Wellness Policies:Strategies for Schools to Address Obesity, Physical Activity, Nutrition, and Tobacco-Use Prevention

Wellness Policies:Strategies for Schools to Address Obesity, Physical Activity, Nutrition, and Tobacco-Use Prevention

Linda S. Crossett, RDH, Lead Health ScientistDivision of Adolescent and School HealthCenters for Disease Control and PreventionACTION Institute, April, 2010

Linda S. Crossett, RDH, Lead Health ScientistDivision of Adolescent and School HealthCenters for Disease Control and PreventionACTION Institute, April, 2010

Government Agencies

Why Schools?Why Schools?

School health programs can improve students’• Health knowledge, attitudes, and skills• Health behaviors and health outcomes• Social outcomes• Educational outcomes

School health programs can improve students’• Health knowledge, attitudes, and skills• Health behaviors and health outcomes• Social outcomes• Educational outcomes

Federal Requirements for a Local Wellness Policy (2004)Federal Requirements for a Local Wellness Policy (2004)

Goals for nutrition education, physical activity, and other wellness activities

Nutrition guidelines and guidelines for school meals

Must involve parents, students, community members, and others

In place by the 2006-07 school year

Plan for measuring implementation; designation of a coordinator

Goals for nutrition education, physical activity, and other wellness activities

Nutrition guidelines and guidelines for school meals

Must involve parents, students, community members, and others

In place by the 2006-07 school year

Plan for measuring implementation; designation of a coordinator

Why Wellness Policies?Why Wellness Policies? Demonstrate commitment and leadership publicly Focus attention on the need for change Provide opportunities to engage the community Provide a framework for action Promote consistency of teaching and practice Facilitate institutionalization of positive changes Provide support, direction, & guidance Provide accountability Assist with evaluation

Demonstrate commitment and leadership publicly Focus attention on the need for change Provide opportunities to engage the community Provide a framework for action Promote consistency of teaching and practice Facilitate institutionalization of positive changes Provide support, direction, & guidance Provide accountability Assist with evaluation

COMMONLY INCLUDED CONTENT Nutrition standards for meals and a la carte Nutrition education Access to breakfast and lunch Nutrition standards for vending machines Physical activity opportunities Time for meals Physical education School health councils or wellness teams

COMMONLY INCLUDED CONTENT Nutrition standards for meals and a la carte Nutrition education Access to breakfast and lunch Nutrition standards for vending machines Physical activity opportunities Time for meals Physical education School health councils or wellness teams

Some Early National Analyses of Wellness Policies: AFHK & SNA

Some Early National Analyses of Wellness Policies: AFHK & SNA

LESS COMMONLY INCLUDED CONTENT Nutrition standards for classroom parties and fundraisers Use of food as a reward Teacher training for nutrition education Qualifications of physical education staff Recess for elementary schools Recess before lunch Qualifications of child nutrition program managers Other topics – tobacco-use prevention

LESS COMMONLY INCLUDED CONTENT Nutrition standards for classroom parties and fundraisers Use of food as a reward Teacher training for nutrition education Qualifications of physical education staff Recess for elementary schools Recess before lunch Qualifications of child nutrition program managers Other topics – tobacco-use prevention

Some Early National Analyses of Wellness Policies: AFHK & SNA

Some Early National Analyses of Wellness Policies: AFHK & SNA

Range of Approaches to Policy Implementation and EvaluationRange of Approaches to Policy Implementation and Evaluation

Policies ranged in length from less than 1 to 20 pages, with the average length being 5 pages

Some emphasized mandates; others encouraged Procedures for implementation varied:

• some had no procedures for implementation

• some had a few specific procedures

• some had a great deal of specificity about procedures for implementation

Many did not specify a timeframe or who was responsible for implementation

Many lacked information on how implementation was to be monitored or evaluated and who was responsible for it

Policies ranged in length from less than 1 to 20 pages, with the average length being 5 pages

Some emphasized mandates; others encouraged Procedures for implementation varied:

• some had no procedures for implementation

• some had a few specific procedures

• some had a great deal of specificity about procedures for implementation

Many did not specify a timeframe or who was responsible for implementation

Many lacked information on how implementation was to be monitored or evaluated and who was responsible for it

Elements of Successful Implementation (1) Elements of Successful Implementation (1)

School leader commitment and willingness to “walk the walk”

The right people at table for development AND implementation

Support from school staff and community

Well written and comprehensive policy

Policy understood by all constituencies

School leader commitment and willingness to “walk the walk”

The right people at table for development AND implementation

Support from school staff and community

Well written and comprehensive policy

Policy understood by all constituencies

Elements of Successful Implementation (2) Elements of Successful Implementation (2)

Alternatives offered when changes in practice required

Plan in place for implementation with designated individual given lead responsibility

Plan in place for monitoring and improvement with designated individuals given lead responsibilities

Linking wellness policy implementation into school improvement efforts

Alternatives offered when changes in practice required

Plan in place for implementation with designated individual given lead responsibility

Plan in place for monitoring and improvement with designated individuals given lead responsibilities

Linking wellness policy implementation into school improvement efforts

Major Recommended Policies – School MealsMajor Recommended Policies – School Meals

Meals served through the National School Lunch and School Breakfast Programs will:

be appealing and attractive to children; be served in clean and pleasant settings; ensure all students have access to the school meals

program; and meet, at a minimum, nutrition requirements established

by local, state, and federal statutes and regulations

Meals served through the National School Lunch and School Breakfast Programs will:

be appealing and attractive to children; be served in clean and pleasant settings; ensure all students have access to the school meals

program; and meet, at a minimum, nutrition requirements established

by local, state, and federal statutes and regulations

Major Recommended Policies – Healthy EatingMajor Recommended Policies – Healthy Eating

Actions to support safe and healthy eating include: sufficient time to receive and consume a meal; at least 10 minutes

to eat to eat breakfast and 20 minutes to eat lunch after students are seated;

opportunities for students to wash their hands in an efficient manner prior to eating;

Tables and chairs of appropriate size with space to accommodate students with special needs (e.g. wheel chairs);

Appropriate ambient noise level using acceptable and positive enforcement practices (e.g. no whistles, no “eat in silence” orders); and

rules for safe behavior

Actions to support safe and healthy eating include: sufficient time to receive and consume a meal; at least 10 minutes

to eat to eat breakfast and 20 minutes to eat lunch after students are seated;

opportunities for students to wash their hands in an efficient manner prior to eating;

Tables and chairs of appropriate size with space to accommodate students with special needs (e.g. wheel chairs);

Appropriate ambient noise level using acceptable and positive enforcement practices (e.g. no whistles, no “eat in silence” orders); and

rules for safe behavior

Major Recommended Policies – Nutrition Education Major Recommended Policies – Nutrition Education

Nutrition Education: Require health education from pre-kindergarten through grade 12 Nutrition education should be part of a comprehensive school

health education curriculum and include concepts to promote healthy eating

Include healthy eating concepts such as achieving the U.S. Dietary Guidelines for Americans; drinking water for thirst; understanding nutrition labels; assessing portion sizes; limiting foods and beverages high in added sugars; and selecting healthy foods when dining out

Nutrition Education: Require health education from pre-kindergarten through grade 12 Nutrition education should be part of a comprehensive school

health education curriculum and include concepts to promote healthy eating

Include healthy eating concepts such as achieving the U.S. Dietary Guidelines for Americans; drinking water for thirst; understanding nutrition labels; assessing portion sizes; limiting foods and beverages high in added sugars; and selecting healthy foods when dining out

Major Recommended Policies- Competitive FoodsMajor Recommended Policies- Competitive Foods

Ensure that all foods and beverages sold or served outside of school meal programs are nutritious and appealing

Establish strong nutrition standards for competitive foods consistent with the Institute of Medicine’s Nutrition Standards for Food in Schools

Use the contracting process to improve the nutritional quality of competitive foods and beverages

Market more healthful foods and beverages Use fundraising activities and student rewards that support

health

Ensure that all foods and beverages sold or served outside of school meal programs are nutritious and appealing

