Research Article Student Involvement in Wellness Policies: A Study of Pennsylvania Local Education Agencies Lamis H. Jomaa, PhD1; Elaine McDonnell, MS, RD1; Elaine Weirich, MEd1; Terryl Hartman, PhD, MPH, RD1; Leif Jensen, PhD2; Claudia Probart, PhD, RD1 ABSTRACT Objective: Explore student-involvement goals in local wellness policies (LWPs) of local education agencies (LEAs) in Pennsylvania (PA) and investigate associations with LEA characteristics. Design: An observational study that helped examine student-involvement goals. Setting: Public PA LEAs. Participants: LWPs submitted by 539 PA public LEAs. Main Outcome Measures: Six student-involvement goals analyzed as dependent variables. Correlations between demographic and policy characteristics of LEAs and student-involvement goals were measured. Analysis: Policies developed by LEAs were abstracted and analyzed. Logistic regression models were developed to analyze relationships between student-involvement goals and the demographic and policy characteristics of LEAs. Results: Majority of LEAs included policy goals that address student involvement in an array of activities related to wellness policy, food service, and role modeling. Regression models showed that LEAs with comprehensive and strong policies were most likely to include student-involvement goals regardless of LEA location, enrollment, or socioeconomic status of students. Conclusions and Implications: Student engagement in school nutrition policies has been shown to increase student acceptance in an array of health-related areas and is therefore promising in the area of obesity prevention. Comprehensiveness and rigor of LWPs were strongly correlated with the inclusion of student-involvement goals on LWPs. The upcoming reauthorization of the Child Nutrition programs in 2010 creates a good opportunity to address student involvement in LWPs. Key Words: school wellness policies, student involvement, child, obesity (J Nutr Educ Behav. 2010;42:372-379.)
INTRODUCTION Childhood obesity is a serious public health problem. The prevalence of obesity has tripled in the past 3 decades among children and adolescents in the United States (US).1 Thus, preventing childhood obesity has become a national concern that requires better understanding of the ‘‘obesogenic’’ environment in which children live.2,3 The Institute of Medicine considered schools a primary location where positive health messages could be dissem-
1
inated and modeled, and recommended that schools provide environments conducive to healthful eating and regular physical activity behaviors.4 According to a joint position paper on nutrition services published in 2003 by the American Dietetic Association, the Society for Nutrition Education, and the American School Food Service Association, recently known as the School Nutrition Association, schools can play a critical role in promoting healthful eating behaviors and physical activity to combat child-
Department of Nutritional Sciences, College of Health and Human Development, Pennsylvania State University, University Park, PA 2 Department of Agricultural Economics and Rural Sociology, College of Agricultural Sciences, Pennsylvania State University, University Park, PA Address for correspondence: Elaine McDonnell, MS, RD, 110 C Chandlee Laboratory, University Park, PA 16802; Phone: (814) 865-5869; Fax: (814) 863-6103; E-mail:
[email protected] Ó2010 SOCIETY FOR NUTRITION EDUCATION doi:10.1016/j.jneb.2009.07.012
372
hood obesity through comprehensive school nutrition policies and services, healthful school environments, and community participation.5 In an attempt to address childhood obesity, the federal government passed the Child Nutrition and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Reauthorization Act of 2004.6 The mandate required each local education agency (LEA) participating in the school meals program to develop a local wellness policy (LWP) and to involve various stakeholders— namely, students, parents, and representatives of the school food authority, the school board, school administrators, and the public—in the development process. In 2009, the federal Child Nutrition Program was scheduled for reauthorization, thus policy makers and nutrition professionals were given the opportunity to revise the current law, including the LWP mandate.
