We Wellness llness Po Poli licy cy Ce Census nsus an and d - - PowerPoint PPT Presentation

We Wellness llness Po Poli licy cy Ce Census nsus an and d Relationship ationship to Student dent BMI

Savannah Morrow, Commissioner’s Fellow, Office of Health Policy | 2018

Agenda Agenda

• Coordinated School Health
• Project Scope
• Project Results
• Implications
• Next Steps

Wh What at is is Co Coor

• rdin

dinated ated Sc Scho hool

• l He

Heal alth th?

• Strategic framework that integrates

– nutrition – physical activity – physical education – health education – health services – healthy school environment – counseling, psychological, and social services – student, family, and community involvement – school staff wellness

• Tennessee has CSH staff in every district

We Well llne ness ss Po Poli licy cy

• Every Tennessee school district must maintain a Wellness Policy that
• utlines their commitment to student health and wellbeing.
• While they must include certain requirements, districts can add more

criteria to their wellness policy.

Es Esse sent ntial ial Qu Ques estio tion

• Is there a relationship or correlation between districts with robust wellness

policies and their percentage of overweight or obese students? More simply… Do districts with complete health policies also have students with healthier BMIs?

Pr Proj

• jec

ect t Ob Obje jecti ctives ves

• Evaluate and score all district wellness policies
• Determine the relationship between district BMI and wellness policy score

– With extra points – Required USDA components

• Identify strong wellness policies

TS TSBA BA Mo Mode del

Commitment to Coordinated School Health School Health Advisory Council Commitment to Nutrition District Goals Commitment to Physical Activity and Physical Education Commitment to Curriculum School Health Index Record Keeping Compliance

Sc Scor

• rin

ing g Ma Matr trix ix

Sc Scor

• rin

ing g Cr Crit iteri eria

• 50 components of the TSBA model including headers, sentences,

references, availability, and last update

• All 140 districts received scored1-50, then % completed.
• Average: 86%
• 81 of the 140 policies: 90-100%
• Lowest scores, all below 50%: Bartlett, Montgomery, Davidson, Hamilton,

Madison, Dickson, Johnson, and Warren.

Sc Scor

• res

es + B + BMI MI

10 20 30 40 50 60 0% 10% 20% 30% 40% 50% 60% 70% Wellness ess Po Policy y Score Pe Percen entage age of students nts overwei weight ght or obese

Rela lati tionship

• nship of Wellnes

llness s Po Poli licy y Scor

• re

e and Pe Percen entag age e of St Students dents Overwei weigh ght t or Obese se

Sc Scor

• rin

ing g wi with th Ad Addi diti tional

• nal Po

Poin ints ts

• Not using food as a reward or punishment
• Not withholding food or beverage as a punishment
• Access to cups of water or water bottles throughout the day
• Cafeteria as a “learning laboratory”
• Commitment to a Healthy School Environment
• “The Board strives to ensure that all schools offer healthy, safe, and

supportive environments for students, staff, parents, and visitors”

Sc Scor

• res

es wi with th Ad Addi ditio tional nal Po Poin ints ts + B + BMI MI

10 20 30 40 50 60 70 0% 10% 20% 30% 40% 50% 60% 70% Wellness ess Po Policy y Score with Extra a Po Points Pe Percen entage age of St Student nts s Overwei weight ght or Obese

Rela lati tionship

• nship of Wellnes

llness s Po Poli licy y Scor

• res

es wit ith h Extra Po Poin ints ts and Pe Percen ent t of St Students dents Overwei weigh ght t or Obese se

Po Poli licy cy Re Requ quir iremen ements ts fr from

• m US

USDA DA

 The council il shall consist of individuals repres esen entin ing g the school

• l and communit

ity, including parents, students, teachers, school administrators, health professionals, school food service representatives, and members of the public.  The board will consider recommendations of the Counc ncil il in making ng policy icy changes ges or revis isio ions ns.  The director of schools will l ensure e complia ianc nce e with the school Wellness Policy, to include an assessment of the implementation of the Wellness Policy and the progress made in attaining the policy goals.  COMMITMENT TO NUTRIT RITIO ION  All schools within the district shall partic icip ipate ate in the USDA child nutrit itio ion n progr gram ams, which may include but not be limited to, the National School Lunch Program, the School Breakfast Program, the Summer Food Service Program, and the After School Snack Program.4,5,6  All food including vending machines, fundraising items, and concessions must meet guidelines set forth by the Healthy, Hunger-free Kids Act, 2010, Smart Snacks ks in Schools

• ls.

