PSE Readiness Assessment and Decision Instrument (PSE READI)

Case Western Reserve University, Ohio State University/Ohio SNAP-Ed, The Cleveland Clinic

Overview

The PSE READI intervention was designed with guidance from SNAP-Ed and public health practitioners in Ohio to promote successful implementation of community nutrition Policy, System, and Environmental (PSE) programs as a broader strategy for obesity prevention. Practitioners can take the online PSE Readiness Assessment and Decision Instrument (READI) to assess their community’s readiness and capacity to implement community nutrition PSE changes. The PSE READI can be completed by an individual or the practitioner can invite community members to share their input in a team assessment. The four different PSE READIs currently available include: Farmers’ Markets, Healthy Food Retail, Farm to School, and Healthy Eating Policies in Childcare. After completion of your PSE READI, a report will be generated with three recommendations tailored to local community readiness and capacity. These recommendations will help practitioners and teams plan next steps and guide community nutrition PSE implementation. The PSE READI website includes a curated resource library with over 1,000 toolkits, guides, and other evidence-based PSE resources that provide guidance to help end-users put into action their community nutrition PSE implementation.  

Target Behavior: Healthy Eating  
Intervention Type: PSE Change 

Intervention Reach and Adoption

PSE READI was designed for SNAP-Ed and other practitioners interested in implementing a PSE intervention in their targeted community. It was developed based on feedback from practitioners in rural and urban counties in Ohio. The tool launched in January 2019, and 193 end-users created an account and completed 216 PSE READIs. Additionally, 198 and 97 SNAP-Ed and community nutrition practitioners attended a “How To” webinar or an in-person training on the PSE READI, respectively. 

Setting: Farmers markets, Childcare (Learn), Community (Live), Retail (Shop/Eat), School (Learn)  
Target Audience: Preschool (<5 years), Pregnant/Breastfeeding Women, Parents/Mothers/Fathers, Adults, Other: Public Health &Community Nutrition Practitioners 
Race/Ethnicity: All 

Intervention Components

The PSE READI intervention helps practitioners to assess, plan, and act to optimize successful interventions in a specific community or targeted service area. Four web-based diagnostic tools were developed and focus on: Farmers’ Markets, Healthy Food Retail, Farm to School, and Healthy Eating in Childcare. Practitioners sign up for a free online account and take the PSE READI assessment individually or as a team. Assessments may be repeated over time to evaluate change. After taking the assessment, a tailored report is provided with three recommendations for action based on high, medium, or low readiness scores for select indicators, which are weighted based on the consensus feedback methodology employed to develop the PSE READI tool. Each recommendation has resources that are intended to advance action toward PSE implementation. Users can explore other resources in the PSE READI library to assist in developing, implementing, or evaluating a PSE change. 

Intervention Materials

The PSE Readiness Assessment and Decision Instrument (PSE READI) supports tailoring of community nutrition PSEs.  

 The online intervention includes 

  • Assessments related to Farmers’ Markets (FM), Farm to School (F2S), Healthy Food Retail (HFR), and Healthy Eating in Childcare (HEC).  
  • Personalized reports with tailored recommendations to support PSE implementation 
  • Library of resources to build capacity and bolster success 
  • Webinars to foster integration of PSE READI into planning and evaluation. 

 Resources can be found on the PSE READI website: www.PSEREADI.org  

Intervention Costs

Materials available at no cost.

Evidence Summary

PSE READI mirrored a collaborative approach across the testing and evaluation stages. Mixed methods were used to develop the PSE READI tool including interviews and focus groups with about 300 stakeholders and feedback from 16 state and national level experts in the targeted PSEs. Usability test of the intervention was conducted in 2017 with 22 practitioners in Ohio. This included a pre-survey, taking the online PSE READI assessment, a post-survey, and a follow-up interview. Results of this evaluation were used to improve the PSE READI tools and disseminations strategy. In 2019, evaluation of the trainings occurred through a pre- and post-survey design to assess the level of confidence in the ability to implement PSE changes after use of the PSE READI. Confidence improved in each PSE area (16.9% for HEC; 32.4% for F2S; 12% for FM; 22.1% for HFR) after the trainings. Overall, 65% of practitioners who attended a training reported increased capacity to implement PSE changes. 

During the evaluation process, practitioners reported variation in the likelihood of using the PSE READI tool. Barriers for delayed use included: PSE implementation not directly related to daily tasks, difficulty in selecting community or PSE topic to get started, lack of knowledge on when to use the tool, lack of funding to implement a PSE change, inability to develop collaborative partnerships for implementation, and time constraints to implement PSE READI interventions. Based on this feedback, unique PSE READI resources are being created for two segments of SNAP-Ed practitioners. The first are for those who have a plan to implement PSE changes now or in the near future and would like to connect with others engaged in this work. The second are resources for practitioners who are novice to PSE changes. These will become available starting in summer 2020. 

Manuscripts that describe methods used to develop the PSE READI tools: 

  • Lee, Dalton, NgendahimanaBebo, Davis, Remley, Smathers, & Freedman (2017). Consensus-based assessment tool of readiness and capacity for implementing community-based nutrition interventions: A case study using farmers’ markets. Translational Behavioral Medicine, 7(3); 506-516.  
  • Lee, SmathersZubietaGinnetti, Shah, & Freedman (2019). Identifying indicators of readiness and capacity for implementing farm to school interventions. Journal of School Health, 89(5), 373-381.  
  • Parsons, Monteban, Lee, BeboZubietaGinetti, Hewitt, & Freedman (2019). Indicators of Readiness and Capacity for Implementation of Healthy Eating Strategies in Childcare Settings Serving Low-income Children. Journal of Nutrition Education and Behavior, 51; 465-477.  
  • Cascio, Lee, Vaudrin, & Freedman (2019). A Team-Based Approach to Open Coding: Considerations for Creating Intercoder Consensus. Field Methods, 31(2); 116-130 

 

Evidence-based Approach: Practice-tested  

Evaluation Indicators

Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.

Readiness and Capacity – Short Term (ST) Changes – Medium Term (MT) Effectiveness and Maintenance – Long Term (LT) Population Results (R)
Individual
Environmental Settings ST5
Sectors of Influence

ST5: Need and Readiness 

  • ST5c: 193 organizations completed a total of 216 PSE READI assessments, which documented their readiness level (high, medium, low) for PSE change 

Evaluation Materials

Evaluation tools are available to assess how training on the PSE READI tools changes perceptions, confidence, and beliefs related to implementing community nutrition PSE changesThe tool itself also serves as an assessment tool, allowing practitioners to reassess their readiness and capacity overtimeidentify change, and receive new tailored recommendations to advance PSE implementation. 

Additional Information

Website: The PSE READI website (www.PSEREADI.org) includes more information about the program and more available resources. 

Contact Person(s):
Darcy Freedman
Phone216-368-3060
Emaildaf96@case.edu