TY - JOUR
T1 - The Role of Technical Assistance in School Wellness Policy Enhancement
AU - Hoke, Alicia M.
AU - Pattison, Krista L.
AU - Hivner, Elizabeth A.
AU - Lehman, Erik B.
AU - Kraschnewski, Jennifer L.
N1 - Funding Information:
Key literature suggests healthier students perform better in school.1-3 Thus, improvements to the school wellness environment can benefit both students and overall academic goals.2 In addition, the 2010 Healthy Hunger Free Kids Act, requires school districts across the United States participating in school meal programs to develop and implement wellness policies.4 School wellness policy revision and quality implementation can improve both physical activity and nutrition practices in schools5,6; however, several studies have highlighted challenges school personnel face in both developing and implementing quality wellness policies. For example, a study by Lucarelli et al7 suggested a disconnect between written policy language and demonstrated school nutrition practice. In addition, a mixed-methods study by Harvey et al8 described limitations in policy implementation, including lack of enforcement, attributed to inadequate policy language. While resources, such as state-developed policy templates, exist to facilitate schools in the development of their wellness policies, studies have shown that these templates are not enough.9,10 Professional development, technical assistance from external groups, and enhanced connections to resources and supportive services are essential for effective policy development that leads to implementation.11-13 Specifically, school personnel require a tailored approach that provides tools, trainings, and materials, including model policies and communication strategies.12 Schools also require coordination at an organizational-level to aid in successful policy development and implementation.14 The Building Healthy Schools (BHS) Program was created to assist Pennsylvania school districts in overcoming barriers to quality policy development and implementation. Through Centers for Disease Control and Prevention (CDC) funding from the Pennsylvania Department of Health (PA DOH), our team partnered with 15 Pennsylvania school districts, representing over 43,000 students, to establish quality wellness infrastructure through the development and implementation of strong, comprehensive wellness policies.
Funding Information:
The authors would like to thank the Pennsylvania Department of Health for their partnership and Lyndsay Nybeck, Consultant, for her guidance on the evaluation strategy for this project. Funding for data analysis was received, in part, through Children's Miracle Network. This work was supported by the cooperative agreement “State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health” from Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services. The project described was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1 TR002014 and Grant UL1 TR00045. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Publisher Copyright:
© 2022 American School Health Association.
PY - 2022/4
Y1 - 2022/4
N2 - BACKGROUND: School settings offer an opportunity to impact student health and wellness. Quality wellness policies are important in establishing strong wellness environments, but current resources to support policy development, maintenance, and dissemination are lacking. The Building Healthy Schools Program aimed to develop capacity of school districts to improve the strength and comprehensiveness of wellness policies and sustain these activities. METHODS: Fifteen school districts in Pennsylvania participated in a program to facilitate the improvement of district wellness policies and practices. Program staff provided technical assistance to evaluate wellness policies before and after program implementation. Professional development and tailored training was provided for school personnel to create sustainability. Statistical analysis was performed to evaluate policy improvement. RESULTS: Thirteen of the 15 participating districts completed a policy revision. Median strength (p =.001) and comprehensiveness (p =.002) scores improved from baseline to post-program and there were significant improvements in most assessment sub-sections. Some districts were hesitant to make strong language improvements due to their limited capacity (ie, staff) for implementation. Champions (n = 13; 87%) reported confidence to revise wellness policy language independently in the future. CONCLUSIONS: Technical assistance provided to districts facilitated significant improvements to wellness policy language, especially in the implementation, evaluation, and communication; critical components for policy impact on school wellness environments. In addition, participant feedback suggested an ability to sustain activities in the future. Both external (ie, technical assistance) and internal resources are needed to facilitate school districts' ongoing wellness policy improvement and implementation, including improved model wellness policy language and enforcement within schools, respectively.
AB - BACKGROUND: School settings offer an opportunity to impact student health and wellness. Quality wellness policies are important in establishing strong wellness environments, but current resources to support policy development, maintenance, and dissemination are lacking. The Building Healthy Schools Program aimed to develop capacity of school districts to improve the strength and comprehensiveness of wellness policies and sustain these activities. METHODS: Fifteen school districts in Pennsylvania participated in a program to facilitate the improvement of district wellness policies and practices. Program staff provided technical assistance to evaluate wellness policies before and after program implementation. Professional development and tailored training was provided for school personnel to create sustainability. Statistical analysis was performed to evaluate policy improvement. RESULTS: Thirteen of the 15 participating districts completed a policy revision. Median strength (p =.001) and comprehensiveness (p =.002) scores improved from baseline to post-program and there were significant improvements in most assessment sub-sections. Some districts were hesitant to make strong language improvements due to their limited capacity (ie, staff) for implementation. Champions (n = 13; 87%) reported confidence to revise wellness policy language independently in the future. CONCLUSIONS: Technical assistance provided to districts facilitated significant improvements to wellness policy language, especially in the implementation, evaluation, and communication; critical components for policy impact on school wellness environments. In addition, participant feedback suggested an ability to sustain activities in the future. Both external (ie, technical assistance) and internal resources are needed to facilitate school districts' ongoing wellness policy improvement and implementation, including improved model wellness policy language and enforcement within schools, respectively.
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U2 - 10.1111/josh.13136
DO - 10.1111/josh.13136
M3 - Article
C2 - 35075644
AN - SCOPUS:85123495376
SN - 0022-4391
VL - 92
SP - 361
EP - 367
JO - Journal of School Health
JF - Journal of School Health
IS - 4
ER -
