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The document outlines the Centers for Disease Control and Prevention's School Health Guidelines to Promote Healthy Eating and Physical Activity. The guidelines provide science-based guidance for schools to establish supportive environments for nutrition and physical activity. They address 9 areas including policies and practices, school environments, nutrition services, physical education, health education, school health services, family/community engagement, employee wellness, and professional development. The overall goal is to use a coordinated approach to address obesity and support students' health, well-being, and academic success.
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- 1. Centers for Disease Control aanndd PPrreevveennttiioonn’’ss SScchhooooll HHeeaalltthh GGuuiiddeelliinneess ttoo PPrroommoottee HHeeaalltthhyy EEaattiinngg aanndd PPhhyyssiiccaall AAccttiivviittyy PPrreesseennttaattiioonn October 2011
- 2. Learning Objectives Presentation and Activity 1. Define the terms overweight and obesity. 2. Describe three health consequences of childhood obesity. 3. Explain the purpose of CDC’s School Health Guidelines to Promote Healthy Eating and Physical Activity. 4. Identify at least two healthy eating and two physical activity policies or practices that can be implemented in schools to address obesity. 5. Prioritize two guidelines to address obesity, physical activity, and nutrition in your state, region, city, or school district. 6. Name three groups of stakeholders in your state, region, city, or school district that need to be informed about the Guidelines.
- 3. Overweight and Obesity Defined • Overweight: having extra body weight, for a particular height, from fat, muscle, bone, or water. • Obesity: having a high amount of excess body fat. Energy Balance Energy In = Energy Out
- 4. Percentage of U.S. Children and Adolescents Classified as Obese, 1963–2008* 4.6 4.2 19.6 18.1 *>95th percentile for BMI by age and sex based on 2000 CDC BMI-for-age growth charts. **1963–1970 data are from 1963–1965 for children 6–11 years of age and from 1966–1970 for adolescents 12–17 years of age. Source: NCHS. Health, United States, 2010: With Special Feature on Death and Dying. Hyattsville, MD. 2011
- 5. Obesity Not just an adult concern anymore… Conditions Seen in Children •High Cholesterol •Type 2 Diabetes/ Impaired Glucose Tolerance •High Blood Pressure •Social Problems and Poor Self-Esteem •Sleep Disturbances •Orthopedic Problems
- 6. Obese children and adolescents are more likely to become overweight or obese adults •Heart Disease •Cancer •Stroke •Type 2 Diabetes •Osteoarthritis •Physical Disability •High Blood Pressure •Sleep Apnea
- 7. Factors Contributing to Obesity Genetics Environment Unhealthy Diet Sedentary Lifestyle Lack of Physical Activity
- 8. MEDIA GOVERNMENT AGENCIES SCHOOLS FAITH-BASED ORGANIZATIONS HEALTH CARE POSTSECONDARY PROVIDERS INSTITUTIONS FAMILY YOUTH-SERVING ORGANIZATIONS EMPLOYERS Y O U T H
- 9. School Environments School Food Environment Low-nutrient, energy-dense foods and beverages are • Served in vending machines, à la carte lines, school stores, fundraisers, and classroom parties. • Marketed to students. (cont.)
- 10. School Environments School Physical Activity Environment •Daily physical education is not provided in most schools. •Daily recess for elementary school students is not offered at many schools. •Walking or biking to school is less common.
- 11. Rationale 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)
- 12. 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
- 13. School Health Guidelines 1. Policies and Practices 2. School Environments 3. Nutrition Services 4. Physical Education and Physical Activity 5. Health Education 6. School Health Services 7. Family and Community 8. School Employee Wellness 9. Professional Development
- 14. Policies and Practices11 Use a coordinated approach to develop, implement, and evaluate healthy eating and physical activity policies and practices. GUIDELINE
- 15. Policies and Practices Assess* Develop and Implement Evaluate School Health Council School Health Team School Health Coordinator * Using the School Health Index (www.cdc.gov/HealthyYouth/SHI) GUIDELINE 1
- 16. School Environments22 Establish school environments that support healthy eating and physical activity. GUIDELINE
- 17. GUIDELINE 2 School Environments Selected Strategies to Encourage Healthy Eating and Physical Activity • Promote access to healthy foods and physical activity at school. • Provide suitable facilities for healthy eating. • Establish safe spaces and facilities for physical activity. • Avoid using physical activity as punishment. • Avoid using food items to reward students.
- 18. Nutrition Services 33 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. GUIDELINE
- 19. Align all foods with Dietary Guidelines for Americans Nutrition Services Promote access to and participation in school meals Make all foods nutritious and appealing GUIDELINE 3
- 20. GUIDELINE 3 Nutrition Services Institute of Medicine’s Nutrition Standards for Foods Served in School www.cdc.gov/healthyyouth/nutrition/standards.htm
- 21. GUIDELINE Physical Education and Physical Activity 44 Implement a comprehensive physical activity program with quality physical education as the cornerstone.
- 22. GUIDELINE 4 Physical Education and Physical Activity A Quality PE Program: 1. Curriculum 2. Supportive Policies and Environment 3. Instruction 4. Student Assessment
- 23. Physical Education and Physical Activity Walk- or Bike-to- School Programs Daily Recess for Elementary Schools Classroom-Based Physical Activity Breaks Intramural and Physical Activity Clubs Quality Physical Education Interscholastic Sports Comprehensive School-Based Physical Activity Program GUIDELINE 4
- 24. Health Education 55 Implement health education that provides students with the knowledge, attitudes, skills, and experiences needed for healthy eating and physical activity. GUIDELINE
- 25. Health Education National Health Education Standards Interactive Learning Strategies Pre-K–12 Science-Based Curricula GUIDELINE 5
- 26. School Health Services66 Provide students with health, mental health, and social services to address healthy eating, physical activity, and related chronic disease prevention. GUIDELINE
- 27. School Health Services Health Services Social Services STAFF Mental Health Services GUIDELINE 6 ASSESS REFER ADVOCATE
- 28. Family and Community77 Partner with families and community members in the development and implementation of healthy eating and physical activity policies, practices, and programs. GUIDELINE
- 29. Family and Community Schools Promote Communication and Involvement Families Community Members GUIDELINE 7
- 30. 8 School Employee Wellness 8 GUIDELINE Provide a school employee wellness program that includes healthy eating and physical activity services for all school staff members.
- 31. GUIDELINE 8 School Employee Wellness • Determine Needs of Staff • Engage Administrative Support Staff • Establish and Evaluate Programs
- 32. Professional Development 99 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. GUIDELINE
- 33. Professional Development FOR: PE Teachers Health Education Teachers Nutrition Services Staff REQUIRE: PROVIDE: Teachers and All Staff Certification Professional Development GUIDELINE 9
- 34. School Health Guidelines 1. Policies and Practices 2. School Environments 3. Nutrition Services 4. Physical Education and Physical Activity 5. Health Education 6. School Health Services 7. Family and Community 8. School Employee Wellness 9. Professional Development
- 35. Access to Public-Use Materials on the Guidelines • School Health Guidelines to Promote Healthy Eating and Physical Activity www.cdc.gov/healthyyouth/npao/strategies.htm • PowerPoint® Presentation www.cdc.gov/healthyyouth/npao/presentationslides.ppt • Facilitator’s Guide to Using the PowerPoint® Presentation www.cdc.gov/healthyyouth/npao/facilitatorguide.pdf • References for PowerPoint® Presentation www.cdc.gov/healthyyouth/npao/references.pdf • Frequently Asked Questions www.cdc.gov/healthyyouth/npao/faq.pdf
- 36. Thank You!
Editor's Notes
- NARRATIVE Today we will be discussing the School Health Guidelines to Promote Healthy Eating and Physical Activity. Notes to Facilitator: Please let the participants know that the URL links for accessing the Guidelines report, this presentation, the Facilitator’s Guide, the Reference list for the notes pages to this presentation, and Frequently Asked Questions are presented in the slide content of slide #35 in their handouts. Prior to delivering this presentation, please look over the key to the pretest/posttest onp. 16 in the Facilitator’s Guide. The slide/notes page number related to the correct answer for each test item is provided in parentheses following the True/False and Fill-in-the-Blank statements.
