How do school wellness policies influence school practices and student health behaviors: An evaluation of Healthy CPS

Introduction: Overweight or obesity prevalence among kindergarten, 6^th and 9^th graders in Chicago Public Schools (CPS) was 43.3% in 2010, with higher rates among African-American and Hispanic students. CPS Office of Student Health and Wellness (CPS-OSHW) adopted strengthened school wellness and physical education policies in school year 2012-13, which encourage healthy school environments to improve healthy weight, nutrition and physical activity of 400,000 students. Simultaneously, CPS-OSHW received a CDC-funded Community Transformation Grant to enhance policy implementation (Healthy CPS), which is currently being evaluated.

Methodology:  Healthy CPS impact is assessed using student survey data, with multilevel models to account for student and school characteristics, including school climate and degree of policy implementation. Stakeholder interviews will inform interpretation of the results. Baseline data from Fall 2013 represent 1,898 4^th and 7^th graders in a total of 16 intervention and control schools; post-program data will be collected in Spring 2014.

Results:  Baseline survey respondents included 30% African-American and 65% Hispanic students. African-American students reported higher rates of teachers rewarding students with junk food (68% vs. 50%), withholding recess (60% vs. 38%) and availability of junk food and soda/sport drinks compared to Hispanic students.  Similarly, African-American students reported lower water consumption (5 vs. 5.6 days) and higher soda intake (4 vs. 3.4 days) compared to Hispanic students.

Discussion: The impact analysis will determine whether Healthy CPS improved nutrition and physical activity outcomes and reduced outcome disparities, especially those related to policies implemented at participating schools, including whether differences are influenced by school culture.