Examining healthy weight promotion and support for overweight/obese students in Appalachian Tennessee high schools

Background: Coordinated school health (CSH) is recommended for its potential to promote healthy weight in adolescents through strategic programming. However, resources for and emphasis on adolescent obesity prevention varies between schools, thereby limiting the intended benefits of CSH. Purpose: To understand gaps in schools' approaches to healthy weight promotion and support for overweight/obese students, we evaluated 1) perceptions of adolescent obesity and 2) environmental factors and programs facilitating adolescent healthy weight in high schools in Appalachian Tennessee. Significance: Results from the study can be used to encourage school-based strengths, and to identify gaps in CSH infrastructure within and between schools. Methods: In 2012, 17 key school personnel from five randomly selected high schools were interviewed. Questions addressed their perceptions of adolescent obesity, school-based physical activity programming and nutrition, and support available to overweight/obese students. Content analysis was conducted to identify emerging themes. Results: Participants consistently identified adolescent obesity and/or associated risk factors as major health problems within their schools. Barriers to physical activity and healthy eating were identified at multiple ecological levels. Due to sensitivity surrounding adolescent overweight/obesity, no particular programs or curriculum targeted overweight/obese adolescents specifically, but were available to all students. Support is not explicitly available in any of the schools; thus, overweight/obese students must seek out these resources. Conclusion: Findings suggest that while school personnel are concerned about the impact of adolescent obesity on health outcomes, there is wide variation across schools participating in CSH on the types and quality of programming available to address the issue.