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.
- Author: Danielle L. Lee
Daily physical activity supports youth physical and phychosocial health and is also important for obesity prevention. Schools are an important location for physical activity promotion and obesity prevention given youth spend up to half of their waking hours in school. The latest study from Nutrition Policy Institute (NPI) researchers suggests that United States Department of Agriculture (USDA) Supplemental Nutrition Assistance Program Education (SNAP-Ed, and known asCalFresh Healthy Living (CFHL) in California) physical activity interventions at school-sites are associated with slightly lower body mass index (BMI) and greater cardiovascular fitness in students compared to sites that did not receive these interventions. Further, schools with higher intervention levels had students with the highest cardiovascular fitness levels. Interventions included physical activity-related direct education, where students were actively engaged with an educator; indirect education, where students received information or resources related to physical activity; or changes to the school or district's physical activity related policies, systems, and/or environments (PSE). Student-level FitnessGram(R) data from between 2015-2016 was obtained from the California Department of Education for the study. Researchers compared BMI and student cardiovascular fitness levels from over 97,000 fifth and seventh grade students from 904 California public schools that implemented the SNAP-Ed physical activity interventions to over 372,000 fifth and seventh grade students from 3,506 California public schools that did not implement the interventions. These findings are important as the California Department of Public Health's Nutrition Education and Obesity Prevention Branch distributes over $50 million in CFHL funding to local health departments to implement physical activity and nutrition interventions, which primarily occur in the public school setting. Also, California has more public schools than any other US state. The study was published online in the journal Preventive Medicine Reports. The study was conducted by NPI's Hannah Thompson, Sridharshi Hewawitharana, Janice Kao, Carolyn Rider, Evan Talmage, Wendi Gosliner and Gail Woodward-Lopez in collaboration with Lauren Whetstone of the California Department of Public Health. The study was funded by the California Department of Public Health, with funding from the USDA Supplemental Nutrition Assistance Program. The full study is available online.
