Adopting Healthy Habits: Nutrition educators expand roles to include policy, systems, and environmental change

introduction: Supporting policy, systems and environmental change (PSE) is increasingly recognized as an essential component of nutrition education in communities. Through community-based participatory research, Adopting Healthy Habits (AHH), leveraged existing Cooperative Extension staff to address this challenge. Study objectives included 1) identifying programmatic supports for professional and paraprofessional nutrition educators to expand beyond direct education and 2) documenting changes that support healthy choices in environments where children and adults live, learn, work, and play.

methods: In seven diverse counties across New York, staff (n=16) focused strategies (staff development, worksite wellness programs, and engagement in local coalitions) to increase healthful food and activity behaviors underpinned by local policy and systems changes. Output and outcome data were collected through yearly work plans, periodic focus groups and interviews with staff and partners, community readiness and other needs assessments, and monthly documentation of activities.

results: With dedicated time, ongoing technical assistance, and skill development, nutrition educators can become agents of PSE changes. Results included best practices for adoption of healthy activities and the importance of supporting guidelines and policies in primary sectors (schools, worksites, and community organizations). Data analysis elucidated needs regarding evaluation tools, resources to support dedicated time for PSEs, and training relevant to multiple community roles undertaken by professional and paraprofessional staff.

discussion: AHH outcomes illuminate opportunities within current partnerships to engage in and implement PSEs.  Site-specific case studies detail contextual variation and serve as roadmaps for PSE initiation.  Challenges remain and additional research is needed to develop sensitive and effective evaluation tools.