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Journal of Nutrition Education and Behavior Volume 42, Number 6, 2010 Participatory action research (PAR) and the concept of community involvement in the development, implementation, and evaluation of programs have been used successfully in various fields, including public health, and obesity and chronic disease prevention programs.7,8 Several school-based obesity prevention and intervention programs highlight community and family involvement in the development of nutritionfriendly school environments. These projects serve as good examples of how the PAR model can be used in the promotion of healthful eating and physical activity.9,10 Although the participation of various stakeholders from the school community is emphasized in the development and implementation of health education and promotion activities, rarely are students regarded as active participants in the decision-making process for these school health–related activities and programs. In the past decade, the importance of student involvement, or what is known as ‘‘student voice,’’ has reemerged as a topic of research and practical interest. Educators observed improvements in student outcomes upon the involvement of students in school policies, thus leading to more successful school reforms.11 The participation of students in decision making and establishment of strong collaborations between students and teachers have led to notable changes in school curricula, methods of instruction, and school policies.12 By empowering students to voice their opinions and involving them in school reform conversations, school administrators and teachers have learned that students have unique perceptions of their school environments and can bring new ideas and tackle existing challenges facing schools in the US.13 Strong partnerships between adults and students have not only led to improvements in the schools,14-16 but also have had a positive impact on youth development and self-confidence.17 In addition, higher levels of student involvement have been associated with higher levels of ownership, greater interest in academic achievement, and higher test scores.8 In the field of wellness policy, the concept of student involvement is still
in an early phase of development. Although the LWP mandate did not require student involvement beyond the development of the LWP, national organizations have advocated for students to be engaged in school wellness programs and activities to create buyin and maintain support for these initiatives.18-21 Researchers have previously expressed concerns about the lack of involvement of key stakeholders in the development of school wellness policies,22-24 and others have urged schools to engage students and youth groups in school wellness to improve policy implementation.25 To date, few studies have investigated the involvement of different stakeholders or the characteristics of schools that involve students in the development of school policies and the processes of implementation.25,26 The purpose of this study is to explore what goals related to student involvement were included in the LWPs of Pennsylvania (PA) LEAs and to identify factors associated with student participation in the implementation of LWPs.
METHODS Pennsylvania represented an ideal setting to conduct the current study because it has one of the highest numbers of National School Lunch Program (NSLP) sponsors in the country and a wide variation in enrollment and socioeconomic status of students within its LEAs. At the beginning of the 2006-2007 academic year, all PA LEAs participating in a federal meals program were required to submit an LWP to the Pennsylvania Department of Education (PDE) for review of compliance. The PDE and the Pennsylvania School Boards Association (PSBA) developed a local wellness policy template and encouraged PA LEAs to use it when developing their own wellness policies.27 Local education agencies could use the PSBA template goals or modify them, use other templates, or develop their own. Copies of the LWP that were submitted to PDE were then sent to this research group for abstraction and analysis. For the purpose of the current study, only public PA LEAs following a traditional school day format (school districts, charter schools, and intermediate units) were included in the anal-
Jomaa et al 373 ysis. Out of 543 public PA LEAs that met the inclusion criteria for this study, 539 LWPs were received and analyzed. This study was approved by the Institutional Review Board of the Pennsylvania State University.
Demographic and Policy Characteristics of LEAs Associations between demographic and policy characteristics of public PA LEAs and the inclusion of studentinvolvement goals in LWPs were explored. Demographic variables (LEA locale, enrollment, and percentage of students who are eligible for free and reduced-price meals [F/R rate]) were publicly available data.28,29 Policy characteristics were measured by comprehensiveness and rigor scores for each LWP compared to the PSBA template. As part of a larger study,26 the comprehensiveness score was calculated as the total count of goals included in each policy, excluding 6 specific student-involvement goals of the present research interest. In addition, a rigor score for each LWP was calculated as a ratio ([number of goals scored to be neutral þ the number of goals scored as strong compared to the PSBA template] / the total number of goals in the respective policy), excluding the 6 student-involvement goals. Both comprehensiveness and rigor scores were categorized into 2 groups: (1) less than the median and (2) greater than or equal to the median. Meeting the team membership requirement of the Child Nutrition and WIC Reauthorization Act was the third variable used to assess policy characteristics of public PA LEAs. This variable was collected through the LWP checklist that was developed by PDE and completed by a representative from each LEA. An LEA met the team membership requirement if the team that developed the policy included, at minimum, representatives from the 6 required groups, namely, students, parents, and representatives of the school food authority, the school board, school administrators, and the public.
