5 Questions with Tisa Hill, Nutritional Sciences Extension Associate

Tisa Fontaine Hill, MPH is an Extension Associate, Research Coordinator, and Policy, Systems and Environmental Change Specialist for Food and Nutrition Education in Communities (FNEC) programming situated in Cornell University’s Division of Nutritional Sciences. Her work has focused on preventing unhealthy weight gain in children through Adopting Healthy Habits (AHH) a Cooperative Extension program that provides parenting and nutrition education to low-income parents and creates community level environmental changes to make healthy choices easier for low-income children and their families.

How did your involvement with CCE begin? 

I was hired to do a project that was called CHANCE (Collaboration for Health, Activity, and Nutrition in Children’s Environments) and that project evolved into what is now called Adopting Healthy Habits (AHH). Initially, CHANCE was focused on helping parents make changes in the home environment through creating and delivering a curriculum that coupled nutrition and physical activity information with parenting skills. It was really the first curriculum in the country that did that. I worked with a broad ranging team across the state to create that curriculum, Healthy Children, Healthy Families: Parents Making a Difference! (HCHF). Nutrition educators in more than four states have been trained to use the HCHF.

How has your work evolved?

The last few years there's been a lot more emphasis on the broader idea of adopting healthy habits in other community environments. Not just making changes within the home, but also making changes in all the environments where low-income individuals and families spend their time. Ultimately the goal of these efforts making the healthy choice the easy choice in schools, worksites, parks, and other community organizations. My work with AHH has specifically been in supporting nutrition educators across NYS as they work to help their community partners create healthy environments.

What New York state counties is the AHH initiative being implemented in?

As part of new funding that FNCE received three years ago, we did research using the model of delivering education and making changes in worksites in Jefferson County and Orange County. Specifically, we worked with daycare centers to make changes that would impact the staff. Nutrition educators also delivered education to help support individual behavior change using the HCHF curriculum. We studied whether or not combining education and environmental change had a bigger impact than each one on its own. We're in the midst of compiling those results right now. We are working on abstracts for presentations this year and we'll be working on paper in the summer.

The other thing I’ve been working on in the last year is putting together online training to be delivered nationally to all Enhanced Food and Nutrition Education Program (EFNEP) and Supplemental Nutrition Assistance Program Education (SNAP-Ed) educators who are involved in new Policy, Systems and Environmental (PSEs) work. It's a six module online training. The first module has already been released and the other ones will be released at the beginning of July. We've already had partners in multiple states signed up for and engage in that training.

Click here for more information about the course: Making the Healthy Choice the Easy Choice: An introduction to policy, systems, and environmental approaches to promote healthy eating and physical activity.

Can you talk a little bit more about PSEs and what the approach is generally?

The idea is that direct nutrition education builds knowledge and skills. Then, to actually apply and use new knowledge and skills, opportunities must be available. It's one thing to learn about the importance of having a variety of fresh fruits and vegetables in your diet, it's another thing to actually be able to go to the store and access a variety of fresh fruits and vegetables.

PSEs are about making the opportunity more accessible and affordable. We break PSE work down into four complementary approaches. The policy, system, or environmental change works in complement with direct nutrition education. There are also a set of promotional materials for increasing awareness and finally, there are activities and events where people really can engage with available initiatives.

The other important thing about PSE work is that it is not just about making a onetime change like adding bananas right next to the check out. It is a more systematized approach that institutionalizes changes so that changes are sustained and grow over time.

Describe a success story from a CCE association that has successfully implemented PSE work.

Jefferson County has worked with a range of partners through their Adopting Healthy Habits Community Coalition that have adopted supportive practices for breast-feeding onsite at worksites, stores, daycare centers and communities centers in the county.  

Jefferson County also has a program though their coalition where they display signage that encourages people to park further away from store entrances to encourage walking further.

It's really about making small little changes but having them be visible enough because they're showing up in enough places in their community that it really does make an impact and encourage people to make a change.

Photo by R.J. Anderson / CCE