- NARRATIVE The purpose of this presentation is to familiarize participants with CDC’s School Health Guidelines to Promote Healthy Eating and Physical Activity. The presentation and accompanying activity will guide you in making a commitment to take action to improve healthy eating and physical activity in schools. Following the presentation and activity, participants from state, territory, regional, or local education and health agencies or other stakeholders will be able to Define the terms overweight and obesity. Describe three health consequences of childhood obesity. Explain the purpose of CDC’s School Health Guidelines to Promote Healthy Eating and Physical Activity. Identify at least two healthy eating and two physical activity policies or practices that can be implemented in schools to address obesity. Prioritize two guidelines to address obesity, physical activity, and nutrition in their state, region, city, or school district. Name three groups of stakeholders in their state, region, city, or school district that need to be informed about the Guidelines. We will first cover an overview of the burden of obesity and then discuss the steps schools can take to address obesity through healthy eating and physical activity. Note to Facilitator: Information on the activities accompanying the presentation can be found in the Facilitator’s Guide.
- NARRATIVE Before we get into the effect obesity has on children and adolescents, it is important to go over the basic definitions of overweight and obesity. Overweight: is having extra body weight, for a particular height, from fat, muscle, bone, or water.1 Obesity: is having a high amount of excess body fat.1 Energy balance occurs when the amount of energy an individual consumes through eating and drinking equals the amount of energy an individual’s body uses for growing, metabolism, and everyday activity. Weight gain may occur when individuals consume more energy or calories through their diet than they exert. As this imbalance continues over time, an individual increases his or her risk of becoming overweight or obese.2 Note to Facilitator: If you are asked, “How does one determine adult or youth weight status?”please refer the participant to the weight status calculator at www.cdc.gov/HealthyWeight.
- NARRATIVE Childhood obesity has dramatically increased since the 1960s; in 2008, the percentage of youth who were classified as obese was more than 4 times greater than it was 50 years ago.3,4 4.2% of youth aged 6 to 11 years were obese in 1970; and as of 2008, 19.6% of youth are obese. 4.6% of youth aged 12 to 19 years were obese in 1970; and as of 2008, 18.1% of youth are obese. 1 in 3 children and adolescents (about 33%) is obese or overweight.4 (Not shown on graph) Obesity affects people of all races, ethnicities, and income levels in all 50 states.2
- NARRATIVE The public health focus on childhood obesity reflects concern for children’s health, not their physical appearance. With the rise in rates of obesity in children, we are seeing more children and adolescents develop health problems that previously were not seen typically until adulthood.2,5-7 Obesity in children and adolescents is linked with a number of problems, including High cholesterol, a condition in which high levels of a fat-like substance build up along arterial walls.8 Type 2 diabetes and impaired glucose levels, a disorder in how the body uses digested food for growth and energy.9 High blood pressure, which creates a higher force of blood flow and makes the heart pump harder.10 Social problems and poor self-esteem, such as increased bullying and stigmatization because of weight.11,12 Sleep disturbances and sleep apnea, which result in shortened sleeping time.5 Orthopedic problems in bones, joints, ligaments, tendons, muscles, and nerves.5
- NARRATIVE Children and adolescents who are obese have a 70% to 80% chance of becoming overweight or obese adults.13-15 This is cause for great concern because overweight and obese adults are at greater risk for heart disease, cancer, and stroke—the three leading causes of death among adults in the United States.15-18 In addition, overweight and obese adults are more likely to develop conditions such as diabetes, osteoarthritis, physical disability, and high blood pressure.15-18 Healthy eating and regular physical activity play a powerful role in preventing chronic diseases.
- NARRATIVE A number of factors contribute to obesity, including lack of physical activity, a sedentary lifestyle, an unhealthy diet, and environmental factors.2 While genetics also plays a role in obesity, we will focus today on the causes of obesity that we CAN change.
- NARRATIVE Many sectors of our society make up the environment we experience everyday. We can make positive changes to our environment that can help reduce or prevent obesity. Families, health care organizations, the media, religious and/or faith-based organizations, businesses, local government, community organizations, and schools can all affect a child’s activity level, diet, and overall health. Although not the only entity responsible for targeting childhood obesity, schools do play a role in the overall health of children and adolescents. About 95% of the nation’s children and adolescents are enrolled in schools, and they typically spend 6 hours per day, for up to 13 years of their life, in school.19,20 Schools may be one of the most effective settings in the community to decrease preventable health problems, such as obesity, among students.21,22
- NARRATIVE While schools have great potential to provide opportunities for students to learn about and practice healthy behaviors, such as healthy eating and physical activity, schools have not always provided the healthiest choices to students. First, students often have access to a variety of less healthy food and beverage options at school through vending machines, school stores, fundraisers, and classroom parties.23-26 Students also are exposed to food advertising and marketing through school score boards, vending machines, book covers, and homework incentives.27,28
- NARRATIVE Also, schools are not regularly providing physical activity opportunities during the school day, such as physical education or recess. In addition, fewer children are walking or biking to school compared to 30 years ago.29,30
- 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
- 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)
- 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.
