Issue 1, Spring 2008

School Wellness Policies: Employee Participation in the Development Process and Perceptions of the Policies


ABSTRACT

Objectives
This study was undertaken to describe school employees’ participation in the Local Wellness Policy (LWP) development process, assess satisfaction with LWPs, identify concerns related to implementation, and identify strategies to facilitate successful policy implementation.

Methods
A 39-item survey instrument was developed and distributed to 130 participants following five presentations about school nutrition environments. Descriptive statistics were done using SPSS software.

Results
One hundred surveys were returned (response rate = 77%). Respondents included school foodservice directors (SFDs) (n= 28), cafeteria managers (n = 22), other school foodservice (SFS) employees (n= 31), teachers (n = 6), secretaries (n = 5), school nurses (n = 3), and five other job titles. Forty-five respondents, indicated involvement in LWP development. Twenty-five of the 28 SFDs indicated being involved, but only five cafeteria managers and 2 other SFS employees indicated involvement. Of the 49 employees not involved, 28 were not familiar with their LWP. Respondents who were involved in policy development were fairly satisfied with the policy (mean=3.9 ± 1.0, on a 5-point scale with 5 being “very satisfied”). Top concerns about implementation were related to cost, support from key stakeholders, and enforcement. Needs were identified related to communication of data demonstrating links between LWPs and both students’ health and academic achievement.

Application to Child Nutrition Professionals
This study identified a need for communication about LWPs to those not involved in development of the policies, including SFS employees. Since the majority of SFDs indicated involvement in policy development, SFDs should capitalize on this opportunity to continue to advocate for student health and wellness, promote the benefits of school meals, and market LWPs to the school community.


INTRODUCTION

The Child Nutrition and WIC Reauthorization Act of 2004 (Public Law 108-265) mandated that all school districts that sponsor school meal programs develop wellness policies to address childhood obesity by the start of the 2006/2007 School Year. This requirement was ground-breaking in several ways. First, it represented a milestone in national efforts to address the growing problem of childhood obesity through school environments. Second, it mandated school districts to undertake a process to come to a common vision at the local level for ways to address a national objective. This represented a novel undertaking for many school districts, as research suggests that few school wellness policies, especially comprehensive policies, existed prior to the 2004 legislation (Barratt, Cross, Mattfeldt-Beman, & Katz, 2004; McDonnell, Probart, Weirich, Hartman, & Bailey-Davis, 2006).

The wellness policy requirement is broad in its intended reach. Specifically, the mandate states that, at a minimum, the wellness policy is required to (1) include goals for nutrition education, physical activity, and other school-based activities that are designed to promote student wellness; (2) include nutrition guidelines for all foods available on each school campus during the school day with the objectives of promoting student health and reducing childhood obesity; (3) provide an assurance that guidelines for reimbursable school meals shall not be less restrictive than regulations and guidance issued by the Secretary of Agriculture; (4) establish a plan for measuring implementation of the local wellness policy, including designation of one or more persons responsible for ensuring that the school meets the local wellness policy; and (5) involve parents, students, representatives of the school food authority, the school board, school administrators, and the public in the development of the school wellness policy (Child Nutrition and WIC Reauthorization Act of 2004).

State agencies that administer school meals programs are charged with monitoring adherence to the wellness policy requirement at the state-level. Therefore, it seems logical that school foodservice directors (SFDs) would play a role in policy development. However, previous research suggests that SFDs are not typically involved in school policy development and may not feel comfortable with playing a leadership role in this process (McDonnell, Probart, & Weirich 2006). Research also suggests weak enforcement of existing policies (McDonnell. Probart, Weirich, Hartman, et al., 2006). Concerns have also been raised by SFDs about the cost and time associated with policy implementation and the need for buy-in for the policy from key stakeholders (McDonnell, Probart, & Weirich 2006; Probart, Snow-Telfer, & McDonnell, 2006). Findings from two studies regarding school nutrition and competitive food policies revealed different perceptions among SFDs and school administrators regarding the existence of such policies in their schools, suggesting possible weaknesses in communication about policies and/or lack of involvement of key stakeholders in policy development (French, Story, Fulkerson, & Gerlach, 2003; McDonnell, Probart, Weirich, Hartman, et al., 2006). Given that the majority of school districts have recently gone through the process of policy development and have established wellness policies, questions remain about school employees’ involvement in the development process and their perceptions of the policies and whether or not earlier expressed concerns about the policies still exist.

This study was undertaken to describe school employees’ participation in the Local Wellness Policy (LWP) development process, assess satisfaction with LWPs, identify concerns related to implementation, and identify strategies to facilitate successful policy implementation.


METHODOLOGY

This study was approved by the Institutional Review Board at the Pennsylvania State University.

A 39-item survey instrument was developed including questions about involvement in development of the LWP, the policy development process, satisfaction with the policy, concerns about policy implementation, and strategies to facilitate policy implementation. Questions were developed based on a review of the literature related to school nutrition and wellness policies. The survey was reviewed by a panel of four nutrition and school foodservice experts and revised based on their comments.

The survey was distributed to 130 participants who voluntarily attended workshops on environmental nutrition strategies to improve students’ food choices in schools between September and October 2006. These presentations were geographically disbursed throughout the state of Pennsylvania with two in the northeastern portion of the state, one in the southeast, one in central Pennsylvania, and one in western Pennsylvania. The sessions were advertised to school foodservice employees, teachers, school administrators, and school nurses.

The survey data were analyzed using SPSS software (SPSS base 11.5 for Windows, 2002, SPSS Inc. Chicago, IL.)


RESULTS AND DISCUSSION

Table 1. School Employees’ Reported Involvement in Wellness Policy Development and Familiarity with the Wellness Policy (n=100)

    Entire Sample (n=100) SFDsa (n=28) Cafeteria Managers (n= 22) Other SFSb Employees(n=31)
Were you involved in development of your school district’s Local Wellness Policy? yes 45 25 5 2
no 49 3 16 25
missing 6 0 1 4
If you were not involved, were you given the opportunity to be involved? yes 6 1 4 1
no 40 1 11 23
missing 3 1 1 1
If you were not involved, are you familiar with your district’s Local Wellness Policy? yes 19 3 7 7
no 28 0 9 17
missing 2 0 0 1

aSFDs = School foodservice directors
bSFS = School food service

Because it was determined that questions related to the wellness policy development process could only be answered accurately by individuals involved in development of the policy, further data were analyzed using only the responses from those respondents who indicated they were involved in this process (n=45). Among these respondents, one indicated that the wellness policy team held no meetings during the 2005/2006 school year. Eighteen indicated the team met between 1-4 times; twenty-four indicated the team met 5-8 times; and two reported more than 8 meetings. Thirty-six indicated that students were involved in policy development and forty-two indicated parents were involved. This reported high level of student and parent involvement is not surprising given the law’s requirement that these groups be represented and the need for buy-in and support from these groups.

Only one individual indicated that his/her concerns and interests were not considered in development of their policy. Ten individuals indicated their concerns were partially addressed and the majority (n=32) indicated their concerns were addressed.

Satisfaction with the wellness policy and perceived impact of the wellness policy were assessed among those individuals who were involved in development of the policies as well as those who were not involved but indicated familiarity with the policy (n=65). These data are presented in Table 2. Respondents indicated a fairly high level of satisfaction with the policy. Also, considering the wide array of factors impacting children’s physical activity and eating habits, respondents indicated a fairly high level of agreement that school wellness policies will have a positive impact on eating and physical activity habits of children both locally and nationwide.

Table 2. School Employees’ Satisfaction with and Perceived Effects of the Local Wellness Policy (n= 65)

  Mean ± SD
How satisfied are you with the final version of the Local Wellness Policy?a 3.9 ± 1.0
My school district’s Local Wellness Policy will have a positive impact on eating and physical activity habits of children.b 6.8 ± 2.3
Nationwide, Local Wellness Policies will have a positive impact on eating and physical activity habits of children. b 6.8 ± 2.3

a (5-point scale with 1= very dissatisfied and 5 = very satisfied)
b (10-point scale with 1- strongly disagree and 10 = strongly agree)

These same respondents (those involved in policy development and those not involved but familiar with the policy) were asked to rate their level of concern about a variety of factors related to wellness policy implementation. These data are presented in Table 3. Top concerns were related to cost, support and acceptance from key stakeholders, and local level enforcement. These findings are consisted with previously reported findings (McDonnell, Probart, & Weirich, 2006; McDonnell, Probart, Weirich, Hartman, et al., 2006; Probart et al., 2006).

Table 3. School Employees’ Concerns about Local Wellness Policy Implementation (n=65)

  Mean ± SD
Costa 7.0 ± 2.4
Support from teachersa 7.0 ± 2.3
Local level enforcementa 6.9 ± 2.2
Student acceptance a 6.8 ± 1.8
Support from administratorsa 6.8 ± 2.7
Support from parentsa 6.4 ± 2.1
My time commitmenta 6.3 ± 2.4
Lack of clear vision about implementation steps/plana 6.2 ± 2.0

a 10 point scale with 1 = not concerned and 10 = very concerned

All of the respondents were asked to rate the usefulness of a variety of strategies and materials to facilitate implementation of wellness policies. These data are presented in Table 4. While there was little variability among the five items, the top selections were communication of data related to links between wellness policies and students’ health and communication of data related to links between wellness policies and academic achievement. While associations have been reported between nutrition and both students’ health and academic performance (Alaimo, Olson, & Frongillo, 2001; Murphy et al., 1998) as well as between physical activity and students’ health and academic performance (Dwyer, Sallis, Blizzard, Lazarus, & Dean, 2001; Shephard, 1997), given the recent introduction of school wellness policies, student-level outcomes related to wellness policies have not yet been reported. This is an area worthy of future investigation.

Table 4. School Employees’ Perceived Usefulness of Methods and Materials to Support Local Wellness Policy Implementation (n=100)

  Mean ± SD
Communication of data related to link between wellness policies and students’ healtha 3.9 ± 0.9
Communication of data related to link between wellness policies and students’ academic achievementa 3.9 ± 0.9
Models for successful implementationa 3.8 ± 0.8
Strategies for student involvementa 3.8 ± 1.0
Suggested steps for implementation (Administrative guidance)a 3.6 ± 0.9

a 5 point scale with 1 = not helpful and 5 = very helpful


CONCLUSIONS AND APPLICATIONS

Local wellness policies have been mandated in an attempt to address the issue of childhood obesity through school environments. Much work has been done by school personnel to develop these policies and by representatives of State agencies and other organizations to provide assistance to schools in this development process. However, to be truly effective, the policies must be marketed to the entire school community, implemented, and enforced. This study, while not generalizable, provides useful information for schools and other groups interested in assisting schools to accomplish these tasks.

This study found a high level of school foodservice director involvement in the policy development process. This finding, coupled with the finding that the large majority of individuals involved in this process felt that their interests and concerns were considered, suggests that school foodservice issues were considerations in the policy development process. An earlier report conducted prior to LWP development identified a concern among some SFDs that members of the policy development team may be interested in advancing their own special interests and advocating changes that could be detrimental to school foodservice operations (McDonnell, Probart, & Weirich, 2006). These current findings suggest that this concern may be unfounded.

While SFDs were highly involved in policy development, this study found that other SFS employees were much less likely to be involved, and much more likely to be unfamiliar with their school district’s LWP. The finding that SFS employees were not involved in policy development is not surprising. However, SFDs should be encouraged to promote policies to their staff so they are aware of the policy goals and implementation strategies. An understanding of the rationale for potential changes in the school food environment and the plans for making these changes can facilitate SFS employees role in promoting healthy choices to students. While not specifically examined, our findings suggest potential weaknesses in communication about LWPs to those who were not involved in the development process. Schools should implement strategies to make the entire school community aware of their LWP. This could be done through presentations at parent/teacher, faculty, and school board meetings; articles in school and local newspapers; targeted mailings to parents, teachers, and SFS staff; features on school websites; and other means.

Both satisfaction with the LWP and agreement that the policy will positively impact students’ eating and physical activity habits were fairly high, indicating confidence in and enthusiasm for the policy. These positive perceptions suggest optimism that the LWPs will meet their intended purpose.

The top concerns identified included issues related to cost, support for or acceptance from teachers, students, and administrators, and local level enforcement. This survey did not allow for details related to the cost issue so one can only speculate on the area of specific concern. The authors’ earlier work suggested cost concerns related to loss of funds due to removal of less nutritious options and costs related to adding more nutrition education and physical education to the curriculum (McDonnell, Probart, & Weirich, 2006). Schools could track the fiscal impact of their policies to determine if cost is an area of concern. Several groups have documented cost implications of policy changes in specific schools and found the effects to be either cost-neutral or revenue-generating (Center for Weight and Health, 2007; Food and Nutrition Service, U. S. Department of Agriculture, Centers for Disease Control and Prevention, U. S. Department of Health and Human Services, & U. S. Department of Education, 2005; French et al., 2001). These examples, along with suggestions for implementation, should be shared with other schools through print and/or video-based materials, conferences and workshops, or websites.

The concern related to buy-in from key stakeholders is consistent with the literature in this area (McDonnell, Probart, & Weirich, 2006; Probart et al., 2006). Marketing strategies will be needed to promote the policies to a variety of audiences and to provide a venue for collecting feedback from these audiences to incorporate into policy revisions and/or implementation strategies. Documented positive impacts of the policies should be shared with these groups.

Local level enforcement remains a concern, as identified in earlier reports (McDonnell, Probart, & Weirich, 2006; McDonnell, Probart, Weirich, Hartman, et al., 2006). This is an area worthy of particular attention since poorly enforced policies are not likely to meet the intended goal of the wellness policy mandate. Plans should be delineated providing specific enforcement responsibilities. Enforcement of the policy should be evaluated on a regular basis. If not addressed in the policy itself, these plans, responsibilities, and evaluation strategies should be detailed in the procedures or guidelines related to the policy. In all communication about the policy, individuals or groups with the authority for enforcement should be identified.

