Public schools offer ideal settings for the dissemination of interventions designed to promote physical activity and life-long healthy eating. As such, schools are the only settings where the majority of children can access the opportunity of consuming healthful meals regularly, being physically active through extracurricular activities, and receiving education on healthy living. Nonetheless, many interventions have been ineffective because they often fail to incorporate environmental factors and system-wide policies that influence the ability of schools, families, and children to alter behavior (Coleman et al., 2012). Although recent investigations have made attempts to address the shortcoming, they have yielded mixed results due to various issues. Firstly, nutrition services face the pressure to improve financial stability, which in turn causes difficulties in the implementation of environmental changes aimed at improving school nutrition. Secondly, the failure to minimize unhealthy foods that kids bring from home into the school setting continues to pose challenges to healthy nutrition programs in schools. Thirdly, poor delivery of research findings has been shown to impede the integration of effective interventions into the daily school practices (Coleman et al., 2012). Such challenges can be attributed to implementation protocols employed by previous investigations. For example, past studies have utilized evidence-based medicine, which focuses on the maintenance of fidelity to various aspects of a given intervention. The approach ignores the numerous variables at the school level that affect the effectiveness of an intervention. The variables may include parental reactions, staff behavior, labor issues, and financial concerns. Accordingly, the present study investigates the issue of nutrition in public schools and makes recommendations to address the problem.
The accessibility of highly nutritious school meals has been known to increase the consumption of low-fat milk, vegetables, fruits, and whole grains among kids. In the last decade, notable improvements in the quality of school meals have been reported (Bevans et al., 2011). However, low-nutrient and high-calorie foods are still abundant in many public schools and can be accessed easily from vending machines, stores, and cafeteria in the schools. Also, the availability of competitive foods has the potential to countervail the beneficial impacts of healthful school meals, as well as create barriers to the promotion of healthy school environments. Thus, there is an urgent need to reduce students’ access to low-nutrient foods and encourage the consumption of healthful foods. Generally, patterns of healthy eating in adolescence and childhood promote intellectual development, growth, and optimal childhood health (World Health Organization (WHO), n. d.). They further prevent the development of immediate health conditions like dental caries, eating disorders, obesity, and iron deficiency anemia. Moreover, they can prevent the development of long-term complications such as stroke, cancer, and heart disease (Coleman et al., 2012). Accordingly, school-based health programs may help adolescents and children to attain good health and fulfill diverse educational goals by offering them environmental reinforcement, social support, and the skills required to ensure the adoption of healthy eating practices. Current school health programs incorporate components such as school-based health centers for students and staff, nutrition services, physical education, integrated community and school efforts, counseling services, health education, and the provision of healthy environments. Each of the components contributes to the integrated efforts aimed at promoting healthy eating.
Additionally, public schools are obligated to refute or question policies that fail to address the health needs of students and staff. However, the implementation of changes in school policies and procedures may present challenges that require schools to make ethical justifications for such modifications. For example, the provision of low-quality foods to benefit commercial entities and finance various school programs fails to accomplish the schools’ ethical obligation of minimizing harm, providing health benefits, and protecting vulnerable kids from commercial exploitation. Such practices are detrimental to the welfare of school children. In particular, students from impoverished families face food insecurities, as well as an increased risk of exposure to low-quality foods (Crawford et al., 2011). Hence, there is a need for schools to oppose policies that foster inadequate school nutrition and implement measures that foster optimal nutrition. The strategy can help to protect students against obesity, as well as maximize academic performance and cognitive function. Therefore, public schools should model environments that promote health and learning. In such contexts, interventions should ensure that competitive foods are limited to foods that support the nutritional health of students.
Basically, public schools can be viewed as community organizations involved in the creation and implementation of individual practices and regulations that contradict the stringent lifestyle-change measures associated with evidence-based medicine’s approach. Consequently, an “evidence-based public health approach (EBPH) may be more effective in achieving positive outcomes when trying to change school environments and policies” (Coleman et al., 2012). In a way, EBPH resembles evidence-based medicine approach because both methods involve the making of decisions based on peer-reviewed and best available evidence. Moreover, information systems and data are utilized systematically in both approaches to evaluate outcomes and make decisions. Nevertheless, EBPH is different from EBM because it relies on “program-planning and evaluation frameworks such as Green and Krueter’s Precede-Proceed model” to address “organizational-level variables,” which determine the effectiveness of an intervention (Coleman et al., 2012). EBPH tailors an intervention to the existing organizational condition by employing stakeholder engagements as components of the different stages of evaluation, implementation, and intervention design. Thus, a model for environmental and policy change aimed at improving school nutrition can be successful if it employs an EBPH strategy that emphasizes stakeholder participation. Such a model should concentrate on altering the practices and organizational policies of students, parents, teachers, school staff, and nutrition services to ameliorate the school nutrition environment. Thus, an EBPH strategy can facilitate the implementation of site-based approaches that allow schools to enforce their mandated wellness policies.
In conclusion, public schools provide ideal settings for the dissemination of approaches that enhance physical activity and life-long healthy eating. However, challenges associated with the implementation of inefficient measures and protocols continue to affect school nutrition. Such measures may include the use of strategies founded on evidence-based medicine. Moreover, the improvement of school nutrition is impeded by ethical challenges resulting from policies that allow students to access low-nutrient foods. Nonetheless, the present study has recommended the implementation of EBPH approaches, which address organizational-level variables by relying on various evaluation and program planning frameworks. As such, EBPH approaches can be effective in ameliorating public school nutrition because they incorporate environmental factors and system-wide policies that impact the ability of schools, families, and children to abandon unhealthy eating behaviors.
References
Bevans, K. B., Sanchez, B., Teneralli, R., & Forrest, C. B. (2011). Children’s Eating Behavior: The Importance of Nutrition Standards for Foods in Schools. The Journal of School Health, 81(7), 424–429. doi:10.1111/j.1746-1561.2011.00611.x.
Coleman, K. J., Shordon, M., Caparosa, S. L., Pomichowski, M. E., & Dzewaltowski, D. A. (2012). 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. The International Journal of Behavioral Nutrition and Physical Activity, 9, 80. doi:10.1186/1479-5868-9-80.
Crawford, P. B., Gosliner, W., & Kayman, H. (2011). The ethical basis for promoting nutritional health in public schools in the United States. Preventing Chronic Disease, 8(5), A98. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181198/
World Health Organization (WHO). (n. d.). Nutrition-friendly schools initiative (NFSI). Retrieved from http://www.who.int/nutrition/topics/nutrition_friendly_schools_initiative/en/
