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NFSC ASHA Presentation - PowerPo

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NFSC ASHA Presentation - PowerPo Powered By Docstoc
					                                                                                                                                                                Nutrition Friendly Schools and Communities (NFSC) Lessons Learned
                                                                                                                                                                                  Stephanie Vecchiarelli1, EdD, MPH, Charlotte Neumann2, MD, MPH, Mike Prelip1, DPA, MPH, Wendy Slusser2, MD, MS, Aurora Cerda1, BA, Sue LaVaccare1, MA, Linda Lange1, DrPH, MPH, Jenny Chang1, MPH




     NFSC Goal                                                                                                                                                                                                            NFSC Data Collection                                                                                                                                                                                          How Did Schools Achieve 15 Steps
     Actively engage school community to prevent overweight in elementary school children through multi-level participative                                                                                               •     Student 24 hour recalls, height, weight, triceps skin fold, nutrition and physical activity knowledge and attitudes
                                                                                                                                                                                                                                                                                                                                                                                                                                             Administration and Environment          ·   Develop nutrition and physical activity policies
     intervention facilitating coordinated changes in the school environment to support healthy eating and physical activity behaviors of                                                                                 •     Adult nutrition and physical activity knowledge, attitudes, and behaviors questionnaire, self-reported dietary and anthropometric measures..                                                                                                         ·   Distribute “No Junk Food” policy to parents
     students, staff, and parents.                                                                                                                                                                                        •     Student level academic measures including test scores, attendance                                                                                                                                                                                    ·   Develop Guidelines for Nutritious Classroom Parties
                                                                                                                                                                                                                          •     School measures including attendance, test scores, discipline records, nurse records                                                                                                                                                                 ·   Post 15 Steps school wide (offices, classrooms, lounge)
                                                                                                                                                                                                                          •     School environment measures                                                                                                                                                                                                                          ·   Generate list of healthy fundraisers
                                                                                                                                                                                                                          •     Process measures baseline and post – intervention                                                                                                                                                                                                    ·   Administrator participation on NFSC committee
                                                                                                                                                                                                                          •     Self-evaluation of 15 Steps
 NFSC Development                                                                                                                                                                                                                                                                                                                                                                                                                            Nutrition Education                     · Identify nutrition education curricula – working with LAUSD Health Education department
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     · Use Dairy Council, 5 A Day, and Nutrition Network curriculum
 Adapted steps and concepts from:
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     · Recruit Los Angeles County public health nurses to speak to students about nutrition
 • Baby Friendly Hospital Initiative (BFHI)
 • Coordinated School Health Model (CSHM)
                                                                                                                                                                                                                         NFSC Environmental (Self-Evaluation) Results                                                                                                                                            Baseline 2003
 • Community Based Participatory Research (CBPR)                                                                                                                                                                                                                                                                                                                                                                                             Food Service                            · Meet recommendations for foods served as part of the National School Breakfast and Lunch Programs.
                                                                                                                                                                                                                                                                                                         Number of Steps Met by Each School                                                                      Post 2005                                                          · Provide healthy snacks and beverages in vending machines
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     · Request to be part of LAUSD Food Service survey
 Collaboration among Los Angeles Unified School District (LAUSD) school community stakeholders and UCLA School of Public Health
 research team.                                                                                                                                                                                                                                   15
 • small work group meetings                                                                                                                                                                                                                                                                                                                                                                                                                 Physical Education and Activity         · Teachers participate in training to use yoga in classroom
                                                                                                                                                                                                                                                  14                                      13                                                                                                                                                                                         · Students walk on school yard in morning
 • development of criteria                                                                                                                                                                                                                        13                                                                                                                                                                                                                                 · Successfully submitted grant to practice yoga in the classroom
 • modified Delphi survey to select top criteria, which became 15 Steps to a Nutrition Friendly School.                                                                                                                                           12                                                                                                                                                                                                                                 · Participate in SPARK training
                                                                                                                                                                                                                                                                   11                                                                                                                                                                                                                · Develop extracurricular activities for students: basketball, karate, dance
 NFSC Process                                                                                                                                                                                                                                     11                                                                                                                            10




                                                                                                                                                                                                                          Number of Steps
 •    Introduction to staff                                                                                                                                                                                                                       10                                                                                                                                                                                         Health Services                         · Raise funds for additional nurse days
 •    Recruitment of NFSC committee members                                                                                                                                                                                                                                                                                                                                                                                                                                          · Nurse promotes healthy nutrition & exercise; refers students to “KidShape”· Health clinic on campus
                                                                                                                                                                                                                                                   9                                                              8                                         8                                                                                                                        · Pediatrician presents on nutrition & physical activity to parents
 •    School self – evaluation
                                                                                                                                                                                                                                                   8
 •    Development of implementation plan
 •    Implementation of plan
                                                                                                                                                                                                                                                   7           6                                                                                                                                     6                                       Staff and Community Involvement         · Students, staff & parents participate in “Hoops for Health” school fundraiser
 •    Progress monitoring through ongoing data collection                                                                                                                                                                                          6                                                                                 5                                                                                                                                               · Parent and NFSC Liaison facilitate discussion on healthy eating at parent meeting
 •    Technical assistance and resources provided by UCLA                                                                                                                                                                                          5                                  4                                          4                                                                                      4                                                            · Parent group formed an ongoing “Healthy Eating” subcommittee
 •    Capacity development through school systems change                                                                                                                                                                                           4                                                                                                                                                                                                                                 · Participates in “Walk to School Day”
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     · Establish a Health and Wellness Cadre · Collaboration with local parks
                                                                                                                                                                                                                                                   3                                                                                                                        2                                                                                                        · Conduct a Nutrition Olympics activity
 Study Schools                                                                                                                                                                                                                                     2                                                          1                                      1                                           1                                                                                   · Implement a Health Fair
 • Eight LAUSD elementary schools,                                                                                                                                                                                                                 1                                                                                                                                                                                                                                 · Recruit neighbors of schools to help plant and upkeep garden
                                                                                                                                                                                                                                                                                                                                                                                                                    0
 • Clustered in two geographic regions: East/South Los Angeles and W. Hollywood/W. Los Angeles                                                                                                                                                                                                                                                                                                                                                                                       · Invite local farmers market to sponsor a cooking class for parents
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 • Majority (30.8%-99.9%) Latino student population                                                                                                                                                                                                                                                                                                                                                                                                                                  · Parents bring only healthy snacks to parent meetings




