Evaluation Indicators: Environmental Settings: Medium Term

Stanford Youth Diabetes Coaching Program

The Stanford Youth Diabetes Coaches Program (SYDCP) facilitates partnerships between medical training programs and high schools serving youth from socioeconomically disadvantaged and underrepresented minority communities. The SYDCP is a “train the trainer program” in which medical residents (and other health professional trainees) train high school students to coach family members with diabetes or other chronic illnesses. The program consists of 8 tightly scripted, interactive PowerPoint based lessons that incorporate evidence-based approaches to chronic disease management, highlighting healthy eating and physical activity. The curriculum is based on Kate Lorig’s Adult Chronic Disease Self-Management Model, Social Cognitive Theory, and peer health coaching, and is designed to address the burden of chronic disease in underserved communities by focusing on health knowledge, communication skills, goal setting, problem solving, and healthy behaviors. 

Please Note: Medical nutrition therapy is not allowable for SNAP-Ed. We strongly recommend you partner with a healthcare professional to provide those components of this intervention. Components focused on healthy eating and physical activity are appropriate for SNAP-Ed. 

Target Behavior: Healthy Eating, Physical Activity and Reduced Screen Time 

Intervention Type: Direct Education

Pennsylvania Healthy Pantry Initiative

The Pennsylvania Healthy Pantry Initiative (PA HPI) is a PSE change intervention designed to increase access to healthy food and promote healthy food choices within the food pantry. PA HPI provides resources to implement strategies included in the pantry assessment. The strategies are divided into five categories: inventory, environment and healthy nudges, health promotion and marketing, nutrition policies and guidelines and services, resources and training. Nutrition educators collaborate with food pantry staff and volunteers, as well as food bank staff to assess, plan and implement strategies according to the needs and capacity of the pantry. 

Target Behavior: Healthy Eating 

Intervention Type: PSE Change 

Steps to Health’s Nuts and Bolts of a Healthy Food Pantry

The Nuts and Bolts of a Health Food Pantry Toolkit is a direct education and PSE change intervention that is designed to support pantries in improving the food environment so their clients can choose healthy food and beverage items. The components of the Toolkit include a resource guide, baseline and follow-up assessments to explore opportunities for PSE, training modules for food pantry staff and volunteers, action planning tools for sustaining PSE changes, and promotional materials, such as signage and “nudge” cards to influence healthy choices. The Toolkit equips partners to share best practices when collaborating with food pantries.  

Target Behavior: Healthy Eating, Food Insecurity/Food Assistance  

Intervention Type: Direct Education, PSE Change 

Steps to Health’s PSE Toolkit: The Ingredients for a Welcoming Farmers Market

The Ingredients for a Welcoming Farmers Market Toolkit is a PSE change intervention that uses best practices to contribute to a more welcoming farmers market environment for all community members. The Toolkit outlines a 7-step process designed to assist with data collection, analysis, and action planning. The baseline assessment determines whether the market is implementing the healthy practice in question or if the market needs some improvement in that area. The resource guide helps staff better understand why questions are included in the assessment, and how the market can improve its practices related to each question. Using the Community Food Survey included in the Toolkit, staff collect responses from community members to better understand why individuals might not attend the farmer’s market or what foods they might be interested in buying at the market.  

Target Behavior: Food Insecurity/Food Assistance 

Intervention Type: PSE Change 

Supporting Wellness at Pantries (SWAP) using the HER Nutrition Guidelines for the Charitable Food System

Supporting Wellness at Pantries (SWAP) is a PSE intervention designed to promote the donation and selection of nutritious foods throughout the charitable food system. The program is based on the theory that categorizing food using simple, intuitive labels and communicating this information at each decision point while food travels through the system (donor, food bank, food pantry, & client) has the potential to transform the policy, systems, and environment of food banks and food pantries. SWAP consists of a suite of tools for food banks and food pantries to rank their inventory using a traffic light nutrition system. SWAP was developed in 2016 and revised in 2020 to align with and use the Healthy Eating Research (HER) Nutrition Guidelines for the Charitable Food System. These guidelines place foods into 11 categories and assign green=choose often; yellow=choose sometimes; and red=choose rarely based on levels of saturated fat, sodium, and added sugars. SWAP can be used as an intervention in multiple levels of the charitable food system to promote food justice and health equity. 

Target Behavior: Healthy Eating, Food Insecurity/Food Assistance 

Intervention Type: PSE Change 

The Farmers Market Food Navigator Program

The Farmers Market Food Navigator Program is a direct education and policy, systems, and environmental (PSE) change intervention designed to increase use of farmers markets to purchase affordable produce, increase frequency of vegetables consumed by farmers market shoppers, and improve access to farmers markets through PSE initiatives. The program follows a social ecological framework and has four key components: 

  • Conduct community outreach to build awareness of farmers markets and increase awareness of the food assistance programs available 
  • Work with farmers market managers and vendors to implement policy, systems, and environmental changes that are supportive of healthy behaviors 
  • Help shoppers effectively use their food budgets at farmers markets through tours that may include introductions to vendors, tips, and support 
  • Provide resources and experiential nutrition education to shoppers at farmers markets, including tastings and cooking demonstrations 

Food Navigators attend a one-day training and are equipped with a program Playbook that provides direction on how to carry out each of the four key components of their role, as well as provides guidance to farmers market managers and community partner organizations. 