- 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
- NARRATIVE School districts should establish a school health council, and schools should establish a school health team. These serve as advisory, decision-making groups and as planning groups, addressing school health policies and practices.42,43 Each school health council and school health team should have a school health coordinator to lead the group.38, 44-46 School health councils and school health teams should include multiple representatives, including health and physical education teachers, nutrition services staff, students, families, school administrators, school nurses, and other community members.42,43 1.The School Health Team should assess current healthy eating and physical activity policies and practices. An assessment allows schools to identify science-based school health policies and determine strengths and weaknesses in school policies and practices related to nutrition, physical activity, and other important health topics.47,48 CDC’s School Health Index is a self-assessment and planning guide schools may use to assess the strengths and weaknesses of their health and safety policies and practices (www.cdc.gov/HealthyYouth/SHI) After the assessment is completed, schools can develop a plan for improving health and safety policies and practices. 2.School districts and schools should establish a system to develop, implement, and monitor healthy eating and physical activity policies. Health policies are vital in driving positive changes in the schools.49 For example, each school district participating in the federally supported school meal programs is required to develop, implement, and monitor a local wellness policy with goals focused on nutrition and physical activity (42 U.S.C. 1758 (b). 2011). 3.Once policies and practices have been developed and implemented, schools and districts should evaluate the program to see if the policy or practice has improved students’ health.50
- 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.
- NARRATIVE A healthy school environment is made up of a number of components. The following traits characterize a school environment that supports healthy eating and physical activity: All students have access to healthy foods and physical activity opportunities throughout the school day.51,52 Schools provide suitable facilities for healthy eating, such as a cafeteria that is clean, pleasant, and has suitable seating for students. Students should be able to enjoy the social aspects of dining without whistles or eating-under-silence orders.53,54 Schools adopt marketing practices that promote the healthy dietary choices available in the cafeteria and other places where food and beverages are sold.55-57 (Not shown on slide.) Students have access to safe spaces and facilities for physical activity, with high levels of supervision during physical activity programs.30,51,58-61 Teachers do not use physical activity as punishment or deny physical activity opportunities as a form of punishment.62 Schools do not use food items to reward student achievement or positive classroom behavior. Instead, rewards should support student health by using nonfood items or activities, such as stickers, books, or extra time for recess.63 A healthy body image is promoted among students, and schools are accepting of diverse body shapes and sizes among all students and staff.53 (Not shown on slide.) Schools implement a universal school bullying policy to discourage students from bullying other students about their weight or body size.53 (Not shown on slide.)
- 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.
- NARRATIVE The U.S. Department of Agriculture administers the federally sponsored school meal programs, including the National School Lunch Program and the School Breakfast Program. All students are eligible for the school meal programs, regardless of income level. School meal programs should offer nutritious and appealing foods and beverages that meet federally defined nutrition standards based on the Dietary Guidelines for Americans. For example, offering a variety of colorful fruits and vegetables with meals and snacks adds to their nutritional value and appeal. Schools should obtain input from students about menu choices through taste-testing.55 In addition to the school meal programs, many schools offer foods and beverages in cafeteria à la carte lines, vending machines, school stores, concession stands, fundraisers, and classroom parties.24,26 These foods are called competitive foods and are any foods or beverages sold or served outside of school meal programs.63 Most competitive foods are high in sugar, fat, and calories. These foods include high-fat salty snacks and high-fat baked goods, as well as high-calorie, sugar-sweetened beverages, such as soft drinks, sports drinks, and fruit drinks.23,25,26 Putting nutrition standards in place can be an effective strategy to ensure healthier foods and beverages are offered in the school.64-66
- NARRATIVE Nutrition standards for competitive foods should provide students with only healthy choices during the regular and extended school day. Fruits, vegetables, whole grain foods, and nonfat or low-fat dairy products should be offered, while foods that are high in fat, added sugar, or sodium, and sugar-sweetened beverages should be removed or limited. CDC developed a set of four audience-specific fact sheets, published by the Institute of Medicine, as a resource for school board members, administrators, and staff; parents; and students to use in supporting and developing strong nutrition standards for foods outside of school meal programs. Examples of recommended healthy foods include low-fat, low-salt, whole-grain crackers; 8-ounce servings of low-fat, fruit-flavored yogurt with 30 or fewer grams of total sugars; and low-sodium, whole-grain bars containing sunflower seeds, almonds, or walnuts.63 Schools can have strong nutrition standards and still maintain financial stability.67
- 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.
