Development of an Innovative and Unique Comprehensive School Health Initiative Involving Community Health Care Professionals

Abstract

BACKGROUNDC hildhood obesity in the United States has increased from 5% in 1980 to over 18% in 2016. 1,2 Obesity is multifactorial, with social norms, the built environment, and policies playing a large role. 3 Thus, the public health, medical, and education communities have called for greater alignment of efforts to prevent childhood obesity. [4][5][6] Multi-component school-based wellness initiatives have been associated with healthier student body mass index (BMI), and are a public health focus to address the obesity epidemic in children for several reasons. [7][8][9] Reach is widespread because most children are enrolled in school and therefore benefit from programing. Also, children spend enough time at school to accommodate half of their daily required physical activity and caloric intake. 6,10 Effective school-based wellness initiatives capitalize on these opportunities while involving stakeholders from the community. 4,6,11

Participation in a School‐Based Wellness Initiative Associated With Improved K‐12 Student Body Mass Index Trends

“…29,38 Participating schools select action items from the SWC, a collection of evidence-based PSE strategies and wellness activities that align with the CDC WSCC model. 18,39 A complete description of implementation methods can be found in Key et al 29 FitnessGram. The South Carolina FitnessGram project is a longitudinal statewide effort to ''evaluate and ultimately improve health related fitness among public school students in South Carolina.''…”

“…Participating schools select action items from the SWC, a collection of evidence‐based PSE strategies and wellness activities that align with the CDC WSCC model 18,39 . A complete description of implementation methods can be found in Key et al 29 …”

“…Annual SWC score was defined by the total number of wellness points achieved by the participating school between school day 1 (mid-August) and programmatic year end when the SWC closed (mid-April). This tool, fully described and depicted in Key et al 29 is not static in nature but is revised by an expert panel yearly based on advances in evidence and community feedback. SWC subscores were calculated by the number of points earned during the programmatic year in each of the 7 SWC categories, and are listed as maximum allowable points in school years (2014, 2018): Getting Started (38,38), Nutrition (85, 76), Physical Activity (54, 71), Stress Management (11,14), Wellness Culture (39, 89), Employee Connections (16,33), and Sustainability (29,44).…”

“…Schools reaching a standard yearly SWC points goal are awarded money to be used for future wellness efforts. 28,29 The purpose of this study was to compare average student BMI in schools participating in the Initiative with those that were not to determine if there was a difference in BMI trajectory between the 2 groups. A secondary objective was to conclude if the degree of school participation or types of programmatic components implemented were associated with differences in average student BMI.…”

“…It incentivizes participation through the use of the School Wellness Checklist© (SWC), a customizable proprietary tool that assigns points to PSE changes based upon level of evidence for promoting wellness and/or overall difficulty. Schools reaching a standard yearly SWC points goal are awarded money to be used for future wellness efforts 28,29 …”