Consensus modeling to develop the farmers' market readiness assessment and decision instrument.

Nutrition-related policy, system, and environmental (PSE) interventions such as farmers' markets have been recommended as effective strategies for promoting healthy diet for chronic disease prevention. Tools are needed to assess community readiness and capacity factors influencing successful farmers' market implementation among diverse practitioners in different community contexts. We describe a multiphase consensus modeling approach used to develop a diagnostic tool for assessing readiness and capacity to implement farmers' market interventions among public health and community nutrition practitioners working with low-income populations in diverse contexts. Modeling methods included the following: phase 1, qualitative study with community stakeholders to explore facilitators and barriers influencing successful implementation of farmers' market interventions in low-income communities; phase 2, development of indicators based on operationalization of qualitative findings; phase 3, assessment of relevance and importance of indicators and themes through consensus conference with expert panel; phase 4, refinement of indicators based on consensus conference; and phase 5, pilot test of the assessment tool. Findings illuminate a range of implementation factors influencing farmers' market PSE interventions and offer guidance for tailoring intervention delivery based on levels of community, practitioner, and organizational readiness and capacity.