Progress 04/01/17 to 03/31/23
Outputs
Target Audience:
Nothing Reported
Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided?As described in previous years, the online, on-demand PD program consists of five total modules (MyPlate, Nutrients, Sometimes Foods, Eating in Color, and A Balanced Plate) with content that is organized under the subheads "Learn," "Plan," and "Teach." The modules can be viewed here https://www.american.edu/cas/healthyschools/professional-development.cfm Learn includes an introductory training video that explains the content corresponding with the USDA's Serving up MyPlate: A Yummy Curriculum. Plan reviews concepts and ideas to help make the content relevant and engaging. Teach provides all needed lesson materials, with teacher instructions and student handouts. Explore More includes links to additional articles, YouTube videos and other online resources for participants to access as they desire. Making the PD program completely available online aligns with the accessibility needs that have been required over the last three years. The program team wanted teachers to be able to determine the lessons most appropriate for their students. Once a PD training module has been completed and a lesson taught, teachers fill out a Qualtrics survey to receive a certificate of completion that can be used toward meeting the PLU (professional learning unit) requirements to maintain their teaching credential, per the Office of the State Superintendent of Education (OSSE). How have the results been disseminated to communities of interest?Information about Healthy Schoolhouse 2.0 continues to be presented at a variety of meetings with stakeholders as well as our Healthy Schoolhouse 2.0 Board of Advisors. The research team presented a poster at the American School Health Association (ASHA) annual conference in July 2022 titled Examining the relationship between job stress, self-efficacy and personal health among elementary school teachers in Washington, D.C.: Empowering teachers through professional development. The program's final Board of Advisors meeting was held February 9, 2023 with final data updates, dissemination highlights, and an opportunity for open discussion on how board members see this work evolving to support teacher and student health in a post pandemic environment. An abstract was also submitted to the 2023 American Public Health Association (APHA) annual conference titled Sick of Teaching: The decline of teacher health and well-being during the pandemic. Status is pending. Two final manuscripts were written. The first summarizes lessons learned from Healthy Schoolhouse 2.0 and how these can advance health equity through collaborative implementation in other school districts with a large proportion of underserved students. Investing in Teacher Well Being is Good For Teachers and Students was submitted to the journal Health Equity. The second manuscript covers much of the data summarized above emphasizing the importance of investing in teacher well-being. The impact of Covid-19 on teacher wellness: Recommendations for systemic reforms was submitted to Teaching and Teacher Education. Both are under review. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
For the 2022-23 school year, no schools were enrolled in Healthy Schoolhouse 2.0 (HS2). This was an additional year (sixth year) covered by a No Cost Extension (NCE). Year 6 of Healthy Schoolhouse 2.0 served as a summation of data analyses, report writing and dissemination. One-hundred percent of students in all four schools are economically disadvantaged. As described above, this school year represented a closeout year for all final data analysis. Control schools were contacted to share all program materials, supplies, and kits with teachers. This gives control schools the ability to deliver all HS2 lessons shared with intervention schools. The teacher health survey (THS) was modified and administered in May/June 2022 to teachers in three of the participating elementary schools (n=128). The modified survey included 13 items on self-efficacy, personal health and health beliefs, and 6 items on demographic characteristics (age, gender, race/ethnicity, role). Items were retained that were found to be associated with lesson implementation in the analysis of the pre and post THS analysis; additional items were added to ask about length of teaching time (both overall and at the school), given the reported increases in teachers leaving the profession during the pandemic. The modified THS was administered in-person at each school and as a thank you for their time, a catered lunch was provided. Overall, 92 teachers completed the pre-survey, 92 teachers completed the post-survey and 128 teachers completed the pandemic-survey survey and 128 teachers completed the pandemic-survey. Analyses were conducted with SPSS Version 29 and R Core Team (2021) tidyverse package. Descriptive analysis summarized teacher sociodemographic characteristics. Teaching time was examined as a continuous variable (years teaching) and dichotomous variable (< 5 years or 5+ year) in the pandemic assessment. An aggregate health score was computed and compared across the three assessment times (pre, post, pandemic).Higher cumulative health scores represent better self-reported health. Most teachers identified as Black (66%), female (85%) with a mean age of 36 years, which is demographically representative of teachers in the region. 38% had been teaching less than five years and 62% had been teaching five years or more. Self-reported teacher health and well-being declined during the pandemic. The average cumulative health scores decreased significantly in the pandemic (F=0.07, df=2, p <0.01); the average health score was 76 in the pandemic compared to averages score of 101 in both the baseline and post-intervention assessment (p<0.01, 95% C.I. 30.0, 44.7). We previously demonstrated that teacher engagement and lesson implementation is associated with increased student nutrition knowledge. Poisson regression was conducted to examine the relationships between teachers' personal health, self-efficacy, and job stress. There was a significant correlation between professional development sessions attended and nutrition lessons implemented (p <0.01, r = .54). Regression analysis yielded self-efficacy, job stress and professional development attendance were significant predictors of teacher nutrition lesson implementation. The majority of teachers reported very high/high job stress at each assessment. However, we found that length of time teaching and age were inversely related to stress in the pandemic THS assessment. Older age was associated with lower stress (r=-.24; p<0.001) and teaching 5 or more years was associated with lower stress (r=-.2; p <0.05). Teachers with 5+ years of experience are also more likely to report having 1 or more chronic diseases (e.g. diabetes, hypertension, or asthma) than teachers with less experience. After the project period, teachers will have the remaining materials from the comprehensive teacher kits that were provided to all participating teachers. Teachers, and the public, also have access to the online Healthy Schoolhouse Professional Development page, which includes 8 brief YouTube videos designed to be aligned with the My Yummy Plate curriculum. Participation is measured through monthly metrics of pageviews and downloads. These training modules can also be used to fulfill PLU (professional learning unit) requirements by DC Office of the State Superintendent of Education (OSSE). Further, our partners Martha's Table, a local community-based nonprofit, continues to that runs monthly, free after-school Joyful Food Markets in all four schools.
Publications
- Type:
Conference Papers and Presentations
Status:
Accepted
Year Published:
2022
Citation:
American School Health Association (ASHA) annual conference in July 2022 titled Examining the relationship between job stress, self-efficacy and personal health among elementary school teachers in Washington, D.C.: Empowering teachers through professional development.
- Type:
Journal Articles
Status:
Under Review
Year Published:
2023
Citation:
Investing in Teacher Well Being is Good For Teachers and Students was submitted to the journal Health Equity.
- Type:
Conference Papers and Presentations
Status:
Accepted
Year Published:
2023
Citation:
2023 American Public Health Association (APHA) annual conference titled Sick of Teaching: The decline of teacher health and well-being during the pandemic.
