Research Article| Volume 46, ISSUE 6, P475-483, November 2014

Download started.


Development and Application of a Framework to Assess Community Nutritionists' Use of Environmental Strategies to Prevent Obesity



      To develop and apply a framework exploring the extent of involvement in promoting environmental changes to prevent obesity by a group of nutrition educators (NE).


      Cross-sectional, mixed methods: qualitative interviews informed framework development; survey applied framework to describe NE's involvement in environmental changes.


      Cooperative Extension in New York State.Participants: Interviewees (n = 7) selected to vary in environmental change activities and rural/urban location. Survey response rate was 100% (n = 58).

      Phenomenon of Interest/Variables Measured

      Dimensions and degree of NE's involvement in promoting environmental change.


      Thematic analysis of qualitative data, triangulated with descriptive analyses of NE's performance of tasks in various settings.


      NE's promotion of environmental changes was characterized using framework based on settings and tasks, dimensions that emerged from qualitative analysis. NE's actions varied across these dimensions and ranged from low to high intensity of collaboration and leadership for environmental change. Most NE surveyed reported actions limited to providing information and recommendations on healthy eating and physical activity. Few reported intensive engagement in developing, implementing, and evaluating plans to change environments for obesity prevention.

      Conclusions and Implications

      Framework identifies the levels of engagement in promoting environmental changes and supports future research and practice of community nutrition professionals by providing a roadmap for assessing their involvement on multiple levels to prevent obesity.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access

      SNEB Member Login

      SNEB Members, full access to the journal is a member benefit. Login via the SNEB Website to access all journal content and features.


      Subscribe to Journal of Nutrition Education and Behavior
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bronfenbrenner U.
        The Ecology of Human Development: Experiments by Nature and Design.
        Harvard University Press, Cambridge, MA1979
      1. Center for Nutrition Policy and Promotion Dietary Guidelines for Americans. July 11, 2013. Accessed July 30, 2013.

        • McLeroy K.R.
        • Bibeau D.
        • Steckler A.
        • Glanz K.
        An ecological perspective on health promotion programs.
        Health Educ Q. 1988; 15: 351-378
        • Swinburn B.
        • Gill T.
        • Kumanyika S.
        Obesity prevention: a proposed framework for translating evidence into action.
        Obes Rev. 2005; 6: 23-33
        • Economos C.D.
        • Hyatt R.R.
        • Goldberg J.P.
        • et al.
        A community intervention reduces BMI z-score in children: Shape Up Somerville first year results.
        Obesity. 2007; 15: 1325-1336
        • Sanigorski A.M.
        • Bell A.C.
        • Kremer P.J.
        • Cutler R.
        • Swinburn B.A.
        Reducing unhealthy weight gain in children through community capacity-building: results of a quasi-experimental intervention program, Be Active Eat Well.
        Int J Obes. 2008; 32: 1060-1067
        • Schwarte L.
        • Samuels S.E.
        • Boyle M.
        • Clark S.E.
        • Flores G.
        • Prentice B.
        Local public health departments in California: changing nutrition and physical activity environments for obesity prevention.
        J Public Health Manag Pract. 2010; 16: E17-E28
        • Gantner L.A.
        • Olson C.M.
        Evaluation of public health professionals' capacity to implement environmental changes supportive of healthy weight.
        Eval Program Plann. 2012; 35: 407-416
        • Centers for Disease Control and Prevention
        Recommended community strategies and measurements to prevent obesity in the United States.
        MMWR Recomm Rep. 2009; 58: 1-29
        • Institute of Medicine
        Koplan J.P. Liverman C.T. Kraak V.I. Preventing Childhood Obesity: Health in the Balance. National Academies Press, Washington, DC2005 (Accessed July 30, 2013)
        • Institute of Medicine
        Birch L.L. Parker L. Burns A. Early Childhood Obesity Prevention Policies. The National Academies Press, Washington, DC2011 (Accessed July 30, 2013)
      2. New York State Department of Health. Strategic plan for overweight and obesity prevention: policy and environmental changes. October 2008. Accessed July 13, 2013.

        • Kumanyika S.
        • Jeffery R.W.
        • Morabia A.
        • Ritenbaugh C.
        • Antipatis V.J.
        Obesity prevention: the case for action.
        Int J Obes. 2002; 26: 425-436
        • Woodruff K.
        • Dorfman L.
        • Berends V.
        • Agron P.
        Coverage of childhood nutrition policies in California newspapers.
        J Public Health Policy. 2003; 24: 150-158
      3. National Institute of Food and Agriculture. The Expanded Food and Nutrition Education Program Policies. 2013. August, 2013. Accessed October 21, 2013.

      4. United States Department of Agriculture. SNAP-Ed Strategies and Interventions: An Obesity Prevention Toolkit for States. July 24, 2013. Accessed October 21, 2013.