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 • At least 50% (60.2-96.1) of students eligible for free/reduced meals                                                                                                                                                                                                                                                                                                                                                                                                              · Have sports leagues for staff, parents and students




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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     · Participate in Activa por Vida – parent wellness program




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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     · Offer parent aerobics class
                                                                                                                                                                                                                        Significant differences from baseline to post intervention for the following schools: 2: p=.0025; 3: p=.0142; 6: p=.0142; 7: p=.0078
15 Steps to a Nutrition Friendly School
                                                                                                                                                                                                                                                                                                                                                                                                                                        Successes
1.      School has written physical activity and nutrition policies.
                                                                                                                                                                                                                                                                                                                                                                                                                   Baseline 2003       •   Collaboration - formation of diverse committee of stakeholders
                                                                                                                                                                                                                                                                                                          Number of Schools Meeting Each Step                                                                                           •   Creativity – with few resources and without a road map of what to do
2.      School administration supports efforts to promote healthy eating and physical activity among all school                                                                                                                                                                                                                                                                                                    Post 2005           •   Uniqueness – each school able to develop plan that met the needs of their school
        community stakeholders.
                                                                                                                                                                                                                                                                                                                                                                                                                                        •   Change - every school improved their school environment based on 15 Steps
3.      There is collaboration throughout the school community regarding nutrition and physical education.                                                                                                                                        8
4.      School has a standardized nutrition education curriculum integrated into other school subjects.                                                                                                                                                                    7
5.      School Food Service provides healthy foods adhering to the USDA recommendations.                                                                                                                                                          7
                                                                                                                                                                                                                                                                                                              6                              6            6                                          6            6                 Challenges
6.      School staff and students have input into school meal planning.                                                                                                                                                       Number of Schools   6
                                                                                                                                                                                                                                                                                                                                                                                                                                    •       Staff overwhelmed – too many mandates
7.      School has a physical education curriculum/program that is adhered to by a minimum of 80% of eligible staff.                                                                                                                                         5                        5                       5
                                                                                                                                                                                                                                                  5                                                                                                                                                                                 •       Funding
8.      A minimum of 85% of classrooms participate in a minimum of 20 minutes of moderate to vigorous daily physical activity.
                                                                                                                                                                                                                                                                                                                                                        4              4                   4                                4       •       Lack of time
9.      The school has one nurse for every 750 students.                                                                                                                                                                                          4                                                                                                                                                                                 •       Not a priority
10.     School Health Services identifies and refers students with nutrition and physical activity issues.                                                                                                                                                             3                                                         33                                             3                                                   •       Lack of collaboration among school community
11.     School has a staff wellness program.
                                                                                                                                                                                                                                                  3                                                                                                                                                                                 •       Use of “junk food” as fundraiser
12.     School staff is committed to serve as role models for healthy behavior.                                                                                                                                                                   2                                                                                                                                                                                 •       Lack of training in PE
13.     School includes family and community members in nutrition education and physical education.                                                                                                                                                                                                                                      1                                               1           1        1                     •       Lack of Administrative Support
14.     Family and community members actively promote healthy eating and physical activity.                                                                                                                                                       1
15.     School Psychosocial Services supports healthy eating and physical activity.                                                                                                                                                                        0                        0           00                    00                                            0           0                                       0
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                                                                                                                                                                                                                                                                                                                                                                                                                                        Conclusions and Next Steps



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                                                                                                                                                                                                                                                                                                                                                                                                                                        step and the number of steps met by each school increased. With the conclusion of the pilot study, the NFSC model has become imbedded in the school cultur
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                                                                                                                                                                                                                                                                                                                                                                                                                                        Each school committee has developed a plan for sustainability and will continue their progress with limited technical assistance provided by the research team.

                                                                                                                                                                                                                        Significant differences from baseline to post intervention for the following Steps: 1: p=.0256; 3: p=.0256; 8: p=.0406; 13: p=.0406; 14: p=.0406                                                                The plans for NFSC certification are being finalized and the certification process will begin in Spring 2006. Additionally, a case study is being developed to
                                                                                                                                                                                                                                                                                                                                                                                                                                        highlight each school’s NFSC achievements. Finally, a tool kit is being developed to assist schools in implementing the NFSC model without intensive suppor
1University   of California Los Angeles (UCLA) School of Public Health, 2 UCLA Schools of Public Health and Medicine
                                                                                                                                                                                                                                                                                                                                                                                                                                        from the research team. The case studies and tool kit will be available in 2006.
The Nutrition Friendly School Certification Process Pilot Study is funded by the Centers for Disease Control and Prevention , Community Based Participatory Prevention Research

				
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