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. Author manuscript; available in PMC: 2016 Aug 1.
Published in final edited form as: Prev Med. 2015 May 9;77:80–98. doi: 10.1016/j.ypmed.2015.05.002

Table 1.

Description of Environmental Audit Tools assessing Healthy Eating and Physical Activity

Tool Name Setting Developer Purpose User
Staff/community member (Self-assessment) Researcher
Child Care Nutrition and Physical Activity Assessment Survey Childcare Rudd Center for Food Policy and Obesity, Yale University. To evaluate nutrition and physical activity environment of child care centers. •
Child Care Nutrition and Physical Activity Policies- Communication & Promotion Childcare Connecticut State Department of Education. To assess communication level and health promotion strategies of childcare centers in the state of Connecticut. •
Child Care Nutrition and Physical Activity Policies- Eating Environment Childcare Connecticut State Department of Education. To assess nutrition standards of childcare centers in the state of Connecticut. •
Child Care Nutrition and Physical Activity Policies- Evaluation Childcare Connecticut State Department of Education. To assess evaluation policies of childcare centers in the state of Connecticut. •
Child Care Nutrition and Physical Activity Policies- Nutrition Education Childcare Connecticut State Department of Education. To assess nutrition education of childcare centers in the state of Connecticut. •
Child Care Nutrition and Physical Activity Policies- Nutrition Standard Childcare Connecticut State Department of Education. To assess nutrition standards of childcare centers in the state of Connecticut. •
Child Care Nutrition and Physical Activity Policies- Physical Activity Childcare Connecticut State Department of Education. To assess nutrition standards of childcare centers in the state of Connecticut. •
Childcare director interview Childcare Rudd Center for Food Policy and Obesity, Yale University. To assess nutrition and physical activity environment at childcare settings. •
Environment and Policy Assessment and Observation (EPAO) Childcare Ward et al., Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill. To evaluate the Nutrition and Physical Activity Self-Assessment for Child Care Program (NAP SACC). •
Nutrition and Physical Activity Self-Assessment for Child Care Program (NAP SACC) Childcare Ward, et al., Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC), Center for Health Promotion and Disease Prevention and Department of Nutrition, University of North Carolina at Chapel Hill. Developed for the Nutrition and Physical Activity Self-Assessment for Child Care Program (NAP SACC) intervention. •
Study of Healthy Activity and Eating Practices and Environments in Head Start (SHAPES) Self-assessment Survey Childcare Whitaker, et al, Department of Public Health and Pediatrics, Center for Obesity Research and Education, Temple University. To evaluate nutrition and physical activity environments in childcare setting. •
Wellness Child Care Assessment Tool (WellCCAT) Childcare Falbe et al., Rudd Center for Food Policy and Obesity, Yale University. To assess written health-related polices (i.e., nutrition and physical activity and wellness polices). •
Abbreviated Wellness School Assessment Tool (WellSAT) School Robert Wood Johnson Foundation Healthy Eating Research Program, Working Group 1. To evaluate the quality of existing schools' district wellness policies. •
Competitive Foods and Beverages Toolkit School Alliance for Healthier Generation. To help schools evaluate the presence of competitive food and Beverages at their schools. •
Food and Beverage Environment Analysis and Monitoring System (FoodBEAM) School Samuels & Associates. Developed to capture the following:
•Venues where competitive foods and beverages are sold.
•Types of foods and beverages sold.