- NARRATIVE Quality physical education should be the cornerstone of a comprehensive, school-based physical activity program. A quality physical education program includes 1) curriculum; 2) supportive policies and environment, such as having adequate space for all students to participate in physical activity; 3) instruction; and 4) student assessment.71,72 The National Association of Sport and Physical Education recommends that schools require daily physical education for students in kindergarten through grade 12. Elementary students should receive 150 minutes per week of physical education; secondary students should receive 225 minutes per week of physical education.53,72,73 In addition, physical education should be considered a core course and include A curriculum based on national standards, Quality instruction that gets students physically active for at least 50% of class time, and Protocols for student assessment.74-76
- NARRATIVE In addition to quality physical education, schools should offer ample opportunities for students to engage in other types of physical activity.69,70 These include Daily recess for elementary school students. Classroom-based physical activity breaks. Intramural and physical activity clubs (after-school recreation clubs). Interscholastic sports (usually competitive team sports, such as football, basketball, and track). Walk- or bicycle-to-school programs. These opportunities should not replace physical education. Physical education and other physical activities should meet the needs and interests of all students, not just those who are most athletically gifted. Physical activities provided in schools should not overstress team sports and should be enjoyable experiences for all students.72,73,77
- 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.
- NARRATIVE Schools should require health education for students in pre-kindergarten through grade 12.78 Instruction should address healthy eating, physical activity, inactivity (such as television watching), and maintaining a healthy weight.79 It is recommended that health education Be culturally appropriate for all students. Have a clear set of behavioral outcomes. Be based on national standards. Follow a planned progression in health lessons that are appropriate for the age, growth, and development of students. Be consistent with scientific evidence and effectiveness.78 Instructional methods and strategies should be interactive and encourage student participation through teacher demonstrations, teacher role modeling of healthy behavior, student rehearsal and teacher feedback (role-playing), and goal setting for behavior change.80,81
- 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
- NARRATIVE School health, mental health, and social services staff should ensure resources are available for health conditions related to diet, activity, and weight.21,84 Health services staff can assess student needs related to physical activity, nutrition, and obesity and provide counseling or other services as needed. Assessments help identify students who may need counseling on improving physical activity, nutrition, or weight management. Schools can use information gathered from student assessments to guide healthy eating and physical activity programs, planning, and advocacy efforts.85 Assessments also can help identify those students who might need to be referred to community medical care providers and healthy eating and physical activity services.53 Health, mental health, and social services staff should Direct students and families to medical and health promotion services in the community. Supply students and families with a list of providers whose services are accessible to all students, including those from low-income families or those lacking health insurance or transportation.53 In addition to providing direct services for students, these staff should advocate to create a healthy, safe, and supportive school environment.86 A supportive environment allows students to make healthy dietary choices—inside and outside of the school setting—and is based on the health needs of the student population. School health services staff can Be actively involved in the school health council. Work with physical education and health education teachers, nutrition services staff, principals, and other school staff to promote consistent messages about healthy eating and physical activity.
