Schools are an ideal setting for policy, systems, and environmental (PSE) approaches to childhood obesity prevention. An initial assessment of a school's health environment, policies, and practices is critical for planning and identifying priority PSE interventions, while reassessment can be used to identify measurable change for ongoing planning and evaluation purposes. School-based obesity prevention programs need an assessment that measures wellness policy implementation and compliance at the school level, as required by the Local School Wellness Policy Implementation Final Rule of the Healthy Hunger-Free Kids Act of 2010. The assessment must comprehensively assesses school nutrition and physical activity practices, and have the measurement properties necessary to detect change over time and differences between schools. Nutrition Policy Institute researchers shared the development and psychometric testing of a site-level questionnaire for elementary schools that fills this gap in an article published December 20, 2021 in the journal Childhood Obesity. Elementary schools and their partners can use the new instrument to plan PSE interventions, measure obesity-prevention best practices and wellness policy implementation, and evaluate their progress towards achieving best practices in nutrition and physical activity. Study authors include researchers from the NPI CalFresh Healthy Living evaluation team, Carolyn Rider, Janice Kao, Sridharshi Hewawitharana, Christina Becker, Amanda Linares, and Gail Woodward-Lopez.
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.
USDA's Supplemental Nutrition Assistance Program – Education (SNAP-Ed) impacts the lives of participants through education as well as policy, systems, and environmental (PSE) change initiatives at schools, early care and education facilities, food banks and pantries, and other community sites. SNAP-Ed, which focuses on individuals and families with low income and the communities in which they live, can improve health equity. However, SNAP-Ed interventions were dramatically impacted in 2020 by the global COVID-19 pandemic. Researchers at the Nutrition Policy Institute presented relevant research findings at the 2021 National Health Outreach Conference, held virtually on May 3-7, 2021. Their presentation, entitled 'Challenges and Opportunities for SNAP-Ed Programs during the COVID-19 Pandemic', described the ways in which California's local health departments shifted their SNAP-Ed efforts, barriers that COVID-19 created in their PSE work, and factors that facilitated new and continued efforts. Despite a 37% reduction in the number of SNAP-Ed sites reached in 2020 when compared to each of the previous two years, many successful PSE efforts were implemented by local health departments in 2020, including new interventions at numerous sites that were initiated in response to COVID-19. A common theme reported in relation to successful efforts was the importance of strong partnerships. NPI's Carolyn Rider presented these findings in collaboration with NPI researchers Janice Kao, Christina Becker, Evan Talmage, and Gail Woodward-Lopez.
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.