Nutrition Friendly Schools and Communities NFSC Lessons Learned

1
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
How Did Schools Achieve 15 Steps

• NFSC Data Collection
• Student 24 hour recalls, height, weight,
  triceps skin fold, nutrition and physical
  activity knowledge and attitudes
• Adult nutrition and physical activity
  knowledge, attitudes, and behaviors
  questionnaire, self-reported dietary and
  anthropometric measures..
• Student level academic measures including test
  scores, attendance
• School measures including attendance, test
  scores, discipline records, nurse records
• School environment measures
• Process measures baseline and post
  intervention
• Self-evaluation of 15 Steps

NFSC Goal Actively engage school community to
prevent overweight in elementary school children
through multi-level participative intervention
facilitating coordinated changes in the school
environment to support healthy eating and
physical activity behaviors of students, staff,
and parents.

• NFSC Development
• Adapted steps and concepts from
• Baby Friendly Hospital Initiative (BFHI)
• Coordinated School Health Model (CSHM)
• Community Based Participatory Research (CBPR)
• Collaboration among Los Angeles Unified School
  District (LAUSD) school community stakeholders
  and UCLA School of Public Health research team.
• small work group meetings
• development of criteria
• modified Delphi survey to select top
  criteria, which became 15 Steps to a Nutrition
  Friendly School.
• NFSC Process
• Introduction to staff
• Recruitment of NFSC committee members
• School self evaluation
• Development of implementation plan
• Implementation of plan
• Progress monitoring through ongoing data
  collection
• Technical assistance and resources provided by
  UCLA

NFSC Environmental (Self-Evaluation) Results
? Baseline 2003 ? Post 2005
Number of Steps Met by Each School
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 1. School has written physical activity
and nutrition policies. 2. School
administration supports efforts to promote
healthy eating and physical activity among all
school

community
stakeholders. 3. There is collaboration
throughout the school community regarding
nutrition and physical education. 4. School has
a standardized nutrition education curriculum
integrated into other school subjects. 5.
School Food Service provides healthy foods
adhering to the USDA recommendations.   6.
School staff and students have input into school
meal planning. 7. School has a physical
education curriculum/program that is adhered to
by a minimum of 80 of eligible staff. 8. A
minimum of 85 of classrooms participate in a
minimum of 20 minutes of moderate to vigorous
daily physical activity. 9. The school has one
nurse for every 750 students. 10. School
Health Services identifies and refers students
with nutrition and physical activity issues. 11.
School has a staff wellness program. 12.
School staff is committed to serve as role
models for healthy behavior. 13. School
includes family and community members in
nutrition education and physical education. 14.
Family and community members actively promote
healthy eating and physical activity.   15.
School Psychosocial Services supports healthy
eating and physical activity.

• Successes
• Collaboration - formation of diverse committee
  of stakeholders
• Creativity with few resources and without a
  road map of what to do
• Uniqueness each school able to develop plan
  that met the needs of their school
• Change - every school improved their school
  environment based on 15 Steps

Number of Schools Meeting Each Step
? Baseline 2003 ? Post 2005

• Challenges
• Staff overwhelmed too many mandates
• Funding
• Lack of time
• Not a priority
• Lack of collaboration among school community
• Use of junk food as fundraiser
• Lack of training in PE
• Lack of Administrative Support

Conclusions and Next Steps From the baseline
self-evaluation in Spring 2003 to the the
post-intervention self-evaluation conducted in
Spring 2005, both the number of schools that met
each 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 culture. Each school committee has
developed a plan for sustainability and will
continue their progress with limited technical
assistance provided by the research team. 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 schools NFSC
achievements. Finally, a tool kit is being
developed to assist schools in implementing the
NFSC model without intensive support from the
research team. The case studies and tool kit
will be available in 2006.
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
1University of California Los Angeles (UCLA)
School of Public Health, 2 UCLA Schools of Public
Health and Medicine The Nutrition Friendly School
Certification Process Pilot Study is funded by
the Centers for Disease Control and Prevention ,
Community Based Participatory Prevention Research