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Heart Smarts is a direct education, PSE change, and social marketing intervention that combines healthy food access, nutrition education, and health and social services for individuals to improve their health and reduce their risk of diet-related disease. The program offers nine lessons for use in retail environments covering topics like fruits and vegetables, whole grains, sodium, sugar-sweetened beverages and making healthy choices along with nutrition-focused tip sheets. Each lesson includes taste tests, recipes, healthy food incentive coupons* and health screenings* (for blood pressure, weight checks, and healthy lifestyle counseling and referrals). Technical assistance and training is provided to site staff and storeowners to support PSE changes including healthier stores, businesses and communities.

Intervention Target Behavior: Healthy Eating

SNAP-Ed Strategies: Direct Education, Social Marketing, PSE Change

*These Heart Smarts components (health screenings, including blood pressure and BMI; counseling and referrals; and healthy food incentive coupons help participants choose heart-healthy items at the site) are not allowable by SNAP-Ed. Heart Smarts lessons and food tastings can be used without these additional components. Screenings and coupons can be funded by grants or partnered organizations.

Intervention Reach and Adoption

Heart Smarts targets SNAP-eligible individuals at local stores and other retail settings where they procure food. All consumers who frequent the settings are exposed to the marketing materials. There are thousands of retail settings in low-income areas. Heart Smarts reaches a relatively small percentage of these settings but achieves a high percentage (over 80%) of adoption among the sites that receive the intervention. All persons frequenting these settings are exposed to the PSE changes; an estimated 10% participate in the direct education/screening due to the number of hours educators are available.

Settings: Gardens (School/Community), Farmers markets, Pre-K & Childcare, Community-wide, Faith-based centers, Food pantries, Healthcare, Retail, Schools, USDA program sites, Worksites 

Age/Population Group: Pregnant/Breastfeeding, Parents/Caregivers, Adults, Older Adults, Unhoused 

Race: All

Ethnicity: All

Intervention Components

Heart Smarts includes technical assistance and training, direct lessons, taste tests, and health screenings (if available). Participants who participate in health screenings and nutrition lessons receive healthy food incentive coupons (if available). These intervention components increase healthy food access and promote healthy behaviors.

Intervention Materials

Heart Smarts empowers individuals to improve their health in a supportive environment where participants are encouraged to buy healthy, affordable food. Heart Smarts programming includes:

  • Nutrition education lessons
  • Healthy recipe demonstrations
  • Free taste tests
  • Free health screenings, including blood pressure and BMI (if available)
  • Counseling and referrals provided by trained health professionals (if available)
  • Heart Bucks coupons (if available)
  • Community outreach, site tours and information about available benefits
Evidence Summary

Heart Smarts brings together nutrition education, healthy food incentives, food access and free health/social services in a supportive environment. The program leverages the role of food retailers in communities and works with health care partners to address social determinants of health to provide needed community health/social services. With partnerships in place, the education and counseling have proven to be successful, and the Heart Bucks provide financial incentives to support healthier choices, which mitigates some challenges of small under-resourced stores.

After each lesson, a survey is administered, providing the ability to track participants over time. Findings demonstrate that Heart Smarts nutrition lessons improve both the health efficacy and behavioral intent of participants: 89% of participants surveyed agreed or strongly agreed with the statement "After today's lesson, I feel like I know how to make healthy food or drink choices", and most (80%) planned to make changes to the foods and drinks they buy at the corner store based on the day's lesson. The Food Trust also monitors environmental changes in the stores over time demonstrating most stores introduced at least 4 new healthy items including at least one fruit or vegetable.

Evidence Base: Practice-tested

Evaluation Indicators

Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.

  Readiness and Capacity - Short Term (ST) Changes - Medium Term (MT) Effectiveness and Maintenance - Long Term (LT) Population Results (R)
Individual ST1, ST2 MT1    
Environmental Settings ST7 MT5  
Sectors of Influence      
  • ST1: In 2018, educators in over 50 corner stores working with adults measured intent to change behavior through one-on-one surveying and reported 79% planned to make meals using healthier foods.
  • ST2: In 2018, educators in over 50 corner stores working with adults measured intent to change behavior through one-on-one surveying and reported 78% planned to buy healthier foods promoted during nutrition lessons.
  • ST7: In 2018, in over 50 corner stores, over 100% of store owners/staff agreed to participate in the Heart Smarts Program by recruiting participants, participating in trainings, and providing space and support for the program. Three active healthcare partners provided screening, counseling, materials, and follow-up services to over 1,500 participants through community benefit dollars.
  • MT1: In 2018, in 10 corner stores with screenings, among those customers with elevated blood pressure levels and reached by phone after screening, 43% reported having reduced the amount of sodium consumed.
  • MT5: in 2018, in 10 corner stores, 80% added at least 4 new healthy products and 87% added at least one new fruit or vegetable item.
Evaluation Materials

Nine lesson specific post-surveys are administered after each lesson evaluating the lesson's objectives. Participants are tracked over time to determine behavioral changes. Environmental changes are administered at the beginning and end of each lesson series to determine PSE changes for inventory, marketing and merchandising. Healthcare partners record blood pressure, BMI and self-reported behavioral changes at each screening event and through follow-up phone calls.

Additional Information

Website: The Heart Smarts website includes detailed descriptions about each component of the intervention as well as information on ordering the program.

Contact Person:

Nyssa Entrekin - Associate Director of Healthy Food Access



*Updated as of August 29, 2023