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| What the Law Looks Like?
In the Child Nutrition and WIC Reauthorization Act of 2004, the U.S. Congress established a requirement that all school districts with a federally funded school meals program develop and implement wellness policies that address nutrition and physical activity by the start of the 2006-2007 school year (Section 204).
When developing wellness policies, school districts needed to take into account their unique circumstances, challenges and opportunities. Among the factors considered were socioeconomic status of the student body, school size, rural or urban location, and presence of immigrant, dual-language, or limited-English students. (http://www.schoolwellnesspolicies.org/)
Policies needed to cover areas of nutrition education, physical activity and nutrition standards for all foods available at school during the day. Areas addressed included nutritional value of foods, portion sizes, vending, after school programs, parties and meetings with food, the use of food as a reward or punishment, time and surroundings during meals, professional qualifications of food service personnel and means to evaluate the policies. Many wellness models were available for school districts to examine.
Policies should include all components required by law, i.e. - Goals for nutrition education, physical activity, and other wellness activities;
- Guidelines for foods and beverages available on campus during the school day;
- Guidelines for other activities promoting wellness;
- Planning for implementation
- Involvement of parents, students, representatives of nutrition program, school and public in the development of the policy
How does the School Wellness Policy Impact the School Nurse?
This was and is a great opportunity for the school nurse to collaborate with a number of school and community members regarding wellness policies. The team should be comprised of a broad group of individuals including parents, students, representatives of the school food authority, the school board, school administrators, and the public. Other members of the committee should include dieticians, parks and recreation leaders, pediatricians, local food vendors, and others. This challenge requires the expertise of a school nurse liaison who practices in the context of school, family, and community.
Local school districts will benefit greatly by having the school nurse involved with or leading the development of their school wellness policy. It is time for school nurses to take the lead in efforts aimed at improving the quality of students’ dietary intake in the school setting. School nurses have knowledge and expertise in the areas of nutrition, weight maintenance, and exercise (NASN Position Statement "Overweight Children and Adolescents", 2002). Because of their role in school, nurses are knowledgeable about the needs and the resources necessary for wellness.
Section 204 of this law requires the Secretary of Agriculture (in conjunction with the Centers for Disease Control and Prevention-CDCP) to make information and technical assistance available to establish healthy school nutrition environments, reduce childhood obesity, and prevent diet-related chronic diseases. As a leader or as a participant, the school nurse role includes that of: - Identifier of incidence of diet-related chronic disease and indications for prevention and treatment;
- Advisor/consultant on school health committees; advise on the necessity of good nutrition for learning and brain function;
- Advocate for healthy, nutritious food and beverage choices to be made available in all school vending machines, school stores, snack bars, and any area in school where food is sold (NASN Resolution, Vending Machines and Healthy Food Choices in Schools, 2004);
- Active participant or team leader in the new wellness policy development;
- Health/nutrition educator for students, staff, parents and community;
- Liaison with school and community as well as student and family involvement;
- Implementer and manager of new wellness policy and school based programs;
- Advocate for school and community facilities for physical activities for all;
- Provider of health referrals as appropriate and as needed;
- Provider of support and follow up as needed;
- Model of healthy eating choices!
There are many resources available to school nurses about health, nutrition and exercise. There is also a wealth of information about how to write a school wellness policy. The following information is provided for your use in understanding the law and the requirements of the policy. NASN does not endorse nor promote the examples listed. They are listed to offer a framework for the school nurse.
School nurses are commended for their involvement in the opportunity to demonstrate a leadership role in the development of school policy.
The following resources offer nutrition guidelines and wellness policy models and requirements. Build a Healthy School Community
NASN Childhood Obesity Resources
http://www.nasn.org/Default.aspx?tabid=594
The Coordinated School Health model serves as an excellent template on which to strengthen wellness concepts already in place. The eight components assist schools to include all of the support services provided for students and staff. The evaluation required by the Act is an expected component of each area (http://www.cdc.gov/healthyyouth/CSHP/). - Health Education - "a planned, sequential, K-12 curriculum that addresses the physical, mental, emotional, and social dimensions of health". An educational component is easily expanded to include the adult population of a school, its faculty, staff, and the parents/caregivers who entrust their children to the school, and participate in the life of the school. "Nutrition education and standards, the value of nutrition awareness, portion control, and vending machine options" are content items that can easily be included or developed further within a health curriculum.
- Physical Education – "a planned, sequential K-12 curriculum that provides cognitive content and learning experiences in a variety of activity areas…." The relationships between nutrition, activity, and a strong, healthy body and mind are content areas related to physical education.
- Health Services – "services provided for students to appraise, protect, and promote health" (Ibid). In this capacity, "qualified" health professionals can assess, plan, implement and coordinate wellness-related activities for the student and adult communities of a school.
- Nutrition Services – "access to a variety of nutritious and appealing meals that accommodate the health and nutrition needs of all students" (Ibid). In addition to preparing meals for students and staff, nutrition services support this Act through education, compliance with standards, nutritional value of foods, portion control, recommendations about vending machine offerings, and qualifications of personnel.
- Counseling and Psychological Services – "Services provided to improve students’ mental, emotional, and social health" (Ibid). Food’s relationship to one’s perception of their appearance, and self-esteem is a very important reality in the lives of many students, and adults. The emphasis on the good, and healthy qualities of food, may result in a crisis or questioning by both students and adults. The "group assessments, [individual counseling], interventions, and referrals" (Ibid) are extremely important in the life of a school community.
- Healthy School Environment – "The physical and aesthetic surroundings and the psychosocial climate and culture of the school" (Ibid). Required policies relating to after-school programs, celebrations at school for students and adults, refreshments served at meetings, incentives provided by faculty, parent organizations, etc, and length of time and surroundings during school meals can all be addressed under the rubric of a healthy school environment.
- Health Promotion for Staff – "Opportunities for school staff to improve their health status through activities such as health assessments, health education, and health-related fitness activities" (Ibid). In addition to examples noted above for a healthy school environment, vending machine choices can be changed upon request of an informed and committed faculty and staff. Overall improvement in the health of any and all adults in the school translates into an improved learning and motivational environment for the students. School Districts have established comprehensive Wellness Programs for faculty and staff to reduce health insurance costs and improve health and wellbeing (Polk County Florida School Board Wellness Program, http://www.polk-fl.net/load.asp?page=/MarkWilcoxCenter/default.htm).
- Family/Community Involvement – "An integrated school, parent, and community approach for enhancing the health and well-being of students. School health advisory councils, coalitions, and broadly based constituencies for school health…." (http://www.cdc.gov/healthyyouth/CSHP/) can build support for wellness activities mandated by the Act.
Identify Outcomes
Although research based outcomes of the Child Nutrition and WIC Reauthorization Act of 2004 remain to be seen, school nurses can speculate a positive outcome for the health of students. Current research indicates the diet of the average student is less than ideal.
Furthermore, school nurses and other children’s health care advocates are alarmed at the risks for development of "adult" diseases at early ages, such as type 2 diabetes and high cholesterol. As these students mature, the resulting long-term effects of these diseases have yet to be documented Barlow and the Expert Committee (2007) http://pediatrics.aappublications.org/cgi/reprint/120/Supplement_4/S164
Breakfast has been shown to be vital to the success of students. The Food Research and Action Center (http://www.frac.org) has compiled references which demonstrate how a student’s nutritional status at breakfast affects his/her academic performance. Missing breakfast affects memory recall, math scores, absenteeism, behavioral and emotional problems in students.
School Wellness Policy Evaluation Models revised 2010 | |
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