Linda S. Crossett, RDH, Lead Health Scientist Division of Adolescent and School Health

1. Wellness Policies:Strategies for Schools to Address Obesity, Physical Activity, Nutrition, and Tobacco-Use Prevention Linda S. Crossett, RDH, Lead Health Scientist Division of Adolescent and School Health Centers for Disease Control and Prevention ACTION Institute, April, 2010

2. Government Agencies YOUTH

3. Why Schools? • School health programs can improve students’ • Health knowledge, attitudes, and skills • Health behaviors and health outcomes • Social outcomes • Educational outcomes

4. Federal Requirements for a Local Wellness Policy (2004) Goals for nutrition education, physical activity, and other wellness activities Nutrition guidelines and guidelines for school meals Must involve parents, students, community members, and others In place by the 2006-07 school year Plan for measuring implementation; designation of a coordinator

5. Why Wellness Policies? • Demonstrate commitment and leadership publicly • Focus attention on the need for change • Provide opportunities to engage the community • Provide a framework for action • Promote consistency of teaching and practice • Facilitate institutionalization of positive changes • Provide support, direction, & guidance • Provide accountability • Assist with evaluation

6. Some Early National Analyses of Wellness Policies: AFHK & SNA COMMONLY INCLUDED CONTENT • Nutrition standards for meals and a la carte • Nutrition education • Access to breakfast and lunch • Nutrition standards for vending machines • Physical activity opportunities • Time for meals • Physical education • School health councils or wellness teams

7. Some Early National Analyses of Wellness Policies: AFHK & SNA LESS COMMONLY INCLUDED CONTENT • Nutrition standards for classroom parties and fundraisers • Use of food as a reward • Teacher training for nutrition education • Qualifications of physical education staff • Recess for elementary schools • Recess before lunch • Qualifications of child nutrition program managers • Other topics – tobacco-use prevention

8. Range of Approaches to Policy Implementation and Evaluation • Policies ranged in length from less than 1 to 20 pages, with the average length being 5 pages • Some emphasized mandates; others encouraged • Procedures for implementation varied: • some had no procedures for implementation • some had a few specific procedures • some had a great deal of specificity about procedures for implementation • Many did not specify a timeframe or who was responsible for implementation • Many lacked information on how implementation was to be monitored or evaluated and who was responsible for it

9. Elements of Successful Implementation (1) • School leader commitment and willingness to “walk the walk” • The right people at table for development AND implementation • Support from school staff and community • Well written and comprehensive policy • Policy understood by all constituencies

10. Elements of Successful Implementation (2) • Alternatives offered when changes in practice required • Plan in place for implementation with designated individual given lead responsibility • Plan in place for monitoring and improvement with designated individuals given lead responsibilities • Linking wellness policy implementation into school improvement efforts

11. Major Recommended Policies – School Meals Meals served through the National School Lunch and School Breakfast Programs will: • be appealing and attractive to children; • be served in clean and pleasant settings; • ensure all students have access to the school meals program; and • meet, at a minimum, nutrition requirements established by local, state, and federal statutes and regulations

12. Major Recommended Policies – Healthy Eating Actions to support safe and healthy eating include: • sufficient time to receive and consume a meal; at least 10 minutes to eat to eat breakfast and 20 minutes to eat lunch after students are seated; • opportunities for students to wash their hands in an efficient manner prior to eating; • Tables and chairs of appropriate size with space to accommodate students with special needs (e.g. wheel chairs); • Appropriate ambient noise level using acceptable and positive enforcement practices (e.g. no whistles, no “eat in silence” orders); and • rules for safe behavior

13. Major Recommended Policies – Nutrition Education Nutrition Education: • Require health education from pre-kindergarten through grade 12 • Nutrition education should be part of a comprehensive school health education curriculum and include concepts to promote healthy eating • Include healthy eating concepts such as achieving the U.S. Dietary Guidelines for Americans; drinking water for thirst; understanding nutrition labels; assessing portion sizes; limiting foods and beverages high in added sugars; and selecting healthy foods when dining out

14. Major Recommended Policies- Competitive Foods • Ensure that all foods and beverages sold or served outside of school meal programs are nutritious and appealing • Establish strong nutrition standards for competitive foods consistent with the Institute of Medicine’s Nutrition Standards for Food in Schools • Use the contracting process to improve the nutritional quality of competitive foods and beverages • Market more healthful foods and beverages • Use fundraising activities and student rewards that support health

15. Major Recommended Policies – PA Include Wellness Policy goals for Physical Education (PE) K-12: - Require students in grades K-12 to participate in daily physical education • 150 minutes/week for elementary school students and 225 minutes/week for middle and high school students - Require schools to report the quantity and quality of physical education offered on school district and state report cards.

16. Major Recommended Policies – PA Offer Physical Activity Opportunities Before, During, and After-School • Provide all elementary school students a period of daily recess of at least 20 minutes in length. • Implement walk and bicycle to school programs • Offer students opportunities to participate in intramural physical activity programs during after-school hours. • Offer both competitive and non-competitive activities. • Intramural physical activity programs should meet the needs of all students, regardless of athletic ability.

17. National Tools to Help School Districts Develop and Implement Wellness Policies

18. CDC School Health Guidelines

19. Priority Strategies • Coordinated School Health Program • Strong wellness policies • Self-assessment and planning for improvement • School health council and coordinator • High-quality health education • High quality physical education • Increased physical activity opportunities • Quality school meal program • Appealing, healthy food and beverage choices outside of school meals • Health promotion for staff

21. Assesses Curricula for:NutritionPhysical ActivityTobaccoHIV and STD PreventionUnintentional Injury Alcohol and Other DrugsCoordinated School Health

22. CDC’s Division of Adolescent and School Health http://www.cdc.gov/HealthyYouth

23. US Dept. of Agriculture, Team Nutrition http://www.fns.usda.gov/tn

24. National Association for Sport and Physical Education http://www.aahperd.org/naspe

25. Action for Healthy Kids http://www.actionforhealthykids.org

26. Alliance for a Healthier Generation http://www.healthiergeneration.org

27. American Association of School Administrators http://www.aasa.org

28. Major Recommended Policies - Tobacco Tobacco-Free Environment Policy: Prohibit all forms of tobacco use on all school property, in school vehicles, at school- sponsored events (on and off school property) for students, staff, and visitors at all times (24/7).

29. CDC/DASH www.cdc.gov/HealthyYouth