District Wellness Policy Nutrition Standards Are Associated with Healthier District Food Procurement Practices in the United States

Food procurement policies often exist to require that schools purchase foods with specific nutrient standards. Such policies are increasingly being used with the hope of improving access to healthier foods and beverages. Local wellness policies, required in any school district that participates in Federal Child Nutrition Programs, often contain specific nutrition standards that detail what can be sold to students during the school day. This study investigated the extent to which nutrition standards in wellness policies may be associated with healthier nutrition standards in district-level purchasing specifications. Cross-sectional data from the 2014–2015 school year for 490 school food authorities from 46 states and the District of Columbia were collected as part of the School Nutrition and Meal Cost Study and the National Wellness Policy Study. Survey-adjusted multivariable logistic regression models were computed to examine the association between district wellness policy nutrition standards and corresponding district food purchasing specifications. Results show that having a district wellness policy with corresponding nutrition standards and being in a rural area were associated with district food purchasing specifications for specific nutrients. These findings contribute to the literature to suggest that having a wellness policy with detailed nutrition standards may help to increase access to healthier foods and beverages.

Download Full-text

The Role of District Wellness Policies in Encouraging Student Participation in the School Breakfast Program, United States

Nutrients ◽

10.3390/nu12082187 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2187 ◽

Cited By ~ 1

Author(s):

Julien Leider ◽

Wanting Lin ◽

Elizabeth Piekarz-Porter ◽

Lindsey Turner ◽

Jamie F. Chriqui

Keyword(s):

School Nutrition ◽

Cross Sectional Survey ◽

Wellness Policy ◽

Cross Sectional ◽

Cost Study ◽

School Breakfast Program ◽

District Policy ◽

School Breakfast ◽

Wellness Policies

Eating breakfast is associated with better academic performance and nutrition and lower risk of obesity, but skipping breakfast is common among children and adolescents, and participation in the U.S. Department of Agriculture’s School Breakfast Program (SBP) is low. This study assessed the association between school district wellness policy provisions coded as part of the National Wellness Policy Study and student SBP participation and acceptance of the breakfasts provided using cross-sectional survey data from the School Nutrition and Meal Cost Study. Separate survey-adjusted multivariable logistic regressions were computed, linking students eating (N = 1575) and liking (N = 726) the school breakfast to corresponding district policy measures, controlling for school and student characteristics. Strong district policy, as opposed to no policy, was associated with significantly higher odds of students eating the school breakfast (odds ratio (OR): 1.86; 95% CI: 1.09, 3.16; p = 0.022), corresponding to an adjusted prevalence of 28.4% versus 19.2%, and liking the school breakfast (OR: 2.14; 95% CI: 1.26, 3.63; p = 0.005), corresponding to an adjusted prevalence of 69.0% versus 53.9%. District policy has the potential to play an important role in encouraging higher levels of SBP participation.

Download Full-text

Can Monitoring Make It Happen? An Assessment of How Reporting, Monitoring, and Evaluation Can Support Local Wellness Policy Implementation in US Schools

Nutrients ◽

10.3390/nu13010193 ◽

2021 ◽

Vol 13 (1) ◽

pp. 193

Author(s):

Lindsey Turner ◽

Yuka Asada ◽

Julien Leider ◽

Elizabeth Piekarz-Porter ◽

Marlene Schwartz ◽

...

Keyword(s):

Policy Implementation ◽

Policy Development ◽

Child Nutrition ◽

Monitoring And Evaluation ◽

School Nutrition ◽

Wellness Policy ◽

Cost Study ◽

Child Nutrition Programs ◽

Local Wellness Policy ◽

Nationally Representative

US school districts participating in federal child nutrition programs are required to develop a local wellness policy (LWP). Each district is allowed flexibility in policy development, including the approaches used for policy reporting, monitoring, and evaluation (RME). The aim of this convergent mixed-methods study was to quantitatively examine RME provisions in policies among a nationally representative sample of districts in the 2014–2015 school year in order to examine whether policies were associated with RME practices in those districts, and to qualitatively examine perceived challenges to RME practices. Data were compiled through the School Nutrition and Meal Cost Study and the National Wellness Policy Study. In multivariable regression models accounting for demographics, survey respondents were significantly more likely to report that their district had informed the public about LWP content and implementation, if there was a relevant policy provision in place. Having a strong policy (as compared to no policy) requiring evaluation was associated with reports that the district had indeed evaluated implementation. Having definitive/required provisions in policies was significantly associated with actual use of RME practices. RME activities are an important part of policy implementation, and these results show that policy provisions addressing RME activities must be written with strong language to require compliance. In interviews with 39 superintendents, many reported that RME activities are challenging, including difficulty determining how to monitor and show impact of their district’s wellness initiatives. Furthermore, the qualitative results highlighted the need for vetted tools that are freely available, widely used, and feasible for districts to use in assessing their progress toward meeting the goals in their LWPs.

