Placing full-service supermarkets in food deserts (areas with limited access to healthy foods) has been proposed as an important policy strategy to confront inequalities in healthy food access. Capitalizing on a natural experiment, we enrolled n=1,372 randomly selected households from two comparable neighborhoods, one of which received a full-service supermarket in 2013. We looked at the impact on residents’ diet, perceived access to healthy foods and satisfaction with one’s neighborhood as a place to live. Baseline data was collected in 2011, and follow-up in 2014. Relative to the comparison neighborhood, we found a net positive change in the intervention neighborhood in overall dietary quality, total kilocalories, added sugars, and solid fats, alcohol and added sugars (SoFAAS). However, we did not observe differential improvement in fruit and vegetable intake, whole grain consumption or body mass index (BMI). Regular users of the new supermarket had significantly improved perceived access to healthy foods compared to others, but use of the new supermarket was not related to dietary changes or to improvements with neighborhood satisfaction. Our study is the first to our knowledge to have found significant improvements in multiple dietary outcomes and neighborhood satisfaction among residents of a food desert, following the opening of a supermarket. Our study supports the Healthy Food Financing Initiative and other policies that incentivize food retail venues to locate in food deserts, but we recommend further efforts proceed with caution until research has clarified the mechanisms through which diet is improved and associations with weight status/obesity have been observed.

Objective Provide a richer understanding of food access and purchasing practices among U.S. urban food desert residents and their association with diet and body mass. Design Data on food purchasing practices, dietary intake, height, and weight from the primary food shopper in randomly selected households (n=1372) was collected. Audits of all neighborhood food stores (n=24) and the most-frequented stores outside the neighborhood (n=16) were conducted. Aspects of food access and purchasing practices and relationships among them were examined and tests of their associations with dietary quality and body mass index (BMI) were conducted. Setting Two low-income predominantly African-American neighborhoods with limited access to healthy food in Pittsburgh, Pennsylvania. Subjects Household food shoppers. Results Only one neighborhood outlet sold fresh produce; nearly all respondents did major food shopping outside the neighborhood. Although the nearest full-service supermarket was an average of 2.6 km from their home, respondents shopped an average of 6.0 km from home. The average trip was by car, took approximately two hours roundtrip, and occurred two to four times per month. Respondents spent approximately $37 per person per week on food. Those who made longer trips had access to cars, shopped less often, and spent less money per person. Those who traveled further when they shopped had higher BMIs, but most residents already shopped where healthy foods were available, and physical distance from full service groceries was unrelated to weight or dietary quality. Conclusions Improved access to healthy foods is the target of current policies meant to improve health. However, distance to the closest supermarket might not be as important as previously thought and thus policy and interventions that focus merely on improving access may not be effective.

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Executive Summary Continued Progress Executive Summary The Bill & Melinda Gates Foundation has engaged RAND to carry out an ongoing study of foundation-funded schools that are employing promising approaches to personalized learning. This research is part of the foundation's public commitment to spread effective practices across districts and charter networks, develop innovative roles for teachers, and support implementation of college-ready standards. This is the second report in a series focused on the achievement data, school design characteristics, and teacher and student perceptions of schools that are implementing personalized learning. The achievement findings in this report focus on 62 public charter and district schools that are pursuing a variety of personalized learning practices. In a smaller set of 32 schools, the report examines details of personalized learning implementation and the relationship of implementation to outcomes.

In the current educational context, school models that leverage technology to personalize instruction have proliferated, as has student enrollment in, and funding of, such school models. However, even the best laid plans are subject to challenges in design and practice, particularly in the dynamic context of a school. In this collective case study, we identify challenges, disruptions, and contradictions as they occur across schools engaged in implementing technology-mediated personalized learning. Using cultural historical activity theory—a theoretical framework concerned with the individual and contextual factors influencing school change—to frame the analysis, we also examine some of the structural and contextual sources of these disruptions and contradictions. Our findings enable us to offer recommendations for policymakers and for practitioners engaged in implementing personalized learning models, as well as directions for future research on this topic.