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Hoke AM, Pattison KL, Hivner EA, Lehman EB, Kraschnewski JL. The Role of Technical Assistance in School Wellness Policy Enhancement. J Sch Health 2022; 92:361-367. [PMID: 35075644 PMCID: PMC10170666 DOI: 10.1111/josh.13136] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/05/2021] [Accepted: 08/22/2021] [Indexed: 05/12/2023]
Abstract
BACKGROUND School settings offer an opportunity to impact student health and wellness. Quality wellness policies are important in establishing strong wellness environments, but current resources to support policy development, maintenance, and dissemination are lacking. The Building Healthy Schools Program aimed to develop capacity of school districts to improve the strength and comprehensiveness of wellness policies and sustain these activities. METHODS Fifteen school districts in Pennsylvania participated in a program to facilitate the improvement of district wellness policies and practices. Program staff provided technical assistance to evaluate wellness policies before and after program implementation. Professional development and tailored training was provided for school personnel to create sustainability. Statistical analysis was performed to evaluate policy improvement. RESULTS Thirteen of the 15 participating districts completed a policy revision. Median strength (p = .001) and comprehensiveness (p = .002) scores improved from baseline to post-program and there were significant improvements in most assessment sub-sections. Some districts were hesitant to make strong language improvements due to their limited capacity (ie, staff) for implementation. Champions (n = 13; 87%) reported confidence to revise wellness policy language independently in the future. CONCLUSIONS Technical assistance provided to districts facilitated significant improvements to wellness policy language, especially in the implementation, evaluation, and communication; critical components for policy impact on school wellness environments. In addition, participant feedback suggested an ability to sustain activities in the future. Both external (ie, technical assistance) and internal resources are needed to facilitate school districts' ongoing wellness policy improvement and implementation, including improved model wellness policy language and enforcement within schools, respectively.
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Affiliation(s)
- Alicia M Hoke
- Project Manager, , Penn State College of Medicine, 90 Hope Drive, Mail Code A145, Hershey, PA 17033
| | - Krista L Pattison
- Project Manager, , Penn State College of Medicine, 90 Hope Drive, Mail Code A145, Hershey, PA 17033
| | - Elizabeth A Hivner
- Project Manager, , Penn State College of Medicine, 90 Hope Drive, Mail Code A145, Hershey, PA 17033
| | - Erik B Lehman
- Biostatistician, , Penn State College of Medicine, 90 Hope Drive, Mail Code A145, Hershey, PA 17033
| | - Jennifer L Kraschnewski
- Professor of Medicine, Public Health Sciences, and Pediatrics, , Penn State College of Medicine, 90 Hope Drive, Mail Code A145, Hershey, PA 17033
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Bobo N, Olson J, Simmons-Wright S. Using Local School Wellness Policies to Build a Culture of Health for Students With Chronic Health Conditions: The School Nurse Role. NASN Sch Nurse 2021; 37:19-24. [PMID: 34189989 DOI: 10.1177/1942602x211026365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Local school wellness policies (LWP) guide school districts' efforts to establish school environments that promote students' health, well-being, and ability to learn that include school U.S. Department of Agriculture nutrition and physical activity requirements. Looking through the lens of the Whole School, Whole Community, Whole Child model and NASN's Framework for 21st Century School Nursing Practice™, LWP can be expanded beyond the tradition focus of nutrition and physical activity to address the health and academic needs of students with chronic health conditions. School nurses need to be actively involved on district wellness councils as schools prepare to conduct their required triennial assessment of current LWP equipped with an understanding of the Alliance for a Healthier Generations' updated model wellness policy and NASN's supplemental wellness policy language to address management of students with chronic health conditions.
