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Sharma P, Altman EA, Hampton KE, Moreno GD, Hecht CA, Patel AI. Strength and Comprehensiveness of Drinking Water Language in California School District Wellness Policies. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:870-879. [PMID: 34167919 DOI: 10.1016/j.jneb.2021.04.466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 04/14/2021] [Accepted: 04/25/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE(S) Assess the quality of water language in California school district wellness policies and examine how language quality relates to school drinking water access. DESIGN Cross-sectional study. PARTICIPANTS Random sample of 240 schools selected from all California public schools, stratified by geography and grades served. VARIABLES MEASURED Policies (2016-2018) were coded for quality (strength and comprehensiveness) using an adapted school wellness policy tool. School administrators completed phone interviews about drinking water access on their campus. ANALYSIS Descriptive statistics (eg, means, standard deviations) summarized school-level characteristics and main outcomes. Mixed-effects linear regression models were used to examine the relationship between the strength and comprehensiveness of water policy language and water access. RESULTS On a scale of 0-100, mean strength was 11.3 (SD, 5.7), and mean comprehensiveness was 28.8 (SD, 8.7). There was an inverse association between the quality of water language in policies and excellence in drinking water access in schools. CONCLUSIONS AND IMPLICATIONS The strength and comprehensiveness of water language in California school district wellness policies were low. Districts would benefit from improving the quality of water language in their wellness policies and examining challenges to implementing policies.
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Affiliation(s)
- Priyanka Sharma
- School of Medicine, University of California Irvine, Irvine, CA
| | - Emily A Altman
- School of Medicine, Stanford University, Stanford, CA; School of Public Health, University of California Berkeley, Berkeley, CA
| | | | - Gala D Moreno
- School of Medicine, Stanford University, Stanford, CA; School of Medicine, University of California San Francisco, San Francisco, CA
| | - Christina A Hecht
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California Berkeley, Berkeley, CA
| | - Anisha I Patel
- School of Medicine, Stanford University, Stanford, CA; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA.
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Koriakin TA, McKee SL, Schwartz MB, Chafouleas SM. Development of a Comprehensive Tool for School Health Policy Evaluation: The WellSAT WSCC. THE JOURNAL OF SCHOOL HEALTH 2020; 90:923-939. [PMID: 33184889 DOI: 10.1111/josh.12956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Stakeholders increasingly recognize the role of policy in implementing Whole School, Whole Community, Whole Child (WSCC) frameworks in schools; however, few tools are currently available to assess alignment between district policies and WSCC concepts. The purpose of this study was to expand the Wellness School Assessment Tool (WellSAT) for evaluation of policies related to all 10 domains of the WSCC model. METHODS Developing the WellSAT WSCC was an iterative process that involved (1) identifying items for each domain based on key concepts and best practice recommendations; (2) expert review of the draft measure; (3) cognitive pre-testing; (4) developing scoring criteria; and (5) pilot-testing the measure. RESULTS Ratings from expert reviewers indicated that the tool included items that were both relevant and important to each of the 10 WSCC domains. Results of cognitive pre-testing indicated that the items were understood as intended. Feedback from expert reviews, cognitive pre-testing, and pilot-testing was used to further revise and refine the measure and develop a final version of the tool. Acceptable interrater reliability was established for the final selection of items. CONCLUSIONS The WellSAT WSCC provides a reliable means for assessing integration and alignment between WSCC model concepts and district policies.
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Affiliation(s)
- Taylor A Koriakin
- Neag School of Education, University of Connecticut, 249 Glenbrook Road, Unit 3064, Storrs, CT, 06269
| | - Sarah L McKee
- Rudd Center for Obesity and Food Policy, University of Connecticut, 1 Constitution Plaza, Suite 600, Hartford, CT, 06103
| | - Marlene B Schwartz
- Rudd Center for Obesity and Food Policy, University of Connecticut, 1 Constitution Plaza, Suite 600, Hartford, CT, 06103
| | - Sandra M Chafouleas
- Neag School of Education, University of Connecticut, 249 Glenbrook Road, Unit 3064, Storrs, CT, 06269
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LeGros TA, Jacobs LE, Goodman GL, Orzech KM, Holmes E. A Systems Approach Helps Explain Significant Improvements in Local Wellness Policies Among SNAP-Ed-Supported School Districts. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:766-774. [PMID: 32276880 DOI: 10.1016/j.jneb.2020.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 02/13/2020] [Accepted: 02/16/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To assess changes in written local wellness policies (LWPs) across time within Supplemental Nutrition Assistance Program Education (SNAP-Ed)-participating districts. DESIGN Sequential, explanatory mixed methods. SETTING From October 1, 2015 to September 30, 2016, SNAP-Ed agencies submitted LWPs from partner school districts in Arizona. They received back scores and customized recommendations. To assess changes, LWPs were rescored between October 1, 2017 and September 30, 2018. PARTICIPANTS Sixteen local SNAP-Ed agencies worked with 57 districts. INTERVENTIONS Districts' LWP revisions supported by SNAP-Ed agencies during the 2-year pre-post period. MAIN OUTCOME MEASURES Policy comprehensiveness and strength from 0 (worst) to 100 (best), measured by the Wellness School Assessment Tool. ANALYSIS Paired t test to compare pre-post scores. Content analysis of State Educational Agency administrative reviews and thematic analysis of SNAP-Ed narrative reports to explore causation. RESULTS Total scores increased (comprehensiveness: +12.4, P < .001, 95% confidence interval, 8.1-16.7; strength: +13.5, P < .001, 95% CI, 9.3-17.7). Improvements were also found for comprehensiveness by section, except Nutrition Education, and for strength across all sections. Qualitative findings suggest that SNAP-Ed interventions combined with state and federal influence contributed to the improvements. CONCLUSIONS AND IMPLICATIONS Local wellness policies in SNAP-Ed-supported districts improved over time. State and federal LWP guidelines can work synergistically with SNAP-Ed interventions to influence improvements.
