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Background Collective impact theory suggests coalitions can encourage community-level policy and systems changes supported by the Supplemental Nutrition Assistance Program – Education (SNAP-Ed). A recent Cochrane review found coalition efforts improved health disparities, but insufficient knowledge of coalition characteristics limited understanding of underlying mechanisms. Objective Measure community coalition characteristics across time to identify potential areas for improvement. Study Design, Setting, Participants Trained SNAP-Ed staff administered the research-tested Wilder Collaboration Factors Inventory (Wilder) as a pretest and 2 years later as a posttest, at the level of the coalition. Community coalitions were established for at least 6 months, worked in the food systems (FS) or active living (AL) SNAP-Ed focus areas, and included at least 5 organizations and a SNAP-Ed representative. Seven coalitions (n = 73 members) completed the Wilder in both years, including 3 FS (n = 36) and 4 AL (n = 37) coalitions. Measurable Outcome/Analysis Within-group (by focus area) analyses across time: Wilcoxon signed-rank tests to compare scores for the 20 Wilder factors. Descriptive statistics for percentage of respondents whose scores for individual factors decreased. Results Across 2 years, coalition members reported improvements related to coalition purpose, collaborative environment, and perception of resources. Coalition processes and membership characteristics showed decreases. For FS coalitions: Unique Purpose improved significantly (P Conclusion Coalitions that persist over time may increase their level of collaboration, collective purpose, and resource security. They may need ongoing support to maintain internal processes and address membership characteristics. Implications of this work include successful measurement of short-term changes in coalition capacity outcomes; this highlighting of strengths and weaknesses may improve coalition efforts to address longer-term community-level objectives. Funding Supplemental Nutrition Assistance Program-Education.

To assess changes in written local wellness policies (LWPs) across time within Supplemental Nutrition Assistance Program Education (SNAP-Ed)-participating districts.Sequential, explanatory mixed methods.From October 1, 2015 to September 30, 2016, SNAP-Ed agencies submitted LWPs from partner school districts in Arizona. They received back scores and customized recommendations. To assess changes, LWPs were rescored between October 1, 2017 and September 30, 2018.Sixteen local SNAP-Ed agencies worked with 57 districts.Districts' LWP revisions supported by SNAP-Ed agencies during the 2-year pre-post period.Policy comprehensiveness and strength from 0 (worst) to 100 (best), measured by the Wellness School Assessment Tool.Paired t test to compare pre-post scores. Content analysis of State Educational Agency administrative reviews and thematic analysis of SNAP-Ed narrative reports to explore causation.Total scores increased (comprehensiveness: +12.4, P.001, 95% confidence interval, 8.1-16.7; strength: +13.5, P.001, 95% CI, 9.3-17.7). Improvements were also found for comprehensiveness by section, except Nutrition Education, and for strength across all sections. Qualitative findings suggest that SNAP-Ed interventions combined with state and federal influence contributed to the improvements.Local wellness policies in SNAP-Ed-supported districts improved over time. State and federal LWP guidelines can work synergistically with SNAP-Ed interventions to influence improvements.

Background The AZ Health Zone administers Arizona's SNAP-Ed program. Our multi-year, statewide evaluations follow national evaluation standards, including accuracy and utility. The Rudd Center for Food Policy & Obesity developed the WellSAT to measure the quality of written SWPs, in consultation with an advisory board. The WellSAT has been updated twice to reflect changes to national regulations from the Healthy, Hunger-Free Kids Act. Objective To identify key characteristics of an accurate, useful system for large-scale SWP assessment. Study Design, Settings, Participants From October 2015—September 2018, the AZ Health Zone State Evaluation Team used a WellSAT scoring process to assess the quality of written school wellness policies (SWPs) from over 120 SNAP-Ed-qualified districts across Arizona's 15 counties. Local SNAP-Ed agencies submitted SWPs for WellSAT scoring and received back results and recommendations to use with districts. Measurable Outcome/Analysis We conducted a meta-evaluation to improve the WellSAT scoring process. Data from SWP meetings, evaluation meetings, debrief sessions, and interviews with Local SNAP-Ed Agencies were systematically analyzed to identify best practices for large-scale SWP assessment using the WellSAT. Results We identified five key characteristics of our scoring system. Use two consistent scorers. We enhanced accuracy by comparing results from two trained, independent scorers to catch errors and resolve discrepancies. Train scorers using state-specific guidelines. We further improved accuracy by developing a state-specific scoring template. Aim for rapid, responsive turnaround. We bolstered the utility of findings by generating results within four to eight weeks, or before district SWP meetings. Offer guidance on interpreting scores. We also enhanced utility by helping users understand how their scores compared to state averages and national trends. Create easy-to-use recommendations. We improved utility by providing users with editable, score-based recommendations on how to revise SWP language. Conclusion The accuracy and utility of large-scale SWP assessment can be enhanced using the five practices described above.