        • Paeratakul S.
        • Lovejoy J.C.
        • Ryan D.H.
        • Bray G.A.
        The relation of gender, race and socioeconomic status to obesity and obesity comorbidities in a sample of US adults.
        Int J Obes. 2002; 26: 1205-1210
        • Trust for America's Health
        F As in Fat: How Obesity Threatens America's Future.
        TFAH, Washington, DC2011 (Accessed August 30, 2013)
        • Larson N.I.
        • Story M.T.
        • Nelson M.C.
        Neighborhood environments: disparities in access to healthy foods in the U.S.
        Am J Prev Med. 2009; 36: 74-81
        • Moore J.B.
        • Davis C.L.
        • Baxter S.D.
        • Lew R.D.
        • Yin Z.
        Physical activity, metabolic syndrome, and overweight in rural youth.
        J Rural Health. 2008; 24: 136-142
        • Powell L.M.
        • Slater S.
        • Chaloupka F.J.
        The relationship between community physical activity settings and race, ethnicity, and socioeconomic status.
        Evid Based Prev Med. 2004; 1: 135-144
        • Contento I.R.
        Nutrition Education: Linking Research, Theory, and Practice.
        Jones and Bartlett Publishers, Sudbury, MA2007
        • Swinburn B.
        • Egger G.
        • Raza F.
        Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity.
        Prev Med. 1999; 29: 563-570
        • Patton M.Q.
        Qualitative Research and Evaluation Methods.
        3rd ed. Sage Publications, Beverly Hills, CA2002
        • Lincoln Y.S.
        • Guba E.G.
        Naturalistic Inquiry.
        Sage Publications, Beverly Hills, CA1985
        • Miles M.B.
        • Huberman A.M.
        Qualitative Data Analysis.
        2nd ed. Sage Publications, Thousand Oaks, CA1994
        • Strauss A.
        • Corbin J.
        Basics of Qualitative Research: Grounded Theory Procedures and Techniques.
        SAGE Publications, Newbury Park, CA1990
        • DeVellis R.F.
        Scale Development: Theory and Applications.
        2nd ed. Sage Publications, Thousand Oaks, CA2003
      5. New York State Department of Health. Eat Well Play Hard. June 2010. Accessed July 13, 2013.

      6. New York State Department of Health. Obesity-related diseases. September 2005. Accessed July 13, 2013.

      7. Minnesota Department of Health. Minnesota plan to reduce obesity and obesity-related chronic diseases 2008–2013. July 2008. Accessed April 3, 2014.

        • Drummond R.L.
        • Staten L.K.
        • Sanford M.R.
        • et al.
        Steps to a healthier Arizona: a pebble in the pond: the ripple effect of an obesity prevention intervention targeting the child care environment.
        Health Promot Pract. 2009; 10: 156S-167S
        • Sacks G.
        • Swinburn B.A.
        • Lawrence M.A.
        A systematic policy approach to changing the food system and physical activity environments to prevent obesity.
        Aust New Zealand Health Policy. 2008; 5: 13-19
        • Wendel M.L.
        • Prochaska J.D.
        • Clark H.R.
        • Sackett S.
        • Perkins K.
        Interorganizational network changes among health organizations in the Brazos Valley.
        Texas. J Prim Prev. 2010; 31: 59-68
        • Mattessich P.W.
        • Murray-Close M.
        • Monsey B.R.
        • Collaboration: What Makes It Work
        Amherst H. Wilder Foundation, St. Paul, MN2001
        • Henderson B.R.
        • Armah N.
        Making the case for community-based wellness programs.
        Natl Civ Rev. 2010; 99: 27-34
        • Schneider L.
        • Ward D.
        • Dunn C.
        • Vaughn A.
        • Newkirk J.
        • Thomas C.
        The Move More Scholars Institute: a state model of the physical activity and public health practitioners course.
        Prev Chronic Dis. 2007; 4 (Accessed September 22, 2013): 1-8
      8. Government of South Australia. Be Active Eat Well Strategy 2011-16. 2012. Accessed August 30, 2013.

        • Sullivan H.
        • Barnes M.
        • Matka E.
        Building collaborative capacity through “theories of change”: early lessons from the evaluation of Health Action Zones in England.
        Evaluation. 2002; 8: 205-226
        • Schwartz M.B.
        • Brownell K.D.
        Actions necessary to prevent childhood obesity: creating the climate for change.
        J Law Med Ethics. 2007; 35: 78-89
        • Rosenthal B.B.
        Collaboration for the nutrition field: synthesis of selected literature.
        J Nutr Educ. 1998; 30: 246-267
        • Glasgow R.E.
        • Emmons K.M.
        How can we increase translation of research into practice? Types of evidence needed.
        Annu Rev Public Health. 2007; 28: 413-433