Healthy options for nutrition environments in schools (HEALTHY ones)

Categories

Categories associated with best practice:

  • Health Equity
  • Organization
  • PP-icon1
  • Children (ages 6-12) icon
  • Elementary School Icon 1
  • Food Security
  • Healthy Eating

Determinants of Health: Food security

Overview

To prevent an increase in obesity rates in elementary school students in a low-income school district, the intervention aims are to: 1) eliminate unhealthy foods and beverages on campus; 2) develop nutrition services as the main source for healthful eating (HE), and promote school staff to model healthy eating. The intervention is a two-year quasi-experimental research project (not a natural experiment) that adapts a rapid improvement process and uses participatory principles in order to build school capacity and sustain change. A change team was created in each intervention school (n=4). Outcome measures were behavioral observation (reflects consumption of healthy and unhealthy foods) and BMI. Compared to control schools (n=4), the total outside food and beverage items per child per week decreased in intervention schools (of both healthy and unhealthy foods). No intervention effect was reported for obesity rates (which increased slightly in both intervention and control schools).

Primary Source Document

KJ Coleman, M Shorden, SL Caparosa, ME Pomichowski, and DA Dzewaltowski, The healthy options for nutrition environments in schools (Healthy ONES) group randomized trial: Using implementation models to change nutrition policy and environments in low income schools International Journal of Behavioral Nutrition and Physical Activity

Contact information of developer(s) and/or implementer(s)

Partnerships of organizations, Kareen.J.Coleman@pg.org

Intervention Focus

Intervention Goal / ObjectiveLevel(s) TargetedEquity Focus
Promote school staff modeling of HE
  • Individual level
People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.
Develop nutrition services as the main source on campus for healthful eating (HE)
  • Organizational level
People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.
Eliminate unhealthy foods and beverages on campus
  • Organizational level
People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.

Health Issue(s) that is/are addressed by the Intervention

Health Promotion

  • Healthy Eating
  • Obesity Prevention

Risk Reduction

    Specific Activities of the Intervention

    • Other

    Priority/Target Population for Intervention Delivery

    Life Stage

    • Children (age 6-12 years)

    Settings

    Educational Settings

    • Elementary school

    Community Setting

      N/A

      Outcomes

      Outcomes and Impact Chart
      Level of ImpactDescription of OutcomeEquity Focus
      Individual LevelBMI: Regardless of group or gender, all children increased significantly in BMI Z scores over time (p<.001). Changes in rates of obesity were similar between intervention and control groups.Outcomes are reported for people living in conditions of disadvantage, and are not compared to people living in more advantaged conditions.
      Individual LevelHealthy food and beverage items per child per week (ANOVA: F(4,13)=4.74, p=0.01): decreased in intervention schools (p=0.03); and no change in control schools. Varied by school environment.Outcomes are reported for people living in conditions of disadvantage, and are not compared to people living in more advantaged conditions.
      Individual LevelUnhealthy food and beverage items per child per week (ANOVA: F(4,13)=4.96, p=0.01): decreased in intervention schools (p<0.001); and increased in control schools (p=0.02). Varied by school environment.Outcomes are reported for people living in conditions of disadvantage, and are not compared to people living in more advantaged conditions.
      Individual LevelTotal outside food and beverage items per child per week (consumption) (ANOVA: F(4,13)=3.43; p =0.04); decreased in intervention schools (p=0.005); and increased in control schools (p=0.04). Varied by school environment (lunch/recess).Outcomes are reported for people living in conditions of disadvantage, and are not compared to people living in more advantaged conditions.

      Adaptability

      Implementation History

      • Implemented once (could be a pilot) - The intervention has been implemented once and is theoretically replicable elsewhere.

      Expertise Required for Implementation within the Context of the Intervention

      • Specialized skills training provided as part of the Intervention - The intervention does not require individuals or groups with highly specialized training, but requires that individuals or groups be trained as part of the implementation of the intervention.

      Are there supports available for implementation

      No.

      Are there resources and/or products associated with the interventions

      Yes. The IHI website offers resources on the rapid improvement process that was used in intervention schools (http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx).