New research from the University of California Nutrition Policy Institute suggests that a 4-week Rethink your Drink curriculum for high school students can improve high school students' use of Nutrition Facts labels and decrease their consumption of diet soda. The Rethink Your Drink curriculum, developed by the California Department of Public Health (CDPH), promotes drinking water and a variety of healthy beverages instead of sugar-sweetened beverages and use of the Nutrition Facts label and Ingredient List to choose beverages with little or no added sugars. The curriculum was pilot-tested in three California high schools with over 220 students and compared to 92 students in two schools that did not receive the curriculum. Despite the positive impact on Nutrition Facts label usage and decreasing consumption of diet soda, there was only a small but not significant decrease in sugar-sweetened beverage intake by students receiving the curriculum compared to those that did not. These findings suggest that developing a curriculum that is effective for improving beverage consumption among high school students may be challenging. Interviews and surveys with teachers and focus groups with students suggest the curriculum could be shortened, made more engaging with interactive activities as well as taste-tests of healthy beverages, and that the curriculum be modified to target younger students to support earlier development of healthy beverage consumption habits. Researchers suggest the effectiveness of the Rethink Your Drink curriculum could be increased if paired with evidence-based policy, systems and environmental change strategies that eliminate sugar-sweetened beverages from high-school students' environments. The study, funded by the CDPH, was published in the Health Education Journal in September 2021. Authors include Ron Strochlic, Gail Woodward-Lopez, Kaela Plank and Sridharshi Hewawitharana from NPI, and Jackie Richardson and Lauren Whetstone from CDPH.
Schools are an ideal setting to improve child nutrition and food security and are critical environments in which to implement policy, systems, and environmental (PSE) public health interventions. Federal mandates for the Supplemental Nutrition Assistance Program-Education, known as CalFresh Healthy Living in California, require PSE interventions for obesity prevention efforts combined with direct and indirect education interventions. Researchers at the University of California Division of Agriculture and Natural Resources, Nutrition Policy Institute developed a new method to evaluate the ‘dose' score of complex and multicomponent SNAP-Ed interventions in schools, which can then be linked to student health outcomes. The method also proposes how to calculate dose scores for different intervention categories, including direct education, PSE, garden-based interventions, and physical education. This novel evaluation method can be used in future SNAP-Ed evaluations to inform practitioners and policymakers about the most promising school-based public health interventions to support children's health. The proposed method was published in the American Journal of Evaluation. Study authors include researchers from the NPI CalFresh Healthy Living evaluation team, Sridharshi Hewawitharana, Janice Kao, Carolyn Rider, Evan Talmage, Karen Webb, Wendi Gosliner, and Gail Woodward-Lopez, and Sadie Costello from UC Berkeley.
The USDA's Supplemental Nutrition Assistance Program-Education (SNAP-Ed) is an evidence-based program that helps low-income individuals live healthier lives through education, social marketing, and policy, systems, and environmental (PSE) changes. Known as CalFresh Healthy Living (CFHL) in California, SNAP-Ed is overseen by the California Department of Social Services and implemented by four state implementing agencies and the local implementing agencies (LIAs) that they fund. The California Department of Public Health (CDPH) is one of four state implementing agencies and funds 60 local health departments. Beginning in 2018, California's LIAs use the Program Evaluation and Reporting System (PEARS) to report their CFHL activities and interventions. The Nutrition Policy Institute serves as CDPH's evaluation contractor for its CFHL program; NPI's PEARS team, Carolyn Rider, Janice Kao, Evan Talmage, and Christina Becker, provide technical and evaluation assistance to CDPH and its LIAs for PEARS reporting. They authored a new report which presents the background, definitions, and methods used by CDPH and its funded local health departments for reporting CFHL interventions implemented throughout California during Federal Fiscal Year 2020. The report, titled “Background on Local Health Department Reporting of CalFresh Healthy Living Programs in the Program Evaluation and Reporting System, FFY 2020”, also details challenges in reporting CFHL activities and gives recommendations to improve reporting.
The COVID-19 pandemic had both positive and negative impacts on the implementation of the California Department of Public Health's CalFresh Healthy Living (CFHL) activities over the past year. CFHL, known nationally as SNAP-Ed, supports healthy, active, and nourished lifestyles by teaching Californians about good nutrition and how to stretch their food dollars, while also building partnerships in communities to make the healthy choice, the easy choice. CFHL activities are implemented by California's Local Health Departments (LHDs) and other agencies. Researchers at the University of California (UC) Nutrition Policy Institute (NPI) evaluated the impact of COVID-19 on CFHL efforts using data gathered in the Program Evaluation and Reporting System (PEARS), a tool used by CFHL professionals to track policy, systems, and environmental change efforts (often referred to as PSE), direct nutrition education, indirect education, partnerships, and multi-sector coalitions. In addition, NPI researchers surveyed 54 LHDs in October 2020 to understand more about how the pandemic impacted their programs. Evaluation results showed that LHDs found new ways to deliver CFHL interventions during COVID‐19, building on existing capacity and branching out into new areas, including developing new sites and partners, developing new skills to implement programming virtually, and developing novel food procurement and distribution mechanisms. NPI researchers presented results from their evaluation in a March 23, 2021 webinar, titled Challenges and Opportunities for Local Health Departments Implementing CalFresh Healthy Living during a Pandemic, with over 50 state agency and LHD staff in attendance. The webinar was hosted by the NPI PEARS team, including Carolyn Rider, Janice Kao, Christina Becker, and Evan Talmage in collaboration with Jennifer Murphy and Kylie Gacad from California State University, Chico, Anna Luciano from Orange County Health Care Agency, and Jessica Bellow and Gaby Gregg, from Community Action Partnership of Orange County. The webinar slides and recording are available online.
The Nutrition Policy Institute (NPI) hosted an online Brown Bag event on Tuesday, June 30 from 12:00-1:00pm PDT titled "CalFresh Healthy Living, University of California - Programmatic Strategies, Adaptation to COVID-19, and Areas for Intentional Collaboration with NPI". CalFresh Healthy Living, University of California previously known as UC CalFresh Nutrition Education Program is a SNAP-Ed program implemented by UC Cooperative Extension teams in 32 counties. The Brown Bag session highlighted programmatic strategies - including adaptation due to COVID-19 - with the goal of identifying potential areas of more intentional collaboration with NPI. Speakers included Kamaljeet Khaira, Barbara MkNelly, and MaryAnn Mills. The presentation slide deck is available online.