Are School Wellness Policies Associated with Weight

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Presentation transcript:

Are School Wellness Policies Associated with Weight and Related Behaviors Among Post Partum Teens? Debra Haire-Joshu, PhD, Michael Elliott, PhD, Rebecca Schermbeck, MPH, MS, RD, Cindy Schwarz, MPH, MS, RD Contact: Debra Haire-Joshu at 314-362-9554, djoshu@gwbmail.wustl.edu Center for Obesity Prevention and Policy Research, George Warren Brown School of Social Work and Department of Internal Medicine, Washington University, St. Louis, MO Background and Methods Results Background The quality of the food and activity environment may impact the ability to make or sustain behavior changes. The Child Nutrition and WIC Reauthorization Act of 2004 required that all school districts with federally-funded school meals develop and implement school wellness policies (SWP). SWPs vary in content and strength. Little is known about the impact of these SWPs on weight reduction interventions. BALANCE (Balance Adolescent Lifestyle Activities and Nutrition Choices for Energy) is a group randomized obesity prevention intervention delivered through Parents As Teachers at home, school, and via internet website 960 postpartum teens across 22 states Primary outcome: decrease in postpartum weight retention Intermediate outcomes : replace sweet drinks, high fat snacks excess portion size, and sedentary activity with water intake, fruit and vegetable intake, recommended portion size and walking. Purpose (1) To describe the quality of SWPs of schools participating in a randomized weight reduction trial for teens; (2) To determine if SWPs are associated with the effectiveness of the BALANCE intervention. Methods We collected and evaluated SWPs from the 335 school districts of randomized to the BALANCE intervention and analyzed relationship between SWP quality and pre-post change in postpartum teens. . Mean SWP Quality Score Policy Area Score type MN (SD) Total score Comp. 39 (19) Physical education 32 (23) Strength 19 (12) 17 (14) Nutrition education 47 (28) Physical activity 38 (27) 29 (21) 22 (18) USDA school meal standards 40 (24) Communication and promotion 39 (25) 24 (17) 20 (18) Competitive foods standards 38 (20) Evaluation 56 (27) 10 (15) 30 (25) Correlations of SWP with BALANCE Pre-Post Outcomes Among Postpartum Teens Policy Area Score type BMI % Change Total Cal. Oz Water Cal. Sugar Bev. Cal. Snacks Cal. Fruit & Veg. Min. Walking District policy total Comp. .035 -.073 .030 -.067 .132 -.076 Strength .101 -.053 .065 -.039 .078 -.062 Nutrition education -.007 -.091 -.064 -.014 -.080 .159* -.029 .046 -.054 .118 -.019 USDA school meal standards .032 .000 -.158* .094 .020 .107 -.081 -.005 -.112 -.022 .060 -.044 Competitive foods standards .071 -.177* -.066 -.121 .017 -.075 .155 -.170* .001 -.017 -.082 -.028 -.047 Physical education -.003 -.033 -.146 .067 -.079 .170* -.108 .040 -.132 .019 -.048 .151 -.061 Physical activity -.008 .002 -.088 .084 -.043 .130 -.006 -.119 .149 .080 -.118 Communication and promotion .041 -.060 .038 -.015 .153* .050 .042 -.089 .059 .053 .013 Evaluation .014 .079 .003 .092 -.025 .083 -.099 .115 .039 .095 -.052 SWP Measures SWP Evaluation Tool A 96 item coding system by Schwartz et al (2009) yielded a total policy score (0% to 100%) and sub scores for comprehensiveness and strength. Teen Measures Height and Weight 2. Beverage and Snack Food Frequency Questionnaire (R=0.67) 31 items measuring: Total calories from snacks and beverages Total ounces of water Calories from sugary beverages Calories from snack foods Calories from fruits and vegetables 3. 3-Day Self-Administered Physical Activity Questionnaire (R=.50) Descriptive Parameters (N=960) Age MN = 17.6 (SD 1.3) BMI% MN=80.86 (SD 18.9) BMI % Change MN=10.0 (SD 17.4) Overweight/Obese 49.5% White Black Hispanic 50.3% 28.1% 18.9% Daily calories from snacks and beverages MN = 1656 (SD 1067) Daily minutes walking MN = 29 (SD 40) *Correlation is significant at the 0.05 level (2-tailed) Conclusions and Policy Implications z SWPs are generally weak (total comp. 39% and strength 19%) ; evaluation area has highest scores ; lowest comp. score was physical education (32%) ; lowest strength score was competitive food standards (10%). Despite low scores, competitive foods standards were related to reduced total calories; comp .score in nutrition education, physical education, and communication were related to improved FV consumption. Policy Implications Improvements in SWP language is needed and may enhance the impact of specific energy balance behaviors. SWPs appear to influence the environment and impact of energy balance interventions. Funded by: National Cancer Institute of the National Institutes of Health