- 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
- NARRATIVE Schools can encourage and facilitate communication among schools, families, and community members. Schools should communicate frequently with parents about healthy eating and physical activity initiatives and policies introduced at the school.89,90 Schools can communicate with parents through flyers, newsletters, telephone calls, conversations at schools, Internet communications, and media coverage.91-93 In addition to maintaining open communication, schools should invite families and community members to participate on school health councils and school health teams and ask for their input on planning and implementing school health policies, practices, and curriculum.42 Schools can involve families in school-based programs and activities that address student health. This might include family homework assignments and family nights focused on healthy eating and physical activity. To increase family participation in activities, schools should provide parents with a variety of ways to participate.94 For example, schools can try to link health promotion activities with those activities that already involve families, such as the PTA, school sport events, and parent-teacher student conferences. Community members are another key resource schools should consider. Community resources can help expand the healthy eating and physical activity opportunities available to students. Schools can reach out to staff from universities, hospitals, local businesses, health centers, health agencies, and others as potential community partners.95,96 Community partners may be able to offer health promotion activities and events, purchase equipment, or advise on health education curricula.92,98-99
- 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.
- NARRATIVE School employee wellness programs should Include health education through lectures and newsletters. Promote healthy behavior changes through counseling, skill-building, or rewards. Adopt policy and environmental changes, such as increasing access to healthy foods in the vending machines or establishing a walking club led by a staff person once a week.71,107 Before starting a school employee wellness program, schools should first determine the nutrition and physical activity needs of school staff.41,42,108 Tailoring programs and practices to staff needs increases the likelihood of staff participation.109 Schools can Identify existing school-employee wellness activities. Ask school employees what they need and would like to have related to nutrition and physical activity.41,109-111 Next, schools should request administrative support for school staff involvement in school employee wellness. Schools can reach out to the district superintendent, the principal, and other key decision makers to explain the benefits of these programs.109 After identifying the need and support for a school employee wellness program, schools should develop, implement, and evaluate it.71,107,109
- 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
- NARRATIVE Schools should require the hiring of physical education teachers, health education teachers, and nutrition services staff members who are certified and appropriately prepared and trained to deliver quality instruction, programs, and practices.113,118,119 For example, to ensure that students receive quality instruction, schools should develop and adopt policies that require certified physical education teachers for grades K12, rather than allowing teachers who are certified to teach other subject areas to teach physical education classes. Research shows that certified physical education teachers teach longer lessons, spend more time developing students’ motor and movement skills, provide more knowledge, and provide more moderate and vigorous physical activity than do other classroom teachers with little or no specialized training in physical education.113,120-122 Schools also need to provide regular professional development for staff members, including Health, mental health, and social services staff members. Staff members who lead or supervise out-of-school-time programs, recess, and cafeteria time. Physical education and health education teachers. Nutrition services staff members. Regular professional development provides staff members with opportunities to improve their knowledge, skills, and competencies, and to be current on the most effective and innovative teaching strategies. Professional development can help provide staff members with the skills needed to lead effective programs and educate students on healthy behaviors.123,124 For example, school nutrition services staff members should receive professional development on improving the school nutrition environment, such as making school meals more appealing to increase student participation in meal programs; planning menus for healthy meals; preparing fresh fruits and vegetables; ensuring food safety; and using the cafeteria for nutrition education.125-127
- NARRATIVE School-based healthy eating and physical activity policies and practices will make a powerful contribution toward a healthy future for our students. Intensifying efforts to promote healthy eating and physical activity is consistent with the mission of schools—educating young people to become healthy, productive citizens who can make meaningful contributions to society. These nine guidelines for school-based healthy eating and physical activity provide the framework for establishing such school-wide strategies. By adopting these guidelines, schools can help ensure that all school-aged children and adolescents attain their maximum educational potential and good health.
- NARRATIVE The School Health Guidelines to Promote Healthy Eating and Physical Activity are available on-line (www.cdc.gov/healthyyouth/npao/strategies.htm). In addition to developing this presentation on the Guidelines, the CDC has made the following materials available for public use: PowerPoint® Presentation (www.cdc.gov/healthyyouth/npao/presentationslides.ppt) Facilitator’s Guide to Using the PowerPoint® Presentation (www.cdc.gov/healthyyouth/npao/facilitatorguide.pdf) The Facilitator’s Guide provides step-by-step instructions on how to lead the PowerPoint® presentation. This guide includes professional development activities to accompany the presentation and handouts for the presentation. References for PowerPoint® Presentation (www.cdc.gov/healthyyouth/npao/references.pdf) This list of references provides scientific evidence for the information provided in the presentation. Frequently Asked Questions (www.cdc.gov/healthyyouth/npao/faq.pdf) This document answers questions you might have about the Guidelines, PowerPoint® presentation, and Facilitator’s Guide.