and full-text screening conflicts were resolved in a consensus meeting with the project manager (S.L.G.) and a third reviewer (K.K.).
Charting the data from peer-reviewed publications and policy documentation
Data were charted into pre-defined tables in a Microsoft Excel(37). Charted data included the document title; author(s); year; country; geographical scope; urban/rural as defined by the authors; aims/purpose; study type; FPG; programme name; intervention; key findings; methods. FPGs activities were then itemised according to six impact domains identified by Calancie et al. (2018) in the Healthy Food Policy Project Food System Crosswalk(Reference Calancie, Cooksey-Stowers and Palmer18,38) . The impact domains were as follows: (1) increased access to healthy food; (2) increased knowledge of and/or demand for healthy food; (3) increased food system equity; (4) support increased economic development; (5) support/promote increased environmental sustainability; (6) support food system resiliency.
Results
Study selection
As summarised by the PRISMA flow diagram in Fig. 1, the searches yielded 355 documents, of which 324 remained after the removal of duplicates. After the removal of 177 documents in screening the title and abstract, the full texts of 147 articles were reviewed. The main reasons for exclusion at the full-text stage included that the documents did not provide evidence of any evaluation of activities (n = 78). For example, they described activities undertaken by their FPG but provided no evidence of the resulting impact of such activities. A resulting thirty-one documents were included(Reference Lo and Delwiche11,12,Reference Jones, Hills and Beardmore14,Reference Bassarab, Santo and Palmer16,Reference Hamel, McCabe, Page and Zaldonis34,Reference Fox40–62) . As two documents reported on the same evaluated activities by one FPG, these documents were combined for the synthesis.
PRISMA flowchart of literature search and selection of inclusion process(Reference Page, McKenzie and Bossuyt39).
Summary characteristics of the included documents and their evaluation activities
An overview of the characteristics of included documents is provided in Table 1. Included documents reported on evaluated activities by FPGs located in the USA (n = 16)(Reference Lo and Delwiche11,Reference Hamel, McCabe, Page and Zaldonis34,Reference Martin41–Reference Rothman and Baughman43,48,50,Reference Augustine51,53,54,56,57,Reference Calancie, Stritzinger and Konich59,61–63) , the UK and England (n = 10)(12–Reference Jones, Hills and Beardmore14,Reference King45–47,49,52,Reference Taylor58,60) , both the USA and Canada (n = 3)(Reference Bassarab, Santo and Palmer16,Reference Fox40,Reference Celovsky44) , and Australia (n = 1)(55).
Summary of characteristics of included FPG documents
Activities were predominantly conducted in urban-only regions (n = 18)(Reference Lo and Delwiche11,12,Reference Hamel, McCabe, Page and Zaldonis34,Reference Schless-Meier42,Reference Rothman and Baughman43,46,47,49,50,52,54,56–Reference Taylor58,60–63) , and a smaller number in both urban and rural regions (n = 10)(Reference Hills and Jones13,Reference Jones, Hills and Beardmore14,Reference Bassarab, Santo and Palmer16,Reference Fox40,Reference Martin41,Reference Celovsky44,Reference King45,48,53,55) . Only one document reported on activities conducted in a rural only region (n = 1)(Reference Calancie, Stritzinger and Konich59).
Most documents reported on evaluated activities of a single FPG (Table 1), and five documents reported on the activities of several FPGs(Reference Hills and Jones13,Reference Jones, Hills and Beardmore14,Reference Bassarab, Santo and Palmer16,Reference Celovsky44,Reference King45) . The evaluation methods utilised within the documents were varied, and often multiple methods of evaluation were reported including quantitative and qualitative processes (Table 1). Methods of evaluation were not explicitly described in thirteen documents(12,47,49,50,52–56,60,61,63) . Most documents reported on the results of surveys and interviews with consumers, programme participants or FPG members (Table 1). A minority of documents reported desk-based evaluation activities of impact including audits of activities and meetings, and data on implementation of programmes (Table 1).
Most documents reported a range of outcomes across the impact domains previously identified. A third of documents (n = 11) reported on only one domain(Reference Fox40,Reference Schless-Meier42,Reference Celovsky44,47,50,53,54,57,60–62) , five reported on two domains(Reference Rothman and Baughman43,49,52,56,63) , seven documents reported on three domains(Reference Lo and Delwiche11,12,Reference Bassarab, Santo and Palmer16,Reference Calancie, Allen and Weiner17,Reference Martin41,48,55) ; five documents reported on four domains(Reference Hills and Jones13,Reference Hamel, McCabe, Page and Zaldonis34,Reference King45,46,Reference Augustine51) , and only one document reported five(Reference Taylor58) and six domains, respectively(Reference Jones, Hills and Beardmore14). A summary of evidence for each impact domain is provided below.
Food system equity
Evaluated initiatives that impacted food system equity were considered in most documents (n = 23, 74%)(Reference Lo and Delwiche11,12,Reference Jones, Hills and Beardmore14,Reference Bassarab, Santo and Palmer16,Reference Hamel, McCabe, Page and Zaldonis34,Reference Fox40–46,48,Reference Augustine51–53,55–Reference Calancie, Stritzinger and Konich59,61,63) . These documents outlined activities conducted across both urban (n = 12), urban and rural areas collectively (n = 10), and rural-only areas (n = 1).
Seven documents reported on initiatives that established, extended or improved school meals programmes or that provided emergency food relief through schools to children and their families(Reference Bassarab, Santo and Palmer16,Reference Hamel, McCabe, Page and Zaldonis34,46,48,53,56,61) (Table 2). For example, the Nevada FPG advocated successfully for a funded mandate requiring schools with a high rate of students eligible for free or reduced-price meals to be provided within school time(Reference Bassarab, Santo and Palmer16). Sometimes, local food procurement was increased within existing school meals programmes(Reference Lo and Delwiche11,50) , for example, Los Angeles Unified School District doubled the amount of its food budget spent on food through local producers. Ten documents reported on enhancing access to and quality of existing emergency food relief programmes or establishing new ways to link food relief with at-risk groups(12,Reference Jones, Hills and Beardmore14,Reference Fox40,Reference Celovsky44–46,55,57,Reference Taylor58) . Some documents reported on activities that increased donations of fruit and vegetables and other locally grown food to food hubs and emergency food relief providers(Reference Fox40,Reference Celovsky44,46,55,57,Reference Taylor58) . For example, one document reported the establishment of a youth-led network that grew and donated fresh food to food relief organisations(55). In another document, a community meal project delivered emergency food parcels as part of the COVID-19 response, with 60% of beneficiaries reporting eating more vegetables(Reference Taylor58).
Summary of FPGs evidence relating to food system equity
↑ Increased; ↓ decreased.
In three documents, initiatives to increase equitable access to healthy food through farmers markets was discussed(Reference Martin41,Reference Schless-Meier42,Reference Calancie, Stritzinger and Konich59) . For example, one document reported an increase in diversity of customers attending a farmers’ market, and strategies to increase food vouchers (such as the Supplemental Nutrition Assistance Program) through farmers markets(Reference Martin41,Reference Schless-Meier42,Reference Calancie, Stritzinger and Konich59) . Lastly, two documents reported initiatives that increased access to food for people experiencing food insecurity through education programmes that increased the use of food vouchers(Reference Rothman and Baughman43,52) .
Knowledge of and/or demand for healthy food
Sixteen documents reported evaluated initiatives that impacted knowledge of and/or demand for healthy food (n = 16)(12–Reference Jones, Hills and Beardmore14,Reference Hamel, McCabe, Page and Zaldonis34,Reference Martin41,Reference Rothman and Baughman43,Reference King45–49,52,55,Reference Taylor58,60,63) (Table 3). These documents outlined activities conducted across both urban and rural areas collectively (n = 8), urban (n = 7) and rural-only areas (n = 1). Activities included strategies to improve knowledge of and/or demand of healthy food and mainly focused on increasing food literacy in adults(12,Reference Martin41,Reference Rothman and Baughman43,46) , both adults and children combined(47,49,52,60) and in school children/adolescents(Reference Hills and Jones13,55) . Increased awareness of local food poverty(Reference King45,46) , resource dissemination through emergency relief or relevant local services(Reference Jones, Hills and Beardmore14,56,Reference Taylor58) , increased knowledge of sustainable eating practices and reducing food waste(47) were also discussed. For example, interviewees in King’s (2017) evaluation of FPGs(Reference King45) discussed educating and raising awareness of the complexity of food poverty through a Smart Sugar campaign, ‘Taste Adventures’ (where children were issued stamps for trying new food) as well as local producer involvement in the education of children. In the evaluation of the Brighton & Hove Food Partnership (BHFP), Taylor (2021) reported increased consumer knowledge about where to purchase local food and benefits of local foods; 74% of survey respondents felt they could eat better within their budget, 56% had tried new foods, and 27% had consumed fewer unhealthy snacks/drinks(Reference Taylor58). Participants also reported improved knowledge and access to relevant local services (45% of project users said they have learnt about other services/activities)(Reference Taylor58). The Montgomery County Food Policy Council reported that increased promotion of food relief services to a wider audience (for example, the ‘Rainbow Community Development Center’) led to an increase in utilisation of the service to a total of 8002 households, a 275% increase over their initial projections, following an educational campaign.
