Daniel M. Finkelstein

School Food Environments and Policies in US Public Schools

OBJECTIVE. The purpose of this study was to describe school food environments and policies in US public schools and how they vary according to school characteristics. METHODS. We analyzed cross-sectional data from the third School Nutrition and Dietary Assessment study by using a nationally representative sample of 395 US public schools in 129 school districts in 38 states. These 2005 data included school reports of foods and beverages offered in the National School Lunch Program and on-site observations, in a subsample of schools, of competitive foods and beverages (those sold in vending machines and a la carte and that are not part of the National School Lunch Program). Seventeen factors were used to characterize school lunches, competitive foods, and other food-related policies and practices. These factors were used to compute the food environment summary score (0 [least healthy] to 17 [most healthy]) of each school. RESULTS. There were vending machines in 17%, 82%, and 97% of elementary, middle, and high schools, respectively, and a la carte items were sold in 71%, 92%, and 93% of schools, respectively. Among secondary schools with vending and a la carte sales, these sources were free of low-nutrient energy-dense foods or beverages in 15% and 21% of middle and high schools, respectively. The food environment summary score was significantly higher (healthier) in the lower grade levels. The summary score was not associated with the percentage of students that was certified for free or reduced-price lunches or the percentage of students that was a racial/ethnic minority. CONCLUSIONS. As children move to higher grade levels, their school food environments become less healthy. The great majority of US secondary schools sell items a la carte in the cafeteria and through vending machines, and these 2 sources often contain low-nutrient, energy-dense foods and beverages, commonly referred to as junk food.

A National Survey of Obesity Prevention Practices in Head Start

OBJECTIVE To describe obesity prevention practices and environments in Head Start, the largest federally funded early childhood education program in the United States. DESIGN Self-administered survey as part of the Study of Healthy Activity and Eating Practices and Environments in Head Start (SHAPES). SETTING Head Start, 2008. PARTICIPANTS Directors of all 1810 Head Start programs, excluding those in US territories. OUTCOME MEASURES Descriptive measures of reported practices and environments related to healthy eating and gross motor activity. RESULTS The 1583 (87%) programs responding to the survey enrolled 828 707 preschool children. Of these programs, 70% reported serving only nonfat or 1% fat milk. Ninety-four percent of programs reported that each day they served children some fruit other than 100% fruit juice; 97% reported serving some vegetable other than fried potatoes; and 91% reported both of these daily practices. Sixty-six percent of programs said they celebrated special events with healthy foods or nonfood treats, and 54% did not allow vending machines for staff. Having an on-site outdoor play area at every center was reported by 89% of programs. Seventy-four percent of programs reported that children were given structured (adult-led or -guided) gross motor activity for at least 30 minutes each day; 73% reported that children were given unstructured gross motor activity for at least 30 minutes each day, and 56% reported both of these daily practices. CONCLUSION Most Head Start programs report doing more to support healthy eating and gross motor activity than required by federal performance standards in these areas.

Barriers To Obesity Prevention In Head Start

Head Start provides early childhood education to nearly one million low-income children, through federal grants to more than 2,000 local programs. About one-third of children who enter Head Start are overweight or obese. But program directors face difficulty in implementing policies and practices to address obesity-and in our national survey, they identified the key barriers as lack of time, money, and knowledge. Also, parents and staff sometimes shared cultural beliefs that were inconsistent with preventing obesity, such as the belief that heavier children are healthier. Minimizing those barriers will require federal resources to increase staff training and technical assistance, develop staff wellness programs, and provide healthy meals and snacks.

Changes in Capacity Among Local Coordinated Community Response Coalitions (CCRs) Supported by the DELTA Program

Coalitions are often the means through which communities plan and coordinate services for individuals and address larger environmental issues associated with social problems. Since 2003, the Centers for Disease Control and Prevention (CDC) has supported local coordinated community response coalitions (CCRs) in 14 states to prevent intimate partner violence (IPV) through its Domestic Violence Prevention Enhancements and Leadership Through Alliances (DELTA) Program. Utilizing quantitative and qualitative evaluation data from 2003 and 2006 from DELTA-funded CCRs (N = 59), this article reports on improvements in internal CCR capacity and external supports that can affect the ability of CCRs to prevent IPV. Data are examined through the Interactive Systems Framework for Dissemination and Implementation (ISF) to convey how CCR internal capacity and external supports contribute to the substantial infrastructure needed to effectively address IPV. Family social workers will gain an understanding of the capacities needed by CCRs to prevent IPV, the multiple organizations and systems that support the work of these CCRs, and how they themselves can work to strengthen the capacities of local coalitions that address IPV.

Promoting Children’s Physical Activity in Low-Income Communities in Colorado: What Are the Barriers and Opportunities?

Introduction Colorado has the highest rate of adult physical activity in the United States. However, children in Colorado have a lower rate of physical activity relative to other states, and the rate is lowest among children in low-income households. We conducted focus groups, surveys, and interviews with parents, youth, and stakeholders to understand barriers to physical activity among children in low-income households in Colorado and to identify opportunities to increase physical activity. Methods From April to July 2016, we recruited participants from 5 communities in Colorado with high rates of poverty, inactivity, and obesity; conducted 20 focus groups with 128 parents and 42 youth; and interviewed 8 stakeholders. All focus group participants completed intake surveys. We analyzed focus group and interviews by using constant comparison. Results We identified 12 themes that reflect barriers to children’s physical activity. Within the family context, barriers included parents’ work schedules, lack of interest, and competing commitments. At the community level, barriers included affordability, traffic safety, illicit activity in public spaces, access to high-quality facilities, transportation, neighborhood inequities, program availability, lack of information, and low community engagement. Survey respondents most commonly cited lack of affordable options and traffic safety as barriers. Study participants also identified recommendations for addressing these barriers. Providing subsidized transportation, improving parks and recreation centers, and making better use of existing facilities were all proposed as opportunities to improve children’s physical activity levels. Conclusion In this formative study of Colorado families, participants confirmed barriers to physical activity that previous research on low-income communities has documented, and these varied by geographic location. Participants proposed a set of solutions for addressing barriers and endorsed community input as an essential first step for planning community-level health initiatives.