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Affiliation(s)
- Theresa A LeGros
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ.
| | - Laurel E Jacobs
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ
| | - Gregory L Goodman
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ
| | - Kathryn M Orzech
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ
| | - Elizabeth Holmes
- Arizona Department of Health Services, Bureau of Nutrition and Physical Activity, Phoenix, AZ
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Schwartz MB, Piekarz-Porter E, Read MA, Chriqui JF. Wellness School Assessment Tool Version 3.0: An Updated Quantitative Measure of Written School Wellness Policies. Prev Chronic Dis 2020; 17:E52. [PMID: 32614770 PMCID: PMC7367066 DOI: 10.5888/pcd17.190373] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Schools play an important role in promoting student wellness. As directed by the Healthy Hunger-Free Kids Act, the US Department of Agriculture updated the requirements for written school wellness policies in 2016. The WellSAT (Wellness School Assessment Tool) is an online tool that provides a quantitative score for wellness policy comprehensiveness and strength. The WellSAT has been updated 3 times over the past decade to remain current with federal law and best practices. In this article, we describe the process of updating to WellSAT 3.0. The steps included: reviewing the language of each item linked to a federal provision; adding and deleting items based on frequencies from the National Wellness Policy Study and the empirical support for specific policies; gathering feedback from a survey of experts (N = 77) about best practices and measure usability; and establishing intercoder reliability in a national sample (N = 50) of policies. We conclude with recommendations and guidance for the use of WellSAT 3.0.
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Affiliation(s)
- Marlene B Schwartz
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut.,Department of Human Development and Family Sciences, Director, Rudd Center for Food Policy and Obesity, University of Connecticut, 1 Constitution Plaza, Suite 600, Hartford, CT 06103.
| | - Elizabeth Piekarz-Porter
- Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Margaret A Read
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut
| | - Jamie F Chriqui
- Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, Chicago, Illinois
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Boehm R, Schwartz MB, Lowenfels A, Brissette I, Pattison MJ, Ren J. The Relationship between Written District Policies and School Practices among High-Need Districts in New York State. THE JOURNAL OF SCHOOL HEALTH 2020; 90:465-473. [PMID: 32220074 DOI: 10.1111/josh.12896] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 09/13/2019] [Accepted: 12/20/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND This study tested the hypothesis that written district wellness policies are associated with higher rates of implementation of nutrition and physical activity practices. METHODS Written wellness policies and building level practices were assessed for schools (N = 295) within high-need districts (N = 70) in New York State. The relationship between policies and practices was measured using multi-level mixed-effects logistic regressions. RESULTS Overall, stronger written district policies significantly increase the likelihood of practice implementation in schools. This relationship is strongest for physical education and physical activity items, followed by nutrition standards for competitive foods in middle and high schools. Most elementary schools implemented nutrition practices with or without a policy and there were differences in implementation rates between elementary and middle/high schools. When examined separately, policies were for the most part not significantly associated with implementation of corresponding practices. CONCLUSIONS Strong and comprehensive written policies are associated with higher rates of practice implementation overall, but the consistency of this relationship varies by policy-practice domain. The newer policy topics areas of school wellness promotion and marketing were less frequently included in written policies. Future research should examine whether districts that strengthen their written policies achieve greater implementation over time.