Summary of FPG evidence relating to increased knowledge and/or demand for healthy food
↑ Increased.
Access to healthy food
A third of documents evaluated initiatives that impacted access to healthy food (n = 12)(Reference Hills and Jones13,Reference Jones, Hills and Beardmore14,Reference Bassarab, Santo and Palmer16,Reference Hamel, McCabe, Page and Zaldonis34,Reference Martin41,Reference King45,46,Reference Augustine51,54,56,Reference Taylor58,Reference Calancie, Stritzinger and Konich59) (Table 4). These documents outlined activities conducted across both urban and rural areas collectively (n = 6), urban-only areas (n = 5) and rural-only areas (n = 1). The documents detailed a variety of methods used by FPGs to increase access to healthy food including: the delivery of fresh food(Reference Hills and Jones13,56) , an improvement of system-level issues (e.g. local food procurement, land use and encouraging people to grow their own)(Reference King45,54) , making healthier food more affordable to low income families(Reference Martin41,Reference Calancie, Stritzinger and Konich59) , increasing fruit and vegetables served to children(Reference Augustine51), and targeted advocacy to improve healthy food access(Reference Hills and Jones13,Reference Bassarab, Santo and Palmer16,46) . One document outlined the implementation of a new bus route to make accessibility to healthy food easier(Reference Hamel, McCabe, Page and Zaldonis34) and the provision of increased food storage capacity for an ‘Affordable Food’ programme(Reference Taylor58). Although some of the methods of evaluation were not disclosed in the documents, the majority reported positive action towards improving access to healthy food. For example, King (2017) undertook qualitative interviews to understand how FPGs were addressing food system issues including changing local food procurement (e.g. school meal service), land use, helping people to grow their own food and helping local suppliers to sell healthy local produce(Reference King45). Augustine (2019), through a review of secondary data, found that after 3 years of following the Good Food Purchasing Policy (GFPP), the Los Angeles Area School District and its produce distributor increased the overall amount of fresh produce purchased and served to students(Reference Schless-Meier42). The Los Angeles Food Policy Council’s ‘Healthy Neighbourhood Market Network program’ provided education and technical assistance to support neighbourhood market owners to increase healthy foods options and store owners learned to purchase, store and market fresh produce. The council reported that 100% of store owners had cited an increase in healthy retail sales and an average US$1453·40 profit increase a week due to including more healthy food options(54).
Summary of FPGs evidence relating to healthy food access
↑ Increased.
Environmental sustainability
Ten documents were included that evaluated initiatives that impacted environmental sustainability outcomes (n = 10)(12–Reference Jones, Hills and Beardmore14,Reference Bassarab, Santo and Palmer16,Reference Hamel, McCabe, Page and Zaldonis34,46,48–50,Reference Taylor58) (Table 5). These documents outlined activities conducted across urban-only areas (n = 4) and both urban and rural areas collectively (n = 4), with none in rural-only areas. Reducing food waste was the most common outcome related to environmental sustainability reported by FPGs, discussed in eight documents(12–Reference Jones, Hills and Beardmore14,Reference Bassarab, Santo and Palmer16,46,49,50,Reference Taylor58) . Examples of food waste reduction initiatives include promoting low-waste food items on menus of existing food outlets to the establishment of new zero-waste food outlets. Other activities included low-waste promotion and education programmes for consumers and food system stakeholders and the establishment of surplus food programmes which aimed to reduce food waste. Initiatives related to increasing urban agriculture was reported by three documents(Reference Jones, Hills and Beardmore14,Reference Hamel, McCabe, Page and Zaldonis34,48) . Examples of initiatives included gardening programmes and policies to support food production (gardens, chickens and bee keeping) by residents in urban areas.
