Family, Child, Adolescent Health (Includes Maternal & Child Health)
School Wellness Policies: Promoting School Health Councils and Local Wellness Policy Implementation
(School of Medicine (UMB) Department of Pediatrics-Intern with Growth and Nutrition Division Master's Student)
Purpose: Written Local Wellness Policies (LWPs) are federally mandated in school systems to enhance healthy eating/physical activity. Schools are encouraged to form school-level School Health Councils (SHCs) to oversee LWP implementation. The purpose of this study is to determine the association of active SHCs and school-level LWP implementation. Methods: A survey was sent via e-mail to school administrators (n=1349; response rate: 55%) in 2013 regarding the 2012-2013 school year. SHCs existed in 311 of the responding schools (42%). The survey included LWP implementation (17-item scale, Cronbach’s alpha=0.923, scored in 3 categories-no, low, high implementation) and SHC composition/activities. An “active SHC score” was generated (scored 0 or 1, summed, higher score=more active SHC): (i) set goals for healthy eating/physical activity; (ii) met ≥4 times during the 2012-2013 school year; (iii) members include ≥3: administrator, PE teacher, cafeteria manager, school nurse; (iv) members include a parent and/or student; (v) activities made publicly available (website, PTA meetings, or newsletter). School demographics provided by State. Analyses: ANOVA (LSD post-hoc testing) and multi-level multinomial logistic regression (adjusting for clustering within school systems). Results: Mean active SHC score was 2.6 (SD=1.4, range 0-5). LWP implementation categories: no (19.6%), low (36.0%), high (44.4%). 26% of schools were majority low-income (>75% of students eligible for Free-or-Reduced-Price Meals). Mean active SHC score differed by LWP implementation category (F=8.98, p<0.001); specifically schools with no and low-implementation had significantly lower SHC scores than schools with high implementation (2.41 and 2.31 versus 3.00, p=0.015 and p<0.001, respectively). Adjusted multi-level models revealed for every one-unit increase in SHC score, schools are 39% more likely to be in high implementation group (p=0.006). Conclusion: Schools with an active SHC have a higher likelihood of LWP implementation. Interventions that focus on the formation and maintenance of active SHCs are likely to increase LWP implementation.
Importance to public health: