Table 4.

Challenges to implementing environmental and policy changes as described by food pantry directors in King County, Washington 2017–2018 (n = 10).

	Challenge	Illustrative Quotes	Lessons Learned
Facility and space constraints	Many pantries operated out of older, relatively small, rented spaces not designed for food distribution. This presented difficulties in allowing for ideal pathways, lighting, or display structures.	“It’s hard to create a welcoming, inviting space … in an old warehouse, gym space.”	This challenge led some pantries to make adjustments to their layouts and shopping pathways to improve customer flow at the same time they worked on applying behavioral economics principles to highlight individual foods. Pantries also opted to purchase equipment to address these challenges, including additional lighting and items on wheels that could be moved as needed.
Strategy-specific challenges.	Some challenges were specific to a change or strategy being implemented. For example, signage was difficult to maintain or minimally effective in some cases due to space constraints and multilingual needs. Presenting healthy foods first in distribution lines conflicted with typical practices of offering produce last so it would not be crushed by heavier items in carts or bags. Conducting food demonstrations required volunteers and space not always available.	“We did try having a lot of signage… trying to direct people to healthy choices, and we didn’t find it very effective. It was almost more in the way. We found that the more signs that were posted, the less people read them.”	Technical assistance providers encouraged pantries to experiment with and adapt changes without feeling they had to commit to any change permanently.
Adjusting to change.	Many directors described initial difficulties associated with some staff, volunteers, and customers resisting changes made. This was especially true for individuals who had long-term history with the agency and were accustomed to things being done in a particular way.	“The people who are still griping—it’s about change. It’s not really about the system.”	All directors who described this challenge said it was typically a short-lived concern. Many also stressed the importance of involving staff and volunteers in the planning process along the way to support buy in for the changes.
Availability, quality, and popularity of healthy foods.	Some directors described ways in which their best efforts to create healthy food environments were limited by the foods available to them and indicated this was often beyond their control. For example, pantries typically set allotment restrictions to ensure that most customers get some of the most desirable foods. This inherently limits customer choice. One director said it would be helpful to focus policy development further upstream in the food supply.	“I don’t like to put limits on food. But then on the other hand, I don’t like to run out of food.” “It should’ve been implemented from the grocery store’s perspective, from [the food bank distributor’s] perspective, USDA’s perspective… So that when we get government commodities, I don’t get regular canned corn; I would get low-sodium corn.”	Several directors noted that, though they feared additional customer choice might result in them running out of popular items, this often did not occur as customers typically only took the amount they needed and wanted to leave some for others. Additionally, the intervention envisioned that concurrent work on nutrition policy development and implementation would lead to a healthier food supply.
Fear of losing donors based on nutritional quality standards instituted by nutrition policies.	Some directors expressed concern or resistance to policy commitments outlining foods to be refused based on nutrition standards because they worried that the donor would then choose not to provide any food. A smaller number of directors expressed concerns about not wanting to “police” the food that should be provided to pantry customers.	“How do we say no to a donation? … That’s really hard for some people who are in this work.” “If we get to the point where we create absolute lists on what we want and what we don’t want, I feel like there’s a lot of those people that donate to us are going to say, ‘Well, forget it then. I’ll find somebody that will take it all.’”	To address this concern, technical assistance providers began inviting pantries experienced in implementing nutrition policies to present at nutrition policy development training. These invited guests were specifically asked to address whether they had lost donors after implementing nutrition standards for donated food; most indicated they had not. Pantries were also encouraged to orient their nutrition policies toward identifying foods they would prioritize for purchase or request from donors as a first step, before identifying foods they would refuse if this was a concern.