Compliance of foods and beverages with the California school nutrition standards for competitive foods.		 •
Food and Fitness School Health Policies and Practices Questionnaire School Turner, Bridging the Gap Research Program. Developed as part of a study to assess school s' health policy and programs. •
Gold Medal Rating Scale – Elementary School School Massachusetts Action for Healthy Kids supported by the MetroWest Community Health Care Foundation. Developed as part of Action for Healthy Kids initiative for schools to assess their local wellness policies. •
Gold Medal Rating Scale – Middle & High School School Massachusetts Action for Healthy Kids supported by the MetroWest Community Health Care Foundation. Developed as part of Action for Healthy Kids initiative for schools to assess their local wellness policies. •
Illinois Needs Assessment & Evaluation Tool School Illinois State Board of Education. Developed to evaluate the local schools wellness polices and practice in Illinois. •
Local Wellness Policy School National Team Nutrition Office for the Colorado Healthy Schools Summit. Developed to assess local schools wellness programs. •
Michigan's Healthy School Action Tools (HSAT)- Nutrition service School Developed for Michigan schools to create healthier environments initiative. •
Michigan's Healthy School Action Tools (HSAT)- Physical education and other physical activity opportunities School Developed for Michigan schools to create healthier environments initiative. •
Michigan's Healthy School Action Tools (HSAT)- School Health & Safety Policies School Developed for Michigan schools to create healthier environments initiative. •
Mississippi School Nutrition and Physical Activity Environment Assessment School Mississippi Department of Education. Developed for Mississippi schools to evaluate their health and wellness environment. •
Neumark-Sztainer Food Policies and Practices questionnaire School Developed by the Minnesota Association of Secondary School Principals and the University of Minnesota, Division of Epidemiology. To evaluate high school food policy and practice environment. •
New Hampshire School Wellness Policy Assessment Form School New Hampshire Department of Education Local. Developed to evaluate the New Hampshire schools wellness policies and practice complete school environment. •
Policy and Systems Toolkit School Alliance for Healthier Generation. Developed to be used by schools enrolled in the Healthy Schools Program •
Principals Survey School Lytle et al, Division of Epidemiology, University of Minnesota. Developed as part of the TEENS intervention project. •
Rhode Island Nutrition & PA survey School Rhode Island Healthy Schools Coalition. Developed for Rhode Island schools to assess their school environment with respect to nutrition and physical activity. •
Rhode Island Needs Assessment Tool (RINAT) School Pearlman, Rhode Island Department of Health.. Developed as part of needs assessment and intervention project in Rhode Island schools. •
School Environment Assessment Tool (SEAT) School Nathan et al, Hunter New England Population Health and School of Medicine and Public Health, The University of Newcastle, Australia. Developed to assess quality of school food and physical activity environment. •
School food policies and practices: a state-wide survey of secondary school principals School French 2002. University of Minnesota, Division of Epidemiology. To evaluate food related policies and practices in secondary schools in Minnesota. •
School Health Index (SHI) (2012) - Elementary School School Centers for Disease Control and Prevention. Developed for schools to assess health and safety policy and for planning. •
School Health Index (SHI) (2012) - Middle/High school School Centers for Disease Control and Prevention. Developed for schools to assess health and safety policy and for planning. •
School Health Policies and Practices Study (SHPPS 2006) questionnaire- Nutrition School Centers for Disease Control and Prevention. Developed for the School Health Policies and Practices study. •
School Health Policies and Practices Study (SHPPS 2006) questionnaires- Physical Education and Activity School Centers for Disease Control and Prevention. Developed for the School Health Policies and Practices study. •
School Health Policies and Practices Study (SHPPS 2006) questionnaires- School Policy & Environment School Centers for Disease Control and Prevention. Developed for the School Health Policies and Practices study. •
School Meals Program Toolkit School Alliance for Healthier Generation. Developed to be used by schools to evaluate the quality of the school meals provided as part of assessing school wellness policies and practice programs. •
School Nutrition by Design School California Department of Education Nutrition Services Division. Developed as part of the recommendation of State Superintendent Advisory Committee on Nutrition Implementation Strategies. •
School Physical Activity Policy Assessment (S-PAPA) School Lounsbery et al., University of Nevada, Las Vegas Developed to assesses physical activity policy at the district & school level. •
Student Wellness Toolkit – Elementary school School Alliance for Healthier Generation. Developed to be used by elementary schools to evaluate overall school wellness policies and practice •
Student Wellness Toolkit – High School School Alliance for Healthier Generation. Developed to be used by high schools to evaluate overall school wellness policies and practice •
Student Wellness Toolkit – Middle School School Alliance for Healthier Generation. Developed to be used by middle schools to evaluate overall school wellness policies and practice •
Survey of school vending machines School Johanson and Wootan. Center for Science in the Public Interest (CSPI). Developed as part of the CSPI nutrition policy project to evaluate the nutrition quality of food in school vending machines. •
Wellness School Assessment Tool (WellSAT-96) School Robert Wood Johnson Foundation Healthy Eating Research Program, Working Group 1. To provide a standard method for assessing school district wellness policies. •
Community Healthy Living Index (CHLI) Community Y-USA collaborated with Stanford, Harvard, and St. Louis Universities. To examine environmental and social supports for healthy eating and active living. •
Healthy Community Checklist community Michigan Healthy Communities Collaborative. To assess community's health environment with regard to promoting and supporting:
•Physical Activity.
•Healthy Eating & Healthy Weight.
Smoke-Free Environments & Tobacco-Free Lifestyles.		 •
Nutrition Environment Assessment Tool (NEAT) – section 3 (school) Community Michigan Healthy Community Collaboration. Developed to help communities assess how supportive their environment is to healthy eating. •
The Environmental Nutrition and Physical Activity Community Tool (ENACT) Community Strategic Alliance (California). Developed to help community assess current policy status and develop an action plan. •
2 Minute Program Assessment Afterschool Harvard School of Public Health Prevention Research Center as part of the Out of School Nutrition and Physical Activity (OSNAP) Initiative. To assess how closely program adheres to the OSNAP nutrition and physical activity environmental standards. •
Healthy Afterschool Activity and Nutrition Documentation Instrument (HAAND) Afterschool Ajja et al., Arnold School of Public Health, University of South Carolina, Columbia. To assess the extent to which the afterschool environment meets current physical activity and nutrition policies. • •
Policy assessment tool Afterschool Harvard School of Public Health Prevention Research Center as part of the Out of School Nutrition and Physical Activity (OSNAP) Initiative. To identify existing nutrition, physical activity and screen time polices. •
Program self-assessment observation tool Afterschool Harvard School of Public Health Prevention Research Center as part of the Out of School Nutrition and Physical Activity (OSNAP) Initiative. To assess the nutrition and physical activity of program during the OSNAP intervention. •
Data collection method Time frame No. of items Domain of physical activity environment covered Domain of nutrition environment covered Note
Observation Document review Interview Self-report Environmental (Policy/ practice) characteristics Physical characteristics Environmental (Policy/practice) characteristics Physical characteristics
• • 1 day site visit 43 Policy, activity types , screen time, staff behavior, training barriers and support Equipment, space Policy, menu quality, meal schedule, food safety, staff behavior, training, curriculum, access (water) Close-ended questions with appropriate responses as follows:
- Choose one response category from several possible answers.
• Not reported 12 Policy, staff behavior Policy, staff behavior, advertising Close-ended questions with appropriate responses as follows:
- Full/Partial/None/NA
• Not reported 31 Policy, meal schedule, food safety, staff behavior, training Close-ended questions with appropriate responses as follows:
- Full/Partial/None/NA
• Not reported 6 Policy, evaluation Policy, evaluation Close-ended questions with appropriate responses as follows:
Full/Partial/None/NA
• Not reported 17 Policy, staff behavior, curriculum, advertising Close-ended questions with appropriate responses as follows:
- Full/Partial/None/NA
• Not reported 51 Policy, menu quality, meal schedule, food safety, access (water, vending machines), fundraising Close-ended question with appropriate responses as follows:
- Full/Partial/None/NA.
• Not reported 45 Policy, amount of time allocated, activity types , screen time, staff behavior, curriculum Equipment, space, safety Close-ended questions with appropriate responses as follows:
- Full/Partial/None/NA
• Not reported 73 Policy, amount of time allocated, screen time, staff behavior, training barriers and support Policy, staff behavior/modeling and training, nutrition curriculum, barriers and support, fundraising Close-ended questions with appropriate responses as follows:
- Yes/No
- Choose one response category from several possible answers.
• • 1 full day visit 192 Policy, amount of time allocated, activity types, screen time, staff behavior and training, curriculum Space, equipment, safety Policy, menu quality, meal schedule, staff behavior/modeling, training, nutrition curriculum, access (water, vending machines), fundraising Vending machine location Close-ended questions with appropriate responses as follow:
- yes/no
- Choose one response category from several arranged in hierarchical order.
• • 1 full day visit 56 Policy, amount of time allocated, activity types, screen time, staff behavior, training Equipment, space Policy, menu quality, meal schedule, staff behavior, training, access (water/vending machines), fundraising Close-ended questions.
- Each question has 4 possible response options ranging from minimum standard to best practice).
• 30 min 90 Policy, amount of time allocated, screen time, curriculum Space, equipment Policy, menu quality, staff behavior/modeling, curriculum, fundraising Close-ended questions with appropriate responses as follows:
- Yes/No
• N/A 64 Policy, amount of time allocated, activity types, screen time, staff behavior, training, curriculum, evaluation Safety, space Policy, menu quality, meal schedule, staff behavior , training, access (water), curriculum, evaluation, fundraising Close-ended questions with 4 possible response options ranging from:
- 0, 1, 2, NA.
• 45 min 50 Policy, amount of time allocated, activity types, , staff behavior, training and credentials, curriculum, evaluation, Equipment Policy, child involvement, menu quality, meal schedule, staff behavior, training and credentials, food safety, access (water, vending machines), curriculum, advertising, fundraising, School policy statement are rated “0” “1” or “2” rating “3” “4” only apply to specific section 3
• Not reported 8 Policy, access (vending machines). Uses best practice framework of criteria at the bronze, silver and gold levels as a way of scoring the program policy.
• Varies based on school size and number, location where food is sold N/A Policy, menu quality, access (vending machines), advertising, fundraising. Online assessment tool. Data collector enters the information guided by the software that matches the information items with nutrient profile which is housed in the nutrient database in imbedded in the software. Software has a drop-down menu as well as the ability to add new items not in the database.
• Not reported 100 Policy, amount of time allocated, activity types, staff credentials, curriculum, barriers and support. Equipment Policy, menu quality, meal schedule, access (vending machines), curriculum, fundraising. Combination of close- and open-ended questions:
Close-ended questions: possible responses
- Yes/ No
- Choose one response category from several possible answers Likert scale
• Not reported 29 Policy, amount of time allocated, activity types, staff behavior, training. Safety Close-ended questions with possible responses. Choose one response category from several arranged in hierarchical order.
• Not reported 33 Policy, amount of time allocated, staff behavior, training, curriculum. Safety Close-ended questions with possible responses. Choose one response category from several arranged in hierarchical order.
• Not reported 49 Policy, amount of time allocated, staff behavior training. Safety Policy, child involvement, menu quality, meal schedule, food safety, staff behavior, training, advertising. Food facility Close-ended questions with possible responses as follows:
- OK/Need For Improvement
• Not reported 40 Amount of time allocated, staff behavior and credentials, curriculum. Space Menu quality, meal schedule, food facility, staff behavior, training, access (water), fundraising. Food facility Close-ended questions with possible responses as follows:
- fully implemented
- partially implemented
- still in planning
- not applicable
- Don't know
• 2 to 7 hours 51 Policy, menu quality, meal schedule, staff behavior , training and credentials, fundraising. Combination of open ended and close ended questions with possible reposes ranging from:
- Yes/No
Choose the most appropriate statement
• 2 to 7 hours 92 Policy, amount of time allocated, activity types, staff behavior, training and credentials, curriculum. Equipment Combination of open-ended and close-ended questions with possible responses ranging from:
- Yes/No.
Choose the most appropriate statement.
• 2 to 7 hours 353 Child involvement, amount of time allocated, activity types, staff behavior, training, evaluation. Equipment, space, safety Policy, child involvement, menu quality, meal schedule, food safety, staff behavior, training, access (water, vending machine), evaluation, food safety, advertising, fundraising. Food facility Combination of open-ended and close-ended questions with possible responses ranging from:
- Yes/No.
Choose the most appropriate statement.
• Not reported 57 Amount of time allocated, screen time, curriculum. Equipment Policy, child involvement, menu quality, meal schedule, food safety, food facility, staff training, access (water, vending machines), curriculum, advertising Close-ended questions: Choose one response category from several arranged in hierarchical order.
• Not reported 36 Policy, access (vending machines). Close-ended questions possible responses:
- Yes/No
- Likert scale.
- Choose one response category from several arranged in hierarchical order.
• Not reported 50 Policy, type, staff behavior, training, credentials, evaluation Policy, nutrition curriculum, staff behavior, , training, meal schedule, evaluation, fundraising. Close-ended questions with
- Yes /No response
Points reported as numeric scores and percentages
• Not reported 8 Policy, child involvement. Policy, menu quality, food facility, staff behavior, training. Uses best practice framework of criteria at the bronze, silver and gold levels as a way of scoring the program policy.
• Not reposted 22 Policy, menu quality, staff training, advertising Combination of open-ended and close-ended questions:
- Close-ended questions possible responses:
Yes/No/Don't know
• Not reported 49 Amount of time allocated, staff behavior, staff credentials. Equipment, space, Policy, menu quality, meal schedule, staff behavior, training, access (vending machine), curriculum Combination of close- and open-ended questions.
Close-ended questions possible responses:
- Yes/No
• Not reported 40 Policy, child involvement, amount of time allocated, barriers and support. Space Policy, child involvement, barriers, advertising, access (vending machines). Combination of open-ended and close-ended questions:
Close-ended questions possible response answers:
- Yes/No
- Likert scale
• 20 min 65 Amount of time allocated, screen time. Facility, equipment, Menu quality, access (water, vending machines), fundraising. Close-ended questions with possible responses:
Yes/ No/Don't know
• Not reported 36 Polices, menu quality, access (vending machines), attitudes, advertising, fundraising. Close-ended questions
• 6 hr 105 Policy, amount of time allocated, activity types, staff behavior, training and credentials Space, safety Policy, menu quality, meal schedule, food safety, staff behavior, training and credentials, access (water), curriculum, evaluation, advertising, fundraising Close-ended questions with possible responses:
Fully in place/partially in place/underdeveloped/not in place
• 6 hr 122 Policy, amount of time allocated, activity types , staff training and credentials, curriculum Space, safety Policy, menu quality, meal schedule, food safety, staff behavior, training and credential, access (water), curriculum, evaluation, advertising, fundraising Close-ended questions with possible responses:
Fully in place/partially in place/underdeveloped/not in place
• 40 min 88 Child involvement, menu quality, meal schedule, food safety, staff training, staff credentials, access (water), evaluation Combination of open-ended and close-ended questions:
- Close ended questions possible responses:
Yes / No, Likert scale
• 60 min 114 Amount of time allocated, activity types , staff training and credential, evaluation Combination of open-ended and close-ended questions:
- Close-ended questions with possible responses:
Yes/No, Likert scale
• 60 min 201 Policy, amount of time allocated Policy, menu quality, meal schedule, access (water) evaluation, fundraising Combination of open-ended and close-ended questions:
Close-ended questions possible responses:
- Yes/No
- Likert scale
• Not reported 29 Policy, menu quality, food facility, staff behavior, training. Uses best practice framework of criteria at the bronze, silver and gold levels as a way of scoring the program policy.
• Not reported 36 Policy, child involvement, staff behavior, training, access (vending machine), curriculum, evaluation, fundraising. Close-ended questions. Choose one response category from three categories arranged in hierarchical order
• • 30 min 96 Policy, amount of time allocated, activity types, staff behavior, training and credential, curriculum, evaluation. Space Close ended questions with possible responses:
- Yes/No/Don't know
- No/Partially/Yes
Choose one response category from several arranged in hierarchical order
• Not reported 11 Policy, amount of time allocated, activity types, staff training, curriculum Policy, staff training, curriculum. Uses best practice framework of criteria at the bronze, silver and gold levels as a way of scoring the program policy.
Close-ended response option:
choose the most appropriate statement.
• Not reported 10 Policy, amount of time allocated, activity types, staff training, curriculum. Policy, menu quality, curriculum. Uses best practice framework of criteria at the bronze, silver and gold levels as a way of scoring the program policy.
• Not reported 8 Policy, amount of time allocated, activity types, curriculum. Uses best practice framework of criteria at the bronze, silver and gold levels as a way of scoring the program policy.
• Not reported 18 Snack/beverages quality. Open-ended questions (listing how many selections of each type of food and drink items available)
• Not reported 96 Policy, amount of time allocated, activity types, staff behavior, training and credentials, curriculum, evaluation Equipment, safety, space Policy, child involvement, menu quality, meal schedule, staff behavior, training and credentials, food safety, access (water, vending machines) curriculum, advertising, fundraising School policy statement are rated “0” “1” or “2”.
• Not reported 160 (childcare)
123 (school)
110 (afterschool)		 Policy, child/parent involvement, amount of time allocated activity types, screen time, staff behavior, training and credentials, curriculum evaluation. Equipment, safety, space Policy, menu quality, meal schedule, staff training, access (water), fundraising. Combination of close- and open-ended questions.
Close-ended questions with possible responses:
Choose one response category from several arranged in hierarchical order
- Yes/No
• Not reported 8 (schools) Polices. Policy Combination of close- and open-ended questions.
Close-ended questions possible responses:
Choose one response category from several arranged in hierarchical order.
Choose all response categories that apply
• 1 to 4 hours 37(school) Policy, access (water), menu quality, staff training, advertising. Combination of open- and close-ended questions.
Close-ended questions with possible responses.
Choose all that applies to your program
• Not reported 8 (Childcare)
6 (school)
7 (afterschool)		 Policy, amount of time allocated, activity types, staff credentials. Space Policy, menu quality, meal schedule, staff training, access (water), fundraising. Close-ended questions with possible responses. Choose one response category from several arranged in hierarchical order ranging from 1 (elements not in place) to 5 (elements are culturally appropriate, accessible and available).
• 2 min 9 Amount of time allocated, screen time. Menu quality, access (water) Close-ended questions with appropriate response as follows:
- Yes/No/In Progress/Unsure answer
• • • 1 day site visit 23 Policy, child involvement, amount of time allocated, activity types, gender equity, screen time, staff training, credentials, curriculum, evaluation. Policy, child involvement, menu quality, access (vending machines), staff training, credentials, curriculum, evaluation. Close-ended questions. Choose one response category from several arranged in hierarchical order.
• Not reported 10 Policy, amount of time allocated, activity types, screen time. Policy, menu quality, access (water) Close-ended questions with appropriate response as follows with appropriate response:
- Yes/No/In Progress/Unsure answer
• Program length 27 Amount of time allocated, activity types, screen time. Menu quality, access (water) Combination of close-ended and open-ended questions.
Close-ended questions with appropriate response as follows:
- Yes/No