Successful strategies for increasing healthy eating and physical activity in schools: Lessons learned from San Diego communities putting prevention to work (CPPW)

Introduction School environments provide opportunities for improvements in nutrition and physical education (P.E.) programs, which can have a substantial impact on health, particularly for low-income children. Through CPPW, six San Diego school districts implemented comprehensive strategies to improve wellness, including model breakfast programs and physical education trainings. The program evaluation used a mixed methods approach to focus on administrative and staff support and key student outcomes. Methods Three tools were employed to evaluate Breakfast in the Classroom: food services data, a breakfast in the classroom survey, and key informant interviews. The P.E. evaluation used System for Observing Instruction Time (SOFIT), teacher surveys, and key informant interviews. One school per district was chosen from the intervention schools for SOFIT measurement and another non-intervention school served as a control. Results School breakfast participation increased 100% over baseline in all schools. Survey results indicated strong support from parents, over 90% felt that the program encourages students to be on time and be more engaged in classroom activities. SOFIT results demonstrated an increase in moderate and vigorous physical activity with an average increase of 74% over baseline in six intervention schools. Over 68% of classroom teachers reported that P.E. is very important for classroom behavior and academic performance. Discussion For both school nutrition and P.E., the most critical component was the support of classroom and administrative staff. Schools with substantial administrative support were more successful in program implementation and the districts that included materials to emphasize program benefits for teachers reported greater acceptance.