Public health is increasingly emphasizing policy, systems, and environmental (PSE) change as a key strategy for population-level health promotion and disease prevention. When applied to childhood obesity, this strategy typically involves school systems, since children spend large portions of their days in school and are heavily influenced by this environment. While most school systems have implemented nutrition education and physical activity programs for some time, their understanding and use of PSE approaches to obesity prevention is accelerating based on several large federally funded initiatives. As part of one initiative's evaluation, key informant interviews reveal the specific obesity prevention PSE strategies schools are attempting and the corresponding barriers and facilitators to their implementation. These evaluation findings raise several fundamental issues regarding school-based obesity prevention, including the potential role of school personnel, the influence of grant funding on school health initiatives, and the fit between public health and educational priorities.

This case discusses how we used scoping review methodology to map the literature in an emergent area of research, "structural change" public health interventions. Scoping reviews are similar to systematic reviews in both scale and rigor; both of these literature review methodologies are comprehensive approaches to reviewing the literature on a topic. However, while a systematic review attempts to answer a specific, targeted research question, a scoping review is designed to map and categorize all of the literature on a broad topic. For this reason, it is an excellent method to employ in emergent research areas, in which researchers have not yet conducted systematic reviews or otherwise attempted to record the entirety of a scholarly conversation. In this case report, we discuss advantages and disadvantages to the methodology, as well as the lessons we learned from our experience, and our recommendations for researchers who utilize this method. We encountered challenges including time limitations, finding a balance between a search strategy that was neither too narrow nor too broad, and adjusting the search throughout the process to accommodate new vocabulary terms as we discovered them. Learning OutcomesBy the end of this case, students should be able to Understand the process of the scoping review methodology, including the major ways that it differs from that of a systematic review and other major literature review methodologies Identify existing frameworks for scoping review methodology Recognize the limitations, advantages, and disadvantages of conducting a scoping review as compared to other literature review methods, including the systematic review; given these limitations, determine whether this is the best methodology to use to review a given topic Describe practical challenges and success strategies for conducting a scoping review (2015) that focused on structural change interventions. "Structural changes" or "structural approaches" are defined as "modifications to the physical, social, political, and economic environment in which people make health-related decisions" (Lieberman, Golden, & Earp, 2013). The field of public health has been interested in structural changes, also called "policy, systems, and environmental" changes or "policy and environmental" changes for over a decade; however, few studies have examined how best to evaluate these SAGE Research Methods Cases Part 2 SAGE

These findings are directly relevant to future reauthorization of the Child Nutrition Act and to revisions to the implementation time line for the federal school meal standards related to sodium, whole grains, and flavored milk. Insights into FSDs' strategies suggest that more time and targeted technical assistance at federal, state, and local levels is warranted.

Students' recommendations point to opportunities where school districts, as well as local, state, and federal organizations can work to improve the school food environment. Their insights are directly relevant to USDA's recently released Local School Wellness Policy final rule, of which school meal standards are one provision.