Community-university partnerships developed for community-based participatory research seek to address local health concerns through a multi-stage approach building on the unique strengths of the community. This collaborative model has been increasingly employed over the last 20 years and is seen as a practical approach to address local health concerns and improve overall quality of life and health outcomes.^1–3 The products of such partnerships are tools and interventions that seek to quickly cross the research-to-practice divide through translational efforts to influence wide-scale implementation and adoption.^4,5 Recognizing early on the positive effects of the Right Choice, Fresh Start (RCFS) farmers’ market, a decision was made to share the results of the market by disseminating a manual about the intervention approach.^6,7 The “Knowledge to Action Framework” guided these decisions by providing a model for understanding the components of translation including the development of knowledge products to assist and support future implementation⁸

A total of 271 respondents completed the survey and downloaded the manual over the six-month period. Respondents represented 38 states, with South Carolina and California downloading it most frequently. Additionally, two foreign nations, Canada and Kenya were represented in the sample. About half of respondents (52%) reported being located in and serving an urban setting and 24% in a rural setting.

Respondents represented a range of organizational types (see Table 1). The greatest proportion of respondents self-identified as representing a school/university (37%), community health center (22%), farm and agriculture setting (20%), and government organization (20%). Respondents self-reported that their organizations primarily addressed issues relating to community development (79%), health disparities (77%), and diet-related chronic disease (76%). Respondents reported implementation of a wide range of organizational programs focused on food and nutrition, including community gardens (47%), farmers’ markets (46%), and supplemental nutrition assistance program/women, infants, and children programs (33%).

Twenty percent of respondents reported their organization currently had an onsite farmers’ market. Among those without a farmers’ market, 32% reported they had plans to eventually open an onsite farmers market and 43% reported no plans to start an on-site farmers’ market. We then looked at differences that may exist between these organizations to identify potential facilitators or barriers relating to farmers’ market development.

Statistically significance differences in mean scores (p=<.05) related to the organizational capacity score existed between respondents who reported plans to open a farmers’ market (2.97) or currently had one in place (3.21) compared to those who did not have future plans to develop and open one (2.35). These differences were related to organizational readiness and capacity (Table 2). Just under half of the respondents (46%) indicated they would be very interested in trainings to develop a farmers’ market at their location.

Qualitative findings shed light into respondent interest and future plans for using the manual. Overall, respondents reported they were interested in the manual because of a general interest in the topic (e.g., farmers’ markets), ways to engage the community, and contents of the manual. Individuals noted the manual provided a means for stimulating and encouraging planning within their community. Respondents reported interest in downloading the manual for dissemination to others, including grantees, community partners, community members, organizational management, and institutions. Respondents additionally reported interest in the manual because it could be used to inform improvements to existing programs, promote farmers’ market sustainability, and provide guidance for understanding policies and procedures around the development of a farmers market.

Tools developed from community-university partnerships such as the “Building Farmacies” manual provide unique opportunities for communities and researchers to document the knowledge products of partnerships that may otherwise be only selectively available in scholarly journals or conference presentations.²¹ The particular focus on the type of tool and the associated dissemination strategy for making that tool available is dependent on a variety of factors, the foremost of which includes the type of partnership, the product of the partnership, and the target of the intervention and the community.^23,24 The output and dissemination strategy must be appropriate and tailored for the partnership and the desired outcomes of dissemination. The “Building Farmacies” manual sought to accomplish this by manualizing the process of the development, operation, evaluation, and sustainability of a community-university partnership into steps, objectives, and goals accompanied by proven resources and processes. The electronic distribution method, while cost-effective and easy to navigate, may have limited the range and scope of distribution in some aspects. The choice of listservs may have additionally limited the audience diversity and promotion of the manual.

Following the K2A framework translation component, the desire of this study was to make the resources and practices in evaluating the suitability for, and the processes for designing, implementing, and evaluating a farmers market at a community health center widely available through the broadest means possible. This resulted in the development of the manual and its subsequent distribution through electronic means versus mail, in-person, or other means. Electronic dissemination of the manual allowed for mass diffusion at no cost to respondents, but it did so in an unpredictable pattern.²⁴ Through diffusion of tools it is possible to see the products of a partnership have relevance beyond that partnership. Although the RCFS was a rural-based health center initiative, its relevancy extended beyond this setting resulting in primarily urban-based downloads accessing the manual. This allowed the concept of the intervention to become more widely available to additional audiences for application in new settings.

Differences exist between those who are capable of applying the disseminated products of partnerships and those who are not. The presence of capacity for the development and implementation of these shared ideas is a necessary component. The absence of capacity at that moment does not mean capacity cannot be acquired, but that supports, such as organizational infrastructure, must be in place to facilitate the development of capacity to respond to the idea. Barriers to implementation, such as the documented lack of financial resources and institutional support, can hinder further advancement of public health initiatives and may pose a challenge to the development and adaption of innovative ideas to address public health challenges thereby slowing the institutionalization phase of the K2A framework.²¹ Community partnerships provide one means of addressing deficits in capacity and barriers to implementation through their reliance on joint resources. Additional and alternative means for increasing the capacity must be identified and utilized to assist in the adaption of innovative means to address public health concerns. In the process of dissemination it is important to reach decision makers, including policy makers, to demonstrate that a process for implementation exists.²⁵

This research is not without limitations. First, it was not possible to track the complete range of dissemination of the manual. Secondly, it was not possible to identify the organizational and structural differences between those without plans to open a market and those who had plans or already had a market. Third, respondents may not have been aware of their organization’s level of capacity around specific topics, such as financial resources.

Future community-university partnership research initiatives should continue to focus on the translatability of their interventions and implications that such interventions could have if they are systematically documented and shared. Dissemination efforts to bridge the gap between research and practice are critical to increase the implementation of effective public health interventions in diverse community settings. Utilizing the K2A framework, future research may examine the influence of different approaches for disseminating evidence resulting from community-university partnerships to promote wide-scale implementation of public health innovations.