Target Behavior: Healthy Eating, Food Insecurity/Food Assistance, Other: Food Resource Management

Intervention Type: Direct Education, PSE Change

The State Nutrition Action Council: Farmers Market Initiative

The State Nutrition Action Council: Farmers Market Initiative (SNAC) is policy, systems, and environmental change intervention designed to:

  • Increase knowledge of Food and Nutrition Service (FNS) programs available at farmers markets.
  • Increase knowledge of locally grown fruits and vegetables and how to use, cook, and store them.
  • Increase the use of Market Match and CalFresh redemption vouchers to support low-income shoppers in maximizing their purchasing power.
  • Increase state and local partnerships of FNS funded programs to support a welcoming market environment that accepts multiple FNS food benefits. 

In 2018, SNAC focused on increasing low-income shoppers’ utilization of their food and nutrition program benefits at local Farmers Markets, and in 2019, SNAC expanded its Farmers Market Initiative (FMI) into additional counties and markets, as well as added an on-site navigator component. The navigator model was tested at three markets, and the CalFresh Healthy Living (CFHL) Navigators were found to address barriers to shopping at farmers markets, including lack of knowledge and comfort using food assistance benefits. CFHL Navigators provided support to shoppers by distributing materials, promoting accepted FNS benefits, providing information on how to use FNS benefits, explaining Market Match, and providing interactive nutrition and health education activities on-site at the market for six consecutive weeks. The FMI has continued to expand into new counties in California since 2019 and increases in food benefit redemptions at FMI markets has sustained. 

Target Behavior: Healthy Eating, Food Insecurity/Food Assistance

Intervention Type: PSE Change

Nutrition Pantry Program (NPP)

The Nutrition Pantry Program (NPP) is a trauma-informed PSE change intervention designed to improve the food environment and client engagement within food pantries and other charitable distribution environments. NPP provides training and resources to support the implementation of strategies for increasing access and utilization of healthy food by pantry clients, increasing engagement of clients and other stakeholders, and sustaining healthy changes over time. Implementers are encouraged to follow a four-stage process; Planning, Needs & Current Work Assessment, Implementation, and Certification & Maintenance. SNAP-Ed implementers work in collaboration with food pantry staff, volunteers, and other stakeholders to use the NPP framework and resources to organize and complete the intervention. Pantry Need and Readiness is assessed and supported using a validated Healthy Food Pantry Assessment, a Client Needs Assessment questionnaire, and client feedback strategies. Based on needs and input, a work plan of PSE changes is created. NPP resources are available to support a variety of PSE changes. Pantries completing the NPP process are recognized and awarded as Bronze, Silver or Gold Certified Nutrition Pantries and celebrated in the community. 

Target Behavior: Healthy Eating, Food Insecurity/Food Assistance  
Intervention Type: PSE Change 

Culture of Wellness in Preschools: Nutrition Education and Physical Activity (COWP NE/PA)

Culture of Wellness in Preschools: Nutrition Education and Physical Activity (COWP NE/PA) is a direct education and PSE change intervention designed to increase fruit and vegetable intake and physical activity levels in children and their parents, as well as to reduce their risk of obesity and chronic disease. In addition to providing nutrition education and physical activity in the classrooms, COWP works with Head Start Agencies and other preschool centers to identify and change school PSEs around nutrition and physical activity by working with preschool wellness teams to impact the health of the students and their families. COWP is also designed to improve the likelihood that persons eligible for SNAP will make healthy food choices within a limited budget and choose physically active lifestyles consistent with current Dietary Guidelines for Americans and the USDA food guidance.  

Target Behavior: Healthy Eating, Physical Activity and Reducing Screen Time  
Intervention Type: Direct Education, PSE Change 

FoodCorps Healthy School Toolkit

The FoodCorps Healthy School Toolkit is a PSE change intervention designed to improve school food environments over time. The Toolkit includes a research-backed assessment tool that is used by school teams to assess healthy school food environment activities. The Toolkit also includes the Action Plan, a tool that guides school teams in setting goals and vision to improve school food environments. The Healthy School Progress Report was developed through an evaluation partnership with Columbia University’s Teachers College. It assesses the school food environment across sixteen indicator areas known to contribute to healthy eating behaviors in children, spanning hands-on nutrition education, school gardening, and food preparation experience to the culture of healthy eating in the cafeteria and throughout the school’s practices. It is expected that schools actively using these tools and seeking to implement activities that support a healthy school food environment will make incremental progress on an annual basis.   

Target Behavior: Healthy Eating  
Intervention Type: PSE Change