The Georgia Department of Public Health 2014 Georgia Middle School Nutrition Policy Data Summary Background More than 870,000 children in Georgia were enrolled in public middle and high schools in Georgia during Spring 2014.1 Students eat one or more meals and/or snacks at school since they typically spend 6-7 hours each day during the school year at school. The school food environment is associated with students' dietary behaviors and obesity.2,3 Schools can help improve dietary behavior of children by implementing policies and practices conducive to healthful eating behaviors.4 Data Description The School Health Profiles (SHP) is a biennial survey of middle and high school principals and lead health educators (LHEs) in middle and high schools. SHP monitors the status of school health education, physical education, and school health policies related to HIV/AIDS, tobacco use prevention, nutrition, asthma management activities, and family and community involvement in school health. For the 2014 SHP survey in Georgia, questionnaires were sent to 392 public schools, charter schools, and alternative schools containing any of grades 6 through 12 during spring 2014. Survey responses were received from principals in 77 percent of schools and from LHEs in 72 percent of schools. Because the response rate was greater than 70 percent, the results were weighted and are considered representative of all regular public schools, charter schools, and alternative schools containing at least one of the grades 6 through 12 in Georgia. This summary focuses on Georgia middle schools. Overview of Nutrition Policies and Practices SHP survey data showed that among Georgia's middle schools in 2014: Only 8 percent allow students to purchase fruits and vegetables from vending machines or at a school store or canteen. 31 percent offer fruits or non-fried vegetables when foods or beverages are offered at school celebrations. 52 percent do not sell less healthy foods and beverages, such as soda, sports drinks, baked goods, salty snacks, and candy. 60 percent have used the School Health Index (available at: http://www.cdc.gov/healthyyouth/shi/) or other self- assessment tool to assess school nutrition policies, activities and programs. 64 percent have a vending machine where students can purchase snack foods or beverages. Lead health educators in 76 percent of schools would like to receive professional development on nutrition and dietary behavior. Lead health educators in 26 percent of schools received professional development on nutrition and dietary behavior during the past two years. 91 percent currently have a Coordinator for school health and safety programs. 91 percent permit students to have a drinking water bottle with them during the school day. 2 Peachtree Street, Atlanta, GA 30303 health.state.ga.us March 2015 2014 Georgia Middle School Nutrition Policy Data Summary School Food and Beverage Purchasing Policies 60 percent of Georgia's middle schools provided bottled water for purchase (Chart 1). Less than half made low or no sodium crackers, non-fat or 1% milk, 100% fruit or vegetable juice, fresh fruits, and non-fried vegetables available for purchase (Chart 1). Less than 50 percent of middle schools made less healthy food and beverage choices available to purchase (Chart 2). Chart 1. Percent of Georgia middle schools that allow students to purchase more healthy snacks , 2014 100 Percent (%) 80 60 60 40 38 40 29 20 13 9 0 Low/No sodium Non-fat/1% milk Bottled water 100% fruit/vegetable Fruit Non-fried vegetables crackers juice Type of Snack Chart 2. Percent of Georgia middle schools that allow students to purchase less healthy snacks, 2014 100 80 Percent (%) 60 40 27 31 32 28 29 30 20 15 14 0 Chocolate candy Other candy *Not low in fat Salty snacks* Cookies/Pastries* Ice cream* Type of Snack Soda Sports drinks Caffeinated items School Advertisement Policies Only 46 percent of Georgia's middle schools prohibit all forms of advertising and promotion for candy, fast food restaurants and soft drinks (Chart 3). More than 50 percent of middle schools prohibit advertisements for candy, fast food restaurants or soft drinks in the school building, on school grounds, in school vehicles, in school publications, or in educational material (Chart 3). Chart 3. Percent of Georgia middle schools that prohibit advertisements for candy, fast food restaurants or soft drinks by location, 2014 100 Percent (%) 80 63 60 56 69 58 61 46 40 20 0 School buildings School grounds School vehicles School publications Location Educational All materials advertisements We Protect Lives. 2014 Georgia Middle School Nutrition Policy Data Summary Supportive School Nutrition Environment Strategies 87 percent of LHEs tried to increase student knowledge of nutrition and dietary behaviors. Only 24 percent of Georgia's middle schools have implemented at least three strategies to promote a supportive school nutrition environment. Less than 50 percent of Georgia's middle schools have implemented most of the supportive school nutrition environment strategies (Table 1). The only two strategies implemented in a majority of middle schools are placing fruits and vegetables near the cafeteria cashier (73 percent) and using attractive displays for fruits and vegetables (70 percent). Table 1. Percent of Georgia middle schools that have implemented supportive school nutrition environment strategies during the current school year, 2014* Strategy Percent (%) Priced nutritious foods and beverages at a lower cost while increasing the price of less nutritious foods and beverages 8 Prohibited school staff from giving students food or food coupons as a reward for good behavior or good academic performance 16 Offered a self-serve salad bar to students 16 Prohibited less nutritious foods and beverages from being sold for fundraising purposes 24 Planted a school food or vegetable garden 28 Conducted taste tests to