Chronic Disease Self-Management Program

The Chronic Disease Self-Management Program (CDSMP) is a direct education intervention that helps individuals and caregivers of those with chronic health conditions build a “toolbox” of strategies they can utilize to help achieve their health goals. Workshops are for adults and are highly participatory and build mutual support. Workshop topics include techniques to deal with symptoms of chronic conditions, such as fatigue, pain, sleeplessness, shortness of breath, stress, and emotional problems, such as depression, anger, fear, and frustration. Participants will learn appropriate exercise for maintaining and improving strength and endurance, falls prevention, healthy eating, better breathing techniques, appropriate use of medication, working more effectively with health care providers, communication skills, action planning, problem solving, and decision making. Through actively achieving small goals, participants obtain success which builds confidence in their ability to manage their health and maintain active, fulfilling lives. 

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 

A Taste of African Heritage

A Taste of African Heritage (ATOAH) is a direct education cooking and nutrition curriculum designed to increase consumption of fruits, vegetables, whole grains, beans, and spices and reduce salt; improve cooking skills and nutritional literacy; reduce diet-related health disparities in the African American community using heritage as a motivator for health; and reframe nutrition and culinary education in a way that is culturally relevant to participants and honors African American’s culture, traditions, and contributions. African Americans are too often told that the foods they grew up eating are unhealthy and that poor health is a part of their heritage. A Taste of African Heritage (ATOAH) flips the script by celebrating the culinary legacy and often-unsung cultural ownership of healthy eating for people of African descent. Consisting of six 2-hour sessions which feature healthy foods (like leafy greens, whole grains, and beans) from across the African diaspora, the accessible six-session format can be easily scaled into existing community health infrastructure, yet it is immersive enough to produce meaningful results. 

Please Note: If using this curriculum with SNAP-Ed audiences, MyPlate must also be introduced and discussed along with the curriculum.

Target Behavior: Healthy Eating 

Intervention Type: Direct Education

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 

Healthy for Life Community Nutrition Program (HFL)

The Healthy for Life (HFL) Community Nutrition Program is direct education designed to change relationships with food and nutrition by inspiring individuals and families to make healthy food choices part of their everyday lives. It was designed from the community engagement model, emphasizing participants’ contribution in refining the program and program resources follow the 4-A format (Anchor, Add, Apply and Away). Also, community fit was ensured through the consideration of existing programs along with the target population and facilitator capabilities. Program material was designed to be culturally relevant and facilitators should connect and establish a reciprocal sense of trust and respect among participants. The materials are flexible and can accommodate individuals with time constraints, limited budgets, and minimal nutrition knowledge. The program aims to improve participant confidence and attitudes to sustain healthy behavior change. The recommendation is to offer at least four educational experiences, over 2-3 months to equips individuals with the knowledge, skills, and confidence to discover, choose, and prepare healthy food. Through facilitated food discovery experiences, participants will build food literacy to improve their health. 

Target Behavior: Healthy Eating  
Intervention Type: Direct Education 

Stay Strong, Stay Healthy (SSSH)

Stay Strong, Stay Healthy (SSSH) is a direct education intervention designed to help older adults increase physical activity, decrease sedentary behaviors, increase fruit and vegetable consumption, and sustain physical activity participation and healthy eating behaviors post program. SSSH strives to meet the need for effective community-based physical activity (PA) and nutrition programs, so classes are offered by trained SSSH instructors in familiar locations such as churches, community centers, and senior centers. SSSH consists of 16 one-hour sessions over eight weeks. Participants complete a warmup, a prescribed set of upper- and lower-body strengthening exercises, and a cool-down. SSSH challenges participants through incremental increases in exercise volume and intensity. Each PA session is followed by a nutrition lesson, and lessons are tailored to older adults by addressing topics such as fiber, bone health, and vitamins and minerals for healthy aging. In addition to weekly group classes, participants are encouraged to complete the program on their own once a week, including preparation of the recipes. After the course ends, participants are still encouraged to continue at home or with a community group. The overall goal of SSSH is to increase PA and improve nutrition behavior to help seniors maintain independence.

