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Culture of Wellness in Preschools with Toolkit Strategy logo

Part of the SNAP-Ed Strategies & Interventions Toolkit.*

The Culture of Wellness in Preschools, Policy, System and Environment Change Process (COWP PSE Change Process) is a PSE change intervention designed to implement an average of five changes that promote healthy eating and physical activity in early childcare centers. Interdisciplinary wellness teams are comprised of 3-8 early childcare center staff who work together to participate in three key change-making strategies: 1) conducting a strengths and needs assessment related to healthy eating and physical activity practices, 2) prioritizing best practice PSE changes based on importance and feasibility, and 3) developing action steps and planning for implementation and sustainability.

Toolkit materials are provided to each site to support the implementation of their selected PSE changes. COWP facilitators help early childcare center staff develop center-specific wellness policies highlighting their adopted PSE changes to ensure sustainability.

University of Colorado.
Funding Source
Free Material
Cost ($)
SNAP-Ed Toolkit Classification
Evaluation Information

Twenty-three focus groups were conducted with teachers to identify needs, barriers and facilitators to program implementation. Focus groups are conducted with wellness teams at the end of the COWP PSE Change Process to inform annual adaptations and improvements. These data are used to inform adaptation of the PSE Change Process for early childcare settings and to improve programming on an annual basis.

As of January 2019, outcome evaluations demonstrate that an average of 5.3 PSE changes were implemented in every participating early childcare center. Approximately half of PSE changes (47%) were focused on nutrition supports (e.g., implementing a school garden) and 53% were focused on physical activity supports (e.g., teachers leading children daily structured play). A center-specific wellness policy poster was developed and displayed at every childcare center highlighting the new PSE changes adopted. Outcome evaluation data collected at 6 months, 1 year, and 2 years after completion of the PSE process demonstrate that PSE changes implemented through COWP are sustainable. After 1 year, 62% of PSE changes were reported fully implemented and after 2 years, 77% of PSE changes were reported fully implemented.


Evaluation Framework Indicators
SNAP-Ed Connection Comments

*SNAP-Ed Strategies & Interventions: An Obesity Prevention Toolkit for States is a compilation of interventions. The toolkit was developed by USDA's Food and Nutrition Service, The Association of SNAP-Ed Nutrition Education Administrators (ASNNA), the University of North Carolina at Chapel Hill's Center for Training and Research Translation (Center TRT), and the National Collaborative on Childhood Obesity Research (NCCOR), a partnership between the Centers for Disease Control and Prevention (CDC), the National Institutes for Health (NIH), the Robert Wood Johnson Foundation, and the USDA. It is designed and updated to help state SNAP-Ed administrative and implementing agencies identify evidence-based obesity prevention programs and policy, systems, and environmental (PSE) strategies and interventions to include in their SNAP-Ed plans.

Review date
Reviewer Initials