Implementation of Local Wellness Policies in Schools: Role of School Systems, School Health Councils, and Health Disparities

Hager, Erin R.; Rubio, Diana; Eidel, G. Stewart; Penniston, Erin; Lopes, Megan; Saksvig, Brit I.; Fox, Renee E.; Black, Maureen M.

doi:10.1111/josh.12430

Cited by 35 publications

(56 citation statements)

References 22 publications

(51 reference statements)

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“…More generally, we found that the presence of any wellness champion, an active School Health Advisory Council (SHAC), or proactive local agency staff considerably influenced the likelihood of success. This is consistent with other studies that have reported the most successful school health initiatives to be associated with the presence of SHACs, and, in some cases, intensely committed individuals . In this study, dedicated human resources and time were the only elements of School or District Capacity that were strongly correlated with policy improvements.…”

Section: Discussionsupporting

confidence: 92%

“…Queries revealed readiness to engage in the assessment process to be unrelated to county size, weakly associated with district or agency capacity, and strongly tied to the presence of a larger, supportive culture of school health that valued the role of the LWP. Similarly, Lucarelli et al found that a positive school health climate and high perceived level of support correlated with a greater number of nutrition‐related accomplishments in schools, and Hager et al reported that while system actions generated a low level of LWP success, stakeholders' perceptions of system actions plus the actions themselves led to greater success. Cheung et al found that the sustainability of school health teams was heavily dependent on district‐ and school‐level administrative support, and Agron et al listed “long‐term, top‐level commitment to student health and wellness from administrators and the school board” and “a community environment that values wellness” among factors that contributed to policy success.…”

Section: Discussionmentioning

confidence: 99%

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A Case Study of a New State Model for Assessing Local Wellness Policies

LeGros

Jones

Jacobs

et al. 2019

Journal of School Health

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BACKGROUND In 2016, the United States Department of Agriculture issued a final rule to strengthen local wellness policies (LWPs). As school districts pursue compliance, states can provide critical guidance by leveraging support from intermediary programs such as the Supplemental Nutrition Assistance Program—Education (SNAP‐Ed). After Arizona SNAP‐Ed piloted a statewide model for assessing LWPs, we evaluated that model by exploring local SNAP‐Ed agency experiences with the pilot. Our case study objectives were to determine the model's feasibility and utility from the perspective of local agencies supporting school districts during LWP review and revision. METHODS We used open‐ended semistructured interviews with the 13 local SNAP‐Ed agencies who engaged in each LWP assessment phase and analyzed data using constant comparative analysis. RESULTS Participants found the model feasible and useful. Five themes emerged, 3 of which tracked strongly with successful LWP review and revision: local agency staff comprehension, the openness of local agency staff and district/school personnel to the process, and the local agency's engagement of the district/school throughout the process. CONCLUSIONS Leveraging local agency support can be an effective strategy to improving LWPs, given understanding, buy‐in, and staff engagement. Findings can inform agencies seeking to engage intermediaries in LWP assessment and revision.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

A Case Study of a New State Model for Assessing Local Wellness Policies

LeGros

Jones

Jacobs

et al. 2019

Journal of School Health

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“…Previous research has identified the need to establish both school health coordinators and councils in order to develop and sustain school health activities . A recent study by Hager et al reported that schools with school health councils were more likely to implement local wellness policies . Our study does not address how or why school health coordinators or councils are supported in the school setting, but additional research could assess reasons, barriers, and facilitators to establishing and maintaining school health coordinators and councils in US schools.…”

Section: Discussionmentioning

confidence: 89%

Practices That Support and Sustain Health in Schools: An Analysis of SHPPS Data

Lee

Miller

Brener

et al. 2019

Journal of School Health

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BACKGROUND The Whole School, Whole Community, Whole Child (WSCC) model provides an organizing framework for schools to develop and implement school health policies, practices, and programs. The purpose of this study was to examine the presence of practices that support school health for each component of the WSCC model in US schools. METHODS Data from the School Health Policies and Practices Study 2014 were analyzed to determine the percentage of schools with practices in place that support school health for WSCC components. RESULTS Less than 27% of schools had a school health council that addressed any specific WSCC component, but more than 50% had a coordinator for all but one component. The use of other practices that support school health varied widely across the WSCC components. For example, more than 80% of schools reported family engagement for health education and nutrition environment and services, but less than 50% reported family engagement for other components. CONCLUSIONS These results indicate that many US schools are using practices that support school health and align with WSCC components, but improvement is needed. These results also highlight discrepancies in the types of practices being used.

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“…Prior studies have reported on barriers and enablers to LWP, relying on either quantitative or qualitative methods, not both. They have shed light on the effectiveness of LWPs based on their strength and comprehensiveness (Lucarelli et al, 2015), the role of external factors such as school system support (Hager et al, 2016) and the community (Sánchez et al, 2014), as well as barriers/enablers in rural communities (Sánchez et al, 2014). This study advances the school wellness promotion field by incorporating a statewide mixed-methods triangulation design, and by elucidating the entities that shape implementation in both HI and LI socioeconomic settings.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have shown that LWP implementation levels in schools are low, inconsistent, or nonexistent (Hager et al, 2016; Sánchez et al, 2014). Some factors linked to discrepancies in LWP implementation, which can serve as barriers or enablers, include funding, time, resources, programming support, administrative support (Agron et al, 2010; Sánchez et al, 2014), and cafeteria choices (Sánchez et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Barriers and Enablers to the Implementation of School Wellness Policies: An Economic Perspective

Schuler

Saksvig

Nduka

et al. 2018

Health Promotion Practice

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Background. Local wellness policies (LWPs) are mandated among school systems to enhance nutrition/physical activity opportunities in schools. Prior research notes disparities in LWP implementation. This study uses mixed methods to examine barriers/enablers to LWP implementation, comparing responses by student body income. Method. Schools (n = 744, 24 systems) completed an LWP implementation barriers/enablers survey. Semistructured interviews (n = 20 random subsample) described barriers/enablers. Responses were compared by majority of lower (≥50% free/reduced-price meals; lower income [LI]) versus higher income (HI) student body. Results. In surveys, LI and HI schools identified common barriers (parents/families, federal/state regulations, students, time, funding) and enablers (school system, teachers, food service, physical education curriculum/resources, and staff). Interviews further elucidated how staffing and funding served as enablers for all schools, and provide context for how and why barriers differed by income: time, food service (HI schools), and parents/families (LI schools). Conclusions. Findings support commonalities in barriers and enablers among all schools, suggesting that regardless of economic context, schools would benefit from additional supports, such as physical education and nutrition education resources integrated into existing curricula, additional funding, and personnel time dedicated to wellness programming. LI schools may benefit from additional funding to support parent and community involvement.

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Implementation of Local Wellness Policies in Schools: Role of School Systems, School Health Councils, and Health Disparities

Abstract: Schools with perceived system support and SHCs had greater likelihood of LWP implementation, with no moderating effect of disparity enrollment. SHCs/support may overcome LWP implementation obstacles related to disparities.

Cited by 35 publications

References 22 publications

A Case Study of a New State Model for Assessing Local Wellness Policies

A Case Study of a New State Model for Assessing Local Wellness Policies

Practices That Support and Sustain Health in Schools: An Analysis of SHPPS Data

Barriers and Enablers to the Implementation of School Wellness Policies: An Economic Perspective

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