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Kolbe LJ. The Future of School Health Education in the United States: An Ontology. THE JOURNAL OF SCHOOL HEALTH 2024; 94:661-673. [PMID: 38268088 DOI: 10.1111/josh.13436] [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: 07/23/2023] [Revised: 11/29/2023] [Accepted: 12/18/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND As summarized in this article, the widespread implementation of modern school health education (SHE) could become one of the most effective means available to improve the well-being of people in the United States and in other nations. However, the development and evolution of SHE largely remains unorganized, underdeveloped, and neglected by health and education agencies, policymakers, and the public. METHODS Essential to the development of any scientific discipline, scientists today use the word ontology to refer to efforts to organize knowledge in particular domains. A useful working definition of a scientific ontology is an explicit, formal specification of a shared conceptualization-a systematic set of shared terms and an explication of their interrelationships. Nine interdependent questions are outlined to help guide the development of an initial, broad, and actionable scientific ontology for SHE. RESULTS Whether and how we respond to these questions arguably will determine the future of SHE research, policy, practice, and equity in the United States. CONCLUSIONS An initial ontology might help conceptualize, inform, and facilitate more systematic and strategic local, state, national, and international deliberations and actions to improve SHE.
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Affiliation(s)
- Lloyd J Kolbe
- Indiana University School of Public Health-Bloomington, c/o 1205 St. George's Lane, Vero Beach, FL, 32967
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Chung CS, Sliwa SA, Merlo C, Erwin H, Xu Y. Coordinated Approach: Comprehensive Policy and Action Planning. THE JOURNAL OF SCHOOL HEALTH 2023; 93:853-863. [PMID: 37670595 DOI: 10.1111/josh.13376] [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: 04/07/2023] [Accepted: 06/22/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Schools play a vital role in student health, and a collaborative approach may affect health factors such as physical activity (PA) and nutrition. There is a lack of recent literature synthesizing collaborative approaches in K-12 settings. We present updated evidence about interventions that used a coordinated school health approach to support K-12 student PA and nutrition in the United States. METHODS A 2-phase literature review search included a search of systematic reviews for individual qualifying studies (2010-2018), followed by a search for individual articles (2010-2020) that evaluated a coordinated approach or use of school wellness councils, committees, or teams to address PA and/or nutrition. RESULTS We identified 35 articles describing 30 studies and grouped them by intervention type. Interventions demonstrated promising findings for environmental changes and student dietary and PA behaviors. IMPLICATIONS Coordinated and multicomponent interventions demonstrated significant improvements or null results, indicating that implementation of programs and/or policies to promote healthier eating and PA practices may support and do not appear to hinder environmental or behavioral outcomes. CONCLUSIONS Schools can use a coordinated approach to implement opportunities for PA and nutrition; this may influence students' PA and dietary behaviors.
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Affiliation(s)
- Chloe S Chung
- Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Sarah A Sliwa
- Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion
| | - Caitlin Merlo
- Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion
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Lee SM, Szucs LE, Young E, Fahrenbruch M. Using Health Education to Address Student Physical Activity and Nutrition: Evidence and Implications to Advance Practice. THE JOURNAL OF SCHOOL HEALTH 2023; 93:788-798. [PMID: 37670599 DOI: 10.1111/josh.13372] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/26/2023] [Accepted: 06/22/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND School-based health education can provide students with learning experiences that improve knowledge, attitudes, and perceptions (KAP) and behaviors regarding physical activity and nutrition. METHODS We conducted a 2-phase systematic review. Phase 1 was a review of reviews (ie, systematic reviews or meta-analyses) that were published 2010-2018. Phase 2 was a search for individual articles published 2010-2020 addressing topics relevant to our review; we searched for articles that had not been part of a sufficiently relevant or recent review or that had been part of a review that concluded that too few articles were available to assert sufficient evidence. RESULTS Forty-three studies were assessed: 20 randomized controlled trials and 23 quasi-experimental designs. Collectively, interventions had a favorable impact on students' PA and nutrition KAP, but behavioral and secondary outcome results (eg, body mass index) were mixed. CONCLUSIONS Using the evidence-based health education strategies identified in this review can help contribute to improvements in students' KAP and behaviors.
