Evaluation of a student participatory, low-intensity program to improve school wellness environment and students’ eating and activity behaviors

Abstract

BackgroundMost schools have not fully implemented wellness policies, and those that have rarely incorporate meaningful student participation. The aim of the Fuel Up to Play 60 (FUTP60) program is to help schools implement wellness policies by engaging students in activities to improve access to healthful, good tasting food and drinks, and increase the number and type of opportunities for students to be physically active. The aim of this paper is to present initial student-level results from an implementation of FUTP60 in 72 schools, grades 6–9.MethodsThe study used a non-controlled pretest/posttest with serial cross-sectional data. School process data and student-level data were collected in fall 2009 (pre-intervention) and spring 2010 (post-intervention). School wellness practices were captured during a baseline needs assessment survey. Validated self-administered questionnaires assessing dietary and physical activity (PA) behaviors were administered to students in grades 6–9 in the 72 pilot schools. Mixed-effects logistic regression controlling for clustering of schools and demographics was used to calculate odds ratios and confidence intervals to evaluate changes pre- and post- intervention.ResultsAll 72 schools implemented FUTP60 during the 2009–2010 school year. Action strategies most frequently chosen by the schools included increasing breakfast participation and new activities before and after school. Positive and significant changes in students’ behaviors (n = 32,482 at pretest and 29,839 at post-test) were noted for dairy, whole grains, fruit, and vegetable consumption and PA levels pre- and post-intervention (OR 1.05 to 1.27). Students aware of the program at post-test were significantly more likely to report healthier eating and PA behaviors than students unaware of the program (OR 1.1 to 1.34).ConclusionsFUTP60 pilot findings indicate that a low intensity program focused on wellness policy implementation is associated with small positive changes in student behaviors, especially when students were aware of the program. Although these initial results are promising, a more rigorous controlled study is warranted as a next step.

Delivering in‐school interventions to improve dietary behaviours amongst 11‐ to 16‐year‐olds: A systematic review

“…The target behaviours in the reviewed studies included increasing fruit and/or vegetable consumption (n = 19); improving snacking behaviours (n = 8) (this included both decreasing the intake of energy‐dense nutrient‐poor snacks) and increasing healthy snacks like fruits and vegetables; decreasing sugar‐sweetened beverage (SSB) intake (n = 8); encouragement to eat meals on a regular basis (n = 4); improving general eating behaviours (eg, increase daily nutritional recommended intake of carbohydrates, fibre minerals, protein, and vitamins, n = 5), and reducing daily fat and sugar intake (n = 3) . A number of studies (n = 13) targeted more than one dietary behaviour in their intervention (eg, increasing fruit and vegetable consumption, decreasing SSB and unhealthy snacks consumption) …”

“…In terms of eating behaviour assessments, behavioural measures included food frequency questionnaires (FFQ) (n = 24), food diaries over periods of time ranging from 24 hours to 7 days (n = 3; including one online), dietary interviews including general structured interviews on daily dietary consumption (n = 2), a paired food questionnaire (one healthy and one unhealthy option; n = 2), and a “true or false” food statement questionnaire (would you eat a foodstuff, “true or false”; n = 1). All of the reviewed studies had a “before and after” measurement of dietary behaviour, and 14 studies included a longer‐term follow‐up assessment (ranging from 6 weeks to 4 years), whilst two studies also included a measure mid‐intervention …”

“…The majority of the studies (n = 22) included at least one other measure that was not dietary behaviour, such as the amount of physical activity (n = 14), anthropometric assessment (body mass index; n = 8), physical and dietary social norms (subjective and group; n = 4), self‐efficacy (n = 3), perceived behavioural control (n = 3), behaviour intention (physical activity and dietary) (n = 5), sedentary behaviours (including television viewing; n = 5), habit strength (n = 1), blood pressure (n = 1), tobacco use (n = 1), and self‐perception (self‐esteem and body dissatisfaction measures; n = 1) …”

“…Interventions were delivered by one or a combination of school staff (n = 15), researchers (n = 4), trained project staff (eg, volunteers; n = 6), peers (n = 9), nutritional professional (n = 2), a professional cook (n = 1), or a nurse (n = 1), whilst one intervention was self‐directed (n = 1) …”

“…Of the 29 studies identified for review, 24 were successful in promoting dietary behaviour change . One of the main contributing factors to a successful intervention was peer involvement.…”