We Wellness llness Po Poli licy cy Ce Census nsus an and d - PowerPoint PPT Presentation

We Wellness llness Po Poli licy cy Ce Census nsus an and d Relationship ationship to Student dent BMI Savannah Morrow, Commissioner’s Fellow, Office of Health Policy | 2018

Agenda Agenda • Coordinated School Health • Project Scope • Project Results • Implications • Next Steps

Wh What at is is Co Coor ordin dinated ated Sc Scho hool ol He Heal alth th? • Strategic framework that integrates – nutrition – physical activity – physical education – health education – health services – healthy school environment – counseling, psychological, and social services – student, family, and community involvement – school staff wellness • Tennessee has CSH staff in every district

We Well llne ness ss Po Poli licy cy • Every Tennessee school district must maintain a Wellness Policy that outlines their commitment to student health and wellbeing. • While they must include certain requirements, districts can add more criteria to their wellness policy.

Es Esse sent ntial ial Qu Ques estio tion • Is there a relationship or correlation between districts with robust wellness policies and their percentage of overweight or obese students? More simply… Do districts with complete health policies also have students with healthier BMIs?

Pr Proj ojec ect t Ob Obje jecti ctives ves • Evaluate and score all district wellness policies • Determine the relationship between district BMI and wellness policy score – With extra points – Required USDA components • Identify strong wellness policies

TS TSBA BA Mo Mode del School Health Index Record Keeping Compliance Commitment to Coordinated School Commitment to Nutrition Health School Health Advisory Council District Goals Commitment to Physical Activity and Physical Education Commitment to Curriculum

Sc Scor orin ing g Ma Matr trix ix

Sc Scor orin ing g Cr Crit iteri eria • 50 components of the TSBA model including headers, sentences, references, availability, and last update • All 140 districts received scored1-50, then % completed. • Average: 86% • 81 of the 140 policies: 90-100% • Lowest scores, all below 50%: Bartlett, Montgomery, Davidson, Hamilton, Madison, Dickson, Johnson, and Warren.

Sc Scor ores es + B + BMI MI Rela lati tionship onship of Wellnes llness s Po Poli licy y Scor ore e and Pe Percen entag age e of St Students dents Overwei weigh ght t or Obese se 60 50 y Score 40 Policy 30 ess Po Wellness 20 10 0 0% 10% 20% 30% 40% 50% 60% 70% Pe Percen entage age of students nts overwei weight ght or obese

Sc Scor orin ing g wi with th Ad Addi diti tional onal Po Poin ints ts • Not using food as a reward or punishment • Not withholding food or beverage as a punishment • Access to cups of water or water bottles throughout the day • Cafeteria as a “learning laboratory” • Commitment to a Healthy School Environment • “The Board strives to ensure that all schools offer healthy, safe, and supportive environments for students, staff, parents, and visitors”

Sc Scor ores es wi with th Ad Addi ditio tional nal Po Poin ints ts + B + BMI MI Rela lati tionship onship of Wellnes llness s Po Poli licy y Scor ores es wit ith h Extra Po Poin ints ts and Pe Percen ent t of St Students dents Overwei weigh ght t or Obese se 70 Points 60 a Po y Score with Extra 50 40 30 Policy ess Po 20 Wellness 10 0 0% 10% 20% 30% 40% 50% 60% 70% Pe Percen entage age of St Student nts s Overwei weight ght or Obese

