title: Developing a Tool to Assess the Capacity of Out-of-School Time Program Providers to Implement Policy, Systems, and Environmental Change.
abstract: Little is known about public health practitioners' capacity to change policies, systems, or environments (PSEs), in part due to the absence of measures. To address this need, we partnered with the Alliance for a Healthier Generation (Alliance) to develop and test a theory-derived measure of the capacity of out-of-school time program providers to improve students' level of nutrition and physical activity through changes in PSEs.
  
  
  
  The measure was developed and tested through an engaged partnership with staff working on the Alliance's Healthy Out-of-School Time (HOST) Initiative. In total, approximately 2,000 sites nationwide are engaged in the HOST Initiative, which serves predominantly high-need children and youths.
  
  
  
  We partnered with the Alliance to conduct formative work that would help develop a survey that assessed attitudes/beliefs, social norms, external resources/supports, and self-efficacy. The survey was administered to providers of out-of-school time programs who were implementing the Alliance's HOST Initiative.
  
  
  
  Survey respondents were 185 out-of-school time program providers (53% response rate). Exploratory factor analysis yielded a 4-factor model that explained 44.7% of the variance. Factors pertained to perceptions of social norms (6 items) and self-efficacy to build support and engage a team (4 items) and create (5 items) and implement (3 items) an action plan.
  
  
  
  We report initial development and factor analysis of a tool that the Alliance can use to assess the capacity of after-school time program providers, which is critical to targeting capacity-building interventions and assessing their effectiveness. Study findings also will inform the development of measures to assess individual capacity to plan and implement other PSE interventions.
authors: School of Nursing, CB#7460, University of North Carolina, Chapel Hill, NC 27599-7460. E-mail: jleeman@email.unc.edu.
authors: Jennifer
authors: J
authors: Leeman
authors: RTI International, Inc, Research Triangle Park, North Carolina.
authors: Jonathan L
authors: JL
authors: Blitstein
authors: RTI International, Inc, Research Triangle Park, North Carolina.
authors: Joshua
authors: J
authors: Goetz
authors: Department of Health Behavior, Gilling's School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.
authors: Alexis
authors: A
authors: Moore
authors: Alliance for a Healthier Generation, Portland, Oregon.
authors: Nell
authors: N
authors: Tessman
authors: RTI International, Inc, Research Triangle Park, North Carolina.
authors: Jean L
authors: JL
authors: Wiecha
mesh_terms: D057191:Capacity Building / Q000379:methods*; D004777:Environment; D015444:Exercise; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D009752:Nutritional Status; D057766:Policy; D012572:School Health Services / Q000592:standards*; D011795:Surveys and Questionnaires; D014481:United States