determine food preferences for nutritious items 30 Served locally or regionally grown foods in the cafeteria or classrooms 39 Labeled healthful foods with appealing names 41 Collected suggestions from students, families and school staff on nutritious food preferences and strategies to promote healthy eating 42 Provided information to students or families on the nutrition and caloric content of foods available 50 Used attractive displays for fruits and vegetables in the cafeteria 70 Placed fruits and vegetables near the cafeteria cashier, where they are easy to access 73 *For more information on strategies to create a supportive nutrition environment, see the Centers for Disease Control and Prevention's School Health Guidelines to Promote Healthy Eating and Physical Activity Policy Data Summary Family and Community Involvement Families and communities play important roles in improving nutritional behavior of students. In 31 percent of middle schools, students' families helped develop or implement policies and programs related to school health during the past two years. 52 percent of middle schools have a school health council, committee or team that offers guidance on the development of policies or coordinates activities on health topics. Among schools with school health councils, committees or teams: 35 percent had community members represented. 46 percent had parents or families of students represented. 44 percent of Georgia's middle schools provided parents and families with health information designed to increase knowledge of nutrition and healthy eating. 59 percent of LHEs gave students homework assignments or health education activities to do at home with their parents during the current school year. We Protect Lives. 2014 Georgia Middle School Nutrition Policy Data Summary How Can Schools Improve Student Nutrition? By designing and implementing health education curricula: Effective health education curricula provide students with functional health information that helps them to develop the essential health skills necessary to adopt, practice and maintain healthy behaviors.5 Such curricula incorporate learning strategies, teaching methods and materials that are age- and developmentally-appropriate, and culturally inclusive.5 Implementation of effective health education also includes providing continuing education and training for health education teachers.6,7 By providing healthy and safe school environments: Healthy school environments help improve dietary behavior and prevent overweight among youths.8 Components of a healthy school environment include increasing the availability of healthful foods such as fruits and vegetables in snack bars and vending machines, restricting the sale of foods high in fat, sodium and added sugars, and beverages containing caffeine on school grounds, and providing students with access to safe, free drinking water throughout the school day.9,10 By incorporating family and community involvement: This provides an effective integrated approach for improving the health and well-being of students. School health interventions aimed at improving student health outcomes are more effective when they involve parents and community organizations.11 It also ensures that parents are more involved in school health activities and communicate more effectively with school staff about their children's health.12 References 1. The Georgia Department of Education. Enrollment by Ethnicity/Race, Gender and Grade Level (PK-12). Enrollment Count. Available at https://app3.doe.k12.ga.us/ows-bin/owa/fte_pack_ethnicsex.entry_form. Accessed 10/28/2014. 2. Briefel RR, Crepinsek MK, Cabili C, Wilson A, Gleason PM. School food environments and practices affect dietetic behaviors of US public school children. Journal of the American Dietetic Association 2009;109(Suppl 1):S91S107. 3. Fox MK, Dodd AH, Wilson A, Gleason PM. Association between school food environment and practices and body mass index of US public school children. Journal of the American Dietetic Association, 2009;109(Suppl 2):S108S117. 4. Food and Nutrition Board, Institute of Medicine, Committee on Prevention of Obesity of Children and Youth--Schools. In: JP Koplan, CT Liverman, VI Kraak, eds. Preventing Childhood Obesity: Health in the Balance. Washington, DC: National Academy Press, 2005, pp. 237284. 5. Centers for Disease Control and Prevention. Characteristics of Effective School Health Education Curricula. Atlanta, GA: CDC; 2008. Available at: http://www.cdc.gov/Healthyyouth/SHER/characteristics/index.htm 6. Jones SE, Brener ND, McManus T. The relationship between staff development and health instruction in schools in the United States. American Journal of Health Education 2004;35:210 7. Public Education Network. Teacher Professional Development: A Primer for Parents and Community Members. Washington, DC: Public Education Network; 2004. 8. Wechsler H, McKenna ML, Lee SM, Dietz WH. The role of schools in preventing childhood obesity. The State Education Standard 2004; 5(2):4- 12. 9. Food and Nutrition Board, Institute of Medicine, Committee on Prevention of Obesity of Children and Youth--Schools. In: JP Koplan, CT Liverman, VI Kraak, eds. Preventing Childhood Obesity: Health in the Balance. Washington, DC: National Academy Press, 2005, pp. 237284. 10. Institute of Medicine. Nutrition Standards for Foods in Schools: Leading the Way toward Healthier Youth. Washington, DC: Institute of Medicine of the National Academies, 2007. 11. Centers for Disease Control and Prevention. Parent Engagement: Strategies for Involving Parents in School Health. Atlanta, GA: U.S. Department of Health and Human Services; 2012. Available at: http://www.cdc.gov/healthyyouth/AdolescentHealth/pdf/parent_ engagement_strategies.pdf. 12. Epstein JL. School, Family, and Community Partnerships: Preparing Educators and Improving Schools Second Edition. Boulder, CO: Westview Press; 2011. We Protect Lives.