University of Maryland School of Medicine, Department of Pediatrics, 737 West Lombard Street, Room 163, Baltimore, MD 21201, USA; Wellness Corporate Solutions, Inc. 7617 Arlington Rd. Bathesda, MD 20814.
University of Maryland School of Medicine, Department of Pediatrics, 737 West Lombard Street, Room 163, Baltimore, MD 21201, USA.
Prev Med. 2017 Aug;101:34-37. doi: 10.1016/j.ypmed.2017.05.016. Epub 2017 May 17.
Schools with wellness teams are more likely to implement federally mandated Local Wellness Policies (LWPs, Local Education Agency-level policies for healthy eating/physical activity). Best practices have been developed for wellness teams based on minimal empirical evidence. The purpose of this study is to determine, among schools with wellness teams, associations between LWP implementation and six wellness team best practices (individually and as a sum score). An online survey targeting Maryland school wellness leaders/administrators (52.4% response rate, 2012-2013 school year) was administered that included LWP implementation (17-item scale: categorized as no, low, and high implementation) and six wellness team best practices. Analyses included multi-level multinomial logistic regression. Wellness teams were present in 311/707 (44.0%) schools, with no (19.6%), low (36.0%), and high (44.4%) LWP implementation. A sum score representing active wellness teams (mean=2.6) included: setting healthy eating/physical activity goals (66.9%), informing the public of LWP activities (71.4%), meeting ≥4times/year (45.8%), and having school staff (46.9%), parent (25.4%), or student (14.8%) representation. In adjusted models, goal setting, meeting ≥4times/year, and student representation were associated with high LWP implementation. For every one-unit increase in active wellness team sum score, schools were 41% more likely to be in high versus no implementation (Likelihood Ratio=1.41, 95% C.I.=1.13, 1.76). In conclusion, wellness teams meeting best practices are more likely to implement LWPs. Interventions should focus on the formation of wellness teams with recommended composition/activities. Study findings provide support for wellness team recommendations stemming from the 2016 Healthy, Hunger-Free Kids Act final rule.
学校设立健康小组更有可能实施联邦授权的《地方健康政策》(LWP,地方教育机构层面的健康饮食/体育活动政策)。根据有限的经验证据,已经为健康小组制定了最佳实践。本研究的目的是确定在设有健康小组的学校中,LWP 实施情况与六个健康小组最佳实践(分别和总和)之间的关联。针对马里兰州学校健康负责人/管理人员(2012-2013 学年,回应率为 52.4%)进行了一项在线调查,其中包括 LWP 实施情况(17 项量表:分为无、低和高实施)和六个健康小组最佳实践。分析包括多层次多项逻辑回归。在 707 所学校中,有 311 所(44.0%)设有健康小组,LWP 实施情况分别为无(19.6%)、低(36.0%)和高(44.4%)。代表积极健康小组的总和分数(均值=2.6)包括:设定健康饮食/体育活动目标(66.9%)、告知公众 LWP 活动(71.4%)、至少每季度开会 4 次(45.8%)以及有学校工作人员(46.9%)、家长(25.4%)或学生(14.8%)代表。在调整后的模型中,目标设定、至少每季度开会 4 次和学生代表与高 LWP 实施相关。健康小组总和分数每增加一个单位,学校高实施的可能性就增加 41%(优势比=1.41,95%置信区间=1.13,1.76)。总之,符合最佳实践的健康小组更有可能实施 LWP。干预措施应侧重于组建具有推荐组成/活动的健康小组。研究结果为源自 2016 年《健康、无饥饿儿童法案》最终规定的健康小组建议提供了支持。