ASNNA
Washington, DC
February 11, 2016
RNECE Initiative
Program Implementation Research
• NCC and Regional Centers began work October 1, 2014
• Year 1 – established communications, working network,
and evaluation framework; coordination among Centers
with significant progress by four Regional Centers
• Year 2 - PSE Change Center and Longitudinal Research
Project began work October 1, 2015
RNECE Initiative Objectives
• Strengthen the evidence-base on effective nutrition education and obesity
prevention programs for diverse population groups
• Evaluate the long-term effectiveness of nutrition education and obesity
prevention interventions for disadvantaged and underserved populations and
opportunities for new research;
• Identify and create research collaborations and synergistic relationships
among researchers and EFNEP/SNAP-Ed program directors, universities and
other implementers, and state and federal agencies; and
• Enhance the impact of state and community nutrition education and obesity
prevention efforts by providing the public health-related training and evidence
that practitioners need for improving nutrition and health behaviors,
environments, and policies in ways that are equitable, efficient, and sustained
over time.
National Coordination Center
Leadership Team
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Ann Vail, Project Director
Janet Kurzynske, Associate Director
Dawn Brewer, Communications
Janet Mullins, Evaluation
• RNECE NCC Web Site: http://rnece-ncc.org
National Coordination Center
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Coordinate across the Centers
Evaluate progress toward four objectives
Aggregate and translate results
Disseminate findings
Communicate about resources
RNECE Working Groups
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Communications
Evaluation
National Training Program
Affiliates Program (Implementers and Researchers)
Comprehensive Toolkit (Direct Education and PSE)
RNECE NCC Web Resources
http://rnece-ncc.org
RNECE NCC Web Resources
http://rnece-ncc.org
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PSE Change Center – Laura Stephenson and Karen Franck
Northeast – Jamie Dollahite
South – Alice Ammerman
West – Susan Baker and Karen Barale
North Central – Jo Britt-Rankin
Questions & Discussion
This work is supported by the U.S. Department of Agriculture (USDA), Food and Nutrition
Service and National Institute of Food and Agriculture. Any opinions, findings, conclusions, or
recommendations expressed in this publication are those of the author(s) and do not
necessarily reflect the view of the USDA.
Rationale: SNAP-Ed and EFNEP networks critically need a
pedagogically sound competency-based training system,
an organized collection of resources and access to broad
network of technical assistance to support effective PSE
implementation based upon a continuum of readiness
levels.
Intercultural Competence
Public Health
Lupita Fabregas
Marsha Davis, Center CoDirector
Elizabeth Payne
Center Staff
Soghra Jarvandi
EFNEP/SNAP-Ed
Laura Stephenson, Center Director
Jeanmarie Salie, Project Director
Kristopher Grimes
Linn Stilwell, Administrative
Support
Stephany Parker
eLearning Extension Assistant
Jacquelyn White
PSE Expert
Evaluation
Sarah Colby
Loren Bell
Rachel Novotny
Karen Franck, Center Co-Director
Danielle Treadwell
Yoonsung Jung
Karla Shelnutt
Objectives
Objective 1: Enhance the ability of SNAP-Ed and
EFNEP networks to effectively implement and
evaluate obesity prevention PSE strategies for lowincome populations throughout the lifespan
Objective 2: Strengthen SNAP-Ed and EFNEP
nutrition education interventions through
incorporation of effective culturally-responsive public
health approaches that are centered on readiness to
change best practices
PSE Change Center Inputs
for SNAP-Ed & EFNEP Networks
Action Plan
• Discovery phase – Assess situation, facilitators and barriers to SNAP-Ed/EFNEP PSE implementation and
evaluation, identified PSE competencies in literature
• Implement DACUM panels of SNAP-Ed and EFNEP Coordinators to identify PSE competencies
• Develop list of expected areas of PSE competence and skills for target audiences
• Develop training and technical assistance plan based upon identified competencies
• Develop web site
• Implement trainings and technical assistance
Northeast Regional Nutrition Education
and Obesity Prevention Center of
Excellence
Jamie Dollahite, Director
Cornell University
RNECE – Northeast Region
• 2 FNS regions – northeast
and most of mid-Atlantic
• Stakeholders from 12
states and District of
Columbia
• Research advisors
Mission and Goal
Mission To promote a culture of health among lowincome populations by bringing researchers and program
implementers together to engage in sound intervention
research congruent with implementation and
dissemination science.