 The school nutrition coordinator/director/principal/designee/Coordinated School Health Counselor shall be responsible for overseeing the school district’s complia ianc nce e with h the State e Board of Educat catio ion Rules and Regulations for sale of food items in the school district.2,5,6  Nutrit itio ion n Education ation will l be offered ered as part of a standar ards based program designed to provide students with the knowledge and skills needed to promote and protect their health as outlined in the State Board of Education Health Education and Lifetime Wellness

• Standards. OR Nutrition Education will be offered as part of a standards based program designed to provide students with the knowledge

and skills needed to promote and protect their health.  COMMITMENT TO PHYSIC ICAL ACTIV IVIT ITY AND PHYSICAL L EDUCATIO ION  Updated since 2017

US USDA DA Sc Scor

• re

e + B + BMI MI

2 4 6 8 10 12 0% 10% 20% 30% 40% 50% 60% 70% Abbrevia viated ed Wellness ess Po Policy Score Pe Percen entage age of St Student nts s Overwei weight ght or Obese

Rela lati tionship

• nship between

ween Abbrev eviat ated ed Welln lnes ess s Po Poli licy y Score re and d Pe Percen entag age e of St Students dents Overwei weigh ght t or Obese se

Im Impo port rtant ant Co Cons nside iderati rations

• ns
• Many districts did not modify their policy yearly to align with the TSBA’s

model.

• The essence of the policy intent was there, but contained older language.
• Some districts also simply added updated phrasing to the end of their

existing policy rather than integrating it.

Li Limi mita tation tions

• Small snapshot – policies available in April and 2016-2017 school year

BMI data.

• Policies are on paper, procedure is in practice.
• Districts represent 2 to 234 schools.

Di Dist stri ricts cts Wo Wort rth h Hi High ghli lighti ghting ng

• Giles County – met all requirements and included water availability,

cafeteria as a learning laboratory, handwashing, and not using food as reward or punishment

• Humphreys County – detailed wellness policy regarding specific health

and nutrition education topics

• Lebanon Special School District – detailed wellness policy regarding

school food staff, scheduling of meals, parent communication, breakfast and free and reduced-priced meals

Co Conc nclu lusion sion

• Wellness policies, so far, have not correlated to district levels of
• verweight and obese students.
• The wellness policies that at least met the minimum required statements

did not have healthier average BMIs.

• Regardless, maintaining a wellness policy is an opportunity for the district

to renew its commitment to school health and wellness.

Ne Next xt St Step eps

• 1. Examine the accuracy of the data
• 2. Meet with the experts
• 3. Study pediatric obesity to find evidence-based interventions
• 4. Encourage the use of best practices to move the needle

St Step eps s in in pr prog

• gre

ress ss

• Data: relatively accurate but limited.
• Experts: Three components determine weight.

– Biology (genetics, anatomy, physical make-up) – Environment (school, neighborhood, rural, urban, rich, poor) – Health Behaviors (physical activity, nutrition, etc)

• Research: Interventions that work target more than one aspect or

component.

Ta Take keaw aways ays

• There is no silver bullet to cure childhood obesity.
• BUT that also means there can be multiple ways to combat the issue.
• Future research and interventions must measure long term impacts.
• The most effective interventions are school based, but include a home or

community component.

