Development and application of a framework to assess community nutritionists' use of environmental strategies to prevent obesity

Objective: 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).

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

Setting: 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.

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

Results: 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.