Goal Expand the evidence base that supports effective
nutrition education of diverse low-income program
participants delivered in conjunction with policy,
systems, and environmental (PSE) approaches that make
healthy choices easier in order to prevent obesity.
Key Initiatives
• Signature Research Program
• Nationwide Training
• Systematic Review
Signature Research Program
Research Question
Does the combination of direct
nutrition education and PSE
changes have greater impact
on dietary intake and physical
activity than either strategy
alone?
Research Projects Summary
5 projects, variation in race, ethnicity, and cultural
contexts, target audience, and methods of delivery
2 implemented in SNAP-Ed, 3 in EFNEP
3 urban, 1 suburban, 1 rural in 2 sites with micropolitan
areas
3 RCTs; 2 quasi-experimental designs
Progress: Baseline data are complete; interventions are
underway; mid-year reports submitted
Adopting Healthy Habits in
Worksites: Increasing adoption and
acceptability of PSEs in agencies
serving low-income families
• RNECE-NE and Cornell Cooperative Extension EFNEP
• Effects of combining direct education with PSEs in
community agencies and day care centers to support
healthy habits for employees and agency participants.
• Direct-Ed Healthy Children, Healthy Families:
Parents Making a Difference!
• PSE worksite environment, policy changes
Nutrition Ed, Access and
Texting (NEAT): Combining the
Hartford Mobile Market with
e-Marketing
• Hispanic Health Council, Hartford CT
SNAP-Ed
• Effects of combining education with text
messaging campaign, mobile produce
markets & vouchers on access, purchase,
and intake of fruits and vegetables.
• Direct Ed series of 4 lessons on MyPlate
• PSEs & social marketing Produce vouchers plus daily
text messages
Sustaining a Successful YouthLeader Program as part of a
Multi-Level, Multi-Component
Food Environment/
Behavioral Intervention
• Johns Hopkins Bloomberg School of
Public Health, Md, SNAP-Ed
Public Health,
• Test model to train teens to implement nutrition education
and implement wellness policies at rec centers.
• Direct-Ed curriculum for younger youth developed with
U Md, SNAP-Ed
• PSE Youth-leaders participate in wellness policy development in centers. Additional impacts of corner store project.
Transforming Lifestyles:
Integrating Direct Nutrition
Education with Physical
Activity Using the Health Care
System Expansion Model
• University of Maryland EFNEP
• Effectiveness of engaging primary health care providers
in assessing children’s physical activity levels and
providing information and referrals to physical activity
resources and EFNEP.
• Direct-Ed Eating Smart Being Active and Cooking
Matters for Kids
• PSE Systems change in health clinic
Empowering Urban
Schoolchildren to Increase
Fruit and Vegetable
Consumption though EFNEPenhanced PSE Interventions
• University of Rhode Island EFNEP
• Effectiveness of engaging 5th grade
students in activities to change school
food environment
• Direct-Ed Fresh Fruit and Vegetable Program
• PSE students engagement with school wellness
committee and food service staff to change
menu
Nationwide Research
Translation and Training
Program
• Training will focus on planning, implementation, and
evaluation of PSE and PSE/direct education integrated
interventions within the EFNEP and SNAP-Ed context
• Delivered online through existing Cornell NutritionWorks
platform.
• Competency-based training
• Certificate/CPEUs provided
• National needs assessment – conducted February 2016
• Workgroup representing each RNECE; working closely
with PSE Change RNECE.
Systematic Review
To address the question: Does the combination of
direct nutrition education with changes to the food
and/or physical activity environment have greater
effect on obesity-related outcomes than either of the
strategies alone?
SOUTHERN REGION
UNC CENTER FOR HEALTH PROMOTION &
DISEASE PREVENTION
ASNNA WINTER 2016 CONFERENCE
FEBRUARY 11 , 2016
RNECE-South Activities
• Signature Sub-Awards
• Innovation Sub-Awards
• Healthy Retail Project
• Social Media Project
• SNAP-Ed Toolkit
• Webinar Trainings
• Partner Network
Signature Research Sub-Awards
Aim: to build the evidence-base for the Faithful
Families program and test dissemination using social
media
• University of Arkansas – Faithful Families:
Implementation and Outcome Evaluation of
Paraprofessional and Volunteer Delivery Methods
• University of Florida – Building Faith through Health
in the Community and Online
• University of Tennessee-Knoxville – Faithful Families
in Tennessee: Improving the Health of Low-Income
Faith-Based Audiences
Signature Research Project
• Faithful Families Program
created in 2007
• Partnership between N.C.