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Affiliation(s)
| | - Jan Olson
- NCSN, Oregon State Nurses Association, Curriculum Director and Local School Health Clinical Consultant
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Komakech JJ, Hildebrand DA. The Association Between School Health Promotion Programs and School Wellness Policies. J Nutr Educ Behav 2020; 52:970-974. [PMID: 32605838 DOI: 10.1016/j.jneb.2020.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 05/18/2020] [Accepted: 05/18/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Determine school wellness policy quality and evaluate the association between health promotion programs on school wellness policy quality. METHODS A descriptive cross-sectional study of 344 school districts in Oklahoma, a south-central region of the US. Secondary data including school districts' participation in health promotion programs for school years 2015 and 2016 and school wellness policy scores were used for this study. Descriptive statistics and Cohen d were used in the analysis. RESULTS School wellness policies had a mean comprehensiveness score of 43.7% and a mean strength score of 21.8%. The presence of ≥3 health promotion programs had a small effect (Cohen d range = 0.20 to 0.48) on school wellness policy scores. CONCLUSIONS AND IMPLICATIONS School wellness policies have room for improvement in both comprehensiveness and strength. Engagement in ≥3 health promotion programs may contribute to improved policy quality.
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Affiliation(s)
- Joel J Komakech
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK.
| | - Deana A Hildebrand
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK
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Budd EL, Franz DJ, Kelly NR, Giuliani NR. Oregon Parents' Perceptions of the Supportiveness of the School Environment for Their Children's Health Behaviors. J Nutr Educ Behav 2020; 52:975-981. [PMID: 32171670 DOI: 10.1016/j.jneb.2020.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To describe Oregon parents' perceptions of their children's school regarding health behaviors; examine how perceptions vary by parent, child, and community characteristics; and identify recommendations for improving school environments. METHODS Oregon parents with an elementary school-aged child completed an electronic survey. RESULTS Over 90% of parents (n = 814) described their child's school as supportive of healthy eating and physical activity. Parents who ate ≥5 fruits/vegetables per day more often perceived their children's school as unsupportive of healthy eating (P < 0.001) and physical activity (P < 0.05) relative to others. Parents of children eligible for free/reduced-price lunch more often perceived the school as unsupportive of physical activity (P < 0.05) relative to others. Parental recommendations included improving school meals and providing short physical activity breaks. CONCLUSIONS AND IMPLICATIONS Parents' suggested school improvements can inform school wellness committees' and administrators' quality-improvement efforts and, in turn, better support children's healthy behaviors.
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Affiliation(s)
- Elizabeth L Budd
- Department of Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR; Prevention Science Institute, University of Oregon, Eugene, OR.
| | - Daschel J Franz
- Department of Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR
| | - Nichole R Kelly
- Department of Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR; Prevention Science Institute, University of Oregon, Eugene, OR
| | - Nicole R Giuliani
- Department of Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR; Prevention Science Institute, University of Oregon, Eugene, OR; Department of Special Education and Clinical Sciences, College of Education, University of Oregon, Eugene, OR
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Guglielmo D, Chantaprasopsuk S, Kay CM, Hyde ET, Stewart C, Gazmararian JA. Nutrition Policies, Practices, and Environments in Low-Income Georgia Elementary Schools, United States, 2015-2017. J Sch Health 2020; 90:278-285. [PMID: 31997370 DOI: 10.1111/josh.12874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 02/06/2019] [Accepted: 02/07/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND A nutritious diet can prevent obesity and chronic disease and improve academic performance, yet many children have energy-dense, nutrient-poor diets. The objective of this study was to assess nutrition policies, practices, and environments in Georgia Supplemental Nutrition Assistance Program Education (SNAP-Ed) elementary schools and compare them across school-level demographic characteristics. METHODS We distributed a cross-sectional online survey to administrators, grade level chairs, and nutrition managers from 113 Georgia SNAP-Ed elementary schools during 2015-2017. Logistic regression, one-way ANOVA, and Tukey's tests were performed to assess differences by free and reduced-price lunch eligibility and percentage black. Fisher's exact and Rao-Scott chi-square tests were performed to assess differences by school size and geography. RESULTS The majority of schools established wellness policies and committees, provided nutrition education, and offered fresh fruits and/or vegetables daily. Fewer schools had policies limiting sugar-sweetened foods within classrooms or had established a school garden. There were minimal significant differences in survey responses across school-level demographics. CONCLUSIONS Georgia SNAP-Ed elementary schools are providing healthy nutrition settings for their students in a number of areas, and can further improve by establishing more comprehensive wellness policies, a committee to enforce them, and engaging children in hands-on nutrition education activities.
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Affiliation(s)
- Dana Guglielmo
- Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, 1518 Clifton Road NE, Atlanta, GA, 30322
| | - Sicha Chantaprasopsuk
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, 30322
| | | | - Eric T Hyde
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, 30322
| | | | - Julie A Gazmararian
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, 30322
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Killian CM, Kern BD, Ellison DW, Graber KC, Woods AM. State Lawmaker's Views on Childhood Obesity and Related School Wellness Legislation. J Sch Health 2020; 90:257-263. [PMID: 31984511 DOI: 10.1111/josh.12871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 03/11/2019] [Accepted: 10/30/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND School wellness legislation has potential to impact the health of children and alter the obesity crisis in the United Sates. Little is known about how state lawmakers perceive child wellness legislation effectiveness relative to obesity prevention. Our purpose was to understand state lawmakers' perceptions of childhood obesity and school wellness policies relative to the Social Ecological Model (SEM). METHODS Twenty-one state representatives and nine state senators from one US state completed in-depth interviews. Member checks and peer debriefing occurred throughout data collection and analysis. Transcripts were coded and triangulated. A conventional content analysis generated consistent themes. RESULTS Five main themes developed: (1) child overweight and obesity is problematic; (2) current legislation is ineffective; (3) funding and enforcing child wellness legislation is difficult; (4) it is difficult to legislate personal behavior; and (5) efforts from other levels of the SEM are more effective at promoting wellness. CONCLUSIONS Lawmakers understand negative impacts of child obesity, but perceive immediate legislative issues like budgetary concerns inhibit robust policy-oriented action. Participants believe parents, guardians, and individuals should ultimately be responsible for child wellness. Community, school, and family efforts to address childhood obesity and support wellness may be more effective in achieving positive outcomes than state and federal policy.
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Affiliation(s)
- Chad M Killian
- Georgia State University, 125 Decatur Street, SE, Suite 137, Atlanta, GA 30303
| | - Ben D Kern
- University of Louisiana at Lafayette, 225 Cajundome Blvd., Lafayette, LA 70506
| | | | - Kim C Graber
- University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801
| | - Amelia Mays Woods
- University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801
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Piekarz-Porter E, Lin W, Chriqui JF. Smart Snacks Fundraiser Exemption Policies: Are States Supporting the Spirit of Smart Snacks? J Sch Health 2019; 89:692-697. [PMID: 31257602 DOI: 10.1111/josh.12807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 10/03/2017] [Accepted: 04/22/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Under Smart Snacks, state agencies can adopt a policy regulating infrequent school-sponsored fundraisers. Fundraiser exemptions allow noncompliant foods and beverages to be sold during the school day. This article examines fundraiser exemption policies in each state as of September 1, 2017. METHODS Laws were collected for all 50 states and the District of Columbia using Boolean searches of LexisNexis and Westlaw. Informal state-level policies (eg, memos) were collected through searches of state department of education and child nutrition program websites. Policies were analyzed to determine the number of exempt fundraisers allowed in each state. RESULTS By September 1, 2017, 47 states adopted a fundraiser exemption policy; 21 states adopted a zero exemption policy; 19 states regulated the number of exempt fundraisers; five states regulated the number of exempt fundraising days; one state regulated the number of exempt events; and one state approved all requested exemptions. Four states had not adopted a policy and default under the rule to zero exemptions allowed. CONCLUSIONS A patchwork of state policies governs the school food-related fundraiser landscape. However, the overall goal of improving the school food environment should persist as an important factor in determining how many, if any, will be allowed each school year.
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Affiliation(s)
- Elizabeth Piekarz-Porter
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608
| | - Wanting Lin
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608
| | - Jamie F Chriqui
- Division of Health Policy and Administration Co-Director, Health Policy Center and Fellow, Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL 60608
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Hildebrand DA, Betts NM, Gates GE. Parents' Perceptions of Childhood Obesity and Support of the School Wellness Policy. J Nutr Educ Behav 2019; 51:498-504. [PMID: 30737096 DOI: 10.1016/j.jneb.2018.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 12/10/2018] [Accepted: 12/17/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Investigate differences in familiarity of parents of school-aged children with school wellness polices (SWP) and perceptions of the problem of childhood obesity related to support for the SWP and school's role in providing a healthy environment. METHODS Descriptive, cross-sectional study using telephone surveys conducted in spring, 2016. T test statistics compared differences between parents with high vs low SWP familiarity and agreement vs disagreement of childhood obesity as problematic. RESULTS Nearly half of parents (49.5%) had low familiarity with SWP. Overall, fewer parents agreed that obesity was a local school problem compared with a statewide problem (P < .001). Differences in agreement about childhood obesity explained some differences in SWP support. CONCLUSIONS AND IMPLICATIONS Greater awareness is needed among parents of schoolchildren regarding the SWP as well as the prevalence of childhood obesity. This could be achieved through increased development, implementation, and evaluation of communication efforts between schools and families regarding health-promoting environments.
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Affiliation(s)
- Deana A Hildebrand
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK.
| | - Nancy M Betts
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK
| | - Gail E Gates
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK
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Hogan L, García Bengoechea E, Salsberg J, Jacobs J, King M, Macaulay AC. Using a participatory approach to the development of a school-based physical activity policy in an Indigenous community. J Sch Health 2014; 84:786-792. [PMID: 25388595 DOI: 10.1111/josh.12214] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 04/04/2014] [Accepted: 04/29/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND This study is part of a larger community-based participatory research (CBPR) project to develop, implement, and evaluate the physical activity component of a school-based wellness policy. The policy intervention is being carried out by community stakeholders and academic researchers within the Kahnawake Schools Diabetes Prevention Project, a well-established health promotion organization in the Indigenous community of Kahnawake, Quebec. METHODS We explored how a group of stakeholders develop a school physical activity policy in a participatory manner, and examined factors serving as facilitators and barriers to the development process. This case study was guided by an interpretive description approach and draws upon data from documentary analysis and participant observation. RESULTS A CBPR approach allowed academic researchers and community stakeholders to codevelop a physical activity policy that is both evidence-based and contextually appropriate. The development process was influenced by a variety of barriers and facilitators including working within existing structures, securing appropriate stakeholders, and school contextual factors. CONCLUSIONS This research offers a process framework that others developing school-based wellness policies may use with appropriate modifications based on local environments.
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Affiliation(s)
- Lindsay Hogan
- Department of Kinesiology and Physical Education, McGill University Montréal, Quebec H2W 1S4, Canada.
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Harriger D, Lu W, McKyer ELJ, Pruitt BE, Goodson P. Assessment of school wellness policies implementation by benchmarking against diffusion of innovation framework. J Sch Health 2014; 84:275-283. [PMID: 24617911 DOI: 10.1111/josh.12145] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 03/26/2013] [Accepted: 04/10/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND The School Wellness Policy (SWP) mandate marks one of the first innovative and extensive efforts of the US government to address the child obesity epidemic and the influence of the school environment on child health. However, no systematic review has been conducted to examine the implementation of the mandate. The study examines the literature on SWP implementation by using the Diffusion of Innovations Theory as a framework. METHODS Empirically based literature on SWP was systematically searched and analyzed. A theory-driven approach was used to categorize the articles by 4 diffusion stages: restructuring/redefining, clarifying, routinizing, and multiple stages. RESULTS Twenty-one studies were identified, and 3 key characteristics of the reviewed literature were captured: (1) uniformity in methodology, (2) role of context in analyzing policy implementation, and (3) lack of information related to policy clarification. Over half of the studies were published by duplicate set of authors, and only 1 study employed a pure qualitative methodology. Only 2 articles include an explicit theoretical framework to study theory-driven constructs related to SWP implementation. CONCLUSIONS Policy implementation research can inform the policy process. Therefore, it is essential that policy implementation is measured accurately. Failing to clearly define implementation constructs may result in misguided conclusion.
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Affiliation(s)
- Dinah Harriger
- Angelo State University Department of Nursing & Rehabilitation Sciences, Texas Tech University System, ASU Station #10902, San Angelo, TX 76909-1092.
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