Healthier students tend to be stronger learners (Busch et al., 2014; Basch, 2011). Student health is related to grades, school attendance, and graduation rates. However, one in three children is overweight or obese (Alliance for Healthier Generation, n.d.). In addition to the connection to poorer education outcomes, childhood obesity is linked to diabetes, cardiovascular disease, and other health issues in adulthood. Given the long-term educational and health consequences of unhealthy behaviors, childhood is a critical time to intervene and establish healthy habits that will have lasting benefits. Schools are an important setting and partner in efforts to promote health, well-being, and safety because the majority of school-aged children in the U.S. attend school and spend a great deal of time in that setting. This article describes how schools can implement efforts to promote health and create conditions to help students establish lifelong healthy habits and behaviors.
The Centers for Disease Control and Prevention (CDC) has developed a “Whole School, Whole Community, Whole Child” (WSCC) model to depict how a collaborative and aligned approach between education and health can improve student’s education, physical, social, and cognitive development (CDC, n.d.). The WSCC model (see below) emphasizes both the psychosocial and physical environment. Additionally, it promotes community, family, and student engagement. Understanding the link between health and academics and the important role schools play in helping their students not only learn but also be healthy, school districts across the country are adopting policies and regulations to improve health and wellness among their students. One way to support school district-wide wellness policies is through local school wellness councils (LSWCs) that work at the school building/campus level.
LSWCs are small groups comprised of faculty, parents, students, and administrators focused on implementing programs, policies, and practices to improve physical activity, nutrition, and the health of students. LSWCs are important vehicles to ensure school district-wide health and wellness efforts address the identified needs and concerns of the school. Each school setting serves different populations, has different needs and resources, and requires an individualized action plan to address its school’s health priorities. LSWCs can implement school district health and wellness policies to fit a school’s context and needs. Research also indicates that schools with LSWCs are more likely to implement wellness policies passed by school systems (Hager et al., 2016), and thus are an important link to putting policy into practice. While it is difficult to ascertain how prevalent LSWCs are in this country, one study conducted in the state of Maryland indicates that 44% of schools in the state have a school wellness team (Profili et al., 2017). This suggests that large-scale adoption of this strategy is possible.
How can schools create effective LSWCs?
- Identify a wellness champion – When creating an LSWC, a school should first identify a wellness champion to start the LSWC and keep efforts moving in the school. This individual may be the principal or other administrator, school nurse, a teacher, parent, or community member. The wellness champion is charged with forming the LSWC and leading the LSWC in its effort to implement an action plan for the school.
- Create a multi-stakeholder LSWC – As the LSWC will focus on the health and needs of students and staff in the school, the LSWC should be comprised of a variety of stakeholders, including school administrators, staff, parents, students, and community partners (CDC, 2014). This team brings various perspectives to the table and can ensure the development of a comprehensive plan for the school.
- Assess the local school environment – It is critical that LSWCs begin with an assessment of the school’s health and wellness environment. Various online tools exist to help schools conduct a self-assessment, including the Centers for Disease Control and Prevention’s School Health Index (SHI) (CDC, 2017), which schools can use to inform their health and wellness improvement efforts. These tools assess strengths and challenges in the school’s health environment, programs, and policies.
- Link assessment to planning – Assessment findings should be used to develop an action plan to make targeted improvements in the school environment. The LSWC should review the assessment findings and prioritize areas for action. Some of the online assessment tools, like the SHI, help schools link assessment to planning by providing recommendations to improve weaknesses identified through the self-assessment and by walking schools through a process for prioritizing the recommendations for action. This allows the LSWC to carefully consider the appropriate starting point for its work, given resources and expertise available.
- Implement activities – The LSWC’s action plan may include some of the following activities: supporting nutrition education and promoting programs and activities; increasing and improving opportunities for physical activity; ensuring that foods and beverages available during the school day meet or exceed United States Department of Agriculture (USDA) requirements; and limiting the marketing of foods and beverages that do not meet USDA Smart Snacks standards. Additionally, the LSWC should engage a good cross-section of school stakeholders to build awareness of and engagement in school and district-wide health policy development, implementation, review, and update.
- Evaluate the activities and impact of the LSWC – LSWCs should track changes in programs, policies, and practices implemented in the school building. In addition, LSWCs should collect data on targeted outcomes, whether it is improving healthy eating, increasing physical activity measures, or reducing obesity among students (Alliance for Healthier Generation, 2013; CDC, 2014).
Community Science has been involved in the evaluation of a school district-wide effort to create and maintain LSWCs, and our experience with the early phase of this project provides some additional factors to consider in this work.