Summary of FPG evidence relating to support environmental sustainability
↑ Increased; ↓ decreased.
Economic development
Evaluated initiatives that impacted economic development were reported in a small number of documents (n = 6)(Reference Lo and Delwiche11,Reference Jones, Hills and Beardmore14,Reference King45,Reference Augustine51,Reference Taylor58,Reference Calancie, Stritzinger and Konich59) (Table 6). These documents outlined activities conducted across both urban and rural areas collectively (n = 3), as well as urban- (n = 2) and rural-only areas (n = 1). Economic development-focused initiatives included ensuring local businesses were not outbid by large food distributors, therefore keeping jobs locally(Reference Jones, Hills and Beardmore14,Reference King45) , for example, school meal programmes providing opportunities for smaller businesses to gain food supply contracts. Others reported activities that maintained income for local food producers and farmers(Reference Lo and Delwiche11,Reference Augustine51,Reference Taylor58,Reference Calancie, Stritzinger and Konich59) and truck drivers within the food supply system(Reference Lo and Delwiche11). For example, Lo and Delwiche (2016) outlined large economic impacts and local food procurement practices resulting from the adoption of the Good Food Purchasing Policy (GFPP). This led to the redirection of at least US$10 million for produce purchasing from local growers and creation of at least 200 new, well-paying food chain jobs in Los Angeles County. Jobs were created on farms, in fruit and vegetable processing, and in bread manufacturing and distribution. GFPP also contributed to higher wages and improved working conditions for over 160 truck drivers in local supply chains(Reference Lo and Delwiche11). The Adams County Food Policy Council also demonstrated improved economic benefits to local farmers through increasing the customer base and sales of local produce at farmers’ markets(Reference Calancie, Stritzinger and Konich59).
Summary of FPG evidence relating to support increased economic development
↑ Increased.
Food system resiliency
Six documents included evaluated initiatives that impacted food system resiliency of regions (n = 6)(Reference Lo and Delwiche11,Reference Hills and Jones13,Reference Jones, Hills and Beardmore14,Reference Augustine51,55,62) . These documents outlined activities conducted across both urban and rural areas collectively (n = 4), and urban-only areas (n = 2), none of which included activities in rural only areas. In three documents, FPGs reported their activities resulted in increased support for and sale for local food producers(Reference Augustine51,55,62) . This was sometimes linked with increased consumption of healthy foods through the provision of local food boxes(55). Government funding commitments and local-food focused food strategies, such as food procurement plans, were reported in two documents(Reference Hills and Jones13,Reference Jones, Hills and Beardmore14) . The development of partnerships, strategies and networks supporting local food producers were reported in two documents(Reference Lo and Delwiche11,62) , sometimes with reported economic benefits for producers and regions (Table 7). For example, Lo and Delwiche (2016) reported on the establishment of a relationship for sustainable wheat farmers in California to become the primary source of grain for baking products for the region’s school district. Additionally, a local food campaign in multiple school districts resulted in increased sales of local food to school cafeterias(62).
Summary of FPG evidence relating to support food system resiliency
↑ Increased.
Discussion
This scoping review aimed to synthesise all available evidence of the impact of FPGs for improving food system action, in urban and non-urban regions of high-income countries. Of the thirty-one documents in this review, approximately half reported on evaluated activities by FPGs located in the USA, with a smaller number within the UK and England, Canada and Australia. Evaluation methods utilised within the documents ranged from comprehensive, mixed methods evaluation to surveys and interviews to activity audits. The evidence points to a positive impact of FPGs on multiple food system domains, with most FPGs conducting a range of activities relevant to their regions, mostly in urban areas and to a lesser extent including rural-only regions. This is consistent with the wider literature that there is a lack of food- and nutrition-related research in rural areas around the world(Reference Osborne and Piper64,Reference Kent, Alston and Murray65) .
