Adapting, Implementing, and Assessing the Impact of the Shaping Healthy Choices Program through UC CalFresh Partnerships

Abstract

The Shaping Healthy Choices Program (SHCP) is a multi‐component, school‐based intervention developed to improve the health of school‐aged children. Previous studies found a decrease in BMI, an increase in vegetable identification and consumption, and an increase in nutrition knowledge in students participating for nine months. This study determined the efficacy of the research‐tested program through dissemination in the University of California (UC) CalFresh Nutrition Education Program in three counties participating during the 2014–2015 school year. Before program implementation, county teams attended two professional development workshops. The first workshop provided an overview of the program and assisted county teams in the development of implementation plans. The second workshop supported the first step in the nutrition education professional development process, engaging county teams in exploring how to facilitate an inquiry‐based curriculum. Technical assistance was provided through regular meetings and webinars. A series of evaluations measuring nutrition knowledge, vegetable identification, and height and weight measurements were collected before and after program implementation. All schools participating in the intervention received the SHCP over the course of four months. Fidelity to SHCP curriculum procedures by the nutrition educators was assessed through classroom observations. Perceptions of feasibility and acceptability were assessed at a forum for all participating counties. A paired‐samples t‐test was conducted to compare outcomes before and after program implementation. There was a significant difference between the scores for nutrition knowledge prior to intervention (20.7, ±4.2) and after (22.6, ±4.2); p=0.001. In analysis by county, significant improvements were observed in all three though some had greater improvements than others, Students in County A significantly increased their ability to identify five of ten vegetables (p<0.05); students in County B increased their ability to identify three of ten vegetables (p<0.05); and students in County C increased their ability to identify six of ten vegetables (p<0.05). No significant changes in BMI percentile were observed over the shortened implementation period. Fidelity to the SHCP curriculum among all counties was 85.5±18.27%, with variation among them (A=80.21±21.35%; B=75.83±21.68%; C=95.49±6.76%). Input gathered from the forum informed the expansion of the SHCP into more counties during the 2015–2016 academic year. Implementation of the SHCP through the UC CalFresh Nutrition Education Prgoram resulted in improvements in knowledge and ability to identify vegetables. Variation among counties in changes in student outcomes may be attributed to variation in fidelity to curriculum procedures.Support or Funding InformationThe UC CalFresh Nutrition Education Program is funded through a joint agreement among the US Department of Agriculture, Food and Nutrition Service, the California Department of Social Services CalFresh Branch, and the University of California Cooperative Extension.