Student-involvement Goals In the present study, the PSBA template was used as the policy abstraction tool
374 Jomaa et al because it was recommended by PDE and was used by most school districts (n ¼ 480; 96.2%). Policies were reviewed against this template, and the presence or absence of each template goal for each policy was recorded. As explained in an earlier publication, 5 research assistants that were trained on the various components of the LWPs abstracted goals from these policies against the PSBA template. Inter-rater reliability assessment was conducted throughout the abstraction process with an accuracy rate determined to be 99.7%.26 Six goals related to the involvement of students in LWPs were identified as dependent variables: (a) students serve as members of the ongoing school wellness committee/ school health advisory council; (b) students will be involved in reviewing their LEAs’ compliance with the new federal regulations and LWPs; (c) LEAs will conduct surveys to assess student needs; (d) LEAs will share the nutritional content of school meals with their students; (e) LEAs will involve students in the selection of school menus; and (f) LEAs will encourage students to be role models of healthful eating and physical activity behaviors through school outreach and community programs. One abstractor analyzed each of the 539 LWPs and binary-coded the 6 student-involvement goals. If the goal was included in a policy, it was coded 1. A student involvement goal would be coded with a score of 1 whether it was modified from the PSBA template or matched in language and content with the PSBA version of the goal. If the goal or the student component was not included in the policy, it was coded 0. For instance, LWPs that had the goal ‘‘nutritional content of school meals shall be available to students,’’ as stated in the PSBA template, were given a score of 1. An LWP that included a weaker version of this goal such as substituting the word ‘‘shall’’ with ‘‘should’’ or ‘‘may’’ were still given a score of 1, however, a LWP that lacks this goal or omits the word ‘‘students’’ from the goal was given a score of 0 for that specific goal. Another trained research assistant experienced in policy abstraction recoded 20 randomly selected policies. A Cohen k statistic was run to measure inter-rater agree-
Journal of Nutrition Education and Behavior Volume 42, Number 6, 2010 ment on scoring the 6 studentinvolvement goals. The 2 abstractors were at ‘‘perfect agreement’’ for 5 goals (k ¼ 1) and at a ‘‘good agreement’’ for 1 goal (k ¼ 0.75).
Data Analysis Data for all dependent and independent variables were entered and analyzed using SPSS software (version 15.0, SPSS, Inc., Chicago, IL, 2006). Local education agency was the unit of analysis. Descriptive and inferential statistical analyses were conducted. Logistic regression models were developed to analyze the relationships between student-involvement goals and the demographic and policy characteristics of LEAs. Odds ratios (OR) for the inclusion of the 6 studentinvolvement goals and their 95% confidence intervals (CI) were reported from the logistic regression models. Nagelkerke’s R-squared values were reported for each of the logistic regression models. These values presented the percent of variation explained by demographic and policy characteristics in the inclusion of each of the student involvement goals in LWPs.30 For all analytical tests, a 2-sided probability of P # .05 was considered to be statistically significant.
RESULTS A total of 539 LWPs received from public PA LEAs were included in the analysis. Public PA LEAs were composed of public school districts (n ¼ 499, 93%), charter schools (n ¼ 33, 6%), and intermediate units (n ¼ 6, 1%). Slightly less than half of the LEAs were in suburban areas (n ¼ 258, 48%), and the remaining were located in rural areas (n ¼ 244, 45%) and less than 10% in principal cities (n ¼ 37, 7%). In the 2005-2006 school year, an average of 3,202 students (range ¼ 30-193,134) were enrolled in public LEAs, and almost one third of the students were eligible for F/R rate (33% 19%). In terms of policy characteristics, the median value of the policy comprehensiveness score was 64 goals, and that of the rigor score was 0.94 (that is, 94% of the LWP goals were scored as neutral or strong when compared to the PSBA template). In addition, 72% (n ¼