Key activities relating to food system equity undertaken by FPGs included evidence-based initiatives such as extension or improvement of school meal programmes or school-based emergency food relief. Our review shows that FPG activities such as extension or improvement of school meals programmes or emergency food relief(66) occurred mostly within the USA, and to a lesser extent in the UK, Canada and Australia, and even less in rural areas. Specific activities included trialling alternative food relief models (i.e. in England), extending school lunch programmes, such as through weekend or holiday periods (England, USA), creating holiday lunch clubs, providing alternative food relief through ‘pay as you feel’ community meals programmes (UK) and food drop-off locations in low-income neighbourhoods (Canada). Given the USA has a National School Lunch Program (NSLP) which provides low-cost or free lunches in almost 100 000 public and non-profit private schools, it is unsurprising that US documents focused on school-based meals. While the UK provides a Free Meal programme, not all students are eligible due to a low threshold of household income limits. Recent advocacy activities from FPGs have called for the extension of such programmes to become universal(67). In Baltimore (USA), and in response to COVID-19, schools, recreation centres and mobile sites provided over 10·5 million ‘Youth Grab and Go Meals’ to children and young people. Initiatives supporting the wider community included a decentralised food network; many small food collection sites were established to support vulnerable community members. Food boxes were home-delivered to older adults and anyone economically, medically or socially impacted by the pandemic(Reference Freishtat68).
Our findings relating to FPG efforts to enhance knowledge of and/or demand for healthy food focused on increasing food literacy, among children, young people and adults included activities that align with the broader literature. For example, England’s ‘Taste Adventures’ programme issued stamps to children when they tried new food and local producers were also involved in food system education of children(Reference King45). Consumer education in the UK increased their awareness about where to purchase local food, and the associated benefits of local food(Reference Taylor58). Other FPGs activities influenced healthy food knowledge (i.e. USA, England, Australia), understanding of sustainable eating practices, how to eat on a budget (both England) and where to purchase locally grown food (England, USA) and food waste reduction activities (England). Consumer-focused activities surrounding nutrition and environmental sustainability have been shown to be effective, particularly with respect to food wastage, in high-income countries(Reference Conrad and Blackstone69).
Predominant activities relating to the healthy food access domain included local food procurement and encouragement of home-grown produce, to overcome the predominant barriers to consumption of regionally grown fruit and vegetables(Reference Godrich, Kent and Murray70). Our review highlighted that FPGs increased access to healthy food through fresh food delivery and local food procurement, via school meal services (England). In addition, FPGs supported the development of a food hub in the UK or conducted targeted advocacy to improve healthy food access, such as advocating for farmers’ markets to accept SNAP benefits (USA), and establishment of a new bus route (USA). FPG members successfully advocated for food objectives to be included in a Local Outcomes Improvement Plan and gained endorsement of a cross-sector partnership to drive local food issues(Reference Hills and Jones13) (UK).
Our review highlights that impactful FPG activities for environmental sustainability (i.e. low-food-waste café initiatives in the UK and USA, consumer waste reduction education in the UK and USA), economic development (i.e. support for improved business management in England, creation of food system jobs in the USA) and food system resiliency (i.e. supporting local food systems and the development of food strategies in the UK), were reported on by fewer documents. This could be related to the outcomes of these activities being harder to quantify or link to outcomes of specific FPG actions. Our study highlighted a range of evaluation strategies and tools used across several countries to measure FPGs’ impact on local food systems. Mixed methods evaluation was used among a third of studies, while others used case study or qualitative approaches. A 20-year FPG scoping review asserted that more mixed methods, quantitative and mixed site evaluation is required, to gain a comprehensive understanding of FPGs’ impact on food systems(Reference Schiff, Levkoe and Wilkinson15). The same scoping review also reported few FPG evaluations had been conducted outside of the USA. Our review builds on this evidence by including findings from several other high-income countries. Regular, formal FPG evaluation on local food systems and policy impacts has been recommended by many previous research authors(Reference Schiff, Levkoe and Wilkinson15). The reasons why many FPGs do not implement existing, comprehensive tools remains to be investigated. Previous research has indicated resourcing and capacity constraints, such as that FPGs are not research or data-driven, as well as a lack of time, and particularly funding, were key challenges facing FPGs(Reference Schiff, Levkoe and Wilkinson15). For example, some FPGs lack core staff funding, almost three-quarters in the USA operate on an annual budget of US$10 000 or less, and more than one third of FPGs have no funding(Reference Bassarab, Clark and Santo71). This demonstrates the substantial challenges faced by FPGs to progress food system support. Widespread measurement of the impact of FPG activities on local food systems could increase the proliferation of FPGs across all high-income countries(Reference Schiff, Levkoe and Wilkinson15). This could be especially important in countries like Australia where the concept remains in its infancy(72), despite some positive, early successes(Reference McCartan and Palermo73).
Based on our review of the evidence supporting the impact of FPGs on local food systems, we make the following recommendations:
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FPGs should utilise tools and frameworks to regularly and systematically evaluate their impact, using such tools as the ‘Get it Toolgether’: Food Policy Capacity Assessment Toolkit(Reference Palmer and Calancie74), Food Policy Council Self-Assessment Tool (FPC-SAT)(Reference Calancie, Allen and Weiner17), Food Power Collective Impact Tracker(Reference Knowles, Nicol, Pitt and Williams75), or Sustainable Food Cities (SFC) Network framework and toolkit(Reference Moragues-Faus and Marceau76). Utilisation of tools like these would facilitate cross-country and setting comparisons and ensure data collected are compelling and credible. Local health researchers, consultants and/or health promotion practitioners may be best to orientate FPGs to these. For example, FPGs could partner with universities, to increase the likelihood that food system impact activities are comprehensively evaluated.
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FPGs should be encouraged in areas where stakeholders have identified an intention to address multiple food system issues collaboratively, with the goal of integrating and aligning their work. Such groups could learn from existing international activities(Reference Lange, Calancie and Onufrak77), but prioritising food system activities that are suitable for the local context. For example, place-based stakeholders should determine whether FPGs need to be embedded within local governments as a strategy to initiate or support the development and implementation of activities.
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More research is needed to firstly understand work addressing food system issues in regional areas, such as which groups currently exist, their food system issues of focus, and challenges associated with their activities. Secondly, where formal FPGs do exist, evaluating their impact on rural food system issues within high-income countries. Given much of the existing evidence relates to FPG activities conducted in urban or across both urban and rural regions, a greater understanding of their potential impact in more rural and remote areas is required to further address inequities in food access that are related to geography.
This study’s strengths include a comprehensive systematic scoping process and analysis of both the peer-reviewed and grey literature. The latter ensured all relevant documents were included, given many FPGs tend not to be academically driven and produce their own evaluation documents outside of scientific journals. Previous research has asserted that evaluations were historically viewed by FPGs as a threat to their growth and new FPG establishment, and there is also a dearth of evidence about FPG impacts outside of the USA. The resource and capacity issues faced by FPGs, such as a lack of funding for operations or core staff and thus a large reliance on volunteers, is a substantial reason why more evaluation about their impact has not occurred to date(Reference Michel, Wiek and Bloemertz78). Given many FPGs lack long-term funding, this could provide further explanation for a lack of longitudinal evaluation(Reference Schiff, Levkoe and Wilkinson15). The lack of evaluation also prevents many FPGs from accessing ‘impact-oriented funding’(Reference Michel, Wiek and Bloemertz78). Another strength of our work is positioning findings within food system domains indicated by leading FPG academics(Reference Calancie, Cooksey-Stowers and Palmer18,38) . This could prove useful to FPGs wanting to identify activities to implement at the local level. Limitations include the inclusion of documents only published in English; several documents from countries such as Germany were unable to be reviewed but may possibly have yielded important learnings. In addition, given the diversity in evaluation methods reported in documents, direct comparisons between documents are difficult. Further, the lack of rural and remote FPG evidence limits application of these findings to those areas and warrants further investigation. There is also the potential for positive bias for the reporting of results, given many evaluations involved surveying or interviewing FPG members or facilitators. Publication bias may also be present, given many included documents were grey-literature reports published by FPGs.
Conclusion
This scoping review identified evaluation evidence supporting food system impact activities implemented by international FPGs and showed a lack of evaluated FPG action in rural and non-urban areas. Activities focused predominantly on food system equity, increasing knowledge and/or demand for healthy food, and access to healthy food. FPGs were mostly undertaking activities in line with the scientific evidence. While there is ample evaluation evidence that FPGs are a mechanism to achieve positive food system outcomes, many documents still report impact without accompanying evidence. Therefore, if FPGs utilise existing and comprehensive tools to thoroughly evaluate their work, the reported impact could be more widespread. FPGs show promise for extensive establishment across other regions of high-income countries; however, they should be further scoped in rural areas, where residents can face unique food system challenges.
Authorship
S.L.G. obtained funding; all authors conceptualised the study; J.D. and S.G. extracted the data; all authors contributed to the write-up and editing of the full manuscript.
Financial support
This work is supported by the Western Australian Future Health Research and Innovation Fund, which is an initiative of the WA State Government. The WA State Government had no role in the design, analysis or writing of this article.
Conflict of interest
None.
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