Background The Supplemental Nutrition Assistance Program-Education (SNAP-Ed) encourages nutrition and physical activity in districts and schools where over 50% of students receive free-and-reduced-price lunch. In Arizona, the AZ Health Zone implements SNAP-Ed, which includes support for developing, implementing, and evaluating local wellness policies (LWPs). Objective To assess changes in written LWPs among SNAP-Ed-participating districts across Arizona. Study Design, Settings, Participants The AZ Health Zone developed a scoring system using the WellSAT 2.0 tool to measure the quality of written LWPs and encourage use of findings among partner districts. From October 1, 2015 to September 30, 2016, local SNAP-Ed agencies in 13 Arizona counties submitted 57 LWPs and received back scores and customized recommendations to share with districts. LWPs from the same districts were scored again between October 1, 2017 to September 30, 2018 to assess changes. Measurable Outcome/Analysis We completed the six-section WellSAT 2.0 to generate scorecards for each LWP. Scorecards included section and total scores for comprehensiveness and strength, from 0 (worst) to 100 (best). We used the paired t-test to compare scores across time, and we explored changes in scores as they related to SNAP-Ed interventions, federal requirements, and state administrative reviews. Results From 2016 to 2018, total comprehensiveness and strength scores increased significantly (comprehensiveness: M = 12.33, SD = 16.05, P P P P Conclusion Written LWPs in Arizona's SNAP-Ed-supported school districts have improved in recent years. SNAP-Ed interventions may have worked synergistically with state administrative reviews and federal LWP guidelines to influence improvements. Further research is needed to understand these interrelationships.

Background The Supplemental Nutrition Assistance Program-Education (SNAP-Ed) encourages healthy nutrition and physical activity (PA) behaviors for SNAP eligible adults. In Arizona, one way the AZ Health Zone SNAP-Ed program promotes behavior change is through direct education classes. While it might be presumed that SNAP-Ed participants enter classes with similar behaviors, we found that baseline behaviors differed between English and Spanish speaking cohorts. Objective To describe differences in nutrition and PA behaviors before education between English and Spanish-speaking SNAP-Ed participants in Arizona. Study Design, Settings, Participants The AZ Health Zone used two validated surveys to measure baseline nutrition and PA behaviors among184 adults in eight Arizona counties between October 1, 2017—September 30, 2018. Sixty adults completed the surveys in English; 124 completed them in Spanish. Adults were surveyed before direct education classes at sites such as schools, libraries, family shelters, and senior centers. Measurable Outcome/Analysis Surveys included 16 nutrition questions and 20 PA questions. Depending upon data type, we used t-tests (PA data), Wilcoxon signed-rank tests (nutrition - Likert data) and Chi-square tests (nutrition - binary data) to compare responses between language groups. Results For nutrition behaviors, we found that Spanish speakers drank more milk (P Conclusion Significant differences were found between SNAP-eligible English and Spanish speakers in Arizona before participating in direct education. Spanish speakers showed healthier behaviors but greater food insecurity. More evaluation is warranted to see if this finding is replicable, and to explore the underlying reasons for the observed differences.

Schools eligible for Supplemental Nutrition Assistance Program Education (SNAP-Ed) can offer programs to address overweight and obesity among low income youth. This study assessed changes in knowle...