1. Comprehensive School Wellness Program Dr. Matthew Cummiskey CCSU Please sign in

2. WHY the Focus on Local Wellness Policies? The prevalence of overweight among children aged 6–11 has more than doubled in the past 20 years Overweight children and adolescents are more likely to remain overweight or become obese adults and develop chronic disease One in three American children born in 2000 will develop diabetes in their lifetime The Problem

3. DID YOU KNOW???? Overweight children miss an average of 1 day per month more of school than their average weight counterparts. Overweight children miss an average of 1 day per month more of school than their average weight counterparts. ***National School Boards Association*** ***National School Boards Association*** The Problem

4. The Problem

5. The Problem

6. The Problem

7. The National Picture The Problem

8. U.S. Prevalence of Recommended Physical Activity (Moderate intensity, 30 min, 5 day/week) The Problem

9. The Problem

10. The Problem

11. Overfed But Undernourished Calcium Folate % Children Consuming Daily Recommended Intake Magnesium Vitamin A Vitamin C Zinc Iron Phosphorus Critical Age Data compiled by Dr. John Lasekan, Ross Labs NHANES 1999-2000 and the Continuing Food Survey 1994-96, 1998 The Problem

12. Percentage of students who attended physical education class daily. The Problem

13. Percentage of students who ate five or more servings of fruits and vegetables per day during the past seven days The Problem

14. Snapshot of Schools 55 million students attend U.S. schools 35-40% of daily energy consumed at school School Breakfast and National School Lunch Programs (USDA) are effective Competitive foods -- a la carte, vended foods, school stores -- dilute school’s power “Open” lunches – promote fast-food French, Am J Pub Health 2003; 93:1161 The Problem

15. 90% of schools offer a la carte lunch Vending machines for students 76% of high schools 55% of middle schools 15% of elementary schools School stores, snack bars or canteens 41% of high schools 35% of middle schools 9% of elementary schools School Nutrition Dietary Assessment Study, 2001 Competitive Foods The Problem

16. A la carte Foods Affect Diet Quality Non-participants in NSLP consume 3x more sugars (21% vs 64%) Top sellers: pizza, chips, soda, french fries, candy and ice cream Access to a la carte and snack bar meals = –lower fruit, vegetable and milk –higher sweetened beverages and fried veggies Cullen, Am J Pub Health 2004; 94:463 The Problem

17. Good News

18. Effects of Improving Nutrition on Learning Improved behavior. Improved behavior. Less visits to school nurse. Less visits to school nurse. Increased attention, creativity and test scores. Increased attention, creativity and test scores. Essential for growth and development. Essential for growth and development. Good News

19. Parental Support Nearly two-thirds of parents support restricting access to high-calorie, low- nutrient snack foods in schools, and half of parents feel their child’s school is doing an “excellent” to “good” job in this area, according to a 2005 Action for Healthy Kids national public opinion survey. However, the CDCP report that between 60% and 95% of schools allow students to purchase snack foods or beverages from vending machines or at the school store, canteen, or snack bar. Another illustration of a “disconnect” between parents’ priorities and perceptions and what actually happens at school occurs in the area of physical activity. Seventy-seven percent of parents support requiring daily physical education for all children, and 62% rate their child’s school as “excellent” or “good” on “making daily physical education available for all students.” However, in reality only 5.8 to 8.0% of schools nationally (depending on grade level) provide students with daily physical education. 83% of parents are unaware of the Local Wellness Policy mandate required by the Child Nutrition and WIC Reauthorizaton Act of 2004 Good News

