Validation of a Collaboration Readiness Assessment Tool for Use by Supplemental Nutrition Assistance Program-Education (SNAP-Ed) Agencies and Partners

Assessing the Impact of Multilevel Comprehensive Programming on SNAP-Ed Participant Behaviors

PURPOSE

To examine differences in dietary, physical activity, and food selection behaviors of Utah SNAP-Ed participants who had varied breadth of engagement with various components of multilevel programming.

METHOD

SNAP-Ed participants received a survey approximately 1 year after participating in nutrition classes. The survey measured diet, physical activity, and food selection behaviors and breadth of engagement with components of SNAP-Ed programming. Components of programming included nutrition education for adults and youth, nudge programs in food pantries and corner stores, farmers' market booths, social marketing campaign materials, and social media platforms. Kruskal-Wallis tests assessed differences in behaviors between varying breadths of program engagement.

RESULTS

Among the 124 respondents, certain dietary behaviors improved with increased breadth of program engagement including intake of vegetables, low-fat dairy, and lean protein. Food selection behaviors including using MyPlate and preparing healthy foods on a budget, also improved with increased engagement. Physical activity was not impacted by additional breadth of exposure.

CONCLUSIONS AND IMPLICATIONS

Findings suggest that multilevel comprehensive programming may enhance the impact of SNAP-Ed education for certain behaviors. Additional research is warranted on the impact of SNAP-Ed multilevel programming on targeted behaviors and health outcomes.

Readiness of SNAP-Ed Implementers to Incorporate Policy, Systems, and Environmental Approaches into Programming

OBJECTIVE

To identify the readiness of Supplemental Nutrition Assistance Program Education (SNAP-Ed) implementers to facilitate policy, systems, and environmental (PSE) changes in conjunction with delivering direct nutrition education.

DESIGN

Qualitative study using semistructured interviews.

SETTING

A southeastern state.

PARTICIPANTS

Purposive sample of SNAP-Ed staff (n = 19) from state implementing agencies (n = 3) in 1 state.

PHENOMENON OF INTEREST

Readiness using the validated framework: readiness equals motivation coupled with general-capacities and innovation-specific capacities (R = MC²).

ANALYSIS

Interviews were audio-recorded and transcribed verbatim. Transcripts were analyzed using an iterative approach to the analysis via emergent coding and constant comparison.

RESULTS

Although a general sense of motivation is present among implementers to meet the new federal guidelines, nutrition education is still prioritized. General capacity for SNAP-Ed implementers, comprised communication, training, and funding and staffing, was limited. Innovation-specific capacities around the implementation of PSEs revealed limited knowledge, experience, and resources among most implementers.

CONCLUSIONS AND IMPLICATIONS

Identifying the nuanced and interrelated aspects of motivation and capacity of SNAP-Ed implementers to incorporate PSEs into their direct education interventions could inform tailored strategies for increasing readiness, such as through training, reallocation of resources, or program restructuring.

Estimating intervention dose of the multilevel multisite children's healthy living program intervention

Increased community collective efficacy (CE), defined as social cohesion among neighbors and their willingness to intervene for common good, is associated with improved community health outcomes. However, processes to increase CE and estimate its dose within an intervention are not well understood. The 2 year Children's Healthy Living (CHL) intervention aimed to improve child behaviors known to affect obesity. We used data from CHL to estimate CE dose and examine its association with a successful outcome from CHL-reduction in children's recreational screen time. Monthly reports from nine intervention communities were quantified, and CE dose was calculated for each community overall, at 4 time intervals (6, 12, 18, and 24 months), and for each CE building block-social bonding, social bridging, social leveraging, empowerment, and civic engagement. CE dose at each time interval and change in screen time was correlated using Spearman's rho. Next, communities were categorized as having a high CE dose or a low CE dose, and differences between four high-dose and five low-dose communities were compared using a two-tailed t-test. The correlation between change in screen time and CE dose was significant (rs = 0.83, p = .003). Significantly more activities facilitating empowerment and civic engagement were conducted in high-dose communities, which were more likely to show improvements in screen time, than in low-dose communities. This method of estimating an intervention's CE dose and examining change over time and effect of CE and its building blocks on intervention outcomes shows promise.

Development and Testing of the Healthy Food Pantry Assessment Tool

OBJECTIVE

To develop and test an observational survey that quantifies food pantry environments (FPE).

DESIGN

Best practices in FPE were identified through key informant interviews. The tool was pilot-tested, including a content review, and then field-tested for reliability.

SETTING

Key informant phone interviews (n = 41); pilot and field test visits occurred at 45 pantries from multiple states.

SUBJECTS

Food bank/pantry staff and nutrition educators were recruited for interviews through purposive and snowball sampling. Pilot and field test survey users (n = 65) were food pantry representatives and matched community partners who both rated the FPE using the tool.

VARIABLES MEASURED

Pearson correlation was used to determine test-retest and interrater reliability.

ANALYSIS

Qualitative data were coded for healthy FPE strategies. Quantitative data were calculated using descriptive statistics (significant at P < .05).

RESULTS

Qualitative data were coded for observable FPE characteristics. Reliability scores were substantial to nearly perfect for 48 of 61 survey items (79%) for test-retest and 49 of 61 (80%) for interrater reliability (Pearson r = .6-1.0).

CONCLUSIONS AND IMPLICATIONS

The Healthy Food Pantry Assessment Tool is research-tested and can be used to evaluate and quantify the healthfulness of FPE.