Staten Lisa K, Teufel-Shone Nicolette I, Steinfelt Victoria E, Ortega Nohemi, Halverson Karen, Flores Carmen, Lebowitz Michael D
Division of Health Promotion Sciences and Southwest Center for Community Health Promotion, Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, Tucson, AZ 85719, USA.
Prev Chronic Dis. 2005 Jan;2(1):A19. Epub 2004 Dec 15.
The increase in childhood obesity and prevalence of chronic disease risk factors demonstrate the importance of creating healthy school environments. As part of the Border Health Strategic Initiative, the School Health Index was implemented in public schools in two counties along the Arizona, United States-Sonora, Mexico border. Developed in 2000 by the Centers for Disease Control and Prevention, the School Health Index offers a guide to assist schools in evaluating and improving opportunities for physical activity and good nutrition for their students.
Between 2000 and 2003, a total of 13 schools from five school districts in two counties participated in the School Health Index project despite academic pressures and limited resources.
The Border Health Strategic Initiative supported the hiring and training of an external coordinator in each county who was not part of the school system but who was an employee in an established community-based organization. The coordinators worked with the schools to implement the School Health Index, to develop action plans, and to monitor progress toward these goals.
The School Health Index process and school team participation varied from school to school. Individual plans were different but all focused on reducing in-school access to unhealthy foods, identified as high-fat and/or of low nutritional value. Ideas for acting on this focus ranged from changing the content of school lunches to discontinuing the use of nonnutritious foods as classroom rewards. All plans included recommendations that could be implemented immediately as well as those that would require planning and perhaps the formation and assistance of a subcommittee (e.g., for developing or adopting a district-wide health curriculum).
After working with the School Health Index, most schools made at least one immediate change in their school environments. The external coordinator was essential to keeping the School Health Index results and action plans on the agendas of school administrators, especially during periods of staff turnover. Staff turnover, lack of time, and limited resources resulted in few schools achieving longer-term policy changes.
儿童肥胖率的上升以及慢性病风险因素的普遍存在表明创建健康学校环境的重要性。作为边境健康战略倡议的一部分，学校健康指数在美国亚利桑那州与墨西哥索诺拉州边境沿线的两个县的公立学校中实施。学校健康指数由疾病控制与预防中心于2000年制定，为学校评估和改善学生体育活动及良好营养的机会提供指导。
在2000年至2003年期间，尽管面临学业压力和资源有限的情况，来自两个县五个学区的13所学校参与了学校健康指数项目。
边境健康战略倡议支持在每个县聘用和培训一名外部协调员，该协调员不属于学校系统，但为一家既定的社区组织的员工。协调员与学校合作实施学校健康指数，制定行动计划，并监测这些目标的进展情况。
学校健康指数流程和学校团队参与情况因校而异。个别计划各不相同，但都侧重于减少校内获取不健康食品的机会，不健康食品被定义为高脂肪和/或低营养价值的食品。针对这一重点采取行动的想法包括从改变学校午餐的内容到停止将无营养食品用作课堂奖励。所有计划都包括了可以立即实施的建议以及那些需要规划且可能需要成立小组委员会并获得其协助的建议（例如，制定或采用全学区的健康课程）。
在参与学校健康指数项目后，大多数学校至少对其学校环境立即做出了一项改变。外部协调员对于将学校健康指数结果和行动计划列入学校管理人员的议程至关重要，尤其是在人员更替期间。人员更替、时间不足和资源有限导致很少有学校实现长期政策变革。