20. Nutrition Enhances Achievement Comprehensive School Health Reading and math scores of third and fourth grade students with comprehensive health education were significantly higher. Schoener, Guerrero, and Whitney, 1988 School Breakfast Programs Increase learning and academic achievement, improve student attention to academic tasks, reduce visits to the school nurse, decrease behavioral problems. Murphy, Pagano, Nachmani,Sperling, Kane, and Kleinman, 1998 Positively impact academic performance, absenteeism, and tardiness among low-income elementary school students. Meyers, Sampson, Weitzman, Rogers, and Kayne, 1989 Enhanced daily nutrient intake and improved nutrient intake were associated with significant improvements in academic performance and psychosocial functioning and decreases in hunger. R.E. Kleinman et al, Annals of Nutrition and Metebolism; 2002. Good News

21. Physical Education, Too Students who participated in school physical education programs did not experience a harmful effect on their standardized test scores, though less time was available for other academic subjects. Sallis, McKenzie, Kolody, Lewis, Marshall, and Rosengard, 1999; Shephard, 1996; Dwyer, Coonan, Leitch, Hetzel,and Baghurst, 1983. Physical activity is positively associated with academic performance. Dwyer, Blizzard, and Dean, 1996 Regular (3 – 5 times per week) periods of moderate to vigorous physical activity enhances the health, academic performance, attitudes and classroom behavior of children at school. Physical education programs are valuable to students and teachers. Keays JJ, Allison KR; Canadian Journal of Public Health; 1995 Good News

22. Part of the Solution

23. Child Nutrition and WIC Reauthorization Act Signed by President Bush on June 30, 2004. Section 204 of this Act requires each district participating in the USDA School Meal Program to have established a local school wellness policy by the school year beginning July 2006.

24. Legislation (a) IN GENERAL - Not later than the first day of the school year beginning after June 30, 2006, each local education agency participating in a program authorized by the Richard B. Russell National School Lunch Act (42 U.S.C.1751 et seq.) or the Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.) shall establish a local school wellness policy for schools under the local educational agency that, at a minimum— (paraphrased) (a) IN GENERAL - Not later than the first day of the school year beginning after June 30, 2006, each local education agency participating in a program authorized by the Richard B. Russell National School Lunch Act (42 U.S.C.1751 et seq.) or the Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.) shall establish a local school wellness policy for schools under the local educational agency that, at a minimum— (paraphrased) 1) Includes goals for nutrition education, physical activity and other school- based activities that are designed to promote student wellness 1) Includes goals for nutrition education, physical activity and other school- based activities that are designed to promote student wellness 2) Includes nutrition guidelines selected by the local educational agency for all foods available with the objectives of promoting student health and reducing childhood obesity; 2) Includes nutrition guidelines selected by the local educational agency for all foods available with the objectives of promoting student health and reducing childhood obesity; 3) Provides an assurance that guidelines are being met 3) Provides an assurance that guidelines are being met 4) Establishes a plan for measuring implementation of the local wellness policy 4) Establishes a plan for measuring implementation of the local wellness policy 5) Involves parents, students, and representatives of the school food authority, the school board, 5) Involves parents, students, and representatives of the school food authority, the school board, school administrators, and the public

25. Plan The Menu Policy must include the following: Policy must include the following: 1a. Nutrition education goals 1b. Physical activity goals 1c. Other school-based activities 2. Nutrition guidelines/standards 3. Assurances that USDA school meals guidelines are being met 4. Plan for measuring implementation – Designation of 1 or more people to ensure wellness policy is being met at all school buildings We recommend having a specific workgroup designated to work on each of the above sections. We recommend having a specific workgroup designated to work on each of the above sections. Sample Goals from USDA

26. Tremendous Resource!!!!!!!!! http://www.actionforhealthykids.org/wellnesstool/index.php

27. Group Work: Practical Strategies for the Wellness Policy: Areas to Consider Nutrition Education Nutrition Education Physical Education & Physical Activity Physical Education & Physical Activity Other School Based Activities Other School Based Activities Health Education Health Education Family/Home Involvement Family/Home Involvement Technology Interdisciplinary connections to wellness Brain Primers (Energizers) Intramural/After School School Nurse Wellness Adventures Eating Environment

28. School Wellness Policy Provisions Requirement #2 Nutrition guidelines for all foods available during the school day: Nutrition guidelines for all foods available during the school day: school meals school meals a la carte foods, a la carte foods, vending machines, vending machines, snack bars, school stores, concession stands snack bars, school stores, concession stands any school-sponsored fundraising activities any school-sponsored fundraising activities

29. School Wellness Policy Provisions Requirement #3 Assurance that nutrition guidelines for school meals will not be less restrictive than federal regulations. Assurance that nutrition guidelines for school meals will not be less restrictive than federal regulations.

30. School Wellness Policy Provisions Requirement #4 A plan for measuring the effectiveness of the wellness policy, including the designation of at least one person to oversee the activities and maintain responsibility for program operation. A plan for measuring the effectiveness of the wellness policy, including the designation of at least one person to oversee the activities and maintain responsibility for program operation. Recommendation - periodically assess how well the policy is being managed and enforced, and evaluate any financial impact to vending policies. Evaluation and feedback are very important in maintaining a sound, school wellness policy. Recommendation - periodically assess how well the policy is being managed and enforced, and evaluate any financial impact to vending policies. Evaluation and feedback are very important in maintaining a sound, school wellness policy.

31. Assessment Tools  USDA Team Nutrition – “Changing the Scene”, a tool kit designed to address improvements in the school nutrition environment. The State of Michigan modified this improvement checklist (a link is available from this website) to help you measure progress as you take action. http://www.fns.usda.gov/tn/Resources/changing.html  Centers for Disease Control/Healthy Youth – “School Health Index”, a self-assessment and planning guide that enables schools to identify strengths and weaknesses of their health policies and programs, develop action plans for improving student health, and involve teachers, parents, students, and the community in improving school policies, programs, and services. This assessment tool is now available to schools online and includes online tools for summarizing results.  http://apps.nccd.cdc.gov/shi/ http://apps.nccd.cdc.gov/shi/

32. http://apps.nccd.cdc.gov/shi/default.aspx

33. SHI Format No Cost No Cost Completed by school health teams Completed by school health teams  Meets Section 204 requirement  Members should represent each school in district  Involving youth in the process is highly desirable Two separate versions Two separate versions  Elementary School  Middle School/High School Self-Assessment: Self-Assessment:  Consists of 8 modules which follow the Coordinated School Health Program model  4 of 8 relate to Local School Wellness Policy Worksheets lead to development of a “Plan for Action” for improvements Worksheets lead to development of a “Plan for Action” for improvements Well tested and frequently used Well tested and frequently used

34. Sample Section of SHI

35. Other Evaluation Tools Collect BMI’s Collect BMI’s Illinois Nutrition Education and Training Program Illinois Nutrition Education and Training Program Action For Healthy Kids Website Action For Healthy Kids Website State profiles & assessment tools State profiles & assessment tools School Nutrition Association’s “Keys to Excellence” School Nutrition Association’s “Keys to Excellence” Michigan Healthy School Assessment Tool (HSAT) Michigan Healthy School Assessment Tool (HSAT) Michigan Healthy School Assessment Tool (HSAT) Michigan Healthy School Assessment Tool (HSAT) Marketing Assessment Tool, CA Project LEAN Marketing Assessment Tool, CA Project LEAN Marketing Assessment Tool, CA Project LEAN Marketing Assessment Tool, CA Project LEAN

36. Recipe for Success (CD available) West Virginia interactive video which you can give to administration or share over lunch.

