CDC School Health Guidelines to Promote Healthy Eating and Physical Activity CSH/1305 Quarterly Meeting December 4, 2014 Audra Walters, BS CSH Director Arkansas Department of Education Patti Scott, DNP, RN, PNP, NCSN Director, School Health Arkansas Department of Health

Centers for Disease Control and Prevention’s School Health Guidelines to Promote Healthy Eating and Physical Activity NARRATIVE Welcome to the Training Tools for Healthy Schools workshop on CDC’s School Health Guidelines to Promote Healthy Eating and Physical Activity.

Rationale Academic Success Health and Well-being Risk for Obesity Physical activity and healthy eating are linked with Academic Success Health and Well-being Risk for Obesity Risk for Chronic Conditions (e.g., osteoarthritis) Risk for Chronic Diseases (e.g., cancer) NARRATIVE Thus far in this presentation, we’ve seen how obesity is affecting our children and adolescents. In the next segment of our presentation, we will discuss the strategies schools can use to help reduce obesity. Schools offer an ideal setting for health promotion activities, such as healthy eating and physical activity, that may lower the risk of childhood obesity. Healthy eating and physical activity can Increase students’ academic success.31-34 Improve health and well-being, such as improved self-esteem.35,36 Lower the risk of chronic disease, such as heart disease, stroke, cancer, and diabetes.35,36 Schools offer an ideal setting for students to learn about and practice healthy behaviors.21,22

School Health Guidelines to Promote Healthy Eating and Physical Activity Purpose: To provide science-based guidance for schools on establishing a school environment supportive of healthy eating and physical activity. The Guidelines support the Dietary Guidelines for Americans Physical Activity Guidelines for Americans U.S. Healthy People 2020 objectives NARRATIVE The School Health Guidelines to Promote Healthy Eating and Physical Activity provide guidance to schools on establishing a school environment supportive of healthy eating and physical activity. The Guidelines are based on scientific research and expert opinion. The Guidelines support the Dietary Guidelines for Americans, Physical Activity Guidelines for Americans, and the National health objectives set forth in Healthy People 2020.* *Note to Facilitator: If any of the participants want to know more about these documents, the URLs for accessing them are provided below: Dietary Guidelines for Americans, 2010: www.cnpp.usda.gov/DGAs2010-PolicyDocument.htm 2008 Physical Activity Guidelines for Americans: www.health.gov/paguidelines/ Healthy People 2020: www.healthypeople.gov/2020/default.aspx (also see Appendix B in School Health Guidelines to Promote Healthy Eating and Physical Activity: www.cdc.gov/mmwr/pdf/rr/rr6005.pdf)

School Health Guidelines Policies and Practices School Environments Nutrition Services Physical Education and Physical Activity Health Education School Health Services Family and Community School Employee Wellness Professional Development NARRATIVE In the following portion of our presentation, we will address the nine general guidelines for school health programs to promote lifelong healthy eating and physical activity among children and adolescents. In addition, we’ll present strategies for implementing each general guideline, which also are included in the publication. Each guideline is important to school health, and there is no priority order. We will be discussing the key components for a comprehensive approach to promoting healthy eating and physical activity in schools, including Policies and Practices School Environments Nutrition Services Physical Education and Physical Activity Health Education School Health Services, including Mental Health and Social Services Family and Community Involvement School Employee Wellness Professional Development Although the ultimate goal is to implement all guidelines recommended in this report, not every guideline will be feasible for every school. Therefore, the recommendation is for schools to identify which guidelines have the highest priority on the basis of school needs and available resources.

Policies and Practices 1 Policies and Practices Use a coordinated approach to develop, implement, and evaluate healthy eating and physical activity policies and practices. NARRATIVE Guideline 1 states that schools should use a coordinated approach to develop, implement, and evaluate healthy eating and physical activity policies and practices. People from different segments of the school and community, including students and parents or other adult caregivers of a child, should work together to maximize healthy eating and physical activity opportunities for students. Bringing together individuals and groups Facilitates better communication, Reduces duplication of policies and practices, Increases options for obtaining additional resources to support healthy eating and physical activity, and Increases efficiency through organized efforts.   This coordination of individuals and groups also increases the likelihood that programs can be sustained over time.37-41

2 School Environments Establish school environments that support healthy eating and physical activity. NARRATIVE Guideline 2 states that schools should establish school environments that support healthy eating and physical activity. The school environment should Foster opportunities for healthy eating and physical activity. Keep students safe during physical activity programs and ensure food safety. Be positive and accepting of diverse body shapes and sizes among students and staff.

3 Nutrition Services Provide a quality school meal program and ensure that students have only appealing, healthy food and beverage choices offered outside of the school meal program. NARRATIVE Schools are in a unique position to promote healthy dietary behaviors and help ensure a quality diet among their students. Guideline 3 states that schools should provide a quality school meal program and ensure that students have only appealing, healthy food and beverage choices offered outside of the school meal program.