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

Intervention Type: Direct Education

Families Eating Smart and Moving More (FESMM)

Families Eating Smart, Moving More (FESMM) is a direct education intervention designed to improve dietary intake, increase daily physical activity, and improve home food safety practices, food resource management, and food security. FESMM is a curriculum package that is evidence-based and hands-on. The intervention provides interactive nutrition education sessions that were developed based on a community needs assessment of existing data showing diet and physical activity behaviors, food resource management skills, food safety practices, and food security practices among low-income, low-resource adults living in NCThe lessons in the curriculum include recipes along with physical activities that help participants learn simple solutions to eat smart and be active every day. FESMM addresses key behaviors linked to obesity by helping families learn how to increase fruit and vegetable intake, eat together as a family, reduce screen/sedentary time, control portion sizes, and limit consumption of sugar-sweetened beverages. 

 

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

Heart Smarts

Heart Smarts is a direct education, PSE change, and social marketing intervention that combines healthy food access, nutrition education, and health and social services for individuals to improve their health and reduce their risk of diet-related disease. The program offers nine lessons for use in retail environments covering topics like fruits and vegetables, whole grains, sodium, sugar-sweetened beverages and making healthy choices along with nutrition-focused tip sheets. Each lesson includes taste tests, recipes, healthy food incentive coupons* and health screenings* (for blood pressure, weight checks, and healthy lifestyle counseling and referrals). Technical assistance and training is provided to site staff and storeowners to support PSE changes including healthier stores, businesses and communities.

Target Behavior: Healthy Eating

Intervention Type: Direct Education, Social Marketing, PSE Change

*These Heart Smarts components (health screenings, including blood pressure and BMI; counseling and referrals; and healthy food incentive coupons help participants choose heart-healthy items at the site) are not allowable by SNAP-Ed. Heart Smarts lessons and food tastings can be used without these additional components. Screenings and coupons can be funded by grants or partnered organizations.

Food eTalk

Food eTalk is direct education intervention designed to increase participant’s daily intake of fruit and vegetables, whole grains, and fat-free or low-fat dairy products; decrease daily intake of sodium; improve food resource management, food safety practices, and physical activity. The 6 interactive eLearning modules are self-paced and the mobile-nature of many Internet accessing devices (i.e., smartphones) encourages learning at the point-of-decision making, such as engaging in quick Food eTalk video-based lessons in a supermarket or restaurant. Additionally, the asynchronous “anytime, anyplace” lessons aim to mitigate traditional barriers to attending in-person classes, such as issues with transportation, variable work schedules, and child-care limitations. Food eTalk includes 6 interactive lessons, 6 accompanying cooking demonstration videos, and 4 “just in time” education videos with focus on meal preparation, food shopping, and food safety in the home.

Target Behavior: Healthy Eating

Intervention Type: Direct Education

Healthy Choices for Every Body Adult Nutrition Education Curriculum

The Healthy Choices for Every Body (HCEB) is a direct education intervention designed to improve diet quality, physical activity, and food safety practices, as well as enhance food security and food resource management skills. HCEB incorporates lessons and activities that recognize participants’ experiences, skills, and knowledge; explains why, what, and how the nutrition education concepts presented relate to real-life situations; and includes active learning activities, hands-on practice, and demonstrations to help participants understand and apply content.

Target Behavior: Healthy Eating, Physical Activity and Reducing Screen Time, Food Insecurity/Food Assistance, Other: Food resource management skills, food safety practices

Intervention Type: Direct Education

Healthy Children, Healthy Families: Parents making a difference!

The Healthy Children, Healthy Families: Parents making a difference! (HCHF) is an 8-week intervention designed to increase healthy eating and physical activity and to reduce screen time. HCHF integrates parenting and nutrition education and is delivered to parents and caregivers of children 3 to 12 years old. HCHF uses a learner-centered dialogue approach, based on the Social Cognitive Theory, to engage participants in discussions and hands-on activities. This method aims to introduce behaviors (a.k.a. Paths to Success) most likely to prevent unhealthy weight gain and chronic disease, along with relevant parenting skills (a.k.a. Keys to Success) to help participants in supporting their families’ with these behavior changes. Sessions are scripted to ensure ease of delivery and are structured using the 4A Dialogue Approach to increase participant engagement. Each of the 8 sessions focuses on a specific behavior, and provides participants an opportunity to learn and apply one or more new parenting skills. These sessions are once per week and last 1.5 hours. Additionally, each session includes tasting a healthy recipe and an “active play break” to help parents practice activities they can take home and do with their children.

