Degree

Doctor of Nutrition and Food Sciences (PNFS)

Department

School of Nutrition and Food Sciences

Document Type

Dissertation

Abstract

Policy, Systems, and Environmental (PSE) changes related to food and physical activity offer promising strategies for improving population-level health behaviors. Federal programs like the Supplemental Nutrition Assistance Program – Education (SNAP-Ed) support these efforts through the Cooperative Extension System (CES) in Louisiana, complementing traditional nutrition education. However, the adoption and implementation of PSE strategies remain understudied.

This dissertation examines factors influencing PSE approaches through the perspectives of Louisiana State University AgCenter (LSU AgCenter) Nutrition and Community Health (NCH) practitioners. It integrates three complementary studies— a systematic review, a cross-sectional survey, and qualitative interviews—guided by the EPIS (Exploration, Preparation, Implementation, Sustainment) implementation science framework.

The systematic review analyzed 25 studies published since 2000 on food and physical activity PSE changes in U.S. community settings, using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Key factors influencing adoption and implementation include funding, partner engagement, and accountability.

A quantitative survey using the Policy Indicator Checklist (PIC) assessed food and physical activity policies among NCH practitioners in Louisiana. Community recreation policies scored highest (M = 1.50, SD = 1.57), followed by farmers' market promotions (M = 0.95, SD = 1.75) and efforts to promote nutrition assistance programs in food retail settings (M = 0.56, SD = 1.03), while policies addressing public service venues and transportation were minimal. These findings establish a baseline understanding of Louisiana’s food and physical activity policy landscape.

The final qualitative study, also guided by the EPIS framework, explored determinants in implementing policy-level changes. Socio-political barriers and limited community leadership emerged as major challenges, whereas support from local intermediaries, such as police juries and community advocates, facilitated progress. Together, these studies highlight the complexities of implementing food and physical activity PSE strategies within CES. Findings offer critical insights and recommendations to enhance adoption, implementation, and long-term sustainability of PSE initiatives in future Cooperative Extension programming.

Date

6-12-2025

Committee Chair

Denise Holston

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Available for download on Saturday, July 31, 2032

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