Bauer Katherine W, Patel Aarti, Prokop Lisa A, Austin S Bryn
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minn, USA.
Prev Chronic Dis. 2006 Apr;3(2):A37. Epub 2006 Mar 15.
Addressing childhood overweight has become a top priority in the United States. Modification of school policies and practices has been used in an attempt to address the overweight epidemic among children and adolescents. Culturally diverse urban schools in low-income communities attempting to improve nutrition and increase physical activity may face unique challenges in the school environment. A better understanding is needed about school environments and how they may affect the implementation, efficacy, and sustainability of initiatives designed to improve nutrition and physical activity.
We carried out a qualitative study in five urban middle schools in low-income communities that had recently implemented Planet Health, a nutrition and physical activity intervention, to assess which aspects of the schools' physical, social, and policy environments were facilitating or impeding the implementation of health promotion initiatives. Thirty-five faculty and staff members participated. We conducted one focus group per school, with an average of seven participants per group. We analyzed focus group transcripts using the thematic analysis technique to identify key concepts, categories, and themes.
Teachers and staff members in our study identified many school-related environmental barriers to successful implementation of nutrition and physical activity initiatives in their schools. School personnel recommended that classroom-based nutrition interventions such as Planet Health be coordinated with school food services so that the healthy messages taught in the classroom are reinforced by the availability of healthy, culturally appropriate cafeteria food. They identified household food insufficiency and overly restrictive eligibility criteria of the federally subsidized meal program as critical barriers to healthy nutritional behaviors. They also identified weight-related teasing and bullying and unhealthy weight-control behaviors as challenges to promotion of healthy nutrition and physical activity.
To maximize intervention efforts, researchers and practitioners must consider the effects of school environments on nutrition and physical activity initiatives.
解决儿童超重问题已成为美国的首要任务。学校政策和做法的调整已被用于应对儿童和青少年超重流行问题。低收入社区中文化多元的城市学校试图改善营养状况并增加体育活动，在学校环境中可能面临独特的挑战。需要更好地了解学校环境以及它们如何影响旨在改善营养和体育活动的举措的实施、效果和可持续性。
我们在低收入社区的五所城市中学开展了一项定性研究，这些学校最近实施了“健康星球”营养与体育活动干预项目，以评估学校的物理、社会和政策环境的哪些方面促进或阻碍了健康促进举措的实施。35名教职员工参与了研究。我们每所学校进行了一次焦点小组讨论，每组平均有7名参与者。我们使用主题分析技术分析焦点小组讨论记录，以确定关键概念、类别和主题。
我们研究中的教师和工作人员指出了许多与学校相关的环境障碍，这些障碍妨碍了他们学校成功实施营养和体育活动举措。学校工作人员建议，像“健康星球”这样基于课堂的营养干预应与学校食品服务协调，以便通过提供健康、符合文化习惯的自助餐厅食物来强化课堂上讲授的健康信息。他们指出家庭食物不足以及联邦补贴膳食计划过于严格的资格标准是健康营养行为的关键障碍。他们还指出与体重相关的取笑和欺凌以及不健康的体重控制行为是促进健康营养和体育活动的挑战。
为了最大限度地提高干预效果，研究人员和从业者必须考虑学校环境对营养和体育活动举措的影响。
