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The Healthy Apple Program is a PSE Change tool designed to improve the nutrition, physical activity practices, and environment of child care facilities. The program recognizes achievements by issuing awards to child care providers who make improvements and reach their goals.

Intervention Target Behavior: Pregnant/Breastfeeding, Healthy Eating, Physical Activity and Reducing Screen Time

SNAP-Ed Strategies: PSE Change

Intervention Reach and Adoption

The Healthy Apple Program empowers and assists child care providers in San Francisco and Sonoma Counties in promoting and establishing lifelong healthy behaviors among young children and their families.

Settings: Pre-K & Childcare

Age/Population Group: Preschool  

Race: All

Ethnicity: All

Intervention Components

Healthy Apple Program includes:

  • Self-assessment
  • Goal setting
  • Trainings
  • Resources
  • Targeted technical support from Healthy Apple coaches
  • Healthy Apple Awards
    • Gold
    • Silver
    • Bronze

These intervention components provide child care sites with the tools to assess their program's nutrition and/or physical activity practices, receive support to make improvements, and be recognized for meeting best practices. The goal of the initiative is to empower and assist child care providers in promoting and establishing lifelong healthy behaviors among young children and their families, ultimately aiming to reduce rates of childhood obesity.

Intervention Materials

The online tools are based on the Nutrition and Physical Activity Self-Assessment for Child Care (GO NAP SACC) and Let's Move Child Care Checklist and include:

  • Nutrition Self-Assessment
  • Physical Activity Self-Assessment
  • Online Healthy Apple Action Plan

Healthy Apple online tools are available in English, Spanish and Chinese:

Additional resources can be found at and include:

  • Healthy Apple Interactive Guide and Physical Activity Toolkit 
  • NAP SACC Technical Assistance Manuals
  • Policy Examples
  • Breastfeeding Support Resources
  • Staff and Family Handouts
  • Screen Time Reduction Tools
  • Additional Supporting Resources
Evidence Summary

The Healthy Apple Program (HAP) pilot tested if provider participation in HAP: (1) Increased best practices at child care centers; (2) Improved weight change of children in child care. Child care center participation in the HAP pilot was associated with adoption of nutrition and PA best practices, beyond those occurring in the background, related to concurrent PA and drinking water initiatives. HAP participation was associated with greater 6-month increases in the proportion of children in child care exposed to multiple nutrition and PA best practices. HAP participation was associated with significant improvements in 6-month weight change for children. The HAP pilot study was limited to child care centers and variables routinely monitored by CCHP. The HAP pilot results warrant further development of HAP workshops and expanded HAP outreach.

Evidence Base: Emerging

Evaluation Indicators

Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.

 Readiness and Capacity - Short Term (ST)Changes - Medium Term (MT)Effectiveness and Maintenance - Long Term (LT)Population Results (R)
Environmental SettingsST5MT5, MT6LT5, LT6, LT7, LT8, LT9, LT10, LT11
Sectors of Influence   
Evaluation Materials

The Healthy Apple Program includes assessment tools for child care providers and is listed in the SNAP-Ed Evaluation Framework Interpretive Guide as a tool to measure the following indicators: ST5: Readiness and Need, MT5: Nutrition Supports, and MT6: Physical Activity and Reduced Sedentary Behavior Supports.

Additional Information

Website: The Healthy Apple Program website ( includes nutrition and physical activity resources, technical assistance resources, and other supporting resources.

Contact Person:

Raegan Sales

Healthy Apple Program Coordinator, Children's Council of San Francisco

Phone: (415) 276-2900



*Updated as of August 4, 2023

Resource Type
Age/Population Group
Intervention Outcome Levels
SNAP-Ed Strategies
Evidence Base