Engaging children and youth in healthy eating and regular physical activity can lower their risk of obesity and related chronic diseases (7,8). The school environment can also influence children and young people's participation in physical activity. Healthy people 2020 includes objectives related to physical activity and healthy diet among children and young people and in schools (Appendix B) (10).
This report includes nine general guidelines for school health programs to promote healthy eating and physical activity.
Use a Coordinated Approach to Develop,
Schools and school districts can consult the School Health Index for a comprehensive list of policies and practices that promote healthy eating and physical activity in schools. The School Health Index guides schools in developing an action plan to improve their school health policies and practices (199,200). Completing the School Health Index can lead to positive changes in the school health environment.
Have the schools established a school health council and carried out an assessment of their existing policies and practices for healthy eating and physical activity.
Establish School Environments that Support
Explicit safety rules should be taught to and followed by students in physical education, extracurricular exercise programs, and community sports and recreation programs. Trained staff or volunteers, including coaches, teachers, parents, paraprofessionals, and community members, must oversee all physical activity programs. Employees should be aware of the potential for physical activity-related injuries and illnesses among students so that the risks and consequences of these injuries and illnesses can be minimized.
Nationally in 2006, school staff in 32% of schools were allowed to use physical activity (eg running laps or doing push-ups) to punish pupils for misbehavior in physical education.
Provide a Quality School Meal Program and
In addition, regular participation in the School Morning Program is associated with lower BMI among students (309). Ensure that all foods and beverages sold or served outside of school meal programs are nutritious and appealing. Offer breakfast to all students at no cost to increase overall participation in the school breakfast program (315).
Ensure that all foods and beverages sold or served outside of school meal programs are nutritious and appealing.
Implement a Comprehensive Physical Activity
Thus, physical education curricula should also include the development of safe and effective individualized physical activity plans. After review, the task force strongly recommended increased school-based physical education as an intervention strategy to increase youth physical activity (378). Provide a significant percentage of each student's recommended daily amount of physical activity in the physical education class.
Integrate instructional strategies into physical education to increase students' confidence in their ability to be physically active and maintain their physical activity behaviors. Providing students with choices during physical education classes can increase students' confidence in their ability to participate in physical activity overall (414-416). Incorporate instructional strategies into physical education and physical activity programs that lead to positive attitudes and perceptions toward physical activity.
Influencing students' attitudes towards and perceptions of physical activity can affect their involvement in physical activity outside of PE lessons (417,418). Give all students plenty of opportunities to participate in physical activity outside of PE lessons. The school environment can offer more opportunities for students to enjoy physical activity outside of sports lessons and increase the daily amount of physical activity, including (377,419).
Ensure that physical education and other physical activity programs meet the needs and interests of all students. Often, students with disabilities or chronic health conditions are discouraged from participating in physical education classes and other forms of physical activity.
Implement Health Education that Provides Students
Nutrition and physical activity topics can also be incorporated into other academic disciplines to complement comprehensive health education and physical education programs (456,457). Implement a planned and sequenced health education curriculum that is culturally and developmentally appropriate, addresses a clear set of behavioral outcomes that promote healthy eating and physical activity, and is based on national standards. Assessment protocols for quality health education include criteria for checking student work (such as a rubric) and incorporate multiple criteria over time.
As a result of participating in a K–12 health education curriculum that includes nutrition, students should have the knowledge and skills to do the following. Health education curricula should reinforce the information taught in physical education classes and provide opportunities for students to apply physical activity knowledge and skills. The National Health Education Standards and Performance Indicators outline the health-related concepts, skills, and healthy beliefs, values, and norms students need for healthy behaviors (453).
The national health goal seeks to increase the proportion of primary, middle and senior secondary schools that have health education goals or goals that address knowledge and skills in the national health education standards (middle school, high school and elementary school) (ECBP goal 3) (10 ). The National Health Education Standards emphasize skill development and specify that as a result of health education, students must be able to 1) understand concepts related to health promotion and disease prevention;. CDC's Health Education Curriculum Analysis Tool (HECAT) helps school districts conduct clear, complete, and consistent analyzes of written health education curricula based on national health education standards and research-based characteristics of effectiveness.