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Progress 04/01/21 to 03/31/22
Outputs
Target Audience:Teachers in the two intervention schools who teach elementary school students. One-hundred percent of students in all four schools are economically disadvantaged. School E1 has an enrollment of 347 students, 90% of whom are Black and 10% Hispanic/Latino. The 2018-19 standardized tests show that 23% of the students tested met or exceeded expectations in Math and 11% met or exceeded expectations in ELA. School E2 has an enrollment of 286 students, 98% of whom are Black and 2% Hispanic/Latino. The 2018-19 standardized tests show that 13% of the students tested met or exceeded expectations in Math and 12% met or exceeded expectations in ELA. School C1 has an enrollment of 506 students, 98% of whom are Black and 2% Hispanic/Latino. The 2018-19 standardized tests show that 24% of the students tested met or exceeded expectations in Math and 10% met or exceeded expectations in ELA. School C2 has an enrollment of 274 students, 94% of whom are Black, 4% Hispanic/Latino, and 1% multiple races. The 2018-19 standardized tests show that 10% of the students tested met or exceeded expectations in Math and 8% met or exceeded expectations in ELA. Changes/Problems:Due to the pandemic, we remained doing our research work in a hybrid format. The demands on teachers and schools remained quite high as students returned to schools with masks and testing. Due to these changes, a no-cost-extension was requested and approved. What opportunities for training and professional development has the project provided?As described in last year's report, the online, on-demand PD program consists of five total modules (MyPlate, Nutrients, Sometimes Foods, Eating in Color, and A Balanced Plate) with content that is organized under the subheads "Learn," "Plan," and "Teach." The modules can be viewed here https://www.american.edu/cas/healthyschools/professional-development.cfm Learn includes an introductory training video that explains the content corresponding with the USDA's Serving up MyPlate: A Yummy Curriculum. Plan reviews concepts and ideas to help make the content relevant and engaging. Teach provides all needed lesson materials, with teacher instructions and student handouts. Explore More includes links to additional articles, YouTube videos and other online resources for participants to access as they desire. With the transition to virtual learning in 2020 and now having returned to in-person learning for SY 21-22, the program team felt it was essential to accessibility to make the PD program materials available online. Further, this allows each teacher to determine the lessons most appropriate and needed for their students. As described above, we did still provide hard copy lesson materials in the teacher kits to our partner schools. As before, once a PD training module has been completed and a lesson taught, teachers can fill out a Qualtrics survey to receive a certificate of completion that can be used toward meeting the PLU (professional learning unit) requirements to maintain their teaching credential, per the Office of the State Superintendent of Education (OSSE). How have the results been disseminated to communities of interest?Information about Healthy Schoolhouse 2.0 continues to be presented at a variety of meetings with stakeholders as well as our Healthy Schoolhouse 2.0 Board of Advisors. At the national level, our poster presentation at the American School Health Association's (ASHA) Annual Conference in July 2021 demonstrated how teacher engagement and lesson implementation is associated with increased student nutrition knowledge in the session "Empowering Teachers to Support Healthy Students and Healthy Learners: Healthy Schoolhouse 2.0." In November 2021, we presented similar findings at the Healthy LifeStars: improving health outcomes through preventing childhood obesity conference in the breakout session "Healthy Schoolhouse 2.0: Empowering Teachers to Shape Healthy Students." The article "Development of a nutrition literacy survey for use among elementary school students in communities with high rates of food insecurity" was published in May 2021 in the Journal of Hunger and Environmental Nutrition. Our manuscript detailing results from year one, "Healthy Schoolhouse 2.0 Health Promotion Intervention to Reduce Childhood Obesity in Washington, DC: A Feasibility Study" was published in the Nutrients Special Edition on Childhood Obesity: Nutrition and Lifestyle Determinants in August 2021. Between April 2021-March 2022, the Healthy Schoolhouse Professional Development page had 239 pageviews. The eight YouTube videos created for the online PD program that provide an overview of the material and suggested lessons have been viewed a total of 180 times. What do you plan to do during the next reporting period to accomplish the goals?The next year will be the sixth and final year of HS2 due to a no cost extension. We will use this time to do all final data analysis and dissemination of results and findings. From our work on Healthy Schoolhouse 2.0 over the last five years, we've witnessed many changes in the school environment as learning transitioned from fully in-person instruction, to fully virtual, to hybrid, and back to in-person. We have seen the demands the COVID-19 pandemic has placed on school systems and individual teachers. Since the beginning, our intent has been to support teachers and the necessity and urgency of doing so now is even more apparent. The research team is thoughtfully considering how we can support teacher well-being moving forward. We want to re-establish their health and wellness front and center so that they are being taken care of while doing so much to take care of students.
Impacts
What was accomplished under these goals?
