Measuring Policy, Systems, and Environmental Changes at Elementary Schools Involved in SNAP-Ed New Mexico Programming, 2018–2022

Abstract

Introduction In 2018, the New Mexico Supplemental Nutrition Assistance Program–Education (SNAP-Ed NM) incorporated policy, systems, and environmental (PSE) strategies into the state plan to increase healthy eating and physical activity. Studies of multiple PSE strategies in elementary schools are lacking. Methods We conducted assessments of physical activity and nutrition environments at 11 elementary schools in New Mexico before and after schools were given school-specific PSE recommendations and technical assistance. Baseline data were collected in 2018 by using the School Physical Activity and Nutrition Environment Tool (SPAN-ET), which measures policy, situational, and physical environments in elementary schools. PSE scores were calculated as the proportion of criteria met within and across 27 areas of interest. Implementation of evidence-based PSE interventions began in 2019. COVID-19 school closures delayed follow-up assessments until 2022. We analyzed descriptive data to examine changes in PSE scores over time. Results Overall mean PSE scores increased significantly from baseline (53.6%) to follow-up (62.7%). Nutrition PSE scores significantly increased by 17.6 percentage points; the policy environment showed the largest improvement (+26.0 percentage points), followed by the situational environment (+13.8 percentage points), and physical environment (+9.1 percentage points). We found a nonsignificant increase in the overall average physical activity score (+2.7 percentage points). Conclusion Use of a standardized instrument for assessing implementation of PSE strategies across multiple schools showed significant overall improvement in nutrition scores and nonsignificant increases in physical activity scores. Providing school-specific recommendations combined with technical assistance may be an effective approach to implementing evidence-based nutrition and physical activity PSE strategies.

Data for Decision Makers: Finding Policy, Systems, and Environmental Solutions for Public Health Problems

“…Tracking can also occur at a program level to inform the decisions of the program funders. The article by Velarde et al demonstrates the uptake and impact of PSE interventions as part of the USDA-funded SNAP-Ed program (Supplemental Nutrition Assistance Program Education) ( 17 ). The authors used a standardized measurement tool to examine the impact over 4 years of an intervention in New Mexico to help schools implement at least 1 PSE strategy for nutrition and physical activity.…”

“…Tracking the implementation of PSE strategies can occur nationally to inform the decisions of multiple partners. Articles by Webber et al (15) and Onufrak et al (16) illustrate this by using data from the Community-Based Survey of Supports for Healthy Eating and Active Living (CBS-HEAL), a nationally representative survey of US municipalities. They documented the proportion of communities implementing recommended policies and practices that support physical activity, diet, and breastfeeding.…”

“…For example, Webber et al found that the most common physical activity policy was maintenance for green spaces and equipment (86%) and that Complete Streets policies increased more between 2014 and 2021 for communities with larger versus smaller population sizes (15). Onufrak et al found that policies that support farmers markets were common (60%) and that the largest change in nutrition policies was for breastfeeding breaktime for government employees (an increase of 27 percentage points) (16). Data from surveillance such as CBS-HEAL can be used by funders of communities (eg, Centers for Disease Control and Prevention or US Department of Transportation) to determine whether the PSE strategies they promote are being implemented and identify where additional resources or technical assistance is needed to maximize impact.…”