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

Intervention Type: Direct Education

Alliance for a Healthier Generation (Healthier Generation)

The Alliance for a Healthier Generation (Healthier Generation) supports school and district leaders in creating and sustaining healthy schools where students – especially those from underserved communities – can thrive. 

Healthier Generation is a PSE intervention designed to create healthier school environments for students and staff. It is among the nation’s largest school-based programs improving whole child health, addressing multiple factors that lead to inadequate health and life outcomes – from physical activity (PA) and nutrition to social and emotional health and tobacco/vaping prevention. Healthier Generation leads school and district staff through the following 6 step continuous improvement process: 1) convene a School or District Wellness Committee, 2) assess the school health environment using the Thriving Schools Integrated Assessment (TSIA), 3) develop an action plan tailored to school or district priorities based on what is important and achievable, 4) explore Healthier Generation resources and tools, 5) take action to implement the plan and achieve school or district goals 6) celebrate success and monitor progress. Healthier Generation facilitates the development of partnerships during step one and provides support to schools to implement evidence-based policies and practices related to nutrition and PA. Schools document their need and readiness for change in step two by completing the TSIA. The sixth step addresses program recognition by celebrating schools’ success through Healthier Generation’s national recognition program.  

Target Behavior: Healthy Eating, Physical Activity

Intervention Type: PSE Change

Cooking for a Lifetime of Cancer Prevention

The Cooking for a Lifetime of Cancer Prevention (C4L program) is a direct education intervention designed to increase participant’s intention to: 1) implement nutrition and physical behaviors for cancer prevention (achieve and maintain a healthy weight, consume fruits and vegetables, limit red meat, avoid processed meat, choose whole grains, and limit alcohol, and meet US physical activity guidelines), and 2) be screened for breast, cervical, and/or colorectal cancer as age and sex appropriate. In addition, participants will be able to: 3) select and prepare healthy foods for an overall healthy lifestyle and for cancer prevention, and 4) eligible participants will be able to connect with referral to free and reduced cost cancer screening services through the Breast and Cervical Cancer Control Program (BCCP) or other cancer resources in their community. The one-time, three-hour workshop includes educational presentations that address SNAP-Ed outcomes, including encouraging healthy eating, increasing physical activity and reducing sedentary time, and improving food resource management.

Target Behavior: Healthy Eating, Physical Activity and Reducing Screen Time, Other: Cancer screening participation

Intervention Type: Direct Education

FNV

The FNV Campaign is a social marketing and PSE change intervention that aims to present fruits and vegetables in a way that is both fun and cool, ultimately shifting attitudes, behavior and social norms relative to healthy eating. The objectives of the FNV Campaign are to create positive attitudes toward fruits and vegetables and to drive increased consumption of fruits and vegetables in targeted communities amongst SNAP eligible audiences. Targeted at millennials, the FNV campaign uses humor and the power of local and/or national celebrity to voluntarily shift consumer behavior toward healthier dietary choices. The campaign’s recommended approach includes surround sound marketing through billboards, retail, and transit media placements and in advertising buys on social and digital media, but it can be customized and tailored based on individual campaign needs.

Target Behavior: Healthy Eating

Intervention Type: Social Marketing, PSE Change

Create Better Health Curriculum

The Create Better Health (CBH) Curriculum is a direct education intervention designed to improve the nutrition and physical activity-related knowledge, skills, and self-efficacy of SNAP-Ed eligible adults to lead an active and healthy lifestyle with limited resources. CBH has a unique emphasis on improving food resource management through the use of “Create” concepts. “Create” concepts teach participants how to use foods they already have in their kitchen to create a variety of nourishing meals. CBH includes 8 lessons that are to be offered in a series of 6-8 classes. Nutrition educators are trained regularly to teach CBH classes all of which include a nutrition topic, physical activity discussion, and a hands-on (ideally) cooking demonstration that utilizes a “Create” concept. CBH addresses and evaluates individual level changes including short term readiness and capacity and mediumterm changes over the course of a series, as well as long-term changes 6 months after participation in the areas of healthy eating, physical activity, and food resource management. CBH also includes a 1-year follow-up survey to evaluate long-term behavior changes. 