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Affiliation(s)
- Sarah M Lee
- Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Leigh E Szucs
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, GA
| | - Emily Young
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, GA
- Oak Ridge Institute of Science and Education (ORISE), Oak Ridge, TN
| | - Melissa Fahrenbruch
- Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
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Michael SL, Barnes SP, Wilkins NJ. Scoping Review of Family and Community Engagement Strategies Used in School-Based Interventions to Promote Healthy Behaviors. THE JOURNAL OF SCHOOL HEALTH 2023; 93:828-841. [PMID: 37670597 PMCID: PMC11181466 DOI: 10.1111/josh.13367] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/02/2023] [Accepted: 06/22/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND School efforts to promote health among students are more successful when families and community members are involved. METHODS We conducted a scoping review to summarize and categorize family and community engagement strategies used in US school and out-of-school time (OST) interventions to address physical activity (PA) and nutrition in kindergarten through 12th grade students. RESULTS The National Network of Partnership Schools' Six Keys to Success framework was useful in organizing the types of family and community engagement strategies used in included interventions. Many interventions used multiple family and community engagement strategies, with the most common being communicating with families and community members; providing support or education to families; and collaborations among school/OST program and community to support students and their families. CONCLUSIONS This review identified six common family and community engagement strategies used in school and OST interventions for PA and nutrition. Including family and community engagement strategies in school and OST interventions could play an important role in maximizing support, resources, and expertise to promote healthy behaviors among all students.
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Affiliation(s)
- Shannon L. Michael
- Senior Health Scientist, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Seraphine Pitt Barnes
- Senior Health Scientist, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Natalie J. Wilkins
- Health Scientist, TeamLead, Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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Merlo C, Smarsh BL, Xiao X. School Nutrition Environment and Services: Policies and Practices That Promote Healthy Eating Among K-12 Students. THE JOURNAL OF SCHOOL HEALTH 2023; 93:762-777. [PMID: 37670594 PMCID: PMC10502941 DOI: 10.1111/josh.13365] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/06/2023] [Accepted: 06/22/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Changes to policies at the federal, state, and local levels over the last decade have influenced the school nutrition environment and services. METHODS This systematic review includes an analysis of individual research articles and government reports published from 2010 to 2021 that examine interventions to improve the school nutrition environment and services and increase the availability, selection, and consumption of healthier foods and beverages in K-12 schools in the United States. RESULTS Nutrition standards for school meals and food outside of meals improved access to healthier options in school. Providing school nutrition professionals with professional development, improving the palatability of school meals, offering taste tests, pre-slicing fruit, providing recess before lunch, offering incentives for trying healthier options, and providing access to drinking water resulted in increased selection and consumption of healthier items. There were inconclusive or mixed findings for some intervention strategies including adequate seat time for meals. CONCLUSIONS Despite demonstrated improvements to school meal programs and competitive foods, more work is needed to change the selection and consumption of healthier options among K-12 students. Schools can use multiple interventions to improve the school nutrition environment and services and help students adopt food and beverage choices that support health.
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Affiliation(s)
- Caitlin Merlo
- Healthy Schools Branch, Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Brianna L Smarsh
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Xiangxue Xiao
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada Las Vegas, Las Vegas, NV
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Hawkins GT, Chung CS, Hertz MF, Antolin N. The School Environment and Physical and Social-Emotional Well-Being: Implications for Students and School Employees. THE JOURNAL OF SCHOOL HEALTH 2023; 93:799-812. [PMID: 37670600 DOI: 10.1111/josh.13375] [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: 05/08/2023] [Accepted: 06/22/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND The school environment, consisting of the physical environment and social-emotional climate (SEC), plays a crucial role in both student and employee health; however, there is a lack of recent literature synthesizing school environment interventions in K-12 settings. We describe updated evidence about school environment interventions to support K-12 student and employee health in the United States. METHODS A 2-phase search included a review of reviews (2010-2018), followed by a search for individual articles (2010-2020) that targeted school physical environment and/or SEC to address physical activity (PA) and/or nutrition. We also investigated how nutrition and PA interventions with an SEC component improves social-emotional and/or mental health outcomes. Because research on dietary and PA behaviors for school employees is limited; we included studies on other worksites (eg, hospitals and offices) to provide insight for school employees. FINDINGS We identified 40 articles describing 40 unique studies and 45 interventions and grouped them by intervention type. Physical environment interventions demonstrated significant and positive nutrition and PA behavioral outcomes for students; outcomes among employees were mixed. Interventions with SEC components reported improvements in some mental health outcomes. IMPLICATIONS The school environment can affect dietary and PA behaviors as well as mental health for students and employees. CONCLUSIONS Establishing healthy school environments can support student and employee PA, dietary behaviors, and mental health.
