Community nutrition policy, system, and environmental (PSE) interventions are effective strategies for promoting healthy diet for chronic disease prevention. PSEs help make environments match healthy eating messages by making the healthy choice the easy choice in the places where we live, work, learn, and play.

Policy change seeks to change laws, ordinances, rules, or regulations. Policy change may target government entities at the national, state, and/or local levels. Policy change can also target organizations such as schools, childcare centers, businesses, or religious institutions.

Systems change seeks to shift the way a community makes decisions about policies, programs, and the allocation of resources, and influence how communities provide services to residents.

Environmental change alters physical or social environments where people live, work, learn, and play. This may include developing or enhancing infrastructure or promoting social norms to shift behaviors within environments.

A PSE READI (Readiness Assessment and Decision Instrument) is an online tool for practitioners to assess community readiness and capacity to implement community nutrition PSEs. This website was designed through a partnership between Case Western Reserve University; The Ohio State University, SNAP-Ed program; and the Ohio Department of Health, Creating Healthy Communities Program (CHC). The goal is to promote successful implementation of community nutrition Policy, System and Environmental (PSE) programs.

A PSE READI has approximately 25 questions and will take about 15-20 minutes to complete. A user will select a response option for each question. There are no text fields in the PSE READI. As there are no right or wrong answers, a user can select the best option for each question.

Just as individuals vary in their readiness to change, communities also vary. Each community may be at a different level of readiness and capacity for community nutrition PSEs. The PSE READI can help you assess, plan, and act to optimize success in a specific community or targeted service area.

Assess: You can take the online PSE READI to assess your community’s readiness and capacity to implement community nutrition PSEs.

Plan: You will get a report tailored to your community to help you plan next steps and guide community nutrition PSE implementation.

Act: You can explore our PSE Resources, which includes more than 1,000 tools, guides, and resources to put your community nutrition plan into action.

No two communities are the same, and many factors influence community readiness and capacity for change. There is a need to tailor PSEs to each community. The objective of the PSE READI is to:

• Provide a tool to assess readiness and capacity factors in the diverse communities where community nutrition PSEs are being implemented.
• Give users tailored guidance and resources to optimize success with community nutrition PSE implementation in targeted communities

Ultimately, our goal is to help communities seeking to make the healthy choice, the easy choice for low-income populations.

To develop each PSE READI, the BCOP team used a multiphase consensus-building approach. The goal was to develop a tool based on perceptions of practitioners and community members to foster relevance and utility. This process was completed in five phases and repeated separately for Farmers’ Markets, Healthy Eating in Childcare, Health Food Retail, and Farm to School. The following articles describe our multiphase approach.

• Lee, E., Dalton, J., Ngendahimana, D., Bebo, P., Davis, A., Remley, D., Smathers, C., & Freedman, D.A. (2017). Consensus-based assessment tool of readiness and capacity for implementing community-based nutrition interventions: A case study using farmers’ markets. Translational Behavioral Medicine, 7(3); 506-516. (PDF found here)
• Parsons, A.A., Monteban, M., Lee, E., Bebo, P., Zubieta, A.C., Ginetti, S., Hewitt, J., & Freedman, D. (2019). Indicators of Readiness and Capacity for Implementation of Healthy Eating Strategies in Childcare Settings Serving Low-income Children. Journal of Nutrition Education and Behavior, 51(4); 465-477. (PDF found here)
• Cascio, M.A., Lee, E., Vaudrin, N., & Freedman, D.A. (2019). A Team-Based Approach to Open Coding: Considerations for Creating Intercoder Consensus. Field Methods. https://doi.org/10.1177/1525822X19838237 (PDF found here)
• Lee, E., Smathers, C., Zubieta, A. C., Ginnetti, S., Shah, A., & Freedman, D. A. (2019). Identifying indicators of readiness and capacity for implementing farm to school interventions. Journal of School Health, 89(5); 373-381. (PDF found here)
• Sanchez-Flack, J., Joshi, K., Lee, E.E., & Freedman, D.A. (2021). Indicators of readiness and capacity for implementation of healthy food retail interventions. Journal of Agriculture, Food Systems, and Community Development, 10(3), 1-17. (PDF found here)

To access the PSE READI tool, you will need to create a user account and then access the PSE READI by going to My Assessments on your account.

You will need an email address which will become your User ID. You also need to select the state and county(s) that you are currently working with.

Go to the Create Your Account page. Here you will enter your email and create a password. You need to select the county(s) you work with as well as your affiliation such as SNAP-Ed or Creating Healthy Communities.

Your email will only be used by the BCOP Team at Case Western Reserve University to link your PSE READIs. It will not be shared with anyone outside of this team. Your email will not be used in any reporting about the PSE READI.

A PSE READI has approximately 25 questions and will take about 15-20 minutes to complete. A user will select a response option for each question. There are no text fields in the PSE READI. As there are no right or wrong answers, a user can select the best option for each question.

A PSE READI is designed to assess readiness and capacity for PSEs in a specific community.

1. Select a PSE READI:

Pick one of the four PSE READI tools: Farmers’ Markets, Healthy Food Retail, Farm to School, and Healthy Eating in Childcare.

2. Before you complete a PSE READI:

• Choose your service area by thinking about the area(s) in which you do your work
• Within the area(s) you work, choose one target area or community you would like to assess with a PSE READI. This area may be an entire county, a city or town, a cluster of zip codes, a specific census tract, a school district, or a combination of these.
• You will be asked to define your service area by checking one category from a list (e.g., county, zip code, census tract, name of city or town) and providing the corresponding information.

3. Decide to take a PSE READI as an individual or as a team

This decision tree can help you determine if you should take the PSE READI as a team or individual.

4. Take a PSE READI:

A PSE READI has approximately 25 questions. You will select one response for each question by choosing the best fit. There are no right or wrong answers. There are no open-ended questions on a PSE READI.

We recommend you include the service area when naming your PSE READI (e.g., Franklin County Assessment). There is a column that shows the type of PSE READI and the date you completed the assessment. It may help to also add the version number to your PSE READI name to distinguish between multiple assessments (eg. Franklin County Assessment_V1).

We recommend completing a new PSE READI every 6-12 months to check your progress in your PSE interventions. More frequent re-assessments are encouraged, especially if major changes have occurred in your community/service area.

There is no right or wrong answer to this question. It is important to consider what would be most valuable for your work in a specific service area or target community. If you are not currently working with a team, it may be helpful to start off by taking the PSE READI individually. Please use the PSE READI decision tree to help you decide.

A key difference between taking the PSE READI as an individual or as a team is when and how the report of tailored recommendations and resources is generated.

Reports for an individual user: If you take a PSE READI as an individual, you will receive a report with three evidence-based recommendations and resources tailored to your specific service area or targeted community. The report will be generated upon completion of a PSE READI and will be saved in your user account for future reference.

Reports for a team: After each team member completes a PSE READI, one report of tailored recommendations and resources will be generated and sent to the team leader (the individual who created the team and selected and invited team members). Results of a team PSE READI are part of a collective process and are designed to be shared with participating team members. The team leader is encouraged to invite all team members to a debriefing meeting to review the results of the report together.

Once your user profile is created, you can take the PSE READI as many times as desired. For the tool to be most effective, take a separate PSE READI for each target community you work in. You will give each PSE READI a unique name to help identify different reports in the future.

Once you have an account, you can take the PSE READI as many times as desired. You should name each PSE READI uniquely to help identify different reports in your account.

Users should select a response on the 5-point scale ranging from “not at all” to “extremely”. The options “don’t know” and “not applicable” should be used the following circumstances:

Don’t Know = If the question may apply, but you are unsure how to answer the question
Not Applicable = If the question does not apply to your area of work.

Once all questions on the PSE READI are completed, a report with three evidence-based recommendations and supporting resources tailored to your community’s readiness and capacity will be provided.

If you are taking a PSE READI as an individual, the report will be generated immediately after you complete the assessment. The report will be saved in your user account for future reference.

If you are taking it as a team, the report will only generate after all team members have completed it or the team leader closes the assessment. Please note, only the team leader will be able to generate this report but has the ability to share it with team members.

Your report includes three key recommendations and associated resources tailored to your level of readiness, along with a county level report. This report provides more information about the social-economic status, food environment, health and chronic disease status, and fruit and vegetable production in the county where you do your work. A county report includes maps that show how your county currently ranks in comparison to other Ohio counties. The sources for the data included in the county level report can be found here.

A county level report can be used along with your recommendations and resources for discussion and PSE planning within your organization and with stakeholders. The data in the county level report can be used to highlight areas of strength and identify challenges that may be considered when planning PSEs. The information may also be useful in grant writing and work plan development.

If you create a team PSE READI, you become the team leader for that assessment. It will be up to you to:
• Decide whom to invite
• Determine how long the PSE READI will be available for team members to complete
• Generate the report once all team members have completed the assessment
• Choose how to best share the report of tailored recommendations and resources with your team.

Team members should be partners and community stakeholders with whom you have a working relationship. They should be familiar with the specific target area or community the PSE READI is focused on and have an interest or investment in the PSE topic you selected. This chart to PSE READI potential team members lists some suggestions you can consider as potential partners for your PSE topic area.

As a team leader, you will have the opportunity to enter the e-mail addresses of the individuals you want on your team. The BCOP website will generate a survey link that will be emailed to those you invited. As a team leader, you can add a personalized message to this invitation as well.

As a team leader, you can decide the deadline for team members to complete the PSE READI, and can close the assessment at any time from your user account. We suggest giving team members at least two weeks to complete a PSE READI. It may be helpful to send a reminder email to your team before you consider closing an assessment.

As the team leader, you will receive a report with three tailored, evidence-based recommendations and supporting resources. This report is based on the responses from all team members. The team leader is responsible for sharing the report to their team members; by using the “Share” button in their account, team leaders can email reports to their team. The report can also be saved as a PDF file, to be shared in the future, by selecting the “Print” option and choosing “Save to PDF.” We strongly encourage team leaders to invite team members to a follow-up, or de-briefing meeting, to review the report and discuss next steps.

The structure of a follow-up, or de-brief meeting, is up to your team leader and team members. You should use your team PSE READI report to begin planning your next steps, using the recommended resources as an initial guide.

You were asked to take a PSE READI because the person who invited you feels you have valuable knowledge and expertise about a specific service area, community, and/or PSE project. Your invitation to participate in a team PSE READI contains a link to a PSE READI assessment. You need to create an account in order to take the PSE READI. More information about creating an account can be found under “Creating a User Account.”

After each team member completes a PSE READI, one report of tailored recommendations and resources will be generated and sent to the team leader (the individual who created the team). Team reports are an average of all team member’s PSE READI assessments and are designed to be shared with the team. The team leader is encouraged to invite all team members to a de-briefing meeting to review the results of the report together.