Making the Healthy Choice the Easy Choice: An Introduction to Policy, Systems, and Environmental (PSE) Approaches to Promote Healthy Eating and Physical Activity

This online course is designed to meet the needs of professionals working to increase access to healthy food and physical activity options for low-income individuals and families.  Learners will gain knowledge and skills to develop, implement, and evaluate effective policies, systems, and environmental approaches in this 12-hour, self-paced course. The online course contains six modules … Continued

First Years in the First State: Improving Nutrition and Physical Activity Quality in Delaware Child Care

The First Years in the First State is a PSE change intervention designed to improve the quality of nutrition, physical activity and screen-viewing activities in child care centers in Delaware by providing training on the new regulations licensed childcare centers, which were changed to better align with best practice. This program provided training and toolkits, evaluates providers’ knowledge of the rules, and satisfaction with the training content and format.

Target Behavior: Breastfeeding, Healthy Eating, Physical Activity

Intervention Type: PSE Change

Out of School Nutrition and Physical Activity (OSNAP)

The Out of School Nutrition and Physical Activity (OSNAP) Initiative is a PSE change intervention designed to increase healthy nutrition and physical activity and reduce screen time for children, including the frequency with which water is served during snack at afterschool programs. By promoting water, the OSNAP Initiative decreases the caloric impact of beverages served in afterschool programs. OSNAP, through its interactive website,, provides afterschool program staff and organizational leaders with resources to improve their program practices and policies related to healthy foods, drinks, and physical activity.  One component of the OSNAP initiative focuses on providing access to free drinking water at snack time for children in afterschool programs.

Target Behavior: Healthy Eating, Physical Activity

Intervention Type:  PSE Change

Appendix C. Physical Activity Guidelines

The Physical Activity Guidelines for Americans (2008) provide science-based guidance to help Americans ages 6 and older maintain or improve their health through regular physical activity. These guidelines are intended to be achievable and customized according to a person’s interests, lifestyle, and goals. Adults and Older Adults – At least 2 hours and 30 minutes … Continued

Unstructured physical activity

Child-led free play for toddlers and preschoolers in which children are left to their own devices within a safe, active environment. Unstructured activity should include:

  • Activities that respect and encourage children’s individual abilities and interests.
  • Teacher engagement with children, support for extending play, and gentle prompts and encouragement by teachers, when appropriate, to stay physically active.

Structured physical activity

Teacher-led activities for toddlers and preschoolers that are developmentally appropriate and fun. Such activities should include:

  • Planned, focused activities designed to improve age-appropriate motor skill development. The activity should be engaging and involve all children with minimal or no waiting.
  • Daily, fun physical activity that is vigorous (gets children “breathless” or breathing deeper and faster than during typical activities) for short bouts of time.

Physical activity

Any body movement that works muscles and requires more energy than resting.

Balanced Energy Physical Activity Toolkit (BEPA-Toolkit)

The Balanced Energy Physical Activity Toolkit (BEPA-Toolkit) is a direct education intervention with added PSE components designed to integrate PA and nutrition concepts through education and activity in K-6th grade school classrooms. Nutrition concepts are linked to PA concepts and active games through an approach that explains the concept of balanced energy as a combination of healthful eating and regular, varied PA. The BEPA-Toolkit provides educators with materials and activity ideas that can be used in and outside of the classroom and before, during, or after school to increase children’s physical activity time at school. The Toolkit has been adapted to align with a PSE approach, which includes teacher trainings, wellness policy supports, and resourcing schools or classrooms with BEPA-Toolkits.

Target Behavior: Healthy Eating, Physical Activity

Intervention Type: Direct Education, PSE Change

School Physical Activity & Nutrition-Environment Tool (SPAN-ET)

The School Physical Activity and Nutrition Environment Tool (SPAN-ET) is a PSE Change tool used by school sector stakeholders to assess elementary school resources and readiness to improve nutrition and physical activity (PA) environments, suggest appropriate improvement strategies, score and measure outcomes resulting from environmentally-based treatments. The assessment tool includes 27 Area of Interest items in two main component categories, PA and nutrition, and considers the policy, situational, and physical environment within each component.

Target Behavior: Healthy Eating, Physical Activity

Intervention Type: PSE Change

Fruit, Vegetable, and Physical Activity Toolbox for Community Educators

The Fruit, Vegetable and Physical Activity Toolbox for Community Educators (Toolbox) is a direct education and social marketing intervention designed to reach African-American women through nutrition education to increase consumption of fruits and vegetables and physical activity (PA) and empower women to overcome barriers to achieving these goals at the personal and community level. The Toolbox Kit and companion Web site were created so that community educators can easily teach low-income adults about eating the recommended amount of fruits and vegetables and enjoying PA every day.

Target Behavior: Healthy Eating, Physical Activity

Intervention Type: Direct Education, Social Marketing