Download Full-text

State Wellness Policy Requirement Laws Matter for District Wellness Policy Comprehensiveness and Wellness Policy Implementation in the United States

Nutrients ◽

10.3390/nu13010188 ◽

2021 ◽

Vol 13 (1) ◽

pp. 188

Author(s):

Jamie F. Chriqui ◽

Julien Leider ◽

Lindsey Turner ◽

Elizabeth Piekarz-Porter ◽

Marlene B. Schwartz

Keyword(s):

Policy Implementation ◽

Nutrition Education ◽

Structural Equation ◽

Structural Equation Models ◽

The United States ◽

School Nutrition ◽

District Level ◽

Wellness Policy ◽

Cost Study ◽

District Implementation

Beginning with the school year 2006–2007, U.S. school districts participating in the federal Child Nutrition Programs were required to adopt and implement a local wellness policy (LWP) that included goals and/or standards for nutrition education, school meals, other foods sold or served in schools, and physical activity. A primary challenge with LWPs has been inconsistent implementation. This study examined whether state wellness policy requirement laws and district LWP comprehensiveness influence district level implementation, using law/policy data from the National Wellness Policy Study and school food authority (SFA)-reported district LWP implementation from the School Nutrition and Meal Cost Study. Generalized linear and structural equation models were used, controlling for SFA and district characteristics. SFAs in states with wellness policy requirement laws (vs. those in states without) reported implementing significantly more practices (59.56% vs. 44.57%, p < 0.01). State wellness policy requirement laws were associated with district LWP comprehensiveness (coeff.: 0.463; 95% CI: 0.123, 0.803) and district-level implementation (coeff.: 1.392; 95% CI: 0.299, 2.485). District LWP comprehensiveness was associated with district implementation (coeff.: 0.562; 95% CI: 0.072, 1.053), but did not mediate the state law–district implementation relationship. This study highlights the important role that state laws and district LWPs can play in facilitating wellness policy implementation.

Download Full-text

Artificial sweeteners in food and beverage products at school

Public Health Nutrition ◽

10.1017/s136898001800143x ◽

2018 ◽

Vol 22 (11) ◽

pp. 1941-1950 ◽

Cited By ~ 2

Author(s):

Rebecca M Schermbeck ◽

Julien Leider ◽

Elizabeth Piekarz-Porter ◽

Jamie F Chriqui

Keyword(s):

Cross Sectional Study ◽

School Nutrition ◽

Ordinal Scale ◽

Artificial Sweeteners ◽

Artificial Sweetener ◽

School Food ◽

Cross Sectional ◽

Cost Study ◽

State Laws ◽

Wellness Policies

AbstractObjectiveExperts recommend that products containing artificial sweeteners are not marketed to children or sold at schools. The present study aimed to provide a baseline assessment of the extent to which state laws and local school district wellness policies (LWP) address restrictions on the use of artificial sweeteners in competitive foods and beverages (CF&B) sold at schools.DesignA descriptive, cross-sectional study of policies in place for the 2014–15 school year.SettingData were collected on laws in all fifty states and Washington, DC. LWP were compiled for 496/518 school food authorities (SFA) for which data were collected as part of the US Department of Agriculture’s School Nutrition and Meal Cost Study.SubjectsState laws and LWP respectively were coded on a 0–3 ordinal scale for the strength of their restrictions on artificial sweeteners in CF&B sold in each of five CF&B venues, separately by grade level. Prevalence of state laws and LWP for SFA nationwide was computed.ResultsThirteen states addressed the use of artificial sweeteners. Six states addressed the use of artificial sweeteners in both CF&B. District-level artificial sweetener policies were most frequently addressed for beverages in elementary schools’ vending machines. District policies also were more likely to address artificial sweeteners in states with laws addressing artificial sweeteners.ConclusionsMost state laws and LWP do not address artificial sweeteners in CF&B. This is not surprising given the Food and Drug Administration has approved eight artificial sweeteners for consumption and the Smart Snacks regulation does not limit artificial sweeteners for CF&B.