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

Intervention Type: Direct Education

Healthy Nutrition Guidelines for LA County

The Healthy Food Procurement Initiative in Los Angeles County is a PSE Change intervention designed to improve the quality of food purchased and offered in food service contracts through the implementation of nutrition standards. In 2011, the County of Los Angeles (“County”) Board of Supervisors adopted Healthy Food Promotion in Los Angeles County Food Service Contracts, a motion aimed at County departmental food procurement policies and practices as they relate to nutrition. The motion established a process for the County’s Department of Public Health (DPH) to develop nutrition standards and/or healthy food procurement practices in new and renewing Requests for Proposals (RFP) for food service and vending contracts across County departments.

Target Behavior: Healthy Eating

Intervention Type: PSE Change

Food Hero

Food Hero is a multi-channel social marketing campaign designed to change family and community behaviors.  Food Hero includes an extensive evaluation process. The program is designed to increase fruit and vegetable consumption among low-income Oregonians, and components of the campaign have been used widely in other states and countries. 

Target Behavior: Healthy Eating

Intervention Type: Direct Education, PSE Change, Social Marketing

EatFresh

EatFresh.org is mobile-friendly website that was created for the SNAP-Ed population and the organizations that serve them. It provides practical resources and encouragement for individuals with varying levels of digital literacy, internet access, health awareness and culinary skills. EatFresh.org is a stand-alone indirect education resource, an extender for direct education interventions, and a useful tool for a variety of PSE strategies. Partners throughout California use EatFresh.org as a tool to direct their participants to healthy recipes during nutrition workshops, to look up preparation and storage tips for food received at food banks, and to apply for SNAP/Calfresh.  They promote the website by distributing recipe cards at health fairs and other indirect events and refer clients to the EatFresh.org Mini Course as a flexible direct education resource. The EatFresh.org Mini Course is a free online direct education course that features 15 SNAP-Ed self-paced topics that can be completed in any order. 

Target Behavior: Healthy Eating

Intervention Type: Direct Education, PSE Change

Texas Mother-Friendly Worksite Program

The Texas Mother-Friendly Worksite program (TMFW) is a Policy Systems and Environmental (PSE) Change, employer recognition program that designates worksites as “Texas Mother-Friendly” if they voluntarily develop and submit to the Department of State Health Services (DSHS) a written policy that supports employees’ efforts to combine continued breastfeeding with employment. At a minimum, the policy must ensure:

  • Flexible work scheduling to allow time for breast milk expression,
  • Access to private, non-bathroom location for breast milk expression,
  • Access to a clean, safe water source to wash hands and clean pumping equipment, and
  • Access to hygienic options for workplace storage of expressed breast milk.

This intervention functions at two levels: at the state-level and at the worksite level. DSHS provides resources and support to worksites wanting to be designated and the worksites must implement their individual plans for achieving and sustaining designation.

Target Behavior: Breastfeeding

Intervention Type: PSE Change

Walk With Ease

Walk With Ease is a direct education program that is designed to promote education about successful physical activity for people with arthritis, arthritis self-management and walking safely and comfortably. Walk With Ease also encourages participants to continue their walking program and explore other exercise and self-management programs that deliver proven benefits for people with arthritis. Walk With Ease can be done by individuals using the Walk With Ease guidebook on their own or by groups led by trained leaders. While walking is the central activity, Walk With Ease is a multi-component program that also includes health education, stretching and strengthening exercises, and motivational strategies.

Camine Con Gusto is the Spanish language and Hispanic/Latinx cultural adaption of the Walk With Ease program. See the Spanish language description of Walk With Ease in italics below:

Camine con gusto es un programa de acondicionamiento físico que puede reducir el dolor y mejorar la salud en general. Si puede pararse por 10 minutos sin sentir dolor, puede beneficiarse de Camine con gusto. Beneficios de Camine con gusto incluyen:

  • Motivación para aumentar su capacidad física.
  • Caminar con comodidad y seguridad.
  • Aumentar su flexibilidad, fortaleza y resistencia.
  • Reducir el dolor y sentirse muy bien.

En los estudios realizados por el Centro Thurston de Investigación sobre la Artritis (Thurston Arthritis Research Center) y por el Instituto de Envejecimiento (Institute on Aging) de la Universidad de Carolina del Norte, se demostró que Camine con gusto reduce el dolor, aumenta el equilibrio y fuerza, y mejora la salud en general.

Target Behavior: Physical Activity

Intervention Type: Direct Education