Physical Education and Physical Activity 4 Physical Education and Physical Activity NARRATIVE Guideline 4 states that schools should implement a comprehensive physical activity program with quality physical education as the cornerstone. Federal physical activity guidelines state that children and adolescents should participate in at least 60 minutes of physical activity daily.68 A comprehensive, school-based physical activity program includes before, during, and after-school physical activity.69,70 A substantial percentage of students’ physical activity can be provided through a comprehensive, school-based physical activity program and can help students achieve the recommended number of minutes of physical activity each day. Implement a comprehensive physical activity program with quality physical education as the cornerstone.

5 Health Education Implement health education that provides students with the knowledge, attitudes, skills, and experiences needed for healthy eating and physical activity. NARRATIVE Guideline 5 states that schools should implement health education that provides students with the knowledge, attitudes, skills, and experiences needed for healthy eating and physical activity. Health education can increase the likelihood that students engage in healthy behaviors and avoid or reduce health risks to become successful learners and productive adults.

School Health Services 6 School Health Services Provide students with health, mental health, and social services to address healthy eating, physical activity, and related chronic disease prevention. NARRATIVE Guideline 6 advises that schools should provide students with health, mental health, and social services to address healthy eating, physical activity, and related chronic disease prevention. Because students spend a majority of their day in schools, schools are responsible for students’ physical health, mental health, and safety during the school day.53 Because students’ academic success and well-being are intertwined with their physical and mental health and safety, schools have become key providers or liaisons for services to address these needs. These services may be especially critical to students with chronic conditions, students who lack health insurance, or students who do not regularly see their medical care provider. School staff who provide these services include nurses, physicians, dentists, counselors, psychologists, social workers, and sometimes psychiatrists.82 School nurses, especially, play a critical role in coordinating student health care services. Schools should have one full-time nurse for every 750 students.83

7 Family and Community Partner with families and community members in the development and implementation of healthy eating and physical activity policies, practices, and programs. NARRATIVE Guideline 7 states that schools should partner with families and community members in the development and implementation of healthy eating and physical activity policies, practices, and programs. Partnerships among schools, families, and community members can Enhance student learning, Promote consistent messaging about healthy behaviors, Increase resources, and Engage, guide, and motivate students to eat healthily and be active.87,88 Schools, families, and community members influence the growth and development of students and share responsibility for nurturing students into becoming healthy and productive adults.87,88

School Employee Wellness 8 School Employee Wellness Provide a school employee wellness program that includes healthy eating and physical activity services for all school staff members. NARRATIVE School employee wellness programs can Improve staff productivity, Increase teacher morale, Improve teachers’ general well-being and their ability to handle job stress, Decrease employee absenteeism, and Decrease employee health care costs.100-106 In addition, school employee wellness programs may influence the adoption of healthy eating and physical activity behaviors by staff and result in school staff modeling positive health behaviors for students.105,106 Examples of services for school employees include individual and group behavior counseling, access to health education lectures, and point-of-decision prompts that encourage the use of stairwells.

Professional Development 9 Professional Development Employ qualified persons, and provide professional development opportunities for physical education, health education, nutrition services, and health, mental health, and social services staff members, as well as staff members who supervise recess, cafeteria time, and out-of-school-time programs. NARRATIVE Guideline 9 states that schools should employ qualified persons, and provide professional development opportunities for Physical education and health education staff members, Nutrition services staff members, Health, mental health, and social services staff members, and Staff members who supervise recess, cafeteria time, and out-of-school-time programs. Providing certified and qualified staff members with regular professional development opportunities allows them to improve current skills and acquire new ones.112-117

School Health Guidelines to Promote Healthy Eating and Physical Activity http://www.cdc.gov/mmwr/pdf/rr/rr6005.pdf

New CDC Resource! Tips for Teachers was developed from science-based recommendations from CDC’s School Health Guidelines to Promote Healthy Eating and Physical Activity http://www.cdc.gov/healthyyouth/npao/pdf/Tips_for_Teachers_TAG508.pdf

Think about the 9 guidelines. Spend 10-15 minutes reviewing them. Activity Time Think about the 9 guidelines. Spend 10-15 minutes reviewing them. Audra will facilitate an activity to help you prioritize which guideline you could implement in your school. 3, 2, 1 --- Let’s go!

School Health Guidelines Policies and Practices School Environments Nutrition Services Physical Education and Physical Activity Health Education School Health Services Family and Community School Employee Wellness Professional Development NARRATIVE In the following portion of our presentation, we will address the nine general guidelines for school health programs to promote lifelong healthy eating and physical activity among children and adolescents. In addition, we’ll present strategies for implementing each general guideline, which also are included in the publication. Each guideline is important to school health, and there is no priority order. We will be discussing the key components for a comprehensive approach to promoting healthy eating and physical activity in schools, including Policies and Practices School Environments Nutrition Services Physical Education and Physical Activity Health Education School Health Services, including Mental Health and Social Services Family and Community Involvement School Employee Wellness Professional Development Although the ultimate goal is to implement all guidelines recommended in this report, not every guideline will be feasible for every school. Therefore, the recommendation is for schools to identify which guidelines have the highest priority on the basis of school needs and available resources.