Re Refe fere rences nces

• https://www.tn.gov/content/dam/tn/education/csh/csh_bmi_school_summary_201

6-17.pdf

• https://www.nature.com/articles/ijo200922#preventing-childhood-obesity-current-

approaches

• https://academic.oup.com/her/article/21/6/783/611143
• http://pediatrics.aappublications.org/content/121/4/e794.short
• http://journals.sagepub.com/doi/10.1111/j.1748-720X.2007.00116.x
• https://highline.huffingtonpost.com/articles/en/everything-you-know-about-obesity-

is-wrong/

• https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.12277
• https://www.aafp.org/afp/2008/0701/p56.html
• https://www.rwjf.org/en/library/articles-and-news/2018/10/nearly-one-in-six-young-

people-nationwide-has-obesity--new-data-show.html

Thank ank you!

Savannah.Morrow@tn.gov

Distri rict

Score re (out t of 50) % Overw erweigh ght t or obes ese

Alamo 42 44% Davidson County 22 37% Henderson County 50 64% Marshall County 39 42% Rogersville 48 48% Alcoa 28 34% Dayton 50 37% Henry County 26 42% Maryville 31 33% Rutherford County 47 41% Anderson County 50 43% Decatur County 50 48% Hickman County 44 43% Maury County 42 42% Scott County 41 47% Arlington 33 32% DeKalb County 44 47% Hollow Rock-Bruceton 40 43% McKenzie 50 40% Sequatchie County 47 46% Athens 40 38% Dickson County 25 38% Houston County 31 37% McMinn County 50 46% Sevier County 27 34% Bartlett 15 33% Dyer County 41 39% Humboldt City 50 51% McNairy County 50 45% Shelby County 36 44% Bedford County 39 43% Dyersburg 50 43% Humphreys County 46 43% Meigs County 50 48% Smith County 46 42% Bells 35 34% Elizabethton 50 43% Huntingdon SSD 50 43% Milan 50 41% South Carroll 48 45% Benton County 39 43% Etowah 40 39% Jackson County 50 44% Millington Municipal 45 36% Stewart County 40 39% Bledsoe County 50 43% Fayette County 50 55% Jefferson County 50 38% Monroe County 29 48% Sullivan County 44 40% Blount County 50 40% Fayetteville 27 37% Johnson City 31 44% Montgomery County 20 38% Sumner County 29 38% Bradford 49 47% Fentress County 42 49% Johnson County 25 35% Moore County 50 42% Sweetwater 37 45% Bradley County 49 38% Franklin County 50 38% Kingsport 42 35% Morgan County 31 40% Tipton County 50 39% Bristol 45 34% Franklin SSD 50 33% Knox County 31 30% Murfreesboro 32 36% Trenton 47 49% Campbell County 50 45% Germantown 34 25% Lake County 50 48% Newport 40 48% Trousdale County 48 57% Cannon County 50 44% Gibson Co Sp Dist 50 41% Lakeland 50 20% Oak Ridge 49 34% Tullahoma 36 38% Carter County 50 44% Giles County 50 35% Lauderdale County 50 44% Obion County 50 48% Unicoi County 48 45% Cheatham County 50 34% Grainger County 50 50% Lawrence County 50 40% Oneida 50 42% Union City 48 43% Chester County 50 36% Greene County 50 44% Lebanon 47 48% Overton County 50 44% Union County 48 40% Claiborne County 50 48% Greeneville 28 41% Lenoir City 33 47% Paris 50 45% Van Buren County 48 43% Clay County 50 39% Grundy County 50 42% Lewis County 44 45% Perry County 50 30% Warren County 25 45% Cleveland 34 40% Hamblen County 44 46% Lexington 50 45% Pickett County 50 49% Washington County 50 36% Clinton 50 40% Hamilton County 23 33% Lincoln County 40 40% Polk County 29 40% Wayne County 49 45% Cocke County 50 48% Hancock County 50 51% Loudon County 50 42% Putnam County 31 38% Weakley County 41 45% Coffee County 50 45% Hardeman County 50 46% Macon County 50 43% Rhea County 48 42% West Carroll Sp Dist 48 48% Collierville 26 25% Hardin County 41 49% Madison County 24 41% Richard City 37 47% White County 48 47% Crockett County 50 51% Hawkins County 45 45% Manchester 50 37% Roane County 46 39% Williamson County 30 21% Cumberland County 50 45% Haywood County 50 45% Marion County 43 44% Robertson County 30 39% Wilson County 37 35%