390) of LEAs met the team membership requirements and about 88% (n ¼ 472) involved students on the team that developed the LWP. Student-involvement goals were categorized into 3 areas: those related to wellness policy, food service, and role modeling of healthful behaviors. Table 1 shows the proportion of public PA LEAs that included each of the 6 student-involvement goals within their LWPs. Within the wellness policy–related area, almost 90% of LEAs had a goal on their LWP that refers to the involvement of students on ongoing wellness committees. However, a smaller proportion of LEAs referred to the role that students can play in annual revisions of LWPs, and slightly less than half of LEAs included within their policies a goal to survey students and collect their input on various wellness and health–related issues. In the food service–related area, almost two thirds of public PA LEAs stated the goal to share nutritional content of school meals with their students, and less than 45% of LEAs included the goal to involve students in menu selection. In addition, one half of LEAs included a goal to encourage students to role model healthful behaviors. The proportion of LEAs that had each of the student-involvement goals on their LWPs per policy and demographic characteristic of LEAs are presented in Table 2. Local education agencies that included studentinvolvement goals in their LWPs tended to have more comprehensive and rigorous LWPs, meet the team membership requirement for policy development, be suburban or rural, and have a medium percentage of students eligible for F/R rate (an indicator of socioeconomic status). Odds ratios and 95% CIs for whether LEAs included each of the 6 student-involvement goals in the logistic regression models are presented in Table 3. The comprehensiveness score was significantly associated with all 6 student-involvement goals. Compared to LEAs with comprehensiveness scores greater than or equal to the median and adjusting for other policy and demographic characteristics, LEAs that had comprehensiveness scores less than the median were significantly less likely to involve students in wellness policy–related areas:
Journal of Nutrition Education and Behavior Volume 42, Number 6, 2010 Table 1. The Proportion of Public LEAs in Pennsylvania That Included Each of the 6 Student-involvement Goals Within Their LWPs (n ¼ 539) Student-involvement Goals Wellness policy–related area On ongoing wellness committees Involved in annual revisions of LWPs Student surveys Food service–related area Sharing nutritional content of school meals with students Involving students in menu selection Role modeling of health behaviors area Encouraging students to be role models of healthful behaviors
Included the Goal, n (%) 483 (89.6) 339 (62.9) 264 (49.0) 348 (64.6) 236 (43.8) 270 (50.1)
LEA indicates local education agency; LWP, local wellness policy.
wellness committees (OR ¼ 0.13, 95% CI ¼ 0.06-0.33), in annual revisions of LWPs (OR ¼ 0.23, 95% CI ¼ 0.130.29), and student surveys (OR ¼ 0.13, 95% CI ¼ 0.09-0.19). Similarly, compared to LEAs with comprehensiveness scores greater than or equal to the median, LEAs with comprehensiveness scores less than the median were significantly less likely to share the nutritional content of school meals with students (OR ¼ 0.18, 95% CI ¼ 0.12-0.27), involve students in school meal menu selection (OR ¼ 0.13, 95% CI ¼ 0.09-0.20), and encourage students to model healthful eating and physical activity behaviors (OR ¼ 0.08, 95% CI ¼ 0.05-0.13; P < .001). In addition, LEAs with rigor scores less than the median were significantly less likely to have 5 of the 6 student-involvement goals within their LWPs compared to public LEAs with rigor scores greater than or equal to the median, adjusting for all other policy and demographic characteristics (P < .001), as seen in Table 3. In addition, LEAs that met the team membership requirement were more likely to involve students on ongoing wellness committees (P ¼ .014). The present logistic regression models could explain about 25%45% of the variation in the odds of having the 6 student-involvement goals on the local wellness policies of public PA LEAs (Table 3). Most of this variation could be explained by the policy characteristics of LWPs: comprehensiveness score, rigor score, and
meeting team membership requirement.
DISCUSSION Student involvement activities have been incorporated into some school health initiatives,31 however, research on student involvement related to LWPs, with the emphasis on preventing childhood obesity, has not been identified. In 2004, the Child Nutrition and WIC Reauthorization Act mandated that each LEA sponsoring a school meal program must develop a LWP and involve students on the wellness policy development team. However, the mandate did not require LEAs to involve students in the implementation of LWPs. Out of 539 LWPs submitted and analyzed in this study, the majority of public PA LEAs included students on the LWP development team. Furthermore, LEAs ranged in their selection of student-involvement goals from about 44% up to 90% representing an array of student-involvement activities, from students expressing their opinions on surveys to serving on evaluative implementation committees in areas related to the wellness policy, food service, and role modeling. Student involvement can be described as a hierarchical array, from fairly lowinvolvement, 1-way communication, to more collaborative, 2-way partnerships, as identified by Mitra and others.14 Collaborative student/adult
Jomaa et al 375 activities reflect more meaningful, and therefore more effective, forms of student involvement that have a positive impact on student and school outcomes.11,15,32
Wellness Policy-related Area Pennsylvania policies included student-involvement goals in the area of wellness policy development and implementation that reflect a hierarchy for student involvement.11,15 The majority of public LEAs not only involved students on the committee that developed the LWPs, as required by the federal legislation, but also included goals to engage students on the ongoing wellness committees. Approximately 60% of public PA LEAs developed policies that included a goal to involve students in the LWP annual reviews and engage them in the preparation of reports on their LEAs’ compliance with the new policies and regulations. In addition, three quarters of public PA LEAs met the team membership requirement having at least 6 of the school and community representatives on their wellness committees. An earlier study showed less student involvement in these areas. However, this early study was not based on final policies.25 Pennsylvania LEAs were required to submit their final policies to PDE for review and feedback, which might account for higher student involvement than was noted in earlier studies. Pennsylvania LEAs also included a goal for conducting student surveys as a form of listening to student opinions and concerns regarding nutrition and wellness issues. According to Mitra,14,17 obtaining student opinions through surveys is the most common form of student involvement, however, surveys represent a lower level of involvement from students than serving on committees. Almost one half of the LEAs included student surveys within their LWPs.
Food Service–related Area Almost two thirds of LEAs developed goals that require sharing the nutritional information of school meals with students. A lower number,
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376 Jomaa et al
Table 2. Frequency of LEAs That Had Student-involvement Goals on Their LWPs per LEA Demographic and Policy Characteristics (n ¼ 535) Student-involvement Goals, n (%)
Students on Ongoing Annual Wellness Revisions of Committees LWP Policy characteristics Comprehensiveness scorea < Median $ Median Rigor scoreb < Median $ Median Team membership Met requirements Did not meet requirements Demographic characteristics Locale Urban Suburban Rural F/R rate Low (% F/R rate< 15) Medium (15 #% F/R rate < 50) High (% F/R rate $ 50) Enrollment (mean [SEM])
Student Surveys
Sharing Involving Nutritional Students in Content of Menu School Meals Selection
Encouraging Students to Role-model Healthful Behaviors
215 (45) 268 (56)
115 (34) 224 (66)
65 (25) 199 (75)
121 (35) 227 (65)
54 (23) 182 (77)
59 (22) 211 (78)
225 (47) 258 (53)
132 (39) 207 (61)
103 (39) 161 (60)
150 (43) 198 (57)
107 (45) 129 (55)
92 (34) 178 (66)
359 (74) 124 (26)
83 (24) 256 (76)
200 (76) 64 (24)
262 (75) 86 (25)
178 (75) 58 (25)
203 (75) 67 (25)
32 (7) 218 (45) 233 (48)
21 (6) 158 (47) 160 (47)
22 (8) 108 (41) 134 (51)
22 (7) 168 (48) 158 (45)
18 (8) 102 (43) 116 (49)
19 (7) 116 (43) 135 (50)
80 (17) 328 (68) 71 (15) 2,841 (129)
51 (15) 234 (69) 53 (16) 2,743 (134)
39 (15) 177 (67) 46 (18) 2,577 (149)
62 (18) 238 (69) 46 (13) 3,459 (564)
38 (16) 160 (68) 38 (16) 3,450 (820)
44 (16) 180 (68) 44 (16) 2,965 (174)
F/R rate indicates free or reduced-price meals; LEA, local education agency; LWP, local wellness policy. median ¼ 64; bmedian ¼ 0.94.
