Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115. E-mail:
Simmons College School of Social Work, Boston, Massachusetts.
Prev Chronic Dis. 2017 Dec 28;14:E142. doi: 10.5888/pcd14.160605.
Despite substantial research on school-based obesity prevention programs, it is unclear how widely they are disseminated. It is also unknown whether schools use obesity programs that inadvertently promote weight stigma or disordered weight-control behaviors.
In spring 2016, we distributed an online survey about school wellness programming to a simple random sample of US public school administrators (N = 247 respondents; 10.3% response rate). We analyzed survey responses and conducted immersion/crystallization analysis of written open-ended responses.
Slightly less than half (n = 117, 47.4%) of schools offered any obesity prevention program. Only 17 (6.9%) reported using a predeveloped program, and 7 (2.8%) reported using a program with evidence for effectiveness. Thirty-seven schools (15.0%) reported developing intervention programs that focused primarily on individual students' or staff members' weight rather than nutrition or physical activity; 28 schools (11.3% of overall) used staff weight-loss competitions. School administrators who reported implementing a program were more likely to describe having a program champion and adequate buy-in from staff, families, and students. Lack of funding, training, and time were widely reported as barriers to implementation. Few administrators used educational (n = 12, 10.3%) or scientific (n = 6, 5.1%) literature for wellness program decision making.
Evidence-based obesity prevention programs appear to be rarely implemented in US schools. Schools may be implementing programs lacking evidence and programs that may unintentionally exacerbate student weight stigma by focusing on student weight rather than healthy habits. Public health practitioners and researchers should focus on improving support for schools to implement evidence-based programs.
尽管针对学校肥胖预防计划进行了大量研究，但目前尚不清楚这些计划的传播范围有多广。也不知道学校是否使用了那些无意中助长体重歧视或紊乱的体重控制行为的肥胖计划。
2016 年春季，我们向美国公立学校管理人员的简单随机样本（N = 247 名受访者；回应率为 10.3%）分发了一份关于学校健康计划编制的在线调查。我们分析了调查结果，并对书面开放性回答进行了沉浸式/结晶分析。
略低于一半（n = 117，47.4%）的学校提供了任何肥胖预防计划。只有 17 所（6.9%）报告使用了预先制定的计划，7 所（2.8%）报告使用了具有有效性证据的计划。37 所学校（15.0%）报告开发了主要关注学生或教职员工个人体重而不是营养或体育活动的干预计划；28 所学校（整体的 11.3%）使用了员工减肥比赛。报告实施了计划的学校管理人员更有可能描述有一个计划的拥护者，以及教职员工、家长和学生的充分认同。缺乏资金、培训和时间被广泛认为是实施的障碍。很少有管理人员在进行健康计划决策时使用教育（n = 12，10.3%）或科学（n = 6，5.1%）文献。
在美国学校，基于证据的肥胖预防计划似乎很少实施。学校可能正在实施缺乏证据的计划，这些计划可能通过关注学生体重而不是健康习惯，无意中加剧学生的体重歧视。公共卫生从业人员和研究人员应重点关注改善对学校实施基于证据的计划的支持。
