The Need to Incorporate Diversity, Equity, and Inclusion: Reflections from a National Initiative Measuring Fruit and Vegetable Intake
Research commentary. Dietary patterns that include fruits and vegetables (F/V) greatly reduce chronic disease risk, but 90% of all adults in the United States do not consume enough F/V. Further, long-standing systemic inequities that produce multiple barriers have contributed to low F/V intake (F/VI) among individuals who report low-income or belong to a racial and/or ethnic minority group. Subsequently, these populations are less likely to meet recommended levels of F/VI and tend to have higher rates of food insecurity, or a lack of ability to access safe, nutritious, and affordable food. Multiple interventions have been implemented to address disparities in F/VI, including policy, systems, and environmental approaches that aim to reduce food access barriers. Research has been conducted to assess the influence of such interventions on F/VI using various measures. Unfortunately, assessment of F/VI does not typically incorporate measures or methods that expose systematic inequities across populations. Issues of diversity (differences between individuals and groups), equity (equal access to opportunities and resources), and inclusion (ensuring all individuals and groups are included) are paramount to assess F/VI. This commentary draws upon experience from the US Department of Agriculture (USDA) National Institute of Food and Agriculture Gus Schumacher Nutrition Incentive Program’s (GusNIP) National Training, Technical Assistance, Evaluation, and Information Center (NTAE) to account for diversity, equity, and inclusion (DEI) in shared measures that include F/VI. The challenges and solutions that arose provide the basis for recommendations that researchers and evaluators can apply when developing, revising, and/or implementing additional or complementary measures that incorporate DEI.