Year 5 of Healthy Schoolhouse 2.0 was originally intended to be a summation of data analyses, report writing and dissemination. However, because of the COVID-19 pandemic and the significant limitations it imposed on implementation during year 4, this fifth year was modified to be a hybrid year. The program team worked diligently over the summer months July-Aug 2021 to reignite commitment to HS2 through outreach and meetings to leaders and contacts at our partner intervention schools. Meetings and connections were established, and modified expectations were agreed upon for teacher PD participation. Having transitioned to an entirely online PD platform during the pandemic, both intervention schools could participate in and complete PD sessions at the pace of their choosing. Online PD sessions are available for five lessons: MyPlate, Eating in Color, A Balanced Plate, Nutrients, and Sometimes Foods (accessible here: https://www.american.edu/cas/healthyschools/professional-development.cfm). Brand new teacher kits with freshly stocked supplies for lessons were provided to E1 & E2 in October 2021. "Welcome bags" were also delivered to teachers with reusable water bottles and journals to support teacher well-being. September 2021 signified the return to in-person school after having been conducted in a virtual or hybrid format since March 2020. With the COVID-19 pandemic still ongoing and numerous modifications to the school day in place, the transition back to in-person learning presented many challenges that required priority attention of school leaders and teachers. Requirements for social distancing, COVID-19 testing, staffing shortages due to illness, and the uncertain nature of the pandemic all took extra energy and effort to absorb and withstand. Understanding the impact of these daily (sometimes hourly) changes, it is reasonable that only three teachers reported having completed six PD training sessions and teaching the corresponding nutrition education lessons. Using the teacher kits and information from the online PD modules, teachers are to implement a minimum of three lessons with their class before the end of the year. They log the lessons on a Qualtrics form that collects information on which lesson was taught, when and to whom the lesson was taught, number of students present, and any feedback on the materials. As of March 2022, only six lessons have been logged, two by the PE teacher at school E1, three by a 1st grade teacher at school E2, and one by a kindergarten teacher at school E2. As described above, this school year represented the return to in-person learning after nearly 17 months of a virtual or hybrid format. The expectations of teachers to make this a smooth and predictable transition while attending to the trauma and learning loss experienced by students all to varying degrees were quite high. We have maintained monthly outreach via email to keep the lines of communication open, but the program team has not actively pursued lesson completions with our partner schools. Teacher survey data (n=92) was examined over the entire project period to explore teacher characteristics that are associated with participation in professional development (PD) sessions, and the impact on implementation of nutrition lessons. Within the intervention schools, teachers were invited to participate in a five-session PD program to empower teachers with personal health knowledge and strategies for integrating nutrition lessons into their classroom curriculum. Given the additional stressors that have been placed on teachers during the ongoing COVID-19 pandemic, we also examined teacher self-reported job stress with the impact of the PD program. On average, intervention school teachers (n=45) attended four PD sessions and implemented three nutrition lessons. There were 49 lessons taught overall. There was a significant correlation between the number of PD sessions attended and the number of nutrition lessons teachers implemented (p <0.01, df = 40, r = .54); teachers who participated in more PD sessions were more likely to implement more nutrition lessons. Participating teachers (n=92) completed the 38-item Teacher Health Survey at baseline and post, which includes questions regarding personal health habits, mental health, job stress, beliefs about health and education, and self-efficacy. Missing data was imputed using predictive mean matching. Surveys