Implementing Nutrition Policies in High-risk Schools: What are the barriers to success and lessons learned?

Introduction: Proper nutrition promotes optimal growth and development for children and deters negative health outcomes including diabetes and childhood obesity. School settings can facilitate healthy food consumption by creating and maintaining supportive nutrition environments and cultures.

Methods: Eight high-risk (characterized by high poverty rates and low academic achievement) school districts in Maine were selected to work with Let’s Go! to develop Action Plans aimed at developing/implementing environmental change policies to improve school nutrition. To examine the efficacy of the policy implementation, we conducted ten structured interviews with food service directors, school administrators and Let’s Go!staff. Interviews lasted approximately one hour. Data were analyzed using an inductive model and thematic analysis.

Results: Positive and negative factors associated with the individual (influence of staff, students, parents), the systems (school infrastructure--schedule, conflicting school policies) and the environmental (equipment available in kitchen, presence/absence of cafeteria) contributions to successful implementation were identified. We also identified specific individual, systems, and environmental barriers and facilitators associated with policy implementation, such as poorly laid out cafeterias and strategic placement of food choices respectively.

Conclusions: Due to the federal mandate that schools participating in federal child nutrition programs establish wellness policies, understanding the implementation of these policies in high-risk schools in Maine has important implications for improving the health of students  and for implementation of such policies elsewhere in the future. We will discuss the potential longer-term outcomes associated with implementation as well as lessons learned and key resources for success.