Cooperative Extension and the
N.C. Division of Public Health
• Posted on Center TRT as
Practice-tested
• Recognized at White House,
Let’s Move Faith and
Community Partners Meeting
Faithful Families Program
• Receive 9 weeks of nutrition
and health education classes
• Complete one policy and one
environmental change in the
faith community within the
year
• Connect with other county
Extension resources
• Signature projects include
social media
Innovation Sub-Award
Aim: to build the evidence for creative new SNAPEd and EFNEP Programing
• University of Georgia - Evaluation of mHealth
nutrition education eLearning program tailored
to SNAP-Ed eligible adult Georgians
Social Media in EFNEP and SNAP-Ed
• Use of social media is emerging as a strategy for
SNAP-Ed and EFNEP program engagement
• Little is known about best practices for designing
social media content related to these programs
• Can social media help low-income nutrition
education programs:
◦ Recruit, Reinforce, Remind, Relate, & Retain
Signature Research Projects
◦ Comparison of Different approaches
◦ Resource Materials
Rural Healthy Corner Store Project
• Implement Baltimore Health Stores program in 8 intervention and 8
comparison corner stores in rural communities in North Carolina.
• Program includes relationship building with store owners, stocking
healthy items, promoting healthy products and taste-testing
products
• Implement five themes each lasting in the store for
one month:
1.
2.
3.
4.
5.
Healthy Breakfast
Healthy Dinner
Healthy Snacks
Healthy Lunch
Healthy Beverages
Interactive
SNAP-Ed Toolkit
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Builds on updated SNAP-Ed Toolkit and Center for
Training and Research Translation (Center TRT)
 Newly released update with 20 new
For corrections/questions
re the current
interventions from ASNNA/NCCOR/CDC
review
(newly released)
toolkit, contact
Adee Kennedy <akennedy@fhi360.org>
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Major revision by March 30
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New (interactive) toolkit will
New!!
to enhance usability
through interactive features that assist with adding PSE to
direct education (expanding along the socioecologic
model)
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Address direct education as well as PSE
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Include strategies as well as interventions
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Include evaluation strategies using SNAP-Ed
Evaluation Framework
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Links to measurement tools
What makes it interactive??
Start with “needs assessment”
 Want to add PSE?
 Want to add Direct Education?
 What sector/setting are you working with?
 Searchable
 Setting/Sector
 Nutrition/PA focus
 Clickable
 Wade through lots of information to get to
what you need
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Department of Toolkit Explanation
It is not REQUIRED that you ONLY use
interventions included in the toolkit.
Others are permitted if justified in terms of the
evidence/reach/feasibility etc.
Therefore:
• It is not a “race to the toolkit”
• Our first priority is to increase usability/interactivity – then
accept more applications for review and posting
Why have the Resource Library AND the Toolkit?
From the “Under Development” Department
SNAP-Ed Evaluation Framework made Easy
Easier
Click!
Click!
Coalition
Effectiveness
Inventory
Tool
New Toolkit idea:
Consultation Case Studies
Example:
How do I add PSE to a one shot
classroom education experience??
AND give school lunch some good PR!
PROGRAM: Food for
Thought
Grade Level: 4th – 5th
Program Length: 60 min.
Schools visit Poe Center or
host program at school.
Interactive program, use
clickers for
feedback/evaluation
Parental
attitudes
about
school
food
Social
norms/Peer
influence
School
Wellness
Policies
Influencing
factors
Intervention
Strategies
Food
available at
home
Food
available at
school
Knowledge
about
diet/health
Team effort
to improve
school lunch
Social and
Cultural Norms
and Values
Sectors of
Influence
Environmental
Settings
Individual
Factors
Current
Program
Potential PSE
Additions
Kids convey
positives about
school nutrition
to parents
Support
School Lunch
Improvements
Awareness
of School
Health
Policies
Facts about food
and health,
calories, labeling
Strategy to nudge one-shot class sessions “Upstream”
toward PSE (support school nutrition program):
Before the session:
Back at School:
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Ask teacher/students to find School Health
Policy and send to the Poe Center staff.
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Detective work on “compliance” with School
Health Policy eg) classroom parties, fundraising
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Learn about how it was developed.
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Writing and communication assignments:
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Alert Child Nutrition Director about hopes
to improve School Lunch Attitudes!