The use of goal-setting skills can also be integrated into health education to help students identify personal goals for dietary and physical activity behaviors (488). Computer-based teaching in physical activity and healthy eating allows for health education at your own pace.
Provide Students with Health, Mental Health, and
School health, mental health, and social services staff should collaborate with community health providers to increase student access to care, coordinate care, and promote evidence-based physical activity and healthy eating initiatives ( 215). Health, mental health, and social services staff should pay attention to students with these conditions to ensure they meet healthy eating and activity recommendations (533-535). Health, mental health, and social services staff may request written permission from families to exchange confidential health information with students' health care providers (515).
Health, mental health, and social service personnel serve as liaisons between school staff members, students, families, community programs, and health care providers (515). Health, mental health, and social service professionals should seek partnerships and work in community health coalitions (515). Refer students to community health care providers and healthy eating and physical activity services.
Health, mental health and social services staff members play an important role in developing and marketing a referral system for students and families. To establish a referral system, health, mental health, and social services personnel should identify health care services and school- or community-based programs that encourage healthy eating and physical activity and address obesity and eating disorders. Health, mental health and social services staff members can assess which services are available at the school and which require outside referral (182).
Health, mental health, and social service professionals are ideally positioned to engage health care providers and community organizations to support healthy eating and physical activity policies and practices within schools. Health, mental health, and social services professionals can advocate for schools to develop strong policies and practices that help students achieve healthy eating and physical activity recommendations.
Partner with Families and Community Members
Health advocacy in schools increases awareness of the importance of health behaviors and can increase school and community support for instruction, programs, policies, and environmental changes that support healthy eating and physical activity (550). Encourage communication between schools, families, and community members to promote the adoption of healthy eating and exercise behaviors among students. Schools that communicate with families and community members about healthy eating and physical activity initiatives create a better understanding of school activities, which could increase students' and their families' support and participation in school policies and practices (188,557).
Strategies for Guideline 7: Partner with families and community members in the development and implementation of healthy eating and physical activity policies, practices, and programs. Encourage communication between schools, families and community members to promote the adoption of healthy eating and physical activity among students. Develop and implement strategies to motivate families to participate in school-based programs and activities that promote healthy eating and physical activity.
Families and community members should be invited to provide input on the design and implementation of healthy eating and physical activity policies, programs and practices. Develop and implement strategies to motivate families to participate in school programs and activities that promote healthy eating and physical activity. Involve staff from universities, hospitals, health centers and other health organizations in school-based healthy eating and physical activity initiatives.
Recruit parents, family and community volunteers to help with healthy eating and physical activity initiatives. Extracurricular programs (eg, after-school programs and parks and recreation programs) provide additional opportunities to reinforce health promotion messages taught in schools and can engage students in healthy eating and physical activity (606).
Provide a School Employee Wellness Program
Assess the status of school employee wellness activities, and identify the nutrition and physical activity interests and needs of school employees. Assessing the current status of school employee wellness activities provides a starting point for planning future programming (625). The CDC School Health Index provides a series of items to assess current policies, programs, and practices for school employee wellness.
Additionally, schools that establish and support school employee wellness programs generally encourage staff members to seek out activities, classes, and information that are most relevant to them personally. Sharing information with school administrators about the benefits of employee wellness programs and the interests and needs of school staff members can increase their support and resource allocation for such programs (628,629). Provide administrative support for school employee wellness programs that include healthy eating and physical activity.
Develop and deliver a presentation identifying the need and benefits of a school employee wellness program in the context of coordinated school health. An existing committee, such as the school health board or health insurance advisory committee, should have the necessary foundation and components to lead the process of developing a school employee wellness program (628). The school employee wellness lead may be the school health coordinator or an employee committed to providing quality programs for all school staff members.
A comprehensive school employee wellness program includes goals, objectives, and activities to promote healthy eating and physical activity. School employee wellness programs should be evaluated to determine if objectives are being met, if employees are satisfied, and what can be done to improve the program.
Employ Qualified Persons, and Provide
The effects of a 2-year physical education program (SPARK) on the physical activity and fitness of elementary school students.