Download Full-text

Local Wellness Policy Strength and Perceived Implementation of School Nutrition Standards across Three States

Childhood Obesity ◽

10.1089/chi.2012.0047 ◽

2012 ◽

Vol 8 (4) ◽

pp. 331-338 ◽

Cited By ~ 9

Author(s):

Rachel Wall ◽

Ruth Litchfield ◽

Alicia Carriquiry ◽

Elaine T. McDonnell ◽

Gail M. Woodward-Lopez

Keyword(s):

School Nutrition ◽

Wellness Policy ◽

Local Wellness Policy ◽

Nutrition Standards

Download Full-text

Differences in Diet Quality between School Lunch Participants and Nonparticipants in the United States by Income and Race

Nutrients ◽

10.3390/nu12123891 ◽

2020 ◽

Vol 12 (12) ◽

pp. 3891

Author(s):

Elizabeth C. Gearan ◽

Kelley Monzella ◽

Leah Jennings ◽

Mary Kay Fox

Keyword(s):

United States ◽

Diet Quality ◽

School Lunch ◽

The United States ◽

School Nutrition ◽

Healthy Eating Index ◽

Lower Income ◽

Cost Study ◽

Hispanic White

Prior research has shown that participation in the United States’ National School Lunch Program (NSLP) is associated with consuming higher-quality lunches and diets overall, but little is known about differences by income and race/ethnicity. This analysis used 24 h dietary recall data from the School Nutrition and Meal Cost Study to examine how NSLP participation affects the diet quality of students in different income and racial/ethnic subgroups. Diet quality at lunch and over 24 h was assessed using the Healthy Eating Index (HEI)-2010, where higher scores indicate higher-quality intakes. HEI-2010 scores for NSLP participants and nonparticipants in each subgroup were estimated, and two-tailed t-tests were conducted to determine whether participant–nonparticipant differences in scores within each subgroup were statistically significant. NSLP participants’ lunches received significantly higher total HEI-2010 scores than those of nonparticipants for lower-income, higher-income, non-Hispanic White, and non-Hispanic Black students, suggesting that participating in the NSLP helps most students consume healthier lunches. These significantly higher total scores for participants’ lunch intakes persisted over 24 h for higher-income students and non-Hispanic White students but not for lower-income students or students of other races/ethnicities. For NSLP participants in all subgroups, the nutritional quality of their 24 h intakes was much lower than at lunch, suggesting that the positive influence of the NSLP on their overall diet quality was negatively influenced by foods consumed the rest of the day (outside of lunch).

Download Full-text

Dimensions of School Food Environments and Their Association with Anthropometric and Dietary Outcomes in Children: The Healthy Communities Study

Current Developments in Nutrition ◽

10.1093/cdn/nzaa043_140 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 289-289

Author(s):

Marisa Tsai ◽

Edward Frongillo ◽

Lorrene Ritchie ◽

Gail Woodward-Lopez ◽

Lauren Au

Keyword(s):

Factor Analysis ◽

Waist Circumference ◽

School Nutrition ◽

Cross Sectional ◽

Added Sugars ◽

Healthy Communities ◽

School Wellness ◽

Meal Quality ◽

Wellness Policies ◽

School Wellness Policies

Abstract Objectives While it has been recommended that schools be the hub of efforts to improve child nutrition, research describing dimensions of U.S. school nutrition environments is limited. This study used exploratory factor analysis to estimate dimensions of school nutrition environments and examined their association with child anthropometric and dietary measures. Methods Cross-sectional analyses of 386 U.S. elementary and middle schools and 4635 children from the national Healthy Communities Study (2013–2015) was conducted. Three complementary instruments to assess the school nutrition environment were used to create 34 variables. Data were collected by observation and surveys. Factor analysis was done with orthogonal rotation. Mixed-effects regression models examined the multivariate-adjusted associations of dimensions of school nutrition environments with child anthropometric and dietary measures accounting for community and school variation. Results Six dimensions of school nutrition environments were derived: 1) nutrition education; 2) fruit and vegetable availability; 3) dining environment, including size and crowding; 4) school meal quality, including compliance with competitive food standards, amount of whole grains, and high fat foods; 5) school participation in state and federal nutrition programs; and 6) self-reported implementation of school wellness policies. Higher school meal quality was associated with lower added sugars intake (ß = –0.94, P < 0.01), better dining environment was associated with higher body mass index z scores (ß = 0.04, P = 0.03), and higher implementation of school wellness policies was associated with higher waist circumference (ß = 0.54, P < 0.01). Conclusions Schools serving meals of higher nutritional quality had children with lower added sugars intake. Associations between dining environment and BMI-z; and implementation of school wellness policies and waist circumference were counterintuitive and may be due to school selection or the inability of cross-sectional data to capture relationships with longer-term health outcomes. More efforts are needed to identify school nutrition environments that have the greatest impact on child diet and adiposity outcomes. Funding Sources National Heart, Lung, and Blood Institute #K01HL131630.