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Letter to child nutrition director (Exercise
in making a persuasive/diplomatic
argument)
During 60 minute session:
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Quick review of health hazards of poor
diet/lack of PA
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Suggestions on how to get kids more
excited about school meals
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Honest/controlled  discussion of school
lunch
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After receiving (screened) letters, CND
meets with students to discuss ideas
If you want to say something bad you also
have to say something good.
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Letter to parents/caregivers about the
School Health Policyand what they learned
about it, send copy to CND
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Discuss benefits of school nutrition policies
and improved health – kid level
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Strategize with kids on ways to enhance
the appeal of the school lunch experience.
Thinking Big – Form a SPOON (Student Power Over
Our Nutrition) Committee at school
AND, how do we get Ms.
North Carolina to be a PSE
Advocate??
25 more minutes of activity in the school day; 25 ideas for promoting
school lunch; 25 minutes of solid activity in a 30 minute PE class, etc…
Adding Direct Education to PSE
EXAMPLE:
Walking Trails
Walking
Trails
Direct Educ. and
Social Marketing
Webinar-based Trainings
Archived Trainings:
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SNAP-Ed: Policy, Systems, and Environmental Change Successes
Understanding the SNAP-Ed Evaluation Framework
PSE Change in SNAP-Ed and EFNEP Programs
School and Childcare Wellness Policies & Best Practices
Farmers Markets and Community Gardens
Up-coming Trainings
• PSE Tracking, Measurement, and Evaluation
(Feb 25, 12:30-2:00 PM EST)
• Use of Collective Impact to Evaluate SNAP-Ed and EFNEP activities
(April)
• Behavioral Economics (June)
RNECE-South Network Partner Pages
Informational pages
for each of the
RNECE-South
Network partner
organizations. Find
organizations that
overlap with your
interests, check out
their pages, and
contact them for
more information.
www.rnece-south.org
Western Region
Susan S. Baker, EdD
Colorado State University
Karen Barale, MS, RD
Washington State University Extension
www.rnece.colostate.edu
Uniqueness of the
Western Region
• 14 states, 3 US
territories
• 8 time zones
• Urban, rural and island
communities
• 3 FNS Regions
• Largest NIFA region
• Hispanic focus
Behavior Checklist Revision
• What content is
in curricula?
• What are the
most important
concepts to
teach?
• What measures
of behavior
exist?
Version 1
Questions
Version 2
Questions
• Are the questions
• easy to
understand?
• sensitive to
changes in
behavior?
• How are they
interpreted?
• Which response
options are best?
• Are responses
consistent?
• Do the questions
measure the
behaviors they
intend to measure?
Final Version
Questions
Environmental
Support Activities
• Augment adult direct education curricula
with PSE strategies
Step 1:
Literature
Review
Step 2:
Formative
Research
Step 3:
Environmenta
l Support
Activities and
Evaluation
Tool
Development
Step 4:
Pilot and
Finalize
Activities;
Evaluate;
Disseminate
Food Pantry Environmental
Assessment Tool
Food Pantry
Assessment Tool
• Develop or adapt and test an E-scan for
Food Pantries
Winter 2016
• Collect Food Pantry Key Informant Perspectives
• Draft “What Works” Strategy Guide to accompany
Spring 2016 environmental scan
Summer
2016
August 2016
• Draft/adapt E-scan
• Pilot Test with Regional Partners, Revise
• Field test
YPAR:
Youth Participatory
Action Research
Implementation
2-3 sites
California,
Washington
Initial training
and regular
technical
assistance
Evaluation
Validate End of
Year Youth
Survey
Data analysis
Conduct Youth
Survey & Adult
Facilitator
Assessment of
Participants
each year
Multi-disciplinary methods for effective,
sustainable, and scalable evaluations of
nutrition education programs
Carrie Durward, PhD RD
Project Director
Assistant Professor and Extension Nutrition Specialist
Utah State University
Objective 1
• Assess the quality and cost of household
grocery food purchases 12 months before
and after program participation.
Grocery
Sales
Database
QualMART
Food
Quality
Tool
Healthy
Eating Index
2010
Household
grocery quality
score
Objective 2
• Evaluate the effectiveness of assessing
diet quality before and after program
participation using ASA24.
