Healthy Eating in K-12 Schools: Assessing Readiness and Capacity to Guide SNAP-Ed Programming in Ohio.

Objective: Identify themes essential to implementing policy, system, and environmental (PSE) interventions within kindergarten to 12th-grade (K-12) settings and provide associated indicators of readiness and capacity to support healthy eating PSE work among Supplemental Nutrition Assistance Program-Education (SNAP-Ed) practitioners in Ohio.

Design: Interview data were collected in Ohio from December, 2020 to May, 2021. Participants: Ohio SNAP-Ed practitioners (n = 12), community residents with low income (n = 26), and K-12 experts statewide (n = 10) and nationally (n = 3). Phenomenon of interest: Healthy eating PSE implementation. Analysis: We conducted a qualitative analysis to identify themes and indicators related to implementing healthy eating PSEs in schools. During virtual consensus conferences (December, 2021-April, 2022), themes and indicators were sorted and ranked by perceived importance to PSE implementation.

Results: Four themes and 14 indicators were identified. Expert-derived weights quantified the themes' importance to PSE implementation efforts in K-12. Themes included: (1) school system support and capacity (weight 0.372), (2) school food environment (0.278), (3) SNAP-Ed practitioner capacity and resources (0.192), and (4) familial influence and awareness (0.158). Conclusions and implications: Findings provide guidance for tailoring healthy eating PSEs in K-12 schools using local levels of readiness and capacity. Results highlight targeted areas of focus to support the implementation of healthy eating PSE interventions in K-12 schools through SNAP-Ed programming in diverse contexts. Future research is needed on the applicability of these findings based on feedback from school district staff and community members with children in different school settings.