Establish strong nutrition standards for competitive foods consistent with the Institute of Medicine’s Nutrition Standards for Food in Schools

Use the contracting process to improve the nutritional quality of competitive foods and beverages

Market more healthful foods and beverages Use fundraising activities and student rewards that support

health

Major Recommended Policies – PAMajor Recommended Policies – PA

Include Wellness Policy goals for Physical Education (PE) K-12:

- Require students in grades K-12 to participate in daily physical education

• 150 minutes/week for elementary school students and 225 minutes/week for middle and high school students

- Require schools to report the quantity and quality of physical education offered on school district and state report cards.

Include Wellness Policy goals for Physical Education (PE) K-12:

- Require students in grades K-12 to participate in daily physical education

• 150 minutes/week for elementary school students and 225 minutes/week for middle and high school students

- Require schools to report the quantity and quality of physical education offered on school district and state report cards.

Major Recommended Policies – PAMajor Recommended Policies – PA

Offer Physical Activity Opportunities Before, During, and After-School

Provide all elementary school students a period of daily recess of at least 20 minutes in length.

Implement walk and bicycle to school programs

Offer students opportunities to participate in intramural physical activity programs during after-school hours.

• Offer both competitive and non-competitive activities.• Intramural physical activity programs should meet the needs of all students,

regardless of athletic ability.

Offer Physical Activity Opportunities Before, During, and After-School

Provide all elementary school students a period of daily recess of at least 20 minutes in length.

Implement walk and bicycle to school programs

Offer students opportunities to participate in intramural physical activity programs during after-school hours.

• Offer both competitive and non-competitive activities.• Intramural physical activity programs should meet the needs of all students,

regardless of athletic ability.

National Tools to Help School Districts Develop and Implement Wellness PoliciesNational Tools to Help School Districts

Develop and Implement Wellness Policies

CDC School Health GuidelinesCDC School Health Guidelines

Priority Strategies Coordinated School Health Program Strong wellness policies Self-assessment and planning for

improvement School health council and

coordinator High-quality health education High quality physical education Increased physical activity

opportunities Quality school meal program Appealing, healthy food and

beverage choices outside of school meals

Health promotion for staff

Priority Strategies Coordinated School Health Program Strong wellness policies Self-assessment and planning for

improvement School health council and

coordinator High-quality health education High quality physical education Increased physical activity

opportunities Quality school meal program Appealing, healthy food and

beverage choices outside of school meals

Health promotion for staff

Assesses Curricula for:

NutritionPhysical Activity

TobaccoHIV and STD Prevention

Unintentional Injury Alcohol and Other Drugs

Coordinated School Health

Assesses Curricula for:

NutritionPhysical Activity

TobaccoHIV and STD Prevention

Unintentional Injury Alcohol and Other Drugs

Coordinated School Health

CDC’s Division of Adolescent and School HealthCDC’s Division of Adolescent and School Health

http://www.cdc.gov/HealthyYouth

US Dept. of Agriculture, Team NutritionUS Dept. of Agriculture, Team Nutrition

http://www.fns.usda.gov/tn

National Association for Sport and Physical Education

http://www.aahperd.org/naspe

Action for Healthy KidsAction for Healthy Kids

http://www.actionforhealthykids.org

Alliance for a Healthier GenerationAlliance for a Healthier Generation

http://www.healthiergeneration.org

American Association of School AdministratorsAmerican Association of School Administrators

http://www.aasa.org

Major Recommended Policies - TobaccoMajor Recommended Policies - Tobacco

Tobacco-Free Environment Policy: Prohibit all forms of tobacco use on all school

property, in school vehicles, at school- sponsored events (on and off school property) for students, staff, and visitors at all times (24/7).

Tobacco-Free Environment Policy: Prohibit all forms of tobacco use on all school

property, in school vehicles, at school- sponsored events (on and off school property) for students, staff, and visitors at all times (24/7).

CDC/DASH

www.cdc.gov/HealthyYouth

CDC/DASH

www.cdc.gov/HealthyYouth