A systematic review of existing observational tools to measure the food and physical activity environment in schools

Cross-cultural adaptation, content validity, and feasibility of the school physical activity and nutrition environment tool

OBJECTIVE

To perform a cross-cultural adaptation, content validity and feasibility of The School Physical Activity and Nutrition Environment Tool (SPAN-ET) for the Spanish context. It is a valuable tool for making comprehensive assessments of school environments in three environmental categories: policy, situation/social, and physical.

METHOD

We followed the cross-cultural adaptation guidelines which consist of a five-stage methodological approach: 1) forward translation, 2) synthesis, 3) back translation, 4) adaptation to the Spanish context, and 5) pilot testing. In addition, an expert panel performed a content validity analysis to assess the level of comprehensibility, applicability, and cultural appropriateness of the SPAN-ET for its use in Spain. The pilot test was carried out in five schools to assess the feasibility of the tool in the Spanish context.

RESULTS

After applying the guidelines for the translation and cultural adaptation of the SPAN-ET into the Spanish context, the new tool (SPAN-ET-ES) preserves the main dimensions of the original document to evaluate school environments in Spain. The evaluation of the SPAN-ET-ES, done by an expert panel, concluded that items included in the revised version of the SPAN-ET-ES were relevant (S-CVI/Ave=0.96), clear (S-CVI/Ave=0.96), simple (S-CVI/Ave=0.98), and non-ambiguous (S-CVI/Ave=0.98) for the Spanish context. Finally, the pilot test offered empirical evidence for the feasibility and content validity of the SPAN-ET-ES at assessing school environments in Spain.

CONCLUSIONS

SPAN-ET-ES is a feasible tool for assessing nutrition and physical activity environments at schools in Spain.

The impact of, and views on, school food intervention and policy in young people aged 11-18 years in Europe: A mixed methods systematic review

Understanding the social and environmental influencers of eating behaviours has the potential to improve health outcomes for young people. This review aims to explore the effectiveness of school nutrition interventions and the perceptions of young people experiencing a nutrition focused intervention or change in school food policy. A comprehensive systematic search identified studies published between 1 December 2007 to 20 February 2020. Twenty-seven studies were included: 22 quantitative studies of nutrition related outcomes and five qualitative studies reporting views and perceptions of young people (combined sample of 22,138 participants, mean ages 12-18 years). The primary outcome was nutrition knowledge/dietary behaviours, with secondary outcomes exploring body mass index (BMI) and wellbeing. Due to the heterogeneity of studies, a narrative results description is presented. The findings demonstrate that school nutrition programmes can be effective in reducing sugar, sugar sweetened beverages (SSB) and saturated fat and increasing fruit and vegetable (FV) intake. The lived experiences of young people in a school context provide valuable insights that should be considered in the development of effective school food policy and interventions. This review affirms the significant role that schools can play in supporting good nutrition in all young people and provides opportunities to inform the school food agenda.

Can Monitoring Make It Happen? An Assessment of How Reporting, Monitoring, and Evaluation Can Support Local Wellness Policy Implementation in US Schools

US school districts participating in federal child nutrition programs are required to develop a local wellness policy (LWP). Each district is allowed flexibility in policy development, including the approaches used for policy reporting, monitoring, and evaluation (RME). The aim of this convergent mixed-methods study was to quantitatively examine RME provisions in policies among a nationally representative sample of districts in the 2014-2015 school year in order to examine whether policies were associated with RME practices in those districts, and to qualitatively examine perceived challenges to RME practices. Data were compiled through the School Nutrition and Meal Cost Study and the National Wellness Policy Study. In multivariable regression models accounting for demographics, survey respondents were significantly more likely to report that their district had informed the public about LWP content and implementation, if there was a relevant policy provision in place. Having a strong policy (as compared to no policy) requiring evaluation was associated with reports that the district had indeed evaluated implementation. Having definitive/required provisions in policies was significantly associated with actual use of RME practices. RME activities are an important part of policy implementation, and these results show that policy provisions addressing RME activities must be written with strong language to require compliance. In interviews with 39 superintendents, many reported that RME activities are challenging, including difficulty determining how to monitor and show impact of their district's wellness initiatives. Furthermore, the qualitative results highlighted the need for vetted tools that are freely available, widely used, and feasible for districts to use in assessing their progress toward meeting the goals in their LWPs.