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Affiliation(s)
- Rebecca Boehm
- Food and Environment Program, Union of Concerned Scientists, 1825 K Street, NW, Suite 800, Washington, DC, 20006
| | - Marlene B Schwartz
- Rudd Center for Food Policy and Obesity, University of Connecticut, 1 Constitution Plaza, Suite 600, Hartford, CT, 06103
| | - Ann Lowenfels
- New York State Department of Public Health, 1084 Corning Tower, Empire State Plaza, Albany, NY, 12237
| | - Ian Brissette
- New York State Department of Public Health, 1084 Corning Tower, Empire State Plaza, Albany, NY, 12237
| | - Mary Jo Pattison
- New York State Department of Public Health, 1084 Corning Tower, Empire State Plaza, Albany, NY, 12237
| | - Jia Ren
- New York State Department of Public Health, 1084 Corning Tower, Empire State Plaza, Albany, NY, 12237
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Hildebrand DA, Betts NM, Gates GE. Parents' Perceptions of Childhood Obesity and Support of the School Wellness Policy. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:498-504. [PMID: 30737096 DOI: 10.1016/j.jneb.2018.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 12/10/2018] [Accepted: 12/17/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Investigate differences in familiarity of parents of school-aged children with school wellness polices (SWP) and perceptions of the problem of childhood obesity related to support for the SWP and school's role in providing a healthy environment. METHODS Descriptive, cross-sectional study using telephone surveys conducted in spring, 2016. T test statistics compared differences between parents with high vs low SWP familiarity and agreement vs disagreement of childhood obesity as problematic. RESULTS Nearly half of parents (49.5%) had low familiarity with SWP. Overall, fewer parents agreed that obesity was a local school problem compared with a statewide problem (P < .001). Differences in agreement about childhood obesity explained some differences in SWP support. CONCLUSIONS AND IMPLICATIONS Greater awareness is needed among parents of schoolchildren regarding the SWP as well as the prevalence of childhood obesity. This could be achieved through increased development, implementation, and evaluation of communication efforts between schools and families regarding health-promoting environments.
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Affiliation(s)
- Deana A Hildebrand
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK.
| | - Nancy M Betts
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK
| | - Gail E Gates
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK
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Development and Validation of the Policies, Opportunities, Initiatives and Notable Topics (POINTS) Audit for Campuses and Worksites. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050778. [PMID: 30836633 PMCID: PMC6427413 DOI: 10.3390/ijerph16050778] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/19/2019] [Accepted: 02/26/2019] [Indexed: 12/22/2022]
Abstract
Background: Workplace or campus wellness/obesity-prevention policies and initiatives can improve health. Research tools to assess worksite or campus policies/initiatives are scarce. Thus, the aim of this research is to develop and validate the policies, opportunities, initiatives, and notable topics (POINTS) audit. Methods: POINTS was developed and refined via expert review, pilot-testing, and field testing. Trained researchers completed a web-based review from a student-focus or employee-focus regarding 34 health-promoting topics for colleges. Each topic was evaluated on a 0⁻2 scale: 0 = no policy/initiative, 1 = initiatives, 2 = written policy. When a written policy was detected, additional policy support questions (administered, monitored, reviewed) were completed. Results: Cronbach's Alpha for the student-focused POINTS audit was α = 0.787 (34 items, possible points = 65), and for the employee-focused POINTS audit was α = 0.807 (26 items, possible points = 50). A total of 115 student-focused and 33 employee-focused audits were completed. Although there was little evidence of policy presence beyond stimulant standards (smoking and alcohol), there were extensive examples of health initiatives. The student-focused POINTS audit was validated using the Healthier Campus Initiative's survey. Conclusions: POINTS is a web-based audit tool that is valid and useful for pre-assessment, advocacy, benchmarking, and tracking policies for health and well-being for students (campus) and employees (worksite).
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Saluja K, Rawal T, Bassi S, Bhaumik S, Singh A, Park MH, Kinra S, Arora M. School environment assessment tools to address behavioural risk factors of non-communicable diseases: A scoping review. Prev Med Rep 2018; 10:1-8. [PMID: 29868351 PMCID: PMC5984208 DOI: 10.1016/j.pmedr.2018.01.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 01/09/2018] [Accepted: 01/20/2018] [Indexed: 11/19/2022] Open
Abstract
We aimed to identify, describe and analyse school environment assessment (SEA) tools that address behavioural risk factors (unhealthy diet, physical inactivity, tobacco and alcohol consumption) for non-communicable diseases (NCD). We searched in MEDLINE and Web of Science, hand-searched reference lists and contacted experts. Basic characteristics, measures assessed and measurement properties (validity, reliability, usability) of identified tools were extracted. We narratively synthesized the data and used content analysis to develop a list of measures used in the SEA tools. Twenty-four SEA tools were identified, mostly from developed countries. Out of these, 15 were questionnaire based, 8 were checklists or observation based tools and one tool used a combined checklist/observation based and telephonic questionnaire approach. Only 1 SEA tool had components related to all the four NCD risk factors, 2 SEA tools has assessed three NCD risk factors (diet/nutrition, physical activity, tobacco), 10 SEA tools has assessed two NCD risk factors (diet/nutrition and physical activity) and 11 SEA tools has assessed only one of the NCD risk factor. Several measures were used in the tools to assess the four NCD risk factors, but tobacco and alcohol was sparingly included. Measurement properties were reported for 14 tools. The review provides a comprehensive list of measures used in SEA tools which could be a valuable resource to guide future development of such tools. A valid and reliable SEA tool which could simultaneously evaluate all NCD risk factors, that has been tested in different settings with varying resource availability is needed.
