Dissemination and Use of a School-Based Nutrition Education Program For Secondary School Students

ABSTRACT: Program dissemination and implementation represent critical components of effective school-based health promotion interventions. This study examined the dissemination and implementation of a nutrition teaching program, Nutrition For Life, in New York State secondary schools. Some 1,312 health, home economics, and physical education teachers in junior and senior high schools provided information through random sample mail surveys. Logistic regression procedures examined teacher and school characteristics associated with receipt and use of the program. Overall, 50% of junior high school and 33% of senior high school teachers received the program and three-quarters of these teachers used it. At both levels, home economics teachers were more likely to receive and use the program than health teachers. Peer-led teacher training workshops organized through an existing community-based network provide an effective and efficient mechanism for disseminating nutrition teaching programs.     

Impacts of a School-Based Intervention That Incorporates Nutrition Education and a Supportive Healthy School Canteen Environment among Primary School Children in Malaysia

In this study, a school nutrition program (SNP) that incorporates nutrition education and a healthy school canteen environment was developed to improve nutrition knowledge among intervention respondents and provide a healthier environment for them to practice healthy eating. In the current study, we evaluated the impacts of the SNP on eating behaviors, physical activity, body mass index-for-age (BAZ), and cognitive performance at pre-intervention, post-intervention, and 3-month follow-up points between intervention and comparison groups. This intervention study involved 523 primary school children (7–11 years old) from six selected schools in Batu Pahat District, Malaysia. Each respondent completed anthropometric and cognitive performance assessments and a set of standardized questionnaire at pre-intervention, post-intervention, and 3-month follow-up points. Multiple linear mixed model analysis was performed to determine the impacts of that SNP after being adjusted for covariates. After the program, the intervention group increased their frequency of breakfast, lunch, and dinner consumption and morning tea snacking and showed more frequent physical activity and better cognitive performance as compared to the comparison group overtime (p < 0.05). At 3-month follow-up, the intervention group showed lower BAZ scores than their comparison counterparts (p < 0.05). The SNP showed positive effects on eating behaviors, physical activity, BAZ, and cognitive performance in school children. Hence, the SNP is highly recommended for all primary school children.     

Design and Implementation of a 5-Year School-Based Nutrition Education Intervention

ObjectiveTo describe the research methods of a multicomponent nutrition education program empowering teachers to improve nutrition literacy and prevent obesity among elementary school students.DesignProspective 5-year study following a pre-post intervention design.SettingFour elementary schools in a high-needs area in Washington, DC: 2 intervention and 2 comparison schools.ParticipantsApproximately 100 teachers (25/school) and 800 students (200/school) enrolled over the study period.InterventionHealthy Schoolhouse 2.0 will engage teachers as agents of change by designing, implementing, and evaluating a structured professional development program to support the integration of nutrition concepts in the classroom.Main Outcome MeasuresChange in pre-post survey assessment of students’ nutrition literacy, attitudes, and intent; change in teachers’ self-efficacy toward teaching nutrition; fruit and vegetable consumption data collected 6 times/y in the cafeteria.AnalysisProcess evaluation throughout the study to document implementation and challenges. Multilevel mixed modeling will be used to determine the impact of the intervention.     

The Status of School-Based Nutrition Education at the State Agency Level

ABSTRACT: The status of school-based nutrition education at the state agency level was examined. Telephone interviews with agencies in all 50 states revealed that nine states mandated nutrition be taught and another 21 included nutrition as a required topic in mandated subjects, frequently health. The other states had initiatives to promote school-based nutrition education but it was not required. Published requirements for teacher certification in elementary education, home economics, and health education seldom (two to three states) specified nutrition as a requirement. However, follow-up investigations revealed many states indirectly promote nutrition preparation for home economics and health education teachers through guidelines for approval of college programs in these areas. An inventory of nutrition education curricular materials revealed they were most frequently directed to grades K-6 and focused mainly on general foods and nutrition or that related to health. Given the links that emerged between health and nutrition, incorporating nutrition into health education may help promote school-based nutrition education. (J Sch Health. 1992;62(3):88–92)     

School Nurses' Perceptions and Practices of Assisting Students in Obtaining Public Health Insurance

BACKGROUND: From January through June 2009, 6.1 million children were uninsured in the United States. On average, students with health insurance are healthier and as a result are more likely to be academically successful. Some schools help students obtain health insurance with the help of school nurses. METHODS: This study assessed public school nurses' knowledge and beliefs of the impact of health insurance on students' health and academic success. The study also determined whether public school nurses or their schools were involved in helping students obtain public health insurance, and if so, how they did so. Additionally, the study assessed the public school nurses' perceived benefits of and barriers to helping students obtain public health insurance. A paper-and-pencil survey was sent to a national random sample of 750 public school nurses. The response rate was 56%. RESULTS: Nearly 60% of respondents had helped students enroll in public health insurance. The majority perceived that helping students obtain public health insurance would reduce school absenteeism (90%), improve attention during school (84%), reduce the number of students held back (80%), reduce school dropouts (72%), and increase academic test scores (69%). Although the majority (53%) of nurses thought schools should assist students' parents with filling out public health insurance enrollment forms, some expressed reservations about the process. CONCLUSION: School nurses indicated health insurance is important for the health and academic success of students. These beliefs are congruent with state Child Health Insurance Program (CHIP) directors' perceptions, yet few schools have taken on the role of facilitating student enrollment in public health insurance programs.     

中小学校领导对学校健康教育的认识、态度和需求

目的 了解中小学校领导对学校健康教育的认识、态度和需求。方法 对6省（直辖市）下属的12个市（县）的57所学校中103名中小学校领导进行访谈调查。结果 多数学校按要求开设了健康教育课，部分学校已将其纳入了学校工作计划，并成立了领导小组。学校领导普遍认为有必要在中小学设置健康教育课，多数人对现有教材及其内容表示满意。认为社会各界对学校健康教育工作的重视不够，多数人未接近过健康方面的专门培训，结论 学校领导提高认识，是做好学校健康教育工作的首要前提。领导小组成员除学校员工代表和学校领导外，还应包括学生、家长和学校所在社区人员。对学校领导进行定期的、系统的健康知识培训有助于推动学校健康教育工作的开展。     

Perceptions of Low-Income Students Completing a Nutrition Education Program

ObjectiveTo capture students’ perceptions of participating in a nutrition education program.DesignFocus groups (n = 16).SettingLow-income schools in Rhode Island.ParticipantsA total of 64 low-income, ethnically and racially diverse third-grade students, 93.5% of whom were eligible for free or reduced-price meals, 62% of whom were Hispanic, and 16% of whom were black.Main Outcome Measure(s)Perceptions about the program's impact on food and beverage consumption, the value of the program, potential changes for improvement, and barriers to change.AnalysisFocus groups were recorded, transcribed, and coded using a hybrid approach of inductive and deductive thematic analysis. Interrater agreement was calculated.ResultsStudents perceived that the program positively influenced their attitudes toward making healthy choices and what they and their families were eating. Students reported increased empowerment, bravery to try new foods, and knowledge. Students enjoyed the program but suggested increasing the duration and frequency of lessons and including peer-to-peer education. Students felt that the tastiness of unhealthy food was a barrier to choosing healthier food.Conclusions and ImplicationsFindings suggest that the program may have improved students’ knowledge, empowerment, and bravery, and that this had a positive influence on healthy food consumption for students and their families. Input from students will help inform future modifications to the curriculum.     

Nurses' Perceptions of Pediatric Nursing Functions

The purpose of this study was to describe nurses' perceptions of the importance of pediatric nursing functions and to determine if there were differences in perceptions of nurses in managerial clinical and teaching positions Subjects were 125 pediatric nurses in managerial clinical and teaching positions Respondents were asked to rate the importance of 43 nursing functions on a 9-point scale ranging from highly important to not at all important Mean ratings of pediatric nursing functions were determined and one-way analyses of variance performed. The five nursing functions perceived to be most important were, in order of ranking (a) providing emotional support of children (b) recognizing significant physical deviations, (c) implementing nursing interventions (d) preparing children psychologically for procedures and surgery and (e) identifying nursing problems Significant differences were found between groups in perceptions of the importance of 23 nursing functions mainly in the areas of psychosocial care teaching and nursing process Most differences were between the teaching and managerial groups or between teaching and the managerial and clinical groups combined Differences in perceptions of the importance of a number of nursing functions though not great suggest a need for more dialogue between managers teachers and clinicians.     

Nurses' Perceptions of Pediatric Nursing Functions

The purpose of this study was to describe nurses' perceptions of the importance of pediatric nursing functions and to determine if there were differences in perceptions of nurses in managerial clinical and teaching positions Subjects were 125 pediatric nurses in managerial clinical and teaching positions Respondents were asked to rate the importance of 43 nursing functions on a 9-point scale ranging from highly important to not at all important Mean ratings of pediatric nursing functions were determined and one-way analyses of variance performed. The five nursing functions perceived to be most important were, in order of ranking (a) providing emotional support of children (b) recognizing significant physical deviations, (c) implementing nursing interventions (d) preparing children psychologically for procedures and surgery and (e) identifying nursing problems Significant differences were found between groups in perceptions of the importance of 23 nursing functions mainly in the areas of psychosocial care teaching and nursing process Most differences were between the teaching and managerial groups or between teaching and the managerial and clinical groups combined Differences in perceptions of the importance of a number of nursing functions though not great suggest a need for more dialogue between managers teachers and clinicians.     

Impact of a Pilot School-Based Nutrition Intervention on Fruit and Vegetable Waste at School Lunches

ObjectiveTo determine the preliminary impact of the Brighter Bites nutrition intervention on decreasing fruit and vegetable (F&V) waste at school lunches among fourth- and fifth-grade children.MethodThis was a nonrandomized pre–post-controlled study in Houston and Dallas, TX. Two schools received the Brighter Bites intervention (n = 76), and 1 comparison school (n = 39), during the 2017-2018 school year. Brighter Bites is a 16-week school-based nutrition intervention providing weekly distribution of fresh F&V plus nutrition education. Main outcome measures were direct observation and weights to measure the number of F&V dishes selected at school lunches, amount of F&V wasted (gm), and related nutrient waste (4 time points/child). Mixed-effects linear regression analysis was used to determine change in F&V selection and waste over time.ResultsThere was a significant decrease over time in proportion of F&V selected among those in the comparison school, but not the intervention schools (P < .001). Compared with children in the comparison group, those receiving Brighter Bites showed a significant decrease in the amount of F&V wasted at each meal (P < .001) and per item (P < .05) at the end of both 8 and 16 weeks of intervention. There were significant decreases in waste of energy (kcal); dietary fiber (gm); vitamins B₁, B₃, and B₆ (mg); total folate (µg); and B₁₂ (µg) among those receiving Brighter Bites (P < .05).Conclusions and ImplicationsAlthough absolute food or nutrient changes were small even when significant, programs such as Brighter Bites may contribute to a healthy intake. Future studies are warranted that include a larger sample size with a stringent, cluster-randomized control trial design and consideration for other covariates.     

A Legislative Perspective on the School Nurse and Education for Children with Disabilities in New Jersey

The New Jersey Dept. of Education has proposed a new direction for interpreting the "Education for All Handicapped Children Act of 1975" (Public Law 94-142). If implemented, a new and broader scope of addressing learning and/or behavior and health problems for the school-aged child will be provided. In this article, the special education process in New Jersey is analyzed, reflecting on political, economic, and social movements that affected past and present legislation. The effects of the new proposal on students, families, school personnel, and community resources are emphasized. Role implications for the school nurse in formulating, interpreting, and managing the child with disability in school are provided.