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

Abstract

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. 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. 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). 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.