a
approaching half of the LEAs, included the goal for involving students in school meal menu planning and selection. Numbers from PA were found to be higher than those reported by a pilot study from a nationally representative sample of school districts (n ¼ 256 approved policies) showing that about 20% of the school districts have policies that require nutritional information to be available for students and families.33 Sharing the nutritional content of school meals with students represents a 1-way communication by which students are only informed. However, involving students in menu selection reflects a 2-way communication process between adults and students in the school, whereby students are not only informed, but also consulted. According to researchers, the latter reflects a higher level of student participation than merely sharing information with students and thus may lead to more meaningful and
effective student involvement school changes.15,17
in
Role Modeling of Healthful Behaviors–related Area Almost one half of the LEAs in this study included the goal to encourage students to act as positive role models of healthful behaviors. Peer influence has been one of the effective approaches used not only in the prevention of unhealthful behaviors, such as alcohol consumption and tobacco use among youth,31,34 but also in the promotion of healthful eating and physical activity behaviors, particularly among adolescents.35,36 Not surprisingly, difficulties that limit the sustainability of peer education initiatives and cause some to fail have emerged, such as the lack of investment in peer education, the lack of adequate training and support for peer educators, and the lack of apprecia-
tion of peer education.37 Despite the limitations and difficulties, peer education can increase adolescents’ selfconfidence and self-efficacy as well as positively influence their health knowledge and attitudes.38
Relationships between LEA Characteristics and Studentinvolvement Goals The research team explored the associations between the demographic and policy characteristics of these LEAs and the inclusion of each of the student-involvement goals within LWPs. Public PA LEAs with comprehensive and strong LWPs were most likely to include student-involvement goals, regardless of the location, the number of students enrolled, or the socioeconomic status of students within an LEA. A previous study identified cost as a perceived barrier to LWP implementation.23 In this study,
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Jomaa et al 377
Table 3. Odds Ratios and 95% CIs for Demographic and Policy Characteristic of LEAs to Predict the Inclusion of Studentinvolvement Goals Among Public LEAs in Pennsylvania (n ¼ 535) OR (95% CI) of Multivariate-adjusted Modelsa Encouraging Sharing Involving Students to Nutritional Students in Role-model Content of Menu Healthful School Meals Selection Behaviors
Students on Ongoing Annual Wellness Revisions Committees of LWP
Student Predictors Surveys Policy characteristics Comprehensiveness score < Median OR 0.14 0.20 0.13 0.18 95% CI 0.06-0.33*** 0.13-0.29*** 0.09-0.19*** 0.12-0.27*** $ Median OR 1.0 1.0 1.0 1.0 Rigor score < Median OR 0.20 0.31 0.48 0.51 95% CI 0.09-0.45*** 0.21-0.46*** 0.32-0.72*** 0.34-0.76*** $ Median OR 1.0 1.0 1.0 1.0 Team membership Met requirements OR 2.30 1.53 1.43 1.30 95% CI 1.19-4.47* 0.98-2.40 0.90-2.26 0.83-2.02 Did not meet requirements OR 1.0 1.0 1.0 1.0 Demographic characteristics Locale Urban OR 0.51 0.90 1.42 1.69 95% CI 0.12-2.18 0.34-2.36 0.54-3.73 0.63-4.52 Suburban OR 0.29 1.20 0.70 1.28 95% CI 0.13-0.64** 0.21-0.46 0.45-1.09 0.82-2.01 Rural OR 1.0 1.0 1.0 1.0 Enrollment OR 1.23 0.98 0.81 1.21 95% CIb 0.89-1.70 0.78-1.23 0.64-1.01 0.96-1.53 F/R rate Low (% F/R rate < 15) OR 1.0 1.0 1.0 1.0 Medium (15 # % F/R rate < 50) OR 1.20 1.22 0.69 0.90 95% CI 0.55-2.62 0.70-2.13 0.39-1.22 0.51-1.57 High (% F/R rate $ 50) OR 1.23 1.44 0.96 0.53 95% CI 0.41-3.73 0.66-3.17 0.43-2.12 0.25-1.16 Nagelkerke R2 0.295 0.281 0.335 0.246 -2 Log likelihood 275.46 580.68 586.74 589.56
0.13 0.08 0.09-0.20*** 0.05-0.13*** 1.0 1.0 0.99 0.67-1.48 1.0
0.25 0.16-0.39*** 1.0
1.24 0.79-1.94 1.0
1.17 0.72-1.90 1.0
1.12 0.45-2.79 0.84 0.54-1.29 1.0 0.99 0.8-1.25
0.84 0.29-2.41 0.67 0.41-1.08 1.0 1.24 0.97-1.59
1.0 0.77 0.44-1.35 0.86 0.39-1.86 0.274 611.69
1.0 0.56 0.31-1.04 1.01 0.43-2.35 0.447 523.08
CI indicates confidence interval; F/R rate, free or reduced-price meals; LEA, local education agency; LWP, local wellness policy; OR, odds ratio. *Significant at .05; **significant at .01; ***significant at .001; aMultivariate logistic regression models; bNaturally log-transformed.
demographic characteristics, including F/R rate, which is a measure of the LEA’s socioeconomic status, did not appear to be barriers to including student-involvement goals in LWPs. These results are consistent with those reported by other groups that examined cost implications of policy changes and found them to be cost neutral or even revenue generating.39,40 Thus, the authors found that policy characteristics were strongly correlated with the inclusion
of student-involvement school wellness policies.
goals
in
Strengths and Limitations To the best of the authors’ knowledge, the present study is the first to examine the inclusion of student involvement–specific goals within LWPs of public LEAs for an entire state. The reliability of the policy abstraction process and the high inter-rater agree-
ment in scoring student-involvement goals are among the strengths of the present study. In addition, PA provided an ideal setting to conduct this study because of the high number of NSLP sponsors and the wide variation in enrollment and socioeconomic status of students in its LEAs. Although findings presented here can help explore an under-researched topic, student involvement in school nutrition policies and LWPs, LWP implementation was not assessed in this
378 Jomaa et al study. Thus, future studies are needed to explore whether student-involvement goals are actually being implemented by LEAs as stated in their LWPs and what impact student engagement in nutrition policies has on the eating and physical activity attitudes and behaviors of students. In addition, the cross-sectional design of this study limits the authors’ ability to draw causal relationships between various LEA characteristics and the student-involvement goals in LWPs.
IMPLICATIONS FOR RESEARCH AND PRACTICE The involvement of students in school nutrition policies has been shown to increase student acceptance in an array of health-related areas and is therefore promising in the area of obesity prevention. Student involvement activities can range from collecting student opinions through surveys and questionnaires, which reflect low levels of involvement, to promoting student-led initiatives and adult–student partnerships in decision making, which represent higher levels of involvement. Training students to become participants in school policies may increase their sense of ownership with regard to changes taking place in the schools, which may have a positive impact on their eating and physical activity behaviors. This study suggests that the socioeconomic status of students as well as the geographical location and enrollment of LEAs were not barriers for LEAs to address student involvement among their local wellness policy goals. The authors found that the comprehensiveness and rigor of the policies most likely determined whether LEAs included student-involvement goals. The present findings show that there might be common underlying factors related to writing comprehensive policies and involving students, which deserve further investigation. Moreover, these results show that LEAs that met the team membership requirement as mandated by the law—that is, LEAs that included students among other school-community members on the local wellness policy development team—were more likely to include
Journal of Nutrition Education and Behavior Volume 42, Number 6, 2010 student-involvement goals within their policies. Thus, by allowing students to serve on the health advisory boards/local wellness policy committees that helped develop these policies, students may have better chances of being involved in the implementation and evaluation of local wellness policies. Research in this field is scarce, thus future studies are required to investigate how policies will be implemented and operationalized by LEAs and to document how students are involved in their school wellness policies and the degree of their involvement. In addition, studies are needed to determine the specific impact of student involvement initiatives on school environments and the health behaviors and attitudes of students. Further studies are needed to identify barriers for student involvement, the best practices for schools to adopt student engagement activities, and factors needed to ensure the sustainability and efficacy of these efforts on the long-term dietary and physical activity behaviors of youth. Most importantly, the local wellness policy mandate provided an impetus for LEAs to include an array of student involvement activities in their districts and schools. Given that in 2010 the Child Nutrition programs are scheduled for reauthorization, nutrition professionals and policy makers will have the chance to revise the various components of the local wellness policy mandate. They can use this unique opportunity to provide recommendations for LEAs to increase student involvement in the ongoing implementation of these policies and encourage students to become active participants in the changes within their school environment, ultimately to help reduce childhood obesity.
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ACKNOWLEDGMENTS This study was funded by the Robert Wood Johnson Foundation, Healthy Eating Research Program.
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