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Affiliation(s)
- Kiran Saluja
- Health Promotion Division, Public Health Foundation of India, India
| | - Tina Rawal
- Health Promotion Division, Public Health Foundation of India, India
| | - Shalini Bassi
- Health Promotion Division, Public Health Foundation of India, India
| | | | - Ankur Singh
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Australia
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Min Hae Park
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Monika Arora
- Health Promotion Division, Public Health Foundation of India, India
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Hoffman PK, Davey CS, Larson N, Grannon KY, Hanson C, Nanney MS. School district wellness policy quality and weight-related outcomes among high school students in Minnesota. HEALTH EDUCATION RESEARCH 2016; 31:234-246. [PMID: 26850060 PMCID: PMC4980870 DOI: 10.1093/her/cyv101] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 12/20/2015] [Indexed: 06/05/2023]
Abstract
Weight-related outcomes were examined among high school students in Minnesota public school districts according to the quality of district wellness policies. Wellness policy strength and comprehensiveness were scored using the Wellness School Assessment Tool (WellSAT) for 325 Minnesota public school districts in 2013. The associations between WellSAT scores and district-level means of high school student responses to a statewide survey of health behaviors were examined in this ecologic study. WellSAT Total Strength and Total Comprehensiveness scores were positively associated with both student mean Body Mass Index (BMI) percentile (Strength: P = 0.018, Comprehensiveness: P = 0.031) and mean percent overweight or obese (Strength: P = 0.008, Comprehensiveness: P = 0.026), but only in districts with > 50% of students eligible for Free or Reduced-Price Lunches (FRPLs), or 'high FRPL districts'. WellSAT Physical Education and Physical Activity subscale scores were also positively associated with the mean days per week students engaged in physical activity for ≥ 60 min in high FRPL districts (Strength: P = 0.008, Comprehensiveness: P = 0.003) and in low FRPL districts (< 35% eligible) for Strength score: (P = 0.027). In medium FRPL districts (35-50% eligible), Nutrition Education and Wellness Promotion Strength and Comprehensiveness subscale scores were positively associated with, respectively, daily servings of vegetables (P = 0.037) and fruit (P = 0.027); and WellSAT Total scores were positively associated with daily vegetable servings (Strength: P = 0.037, Comprehensiveness: P = 0.012). Administrators of economically disadvantaged school districts with a higher percentage of overweight students may be recognizing the need for stronger wellness policies and the specific importance of implementing policies pertaining to physical activity as a means to improve student health.
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Affiliation(s)
- Pamela K Hoffman
- Department of Family Medicine and Community Health, Program in Health Disparities Research,
| | - Cynthia S Davey
- Biostatistical Design and Center, Clinical and Translational Science Institute
| | - Nicole Larson
- School of Public Health, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, USA and
| | - Katherine Y Grannon
- Department of Family Medicine and Community Health, Program in Health Disparities Research
| | - Carlie Hanson
- College of Public Health, Temple University, Philadelphia, PA, USA
| | - Marilyn S Nanney
- Department of Family Medicine and Community Health, Program in Health Disparities Research
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Abstract
OBJECTIVE To compare the strength of district wellness policies with corresponding school-level practices reported by principals and teachers. DESIGN District-level wellness policy data were collected from school district websites and, if not available online, by requests made to district administrators in the autumn of 2013. The strength of district policies was scored using the Wellness School Assessment Tool. School-level data were drawn from the 2012 Minnesota School Health Profiles principal and teacher surveys and the National Center for Education Statistics Common Core Data. Generalized estimating equations which accounted for school-level demographics and the nesting of up to two schools within some districts were used to examine ten district policy items and fourteen school-level practices of relevance to nutrition standards, nutrition education and wellness promotion, and physical activity promotion. SETTING State-wide sample of 180 districts and 212 public schools in Minnesota, USA. RESULTS The mean number of energy-dense, nutrient-poor snack foods and beverages available for students to purchase at school was inversely related to the strength of district wellness policies regulating vending machines and school stores (P=0·01). The proportion of schools having a joint use agreement for shared use of physical activity facilities was inversely related to the strength of district policies addressing community use of school facilities (P=0·03). No associations were found between the strength of other district policies and school-level practices. CONCLUSIONS Nutrition educators and other health professionals should assist schools in periodically assessing their wellness practices to ensure compliance with district wellness policies and environments supportive of healthy behaviours.
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