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Affiliation(s)
- Georgianne Tiu Hawkins
- Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Chloe S Chung
- Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Marci F Hertz
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, GA
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Pitt Barnes S, Lang JE. Supporting School Staff: Insights From Employee Health and Well-Being Programs. THE JOURNAL OF SCHOOL HEALTH 2023; 93:842-852. [PMID: 37670593 DOI: 10.1111/josh.13377] [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: 03/29/2023] [Accepted: 06/22/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND The workplace is an important setting for health protection, health promotion, and disease prevention programs. In the school setting, employee health and well-being programs can address many physical and emotional concerns of school staff. This systematic review summarizes evidence-based approaches from employee health and well-being interventions supporting nutrition and physical activity (PA) in a variety of workplace settings. METHODS The 2-phase systematic review included a search for articles within systematic reviews that met our criteria (addressing employee health and well-being programs; published 2010-2018; Phase 1) and the identification of individual articles from additional searches (addressing school-based employee interventions; published 2010-2020; Phase 2). We included 35 articles. FINDINGS Across all studies and types of interventions and workplace settings, findings were mixed; however, multicomponent interventions appeared to improve health behaviors and health outcomes among employees. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Schools can apply this evidence from employee health and well-being programs in various workplace settings to implement coordinated and comprehensive employee health and well-being programs. CONCLUSIONS Employee health and well-being programs may be effective at supporting nutrition and PA. Schools can use findings from employee health and well-being programs in workplaces other than schools to support school staff.
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Affiliation(s)
- Seraphine Pitt Barnes
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jason E Lang
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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Cornett K, Murfay K, Fulton JE. Physical Activity Interventions During the School Day: Reviewing Policies, Practices, and Benefits. THE JOURNAL OF SCHOOL HEALTH 2023; 93:778-787. [PMID: 37670602 PMCID: PMC11106808 DOI: 10.1111/josh.13371] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/02/2023] [Accepted: 06/22/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND There are many ways to increase physical activity (PA) during the school day as part of a Comprehensive School Physical Activity Plan. This article reviews policies and practices that can be used during the school day to increase PA for students. METHODS We searched systematic reviews for articles that met criteria (2010-2018, phase 1), followed by a search for individual articles addressing topics for which we did not identify a sufficiently relevant or recent review or to update an earlier review that concluded insufficient evidence (2010-2020, phase 2). We included 45 articles (45 studies, 54 interventions). RESULTS We grouped studies by intervention type: school-wide PA approaches to reach all students within the school setting (17), physical education (PE) interventions (13), and interventions related to recess (15). Few studies involved secondary schools or rural settings. Among 45 studies reporting PA behavior or fitness outcomes, 37 reported at least 1 improvement. CONCLUSIONS PA policies, PE, and recess can help improve school health by increasing the PA levels of students.
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Affiliation(s)
- Kelly Cornett
- Research Application and Evaluation Team, Healthy Schools Branch, Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Ken Murfay
- Department of Health, Sport & Exercise Sciences, The University of Kansas, School of Education and Human Sciences, Lawrence, KS
| | - Janet E. Fulton
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
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Sliwa SA, Chang Chusan YA, Dahlstrom C. Opportunities in the Extended Day: Approaches for Promoting Physical Activity and Healthy Eating During Out-of-School Time. THE JOURNAL OF SCHOOL HEALTH 2023; 93:813-827. [PMID: 37670603 PMCID: PMC11181343 DOI: 10.1111/josh.13370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND This systematic review aims to identify out-of-school time (OST) interventions (eg, programming, policies) that increased opportunities for physical activity (PA) and healthy eating and/or improved youth PA and dietary behaviors. METHODS We searched for articles within systematic reviews that met our criteria (2010-2018) and for individual articles (2010-2020). Reviewer pairs screened articles, double-extracted data, assessed risk of bias (RoB), and achieved consensus. We included 71 articles (55 studies, 60 intervention arms). RESULTS Health (n = 3) and nutrition education (n = 7) interventions showed promising results, but most used weak designs and had high RoB. PA-focused interventions (n = 23) were largely consistent in improving fitness and moderate to vigorous PA during programming. Programmatic interventions that improved both PA and nutrition outcomes engaged family or community members (n = 4/13). Most organizational policy interventions improved the nutrition environment and student PA during OST. CONCLUSIONS Organization-level policy and programmatic interventions can improve environmental supports and youth behaviors during OST programming, complementing school-day efforts to address student PA and dietary intake. To maximize their potential impact, OST programs need to be accessible to families. Administrators can consider actions to reduce participation barriers.
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Affiliation(s)
- Sarah A Sliwa
- Division of Population Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Yuilyn A Chang Chusan
- Tufts University Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Boston, MA
| | - Christina Dahlstrom
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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