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Published on December 12, 2007

Author: Laurie

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Slide1:  Nutrition Friendly Schools and Communities (NFSC) Lessons Learned Stephanie Vecchiarelli1, EdD, MPH, Charlotte Neumann2, MD, MPH, Mike Prelip1, DPA, MPH, Wendy Slusser2, MD, MS, Aurora Cerda1, BA, Sue LaVaccare1, MA, Linda Lange1, DrPH, MPH, Jenny Chang1, MPH NFSC Development Adapted steps and concepts from: • Baby Friendly Hospital Initiative (BFHI) • Coordinated School Health Model (CSHM) • Community Based Participatory Research (CBPR) Collaboration among Los Angeles Unified School District (LAUSD) school community stakeholders and UCLA School of Public Health research team. • small work group meetings • development of criteria • modified Delphi survey to select top criteria, which became 15 Steps to a Nutrition Friendly School. NFSC Process • Introduction to staff Recruitment of NFSC committee members School self – evaluation Development of implementation plan Implementation of plan Progress monitoring through ongoing data collection Technical assistance and resources provided by UCLA Capacity development through school systems change Study Schools • Eight LAUSD elementary schools, • Clustered in two geographic regions: East/South Los Angeles and W. Hollywood/W. Los Angeles • Majority (30.8%-99.9%) Latino student population • At least 50% (60.2-96.1) of students eligible for free/reduced meals 15 Steps to a Nutrition Friendly School 1. School has written physical activity and nutrition policies. 2. School administration supports efforts to promote healthy eating and physical activity among all school community stakeholders. 3. There is collaboration throughout the school community regarding nutrition and physical education. 4. School has a standardized nutrition education curriculum integrated into other school subjects. 5. School Food Service provides healthy foods adhering to the USDA recommendations.   6. School staff and students have input into school meal planning. 7. School has a physical education curriculum/program that is adhered to by a minimum of 80% of eligible staff. 8. A minimum of 85% of classrooms participate in a minimum of 20 minutes of moderate to vigorous daily physical activity. 9. The school has one nurse for every 750 students. 10. School Health Services identifies and refers students with nutrition and physical activity issues. 11. School has a staff wellness program. 12. School staff is committed to serve as role models for healthy behavior. 13. School includes family and community members in nutrition education and physical education. 14. Family and community members actively promote healthy eating and physical activity.   15. School Psychosocial Services supports healthy eating and physical activity. 1University of California Los Angeles (UCLA) School of Public Health, 2 UCLA Schools of Public Health and Medicine The Nutrition Friendly School Certification Process Pilot Study is funded by the Centers for Disease Control and Prevention , Community Based Participatory Prevention Research NFSC Data Collection Student 24 hour recalls, height, weight, triceps skin fold, nutrition and physical activity knowledge and attitudes Adult nutrition and physical activity knowledge, attitudes, and behaviors questionnaire, self-reported dietary and anthropometric measures.. Student level academic measures including test scores, attendance School measures including attendance, test scores, discipline records, nurse records School environment measures Process measures baseline and post – intervention Self-evaluation of 15 Steps Number of Steps Met by Each School Conclusions and Next Steps From the baseline self-evaluation in Spring 2003 to the the post-intervention self-evaluation conducted in Spring 2005, both the number of schools that met each step and the number of steps met by each school increased. With the conclusion of the pilot study, the NFSC model has become imbedded in the school culture. Each school committee has developed a plan for sustainability and will continue their progress with limited technical assistance provided by the research team. The plans for NFSC certification are being finalized and the certification process will begin in Spring 2006. Additionally, a case study is being developed to highlight each school’s NFSC achievements. Finally, a tool kit is being developed to assist schools in implementing the NFSC model without intensive support from the research team. The case studies and tool kit will be available in 2006. NFSC Goal Actively engage school community to prevent overweight in elementary school children through multi-level participative intervention facilitating coordinated changes in the school environment to support healthy eating and physical activity behaviors of students, staff, and parents. NFSC Environmental (Self-Evaluation) Results Number of Schools Meeting Each Step  Baseline 2003  Post 2005  Baseline 2003  Post 2005 Successes Collaboration - formation of diverse committee of stakeholders Creativity – with few resources and without a road map of what to do Uniqueness – each school able to develop plan that met the needs of their school Change - every school improved their school environment based on 15 Steps Challenges • Staff overwhelmed – too many mandates Funding Lack of time Not a priority Lack of collaboration among school community Use of “junk food” as fundraiser Lack of training in PE Lack of Administrative Support How Did Schools Achieve 15 Steps Significant differences from baseline to post intervention for the following Steps: 1: p=.0256; 3: p=.0256; 8: p=.0406; 13: p=.0406; 14: p=.0406 Significant differences from baseline to post intervention for the following schools: 2: p=.0025; 3: p=.0142; 6: p=.0142; 7: p=.0078

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