Po Poli licy cy Re Requ quir iremen ements ts fr from om US USDA DA  The council il shall consist of individuals repres esen entin ing g the school ol and communit ity, including parents, students, teachers, school administrators, health professionals, school food service representatives, and members of the public.  The board will consider recommendations of the Counc ncil il in making ng policy icy changes ges or revis isio ions ns.  The director of schools will l ensure e complia ianc nce e with the school Wellness Policy, to include an assessment of the implementation of the Wellness Policy and the progress made in attaining the policy goals.  COMMITMENT TO NUTRIT RITIO ION  All schools within the district shall partic icip ipate ate in the USDA child nutrit itio ion n progr gram ams, which may include but not be limited to, the National School Lunch Program, the School Breakfast Program, the Summer Food Service Program, and the After School Snack Program.4,5,6 All food including vending machines, fundraising items, and concessions must meet guidelines set forth by the Healthy, Hunger-free Kids  Act, 2010, Smart Snacks ks in Schools ols.  The school nutrition coordinator/director/principal/designee/Coordinated School Health Counselor shall be responsible for overseeing the school district’s complia ianc nce e with h the State e Board of Educat catio ion Rules and Regulations for sale of food items in the school district.2,5,6  Nutrit itio ion n Education ation will l be offered ered as part of a standar ards based program designed to provide students with the knowledge and skills needed to promote and protect their health as outlined in the State Board of Education Health Education and Lifetime Wellness Standards. OR Nutrition Education will be offered as part of a standards based program designed to provide students with the knowledge and skills needed to promote and protect their health.  COMMITMENT TO PHYSIC ICAL ACTIV IVIT ITY AND PHYSICAL L EDUCATIO ION  Updated since 2017

USDA US DA Sc Scor ore e + B + BMI MI Rela lati tionship onship between ween Abbrev eviat ated ed Welln lnes ess s Po Poli licy y Score re and d Pe Percen entag age e of St Students dents Overwei weigh ght t or Obese se 12 Policy Score 10 8 ess Po ed Wellness 6 viated 4 Abbrevia 2 0 0% 10% 20% 30% 40% 50% 60% 70% Pe Percen entage age of St Student nts s Overwei weight ght or Obese

Im Impo port rtant ant Co Cons nside iderati rations ons • Many districts did not modify their policy yearly to align with the TSBA’s model. • The essence of the policy intent was there, but contained older language. • Some districts also simply added updated phrasing to the end of their existing policy rather than integrating it.

Li Limi mita tation tions • Small snapshot – policies available in April and 2016-2017 school year BMI data. • Policies are on paper, procedure is in practice. • Districts represent 2 to 234 schools.

Di Dist stri ricts cts Wo Wort rth h Hi High ghli lighti ghting ng • Giles County – met all requirements and included water availability, cafeteria as a learning laboratory, handwashing, and not using food as reward or punishment • Humphreys County – detailed wellness policy regarding specific health and nutrition education topics • Lebanon Special School District – detailed wellness policy regarding school food staff, scheduling of meals, parent communication, breakfast and free and reduced-priced meals

Co Conc nclu lusion sion • Wellness policies, so far, have not correlated to district levels of overweight and obese students. • The wellness policies that at least met the minimum required statements did not have healthier average BMIs. • Regardless, maintaining a wellness policy is an opportunity for the district to renew its commitment to school health and wellness.

Ne Next xt St Step eps 1. Examine the accuracy of the data 2. Meet with the experts 3. Study pediatric obesity to find evidence-based interventions 4. Encourage the use of best practices to move the needle

St Step eps s in in pr prog ogre ress ss • Data: relatively accurate but limited. • Experts: Three components determine weight. – Biology (genetics, anatomy, physical make-up) – Environment (school, neighborhood, rural, urban, rich, poor) – Health Behaviors (physical activity, nutrition, etc) • Research: Interventions that work target more than one aspect or component.

Ta Take keaw aways ays • There is no silver bullet to cure childhood obesity. • BUT that also means there can be multiple ways to combat the issue. • Future research and interventions must measure long term impacts. • The most effective interventions are school based, but include a home or community component.

Re Refe fere rences nces • https://www.tn.gov/content/dam/tn/education/csh/csh_bmi_school_summary_201 6-17.pdf • https://www.nature.com/articles/ijo200922#preventing-childhood-obesity-current- approaches • https://academic.oup.com/her/article/21/6/783/611143 • http://pediatrics.aappublications.org/content/121/4/e794.short http://journals.sagepub.com/doi/10.1111/j.1748-720X.2007.00116.x • • https://highline.huffingtonpost.com/articles/en/everything-you-know-about-obesity- is-wrong/ • https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.12277 • https://www.aafp.org/afp/2008/0701/p56.html • https://www.rwjf.org/en/library/articles-and-news/2018/10/nearly-one-in-six-young- people-nationwide-has-obesity--new-data-show.html

Thank ank you! Savannah.Morrow@tn.gov