The school food environment and adolescent obesity: qualitative insights from high school principals and food service personnel

Abstract

ObjectivesTo examine high school personnel's perceptions of the school environment, its impact on obesity, and the potential impact of legislation regulating schools' food/beverage offerings.MethodsSemi-structured interviews were conducted with the principal (n = 8) and dietitian/food service manager (n = 7) at 8 schools (4 rural, 4 suburban) participating in a larger study examining the relationship between the school environment and adolescent health behavior patterns.ResultsPrincipal themes included: 1) Obesity is a problem in general, but not at their school, 2) Schools have been unfairly targeted above more salient factors (e.g., community and home environment), 3) Attempts at change should start before high school, 4) Student health is one priority area among multiple competing demands; academic achievement is the top priority, 5) Legislation should be informed by educators and better incorporate the school's perspective. Food service themes included: 1) Obesity is not a problem at their school; school food service is not the cause, 2) Food offerings are based largely on the importance of preparing students for the real world by providing choice and the need to maintain high participation rates; both healthy and unhealthy options are available, 3) A la carte keeps lunch participation high and prices low but should be used as a supplement, not a replacement, to the main meal, 4) Vending provides school's additional revenue; vending is not part of food service and is appropriate if it does not interfere with the lunch program.ConclusionDiscrepancies exist between government/public health officials and school personnel that may inhibit collaborative efforts to address obesity through modifications to the school environment. Future policy initiatives may be enhanced by seeking the input of school personnel, providing recommendations firmly grounded in evidence-based practice, framing initiatives in terms of their potential impact on the issues of most concern to schools (e.g., academic achievement, finances/revenue), and minimizing barriers by providing schools adequate resources to carry out and evaluate the effectiveness of their efforts.

Culture matters: a case of school health promotion in Canada

“…Political support, top-down through policies and resources, can help to set standards and priorities for health promotion activities (Sabatier, 1997;Tang et al, 2009); however, increasing pressures and demands on the school system create a paradoxical challenge for schools to support school health interventions and policy initiatives (Nollen et al, 2007;Evenson et al, 2009;Kelder et al, 2009;MacLellan et al, 2009;Langille and Rodgers, 2010). Consistent with recent literature (Amis et al, 2012), the participants in the current study reported that increasing demands on teachers and principals limited the overall support that a school could provide to health promotion activities.…”

Identifying barriers to promoting healthy nutrition in New Zealand primary schools

“…The findings are likely to be relevant outside of New Zealand, when considering school food environments across socioeconomic and geographic contexts. The barriers identified generally echo those expressed in other studies, especially related to resources to implement changes, and the role of food sales in fundraising 32,33,35 . Williden et al 34 , in a different region of New Zealand, identified the barriers to healthy eating as: the cost of food; availability of healthy food; children's food preferences; and nutrition knowledge of parents.…”

Using community-based participatory research to identify potential interventions to overcome barriers to adolescents’ healthy eating and physical activity

“…Prior research has revealed several barriers to healthy eating, including convenience and low cost of less nutritious fast food (Croll et al 2001; Cullen et al 2007; Drewnowski and Specter 2004), lack of availability and high cost of healthier food (Harrison 2005; McKinley et al 2005; Monsivais and Drewnowski 2007), and perceived need by school staff to provide tastier, less healthy food to maintain student participation in cafeteria programs (Bauer et al 2004; Nollen et al 2007). Youth have cited a preference for unhealthy food (including fast food) due to the perception that healthy food looks less appealing and tastes worse (Evans et al 2006; Harrison 2005; Shepherd et al 2006).…”

“…Youth have cited a preference for unhealthy food (including fast food) due to the perception that healthy food looks less appealing and tastes worse (Evans et al 2006; Harrison 2005; Shepherd et al 2006). In schools, staff and students note easy vending machine access (Cullen et al 2007; Nollen et al 2007) and inadequate funding for food services to provide healthier food (Cullen et al 2007). Social pressure, such as peers’ teasing, may prevent students from eating healthy foods at school, including meals served through the National School Lunch Program, the federally subsidized program with nutritional content standards (Bauer et al 2006; Cullen et al 2007; Nollen et al 2007), and food brought from home that may potentially be healthier than some other options (Croll et al 2006; Evans et al 2006).…”