39. Sample Wellness Policies Sample Wellness Policies–NANA Sample Wellness Policies–NANA Sample Wellness Policies–NANA Sample Wellness Policies–NANA Sample Wellness Policy-OK Sample Wellness Policy-OK Sample Wellness Policy-OK Sample Wellness Policy-OK Sample Wellness Policy-KA Sample Wellness Policy-KA Sample Wellness Policy-KA Sample Wellness Policy-KA Sample Wellness Policy-IL Sample Wellness Policy-IL Sample Wellness Policy-IL Sample Wellness Policy-IL Sample Wellness Policy-ND (many district examples) Sample Wellness Policy-ND (many district examples) http://www.ag.ndsu.edu/k12wellpolicy/policies.html http://www.ag.ndsu.edu/k12wellpolicy/policies.html http://www.ag.ndsu.edu/k12wellpolicy/policies.html Image Image Image

40. Resources Slides and materials used from several government and public websites. Action for Healthy Kids Action for Healthy Kids www.actionforhealthykids.org www.actionforhealthykids.org www.actionforhealthykids.org Team Nutrition Team Nutrition www.fns.usda.gov/tn/healthy/wellnesspolicy.html www.fns.usda.gov/tn/healthy/wellnesspolicy.html www.fns.usda.gov/tn/healthy/wellnesspolicy.html National Alliance for Nutrtion and Activity National Alliance for Nutrtion and Activity www.schoolwellnesspolicies.org/ www.schoolwellnesspolicies.org/ www.schoolwellnesspolicies.org/ Making it Happen – School Nutrition Success Stories Making it Happen – School Nutrition Success Stories www.fns.usda.gov/tn/resources/makingithappen.html www.fns.usda.gov/tn/resources/makingithappen.html www.fns.usda.gov/tn/resources/makingithappen.html School Nutrition Association School Nutrition Association www.asfsa.org/childnutrition/fsoperations/policies/index.asp www.asfsa.org/childnutrition/fsoperations/policies/index.asp www.asfsa.org/childnutrition/fsoperations/policies/index.asp

41. Resources http://www.schoolwellnesspolicies.org/WellnessPolicies.html http://www.schoolwellnesspolicies.org/WellnessPolicies.html http://www.schoolwellnesspolicies.org/WellnessPolicies.html http://www.schoolwellnesspolicies.org/WellnessPolicies.html http://www.schoolwellnesspolicies.org/WellnessPolicies.html http://www.schoolwellnesspolicies.org/WellnessPolicies.html http://www.schoolnutrition.org/uploadedFiles/SchoolNutrition.org/Child_Nutrition/Loca l_School_Wellness_Policies/SNALocalWellnessPolicyGuidelinesFinal.pdf http://www.schoolnutrition.org/uploadedFiles/SchoolNutrition.org/Child_Nutrition/Loca l_School_Wellness_Policies/SNALocalWellnessPolicyGuidelinesFinal.pdf http://www.schoolnutrition.org/uploadedFiles/SchoolNutrition.org/Child_Nutrition/Loca l_School_Wellness_Policies/SNALocalWellnessPolicyGuidelinesFinal.pdf http://www.schoolnutrition.org/uploadedFiles/SchoolNutrition.org/Child_Nutrition/Loca l_School_Wellness_Policies/SNALocalWellnessPolicyGuidelinesFinal.pdf http://departments.oxy.edu/uepi/cfj/resources/healthy_school_food_policies_05.pdf http://departments.oxy.edu/uepi/cfj/resources/healthy_school_food_policies_05.pdf http://departments.oxy.edu/uepi/cfj/resources/healthy_school_food_policies_05.pdf www.mihealthtools.org/schools www.mihealthtools.org/schools www.mihealthtools.org/schools The CDC's data on obesity trends: http://www.cdc.gov/nccdphp/dnpa/obesity/trend/ http://www.cdc.gov/nccdphp/dnpa/obesity/trend/ The CDC's Youth Risk Surveillance System: http://www.cdc.gov/HealthyYouth/yrbs/index.htm http://www.cdc.gov/HealthyYouth/yrbs/index.htm Action for Healthy Kids' State Profiles for Action http://www.actionforhealthykids.org/state.php http://www.actionforhealthykids.org/state.php http://www.actionforhealthykids.org/state.php

42. Questions & Comments