A Mixed-Methods Evaluation of a School Wellness Initiative: An Examination of Longer Lunch Periods and More Physical Activity Opportunities

The Continued Implementation and Perceived Impact of an Elementary School Wellness Policy After Extended COVID-19-Related School Closures

BACKGROUND

Schools play a key role in children's health. Following COVID-19, programs that promote students' well-being are needed more than ever. This study examines the continuation of a wellness initiative in Anchorage, Alaska, in the 2021-2022 school year.

METHODS

Interviews were conducted with n = 25 principals and cafeteria managers. Content analyses of the qualitative data were conducted using an immersion/crystallization approach. Codes were grouped to create themes contained under larger domains.

RESULTS

All schools continued aspects of the wellness initiative following COVID-19. Principals and cafeteria managers indicated: recess, movement opportunities, and longer lunch periods are important for mental health, socialization, and relationship building; COVID-19 exacerbated previous challenges with staffing shortages; additional pressure for the academic time made scheduling the wellness initiative challenging; longer lunch periods give younger students time to eat but cause poor behavior in older students which were alleviated through supportive strategies; and 30-minute recess and movement breaks offer more time to move, reset, and focus on schoolwork.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

The study underscores the importance of school administrators integrating wellness initiatives into their policies, with buy-in from school and district leadership.

CONCLUSIONS

This study highlights the need for and importance of school wellness initiatives following COVID-19 extended school closures.

Outdoor recess is associated with more positive attitudes toward physical activity among pre-adolescent students and their parents

Introduction

School day structure has the potential to increase students' physical activity (PA) levels and form positive attitudes about PA. Including various PA opportunities and free play possibilities in the school schedule, especially outdoor recess, can improve students' moderate-to-vigorous PA (MVPA) levels during school time. Therefore, the main aim of the study was to investigate students' and their parents' attitudes about outdoor recess and PA opportunities in schools with different recess opportunities.

Methods

Students from grades three to six (9-13-year-olds) and their parents responded to a questionnaire about the effect of outdoor recess and opportunities for PA during the school day. Schools were divided into three groups based on the recess opportunities during the school day: (1) "outdoor recess", (2) "outdoor recess on some days", (3) "indoor recess".

Results

Students and parents of the "outdoor recess" group had significantly more positive attitudes about outdoor recess and PA opportunities in school. Students of the "outdoor recess" group stated being significantly more active during their leisure-time compared to other groups. Parents of the "outdoor recess" group stated that the school has asked their opinion regarding PA opportunities during the school day significantly more compared to the other two groups.

Discussion

These findings emphasize the positive effect outdoor recess can have on students' PA beliefs and habits. Parents of the "outdoor recess" group also had more positive attitudes toward PA which is important as parents most likely convey their attitudes and beliefs to their children. In addition, involving and informing parents is critical when changing the school schedule and introducing new school culture, to make the changes last.

Teachers' Experiences Implementing a School Wellness Initiative in Anchorage, Alaska: A Qualitative Study

BACKGROUND

Teachers are uniquely poised to support students' healthy eating habits and physical activity. However, research is needed to examine the successes and challenges teachers face when implementing a school wellness initiative.

OBJECTIVE

The purpose of this study was to examine teachers' experiences implementing and managing a pilot school wellness initiative where students had longer lunch and recess, and more physical activity throughout the day.

DESIGN

Focus groups were conducted to understand the challenging and successful experiences of teachers as they implemented and managed a school wellness initiative.

PARTICIPANTS/SETTING

The participants were teachers (n=39) from six purposively selected elementary schools participating in a school wellness initiative. Focus groups were conducted in-person at participating schools.

ANALYSIS

Using a grounded theory approach, transcripts were analyzed qualitatively using principles of content analysis to identify themes and domains. Application of the codes and inter-rater reliability were conducted with a trained research assistant.

RESULTS

Teachers observed calmer students who ate more lunch with longer lunch periods. Additionally, teachers observed improved focus in the classroom and fewer behavioral issues with more physical activity opportunities. Successful strategies included reversing lunch and recess and implementing physical activity into daily lessons. However, some teachers had difficulty managing the extra time in the cafeteria and scheduling physical activity throughout the day, particularly in schools where administrators were not as supportive of the initiative. In the schools with greater administrative buy-in and support, teachers had easier, more positive experiences implementing the wellness initiative.

CONCLUSIONS

School wellness initiatives in which teachers play a large role have the potential to support teachers and students. This study found that teachers value student health and understand students need to be nourished to learn, but teachers' experiences suggest they need support and buy-in from their administrators to be successful.

Strategies to Improve School Meal Consumption: A Systematic Review

School meals can play an integral role in improving children's diets and addressing health disparities. Initiatives and policies to increase consumption have the potential to ensure students benefit from the healthy school foods available. This systematic review evaluates studies examining initiatives, interventions, and policies to increase school meal consumption. Following PRISMA guidelines, this review was conducted using four databases and resulted in a total of 96 studies. The research evidence supports the following strategies to increase school meal consumption: (1) offering students more menu choices; (2) adapting recipes to improve the palatability and/or cultural appropriateness of foods; (3) providing pre-sliced fruits; (4) rewarding students who try fruits and vegetables; (5) enabling students to have sufficient time to eat with longer (~30 min) lunch periods; (6) having recess before lunch; and (7) limiting students' access to competitive foods during the school day. Research findings were mixed when examining the impact of nutrition education and/or offering taste tests to students, although multiple benefits for nutrition education outside the cafeteria were documented. There is some evidence that choice architecture (i.e., "Smarter Lunchroom") techniques increase the proportion of students who select targeted meal components; however, there is not evidence that these techniques alone increase consumption. There were limited studies of the impact of increasing portion sizes; serving vegetables before other meal components; and strengthening local district and/or school wellness policies, suggesting that further research is necessary. Additionally, longer-term studies are needed to understand the impact of policies that limit students' access to flavored milk. Several studies found increases in students' meal consumption following the Healthy Hunger-Free Kids Act (HHFKA) and concerns regarding an increase in food waste following the HHFKA were not supported. Overall, there are a range of effective strategies to increase school meal consumption that can be implemented by schools, districts, and policymakers at the local, state, and federal levels (PROSPERO registration: CRD42021244688).

Prevalence of Evidence-Based School Meal Practices and Associations with Reported Food Waste across a National Sample of U.S. Elementary Schools

Providing meals at school is an important part of the hunger safety net for children in the United States and worldwide; however, many children do not receive school meals even when they qualify for federally-subsidized free or reduced-priced meals. This study investigates the prevalence of several evidence-based practices that have previously been shown to increase the reach and impact of school meals. A survey was sent to a national sample of US elementary schools, with items examining practices regarding school breakfast, school lunch, recess, the promotion of meals, nutrition standards, and food waste, during the 2019-20 school year. Almost all schools that offered lunch also offered breakfast. More than 50% used a breakfast service strategy other than cafeteria service, such as grab-and-go breakfast meals. Providing at least 30 min for lunch periods and providing recess before lunch were reported by less than half of schools. About 50% of schools reported using only one or fewer meal promotional strategies (such as taste tests) throughout the school year. Use of more promotional strategies was associated with less reported food waste in a multivariable regression model accounting for school demographic characteristics. Findings show that some evidence-based practices for school meals are being implemented, but many recommendations are not being widely adopted.