Nollen Nicole L, Befort Christie A, Snow Patricia, Daley Christine Makosky, Ellerbeck Edward F, Ahluwalia Jasjit S
Department of Preventive Medicine and Public Health, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, USA.
Int J Behav Nutr Phys Act. 2007 May 18;4:18. doi: 10.1186/1479-5868-4-18.
To examine high school personnel's perceptions of the school environment, its impact on obesity, and the potential impact of legislation regulating schools' food/beverage offerings.
Semi-structured interviews were conducted with the principal (n = 8) and dietitian/food service manager (n = 7) at 8 schools (4 rural, 4 suburban) participating in a larger study examining the relationship between the school environment and adolescent health behavior patterns.
Principal themes included: 1) Obesity is a problem in general, but not at their school, 2) Schools have been unfairly targeted above more salient factors (e.g., community and home environment), 3) Attempts at change should start before high school, 4) Student health is one priority area among multiple competing demands; academic achievement is the top priority, 5) Legislation should be informed by educators and better incorporate the school's perspective. Food service themes included: 1) Obesity is not a problem at their school; school food service is not the cause, 2) Food offerings are based largely on the importance of preparing students for the real world by providing choice and the need to maintain high participation rates; both healthy and unhealthy options are available, 3) A la carte keeps lunch participation high and prices low but should be used as a supplement, not a replacement, to the main meal, 4) Vending provides school's additional revenue; vending is not part of food service and is appropriate if it does not interfere with the lunch program.
Discrepancies exist between government/public health officials and school personnel that may inhibit collaborative efforts to address obesity through modifications to the school environment. Future policy initiatives may be enhanced by seeking the input of school personnel, providing recommendations firmly grounded in evidence-based practice, framing initiatives in terms of their potential impact on the issues of most concern to schools (e.g., academic achievement, finances/revenue), and minimizing barriers by providing schools adequate resources to carry out and evaluate the effectiveness of their efforts.
研究高中工作人员对学校环境的看法、其对肥胖的影响以及规范学校食品/饮料供应的立法的潜在影响。
对参与一项关于学校环境与青少年健康行为模式关系的更大规模研究的8所学校（4所农村学校，4所郊区学校）的校长（n = 8）和营养师/食品服务经理（n = 7）进行了半结构化访谈。
主要主题包括：1）肥胖总体上是个问题，但在他们学校不是；2）学校在比更突出的因素（如社区和家庭环境）之上被不公平地作为目标；3）变革尝试应在高中之前开始；4）学生健康是多项相互竞争需求中的一个优先领域；学业成绩是首要优先事项；5）立法应由教育工作者提供信息，并更好地纳入学校的观点。食品服务主题包括：1）肥胖在他们学校不是问题；学校食品服务不是原因；2）食品供应很大程度上基于通过提供选择让学生为现实世界做好准备的重要性以及维持高参与率的需要；健康和不健康的选择都有；3）单点菜品使午餐参与率高且价格低，但应作为主餐的补充，而非替代品；4）自动售货机为学校提供额外收入；自动售货机不属于食品服务，如果不干扰午餐计划则是合适的。
政府/公共卫生官员与学校工作人员之间存在差异，这可能会抑制通过改变学校环境来解决肥胖问题的合作努力。未来的政策举措可以通过征求学校工作人员的意见、提供基于循证实践的坚定建议、根据对学校最关心的问题（如学业成绩、财务/收入）的潜在影响来制定举措，以及通过为学校提供足够资源来实施和评估其努力的有效性来减少障碍而得到加强。