Data relating wellness policies to both students’ health and academic achievement were identified as the most useful items to facilitate successful policy implementation. Schools could potentially track such data on their own or partner with a university to do so. On a state or national level, research is needed to document these potential associations on a more generalizable level. Current data exists linking both nutrition and physical activity to health and academic achievement (Alaimo et al., 2001; Dwyer et al., 2001; Murphy et al., 1998; Shephard, 1997). These data should continue to be shared with schools to provide the rationale and anticipated outcomes of LWP implementation.

This study has documented positive findings related to the role of SFDs in development of LWPs, satisfaction with the policies, and the perception that the policies will meet their intended purpose. However, it has also identified concerns related to communication, cost, enforcement, and documentation of positive outcomes of policy implementation that should be addressed by schools, state agencies, policy makers, and funding agencies.


REFERENCES

Alaimo, K., Olson, C. M., & Frongillo, E. A. (2001). Food insufficiency and American school-aged children’s cognitive, academic, and psychosocial development. Pediatrics, 108(1): 44-53.

Barratt, R. D., Cross, N. A., Mattfeldt-Beman, M. K., Katz, B. M. (2004). School policies that promote healthy eating: A survey of foodservice directors in North Carolina public schools. The Journal of Child Nutrition and Management, 1. Retrieved January 21, 2008 from http://docs.schoolnutrition.org/newsroom/jcnm/04spring/barratt/.

Center for Weight and Health, University of California, Berkeley. (2007). Dollars and sense: The financial impact of selling healthier school foods. Retrieved January 21, 2008 from http://www.cnr.berkeley.edu/cwh/PDFs/Dollars_and_Sense_FINAL_3.07.pdf.

Child Nutrition and WIC Reauthorization Act of 2004, P.L. No. 108-265, § 204, 118 Stat. 204. (2004).

Dwyer, T., Sallis, J. F., Blizzard, L., Lazarus, R., & Dean, K. (2001). Relation of academic performance to physical activity and fitness in children. Pediatric Exercise Science, 13, 225-238.

Food and Nutrition Service, U. S. Department of Agriculture; Centers for Disease Control and Prevention, U. S. Department of Health and Human Services; and U. S. Department of Education. FNS-374, (2005). Making it happen! School nutrition success stories. Alexandria, VA. Retrieved January 21, 2008 from http://www.fns.usda.gov/TN/Resources/makingithappen.html.

French, S.A., Jeffery, R.W., Story, M., Breitlow, K.K., Baxter, J.S., Hannan P., et al. (2001). Pricing and promotion effects on low-fat vending snack purchases: The CHIPS study. American Journal of Public Health, 91, 112-117.

French, S. A., Story, M., Fulkerson, J. A., & Gerlach, A.F. (2003). Food environment in secondary schools: A la carte, vending machines, and food policies and practices. American Journal of Public Health, 93, 1161-1167.

McDonnell, E., Probart, C.K., Weirich, J.E. (2006). School foodservice directors’ perceptions and concerns about local wellness policy development, implementation, and enforcement. The Journal of Child Nutrition and Management, 1. Retrieved January 21, 2008 from http://docs.schoolnutrition.org/newsroom/jcnm/06spring/mcdonnell/index.asp.

McDonnell, E., Probart, C., Weirich, J. E., Hartman, T., & Bailey-Davis, L. (2006). School competitive food policies: Perceptions of Pennsylvania public high school foodservice directors and principals. Journal of the American Dietetic Association, 106, 271-6.

Murphy, J. M., Pagano, M. E., Nachmani, J., Sperling, P., Kane, S., & Kleinman, R.E. (1998). The relationship of school breakfast to psychosocial and academic functioning: Cross-sectional and longitudinal observations in an inner-city school sample. Archives of Pediatric and Adolescent Medicine, 152, 899-907.

Probart, C., Snow-Telfer, H., & McDonnell, E. (2006). Use of stakeholder theory to examine groups salient in decisions related to a la carte offerings. The Journal of Child Nutrition and Management, 2, Retrieved January 21, 2008 from http://docs.schoolnutrition.org/newsroom/jcnm/06fall/probart/index.asp.

Shephard, R.J. (1997). Curricular physical activity and academic performance. Pediatric Exercise Science, 9, 113-126.


BIOGRAPHY

McDonnell and Probart are, respectively, project coordinator and associate professor for the Department of Nutritional Sciences at The Pennsylvania State University in University Park, PA.

Journal of Child Nutrition & Management | School Nutrition Association