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.