with 40% of more missing data were exclude from analyses. There were no significant demographic differences between teachers in the intervention and comparison schools. The majority of teachers were female (85%, n=78) and identify as African-American/Black (68%, n=63). The average age was 36 years old. An aggregate health score was computed which included: self-reported overall health, chronic condition (diabetes, asthma, and/or high blood pressure), health education beliefs (8 items), and self-efficacy (5 items). The average aggregate health score was 64% (0-100) at baseline. The Welch Two Sample t-test demonstrated that teachers who reported lower stress scores were significantly more likely to implement nutrition lessons than teachers who reported high stress (p <0.01). Stress scores are inversely correlated with lesson implementation (r = 0.46; p < 0.01). There was also a significant association between stress levels, cumulative health scores and lesson implementation. Teachers who did not implement nutrition lessons had an average overall health score of 63%, whereas teachers who implemented 3 or more lessons, had an average overall health score of 86%. In previous analyses, we found that students who received3 or more nutrition lessons had significantly higher nutrition knowledge scores which were on average 10% higher than students who received fewer lessons. Principal components analysis and Poisson regression were conducted to examine the relationships between teachers' personal health, self-efficacy, and job stress. Principal components analysis determined eight components explain 70% of the variation. Regression analysis yielded self-efficacy, job stress and professional development attendance predicted nutrition lesson implementation (p <0.01). In order to empower teachers to manage workplace stress to protect and maintain a robust teacher workforce, it is imperative to offer ongoing support for professional learning about health. The Healthy Schoolhouse 2.0 program is designed to engage teachers as agents of change by creating a culture of health within their classrooms and in the school and provides preliminary evidence of the positive impact of supporting teacher well-being in order to support student well-being. This work supports calls for ongoing and structural support for teacher stress management. Healthy Schoolhouse 2.0 partners with Martha's Table, a local nonprofit, that runs monthly, free after-school Joyful Food Markets in over 50 schools in DC (including E1, E2, C1, and C2). Joyful Food Markets (JFMs) represent the setting in which HS2 nutrition education lessons are extended from the classroom and applied in real world situations. Due to restrictions imposed by COVID-19, Martha's Table transitioned from in-person JFMs in March 2020 to bagged "grab-n-go" grocery distributions at select school locations for DC students and families through March 2021 (year 4 of HS2). Between April 2021-March 2022 (year 5 of HS2), JFMs were reinstated at our partner schools but with limited attendance by non-school staff to maintain social distancing and contact tracing. Individuals not directly responsible for administering the JFMs were not encouraged to participate.
Publications
- Type:
Journal Articles
Status:
Published
Year Published:
2021
Citation:
2. Hawkins M, Belson SI, McClave R, Kohls L, Little S, Snelling A. (2021) Healthy Schoolhouse 2.0 Health Promotion Intervention to Reduce Childhood Obesity in Washington, DC: A Feasibility Study. Nutrients. https://www.mdpi.com/2072-6643/13/9/2935
- Type:
Journal Articles
Status:
Published
Year Published:
2021
Citation:
4. Hawkins M, Fuchs H*, Watts E, Belson SI, Snelling A. (2021) Development of a nutrition literacy survey for use among elementary school students in communities with high rates of food insecurity. Journal of Hunger and Environmental Nutrition. https://doi.org/10.1080/19320248.2021.1928577
- Type:
Conference Papers and Presentations
Status:
Accepted
Year Published:
2021
Citation:
Empowering Teachers to Support Healthy Students and Healthy Learners: Healthy Schoolhouse 2.0.
Association of school health conferences
- Type:
Journal Articles
Status:
Under Review
Year Published:
2022
Citation:
" McClave R, Hawkins M, Irvine Belson S, Snelling A. Healthy schoolhouse 2.0 strides towards equity in obesity prevention. Childhood Obesity. Revise and resubmit March 2022.