Download Full-text

Worksite Food and Physical Activity Environments and Wellness Supports Reported by Employed Adults in the United States, 2013

American Journal of Health Promotion ◽

10.1177/0890117116664709 ◽

2016 ◽

Vol 32 (1) ◽

pp. 96-105 ◽

Cited By ~ 9

Author(s):

Stephen J. Onufrak ◽

Kathleen B. Watson ◽

Joel Kimmons ◽

Liping Pan ◽

Laura Kettel Khan ◽

...

Keyword(s):

Physical Activity ◽

United States ◽

Health Promotion ◽

Nutrition Education ◽

Healthy Eating ◽

The United States ◽

Cross Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Wellness Policies

Purpose: To examine the workplace food and physical activity (PA) environments and wellness culture reported by employed United States adults, overall and by employer size. Design: Cross-sectional study using web-based survey on wellness policies and environmental supports for healthy eating and PA. Setting: Worksites in the United States. Participants: A total of 2101 adults employed outside the home. Measures: Survey items were based on the Centers for Disease Control and Prevention Worksite Health ScoreCard and Checklist of Health Promotion Environments and included the availability and promotion of healthy food items, nutrition education, promotion of breast-feeding, availability of PA amenities and programs, facility discounts, time for PA, stairwell signage, health promotion programs, and health risk assessments. Analysis: Descriptive statistics were used to examine the prevalence of worksite environmental and facility supports by employer size (<100 or ≥100 employees). Chi-square tests were used to examine the differences by employer size. Results: Among employed respondents with workplace food or drink vending machines, approximately 35% indicated the availability of healthy items. Regarding PA, 30.9% of respondents reported that their employer provided opportunities to be physically active and 17.6% reported worksite exercise facilities. Wellness programs were reported by 53.2% working for large employers, compared to 18.1% for smaller employers. Conclusion: Employee reports suggested that workplace supports for healthy eating, PA, and wellness were limited and were less common among smaller employers.

Download Full-text

The School Nutrition and Meal Cost Study-I: Overview of Findings Related to Improving Diet Quality, Weight, and Disparities in US Children and Policy Implications

Nutrients ◽

10.3390/nu13041357 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1357

Author(s):

Mary Story ◽

Lindsey Miller ◽

Megan Lott

Keyword(s):

Low Income ◽

Safety Net ◽

The United States ◽

School Nutrition ◽

Policy Implications ◽

United States Department ◽

Department Of Agriculture ◽

Cost Study ◽

Low Income Families ◽

Us Children

The national school breakfast and lunch programs administered by the United States Department of Agriculture (USDA) are a cornerstone of the nation’s nutrition safety net for children from low-income families [...]

Download Full-text

Does a Graduate Course in Fluency Disorders Make a Difference?

Perspectives on Fluency and Fluency Disorders ◽

10.1044/ffd20.1.10 ◽

2010 ◽

Vol 20 (1) ◽

pp. 10-14 ◽

Cited By ~ 2

Author(s):

Evelyn R. Klein ◽

Barbara J. Amster

Keyword(s):

Undergraduate Students ◽

Graduate Programs ◽

The United States ◽

Cross Sectional Study ◽

Sectional Study ◽

Graduate Course ◽

Cross Sectional ◽

Fluency Disorders ◽

Introductory Course ◽

Communicative Disorders

Abstract A study by Yaruss and Quesal (2002), based on responses from 134 of 239 ASHA accredited graduate programs, indicated that approximately 25% of graduate programs in the United States allow students to earn their degree without having coursework in fluency disorders and 66% of programs allow students to graduate without clinical experience treating people who stutter (PWS). It is not surprising that many clinicians report discomfort in treating PWS. This cross-sectional study compares differences in beliefs about the cause of stuttering between freshman undergraduate students enrolled in an introductory course in communicative disorders and graduate students enrolled and in the final weeks of a graduate course in fluency disorders.

Download Full-text