Timeline
Year 1
• Revise and validate QualMARTTM
• Recruit participants and controls for
objective 1
• ASA24 validation study
Year 2
• Collect grocery Sales Data
• Recruit participants and
controls for ASA24 Study
Year 3
• Analyze and report
grocery sales data
results
• Analyze and report
ASA24 results
Project Team
John Hurdle
U. Utah
Mindy Meuli
U. Wyoming
Patricia Guenther Susan Baker
U. Utah
Colo. State
Mateja Roskos
USU
Paula Scott
USU
Heidi LeBlanc
USU
Amy Subar
NCI
Karen Franck
U. Tenn
Paul McCawley
U. Idaho
Thea ZimmermanDeirdre Douglass
Westat
Westat
Leadership
• Dennis Savaiano, Purdue University
– Director and Research Coordinator
• Marci Scott, Michigan Fitness Foundation,
– Associate Director-Implementation
• Jo Britt-Rankin, University of Missouri
– Associate Director-Communications
• Dawn Contreras, Michigan State University
– Associate Director- Center Assessment
Steering Committee
Name
Institution
Institutional Position
Pat Aune
United Tribes Technical College
Director
Trina Barno
University of Minnesota
Program Leader, Extension
Patricia Bebo
Ohio State University
Leader, Community Nutrition Programs
(EFNEP/SNAP-Ed)
Linda Boeckner
University of Nebraska
Extension Nutrition Specialist
Kathleen Cullinen
Michigan Fitness Foundation
Director of Network Programs
Christine Hradek
Iowa State University
EFNEP and SNAP-Ed Coordinator
Sarah Jones
Michigan Fitness Foundation
Project Manager
Melissa Maulding
Purdue University
Jennifer McCaffrey
University of Illinois
Megan Ness
North Dakota State University
Paula Peters
Kansas State University
Assistant Director, Family and Consumer
Sciences, K-State Research and Extension
Amber Canto
University of Wisconsin-Extension
State Coordinator, Wisconsin Nutrition
Education Programs
Sandra Procter
Kansas State University
Coordinator, Kansas EFNEP and Kansas SNAPEd
Suzanne Stluka
South Dakota State University
EFNEP and SNAP-Ed Coordinator
Director, Extension EFNEP and SNAP-Ed
Programs
Assistant Dean, Family and Consumer
Sciences
Program Coordinator and Specialist,
EFNEP/FNP
• Website
– http://ncnece.org/
• Leadership
– http://ncnece.org/whoweare.htm
• Affiliate Members
http://ncnece.org/affiliatemembers.htm
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Affiliate Members
30 to date from all 12 NC States
Researchers and implementers
Two webcasts to date
– Networking research
– Research opportunities
• Formative evaluation: Online focus groups
– Individual Level:
• Research related to the longitudinal effects of SNAP-Ed and EFNEP
• Tools and PSE interventions for use with diverse audiences
– Interpersonal Level:
• Measuring the effects of social networking strategies, including social
support, champion/ambassadors
• Research and tools for measuring the “spill-over” effects of SNAP-Ed
and EFNEP interventions from child to family and vice versa
– Organizational Level:
• Research and tools for measuring the effectiveness of communitybased teamwork interventions, coaching, collective impact.
– Policy Level:
• Tools/measurement methodologies for PSE interventions within
diverse settings, i.e. coalitions, child care, farmers markets, food
pantries, parks, etc.
The online focus group suggestions of other ways
NC-NECE can support SNAP-Ed and EFNEP
• Coordinating cross-state discussion groups and
fostering connections
• Organizing, promoting and funding cross-state
research projects
• Hosting a database and serving as a clearinghouse
of PSE interventions being used for SNAP-Ed
and/or EFNEP in the region
• Priorities for research:
– Address the policy, systems and/or environmental
aspects of the rural communities of the North
Central region
– Address the specific needs of immigrant, minority
and/or other at-risk populations in this region
– Strengthen the evidence base on effective
nutrition-education/obesity-prevention programs
for diverse groups, notably SNAP-Ed and EFNEP
• Funded research
– University of Missouri. Eat Smart in Parks. Youth Mapping and
PhotoVoice to Inform Healthy Food Environments (Rd 1)
– University of Illinois. Evaluating a Multi-Modal Community Nutrition
Education Model within SNAP-Ed and EFNEP (R1 & 2)
– Ohio State University. Summer Weight and Environmental Assessment
Trial (SWEAT) (Rd 2)
– Purdue University. A Longitudinal Randomized and Controlled
Evaluation of the Integrated Impact of SNAP-Ed on Food Security and
Obesity Prevention in Rural and Urban Counties (Rd 2)
– Michigan State University. Influence of PSA on Dietary Quality at
Diverse Low Income Child Care Settings (Rd 2)
• Considering a third round of funding in Spring 2016