The Michigan Healthy School Action Tools Process Generates Improvements in School Nutrition Policies and Practices, and Student Dietary Intake

Abstract

The Michigan Healthy School Action Tools (HSAT) is an online self-assessment and action planning process for schools seeking to improve their health policies and practices. The School Nutrition Advances Kids study, a 2-year quasi-experimental intervention with low-income middle schools, evaluated whether completing the HSAT with a facilitator assistance and small grant funding resulted in (1) improvements in school nutrition practices and policies and (2) improvements in student dietary intake. A total of 65 low-income Michigan middle schools participated in the study. The Block Youth Food Frequency Questionnaire was completed by 1,176 seventh-grade students at baseline and in eighth grade (during intervention). Schools reported nutrition-related policies and practices/education using the School Environment and Policy Survey. Schools completing the HSAT were compared to schools that did not complete the HSAT with regard to number of policy and practice changes and student dietary intake. Schools that completed the HSAT made significantly more nutrition practice/education changes than schools that did not complete the HSAT, and students in those schools made dietary improvements in fruit, fiber, and cholesterol intake. The Michigan HSAT process is an effective strategy to initiate improvements in nutrition policies and practices within schools, and to improve student dietary intake.

Health Literacy in Schools? A Systematic Review of Health-Related Interventions Aimed at Disadvantaged Adolescents

“…Significant increases, however, were seen in psychosocial mediators, and qualitative assessments suggest that the intervention promoted skill building, but environmental barriers made these difficult to use. The two other interventions targeting dietary behaviours reported significant improvements as a result of the interventions [62,78]. School nutrition practice and policy was also significantly improved in the intervention by Alaimo et al [62].…”

“…The year of publication ranged from 1996 [59] to 2020 [76], with the majority published in the last decade (n = 35). A total of 22 studies were randomised controlled trials (RCTs) [47,48,51,52,55,58,59,63,67,68,[70][71][72][73][74][75][76][77][78]82,85,86], ten employed pre-test-post-test quasi-experimental designs [49,53,62,[64][65][66]69,79,80,84], four employed a single group pretest-post-test designs [54,56,61,83], three were post-test qualitative evaluations [57,81,87], and the remaining two adopted cross-sectional designs [50,60]. All studies assessed the interventions using quantitative techniques, with the exception of five which employed mixed methods [49,54,69,…”

“…The largest group of interventions focused on PA and diet (n = 13) [49,55,[64][65][66][67][69][70][71]77,81,84,86], followed by PA (n = 8) [47,48,58,61,[73][74][75][76]80] and mental health (n = 7) [51,53,56,72,82,83,85]. The remainder targeted diet (n = 4) [54,60,62,78]; substance abuse (n = 2) [50,68]; PA, diet, substance abuse and mental health [59]; mental health and sleep [64]; PA, diet and substance abuse [52]; Sleep [57]; mental health and PA [87] and PA, diet and mental health [79]. Interventions were delivered by a wide range of people.…”

“…The majority of outcomes associated with the included interventions were concerned with health-related behaviours [50,52,[54][55][56]59,[61][62][63][64][65][66]68,69,73,74,76,78,80,84,86]. Other outcomes included psychosocial function [51,[53][54][55][56]63,68,72,74,78,[83][84][85], health-related knowledge [49,52,59,68,69], physical measures (body composition, physical fitness and biochemical measures) [47,59,63,67,70,71,73,77,78] and the cohort's evaluation of the intervention [57,…”

Comprehensive Approaches to Improving Nutrition: Future Prospects

“…In addition, schools can profit from student purchases, and therefore they wish to sell what the students will readily purchase [43]. In South Africa time and purchasing power were held partially to blame for the lack of implementation of nutritional interventions in a low-income setting [46], whilst in the School Nutrition Advances Kid (SNAK) study, one limitation included the low response rate of students completing the dietary survey, due to the lack of signed consent forms [45].…”