- First, even with district-wide health and wellness policies in place, school districts should give a clear directive that requires the creation of a LSWC for each school building; this sets the expectation for the schools. Additionally, to help carry out the directive, there should be a wellness champion at the school-district level. This champion should have a relationship with the schools and clear authority to guide schools in their health and wellness efforts. The champion should be able to clearly articulate the requirements coming down from the school district, but also encourage the LSWCs in their work, check in with schools and provide support and technical assistance, and review and provide feedback on the assessment, action planning, and implementation efforts.
- Second, it is important for LSWCs to merge their work with other school district policies and regulations so that efforts are part of a broad, comprehensive health and wellness effort. For example, as schools develop School Improvement Plans (SIPs) to plan for achievement for all children, school districts should also align SIPs with LSWC efforts. This means that LSWCs can help schools become compliant with the health and wellness regulations of the school district by including this as an activity or focus of their action plan.
- Third, more evaluation and monitoring are needed. As documented by the CDC (2014), evaluation and monitoring are challenges for most schools and school districts as they implement school wellness policies. While schools may be able to anecdotally report on activities implemented, very little quantitative data are collected to measure outcomes of these activities. Even more challenging is evaluating if improvements in student health and wellness have been achieved as a result of the LSWCs. This is a clear barrier for the LSWC movement. School districts, funders, evaluators, and technical assistance providers must find solutions to developing efficient, low cost, and simple performance monitoring and evaluation systems to help schools better measure their results.
- Finally, finding small ways to acknowledge those involved in these efforts can go a long way to helping stakeholders feel appreciated and will encourage them to continue their contributions in a valuable endeavor. LSWCs are often “unfunded mandates” that come down from the school district. LSWC members volunteer their time to be involved on the team, and there may not be a great deal of resources available to support the creation of the LSWC and implementation of the action plan. Additionally, the burden of schools to meet academic standards is high, and LSWCs, while important, are another effort that require a great deal of time, focus, and resources. It is important to find ways to acknowledge the hard work and time given by the school champions, LSWC members, and the schools themselves.
While it appears that the LSWC model has great promise, particularly in increasing the likelihood of implementation of school wellness policies, further efforts are needed to truly understand the role LSWCs play to achieve a “Whole School, Whole Community, Whole Child.” To learn more about one school district’s effort to implement LSWCs county-wide and Community Science’s evaluation of this effort, please read the program feature article.
Alliance for a Healthier Generation. Childhood obesity facts. Retrieved April 23, 2018, from https://www.healthiergeneration.org/about_childhood_obesity/get_informed/childhood_obesity_facts/.
Alliance for a Healthier Generation. (2013). School wellness committee toolkit. Retrieved from https://www.healthiergeneration.org/_asset/ppvhfi/09-875_SWCToolkit.pdf.
Basch, C. (2011). Healthier students are better learners: A missing link in school reforms to close the achievement gap. J Sch Health, 81(10), 593–598. doi:10.1111/j.1746-1561.2011.00632.x.
Busch, V., Loyen, A., Lodder, M., Schrijvers, A., van Yperen, T., de Leeuw, J. (2014). The effects of adolescent health-related behavior on academic performance: A systematic review of the longitudinal evidence. Rev Educ Res, 84(2), 245–274. doi:10.3102/0034654313518441.
Centers for Disease Control and Prevention. (2014). Putting local school wellness policies into action. Retrieved from https://www.cdc.gov/healthyyouth/npao/pdf/SchoolWellnessInAction.pdf.
Centers for Disease Control and Prevention. (2017). School Health Index (SHI): Self-assessment & planning guide 2017. Retrieved from https://www.cdc.gov/healthyschools/shi/index.htm?s_cid=hy-tools-001.
Centers for Disease Control and Prevention. Whole school, whole community, whole child (WSCC). Retrieved from https://www.cdc.gov/healthyschools/wscc/index.htm.
Hager, E., Rubio, D., Eidel, G., Penniston, E., Lopes, M., Saksvig, B., Fox, R. and Black, M. (2016). Implementation of local wellness policies in schools: Role of school systems, school health councils, and health disparities. J School Health, 86, 742–750. doi:10.1111/josh.12430.
Profili, E., Rubio, D., Lane, H., Jaspers, L., Lopes, M., Black, M., Hager, E. (2017, August). School wellness team best practices to promote wellness policy implementation. Prev Med, 101, 34–37. doi: 10.1016/j.ypmed.2017.05.016. Epub 2017 May 1.