Lucarelli Jennifer F, Alaimo Katherine, Belansky Elaine S, Mang Ellen, Miles Richard, Kelleher Deanne K, Bailey Deborah, Drzal Nicholas B, Liu Hui
Oakland University, Rochester, MI, USA
Michigan State University, East Lansing, MI, USA.
Health Promot Pract. 2015 Mar;16(2):193-201. doi: 10.1177/1524839914550245. Epub 2014 Sep 23.
The Child Nutrition and WIC Reauthorization Act of 2004 mandated written school wellness policies. Little evidence exists to evaluate the impact of such policies. This study assessed the quality (comprehensiveness of topics addressed and strength of wording) of wellness policies and the agreement between written district-level policies and school-reported nutrition policies and practices in 48 low-income Michigan school districts participating in the School Nutrition Advances Kids study.
Written wellness policy quality was assessed using the School Wellness Policy Evaluation Tool. School nutrition policies and practices were assessed using the School Environment and Policy Survey. Analysis of variance determined differences in policy quality, and Fisher's exact test examined agreement between written policies and school-reported practices.
Written wellness policies contained ambiguous language and addressed few practices, indicating low comprehensiveness and strength. Most districts adopted model wellness policy templates without modification, and the template used was the primary determinant of policy quality. Written wellness policies often did not reflect school-reported nutrition policies and practices.
School health advocates should avoid assumptions that written wellness policies accurately reflect school practices. Encouraging policy template customization and stronger, more specific language may enhance wellness policy quality, ensure consistency between policy and practice, and enhance implementation of school nutrition initiatives.
2004年的《儿童营养与妇女、婴儿和儿童特别补充营养计划重新授权法案》要求制定书面的学校健康政策。但几乎没有证据可用于评估此类政策的影响。本研究评估了密歇根州48个参与“学校营养促进儿童”研究的低收入学区的健康政策质量(所涵盖主题的全面性和措辞力度),以及地区层面书面政策与学校报告的营养政策及实践之间的一致性。
使用学校健康政策评估工具评估书面健康政策的质量。使用学校环境与政策调查评估学校营养政策及实践。方差分析确定政策质量的差异,费舍尔精确检验考察书面政策与学校报告的实践之间的一致性。
书面健康政策语言模糊,涉及的实践很少,表明全面性和力度较低。大多数地区未经修改就采用了示范健康政策模板,所使用的模板是政策质量的主要决定因素。书面健康政策往往不能反映学校报告的营养政策及实践。
学校健康倡导者应避免认为书面健康政策能准确反映学校实践的假设。鼓励对政策模板进行定制,并使用更强有力、更具体的语言,可能会提高健康政策质量,确保政策与实践的一致性,并加强学校营养倡议的实施。