|
Progress 04/01/20 to 03/31/21
Outputs
Target Audience:Target audience is Washington, DC Public school teachers and their students in elementary schools. Changes/Problems:For the 2020-21 school year, four schools were enrolled in Healthy Schoolhouse 2.0: Intervention School 1 (E1), Intervention School 2 (E2), Control School 1 (C1), and Control School 2 (C2). For both schools E1 and E2, this would have been a "booster" year. This is the fourth year for E1 and third year for E2 in the program. However, due to the transition to virtual learning that took place in March 2020 as a result of the COVID-19 pandemic, the program team had to significantly modify expectations around teacher PD participation. What opportunities for training and professional development has the project provided?In year three (Apr 2019-Mar 2020), the program team converted the PD program content to three online, on-demand training videos. New in year four, we expanded the online PD training to encompass five total modules (MyPlate, Nutrients, Sometimes Foods, Eating in Color, and A Balanced Plate) that are organized in user friendly snippets "Learn," "Plan," and "Teach." The modules consist of training videos and lesson materials that align with the content of the USDA's Serving up MyPlate: A Yummy Curriculum and each module also includes links to additional articles, YouTube videos and other online resources for participants to "Explore More" as they desire. Feedback from our intervention schools emphasized the demands on their out of class time and the numerous other required PD sessions and the program team felt this user led approach allows participants to choose how many sessions they want to take part in. We will still provide all the hard copy materials in the teacher kits, but especially during the COVID-19 pandemic the program team felt offering the PD program content in electronic format was essential. The modules can be viewed here https://www.american.edu/cas/healthyschools/professional-development.cfm As before, once a training module has been viewed and a lesson taught, teachers can fill out a Qualtrics survey to receive a certificate of completion that can be used toward meeting the PLU (professional learning unit) requirements to maintain their teaching credential, per the Office of the State Superintendent of Education (OSSE). In addition to sharing the PD modules with our intervention schools, we presented to 18 DC public school and public charter school Health & Physical Education teachers on March 17, 2021. We are focused on maintaining connections with elementary school teachers and providing engaging and educational lessons they can easily implement. How have the results been disseminated to communities of interest?Information about Healthy Schoolhouse 2.0 continues to be presented at a variety of meetings with stakeholders as well as our Healthy Schoolhouse 2.0 Board of Advisors. On a national level we presented Nutrition Education Program Design, Implementation, and Evaluation for the Society for Nutrition Education and Behavior (SNEB) Fall Journal Club Webinar Series in November 2020. We also did a poster presentation at the American School Health Association's (ASHA) Annual Conference in September 2020 on The Healthy Schoolhouse through the WSSC Framework: The role of policy and practice?. Locally, we presented to the Healthy Youth and Schools Commission (HYSC) in June 2020 on Healthy Schoolhouse 2.0 year one results. The HYSC was born out of DC's Healthy Schools Act from 2010 in which nutrition and physical education standards were significantly strengthened. In January 2020 our manuscript Design and Implementation of a 5-year School-Based Nutrition Education Intervention was published in Journal of Nutrition Education and Behavior. We also completed revisions in January 2021 to the manuscript on the validation of the student nutrition knowledge survey instrument submitted to Journal of Hunger and Environmental Nutrition. Lastly, a manuscript for year one results is currently underway for submission to a special issue of the journal Nutrients in July 2021. Between April 2020-March 2021, the Healthy Schoolhouse Professional Development page had 379 unique pageviews. The eight YouTube videos created for the online PD program that provide an overview of the material and suggested lessons have been viewed a total of 115 times. What do you plan to do during the next reporting period to accomplish the goals?In the current environment of schools transitioning from fully virtual instruction to hybrid formats due to COVID-19, we are thoughtfully considering how we can support teachers in incorporating this content along with the many other priorities they must attend to around student learning and health. We are making plans to revitalize relationships with our school partners before SY 20/21 closes, knowing how critical these connections are to the success of the project. We want to strongly support teacher well-being as we move forward knowing that they have responded to many demands on their own health in trying to maintain a stable learning environment for their students. While Y5 of the Healthy Schoolhouse was originally slated for data analysis and report dissemination, we are planning for a condensed data collection timeline September 2021-January 2022. A no cost extension will be requested for April 2022-March 2021 to allow for final data analysis and dissemination of findings. We plan to resume our partnership with Martha's Table, as school health and safety protocols allow, in supporting monthly Joyful Food Markets. The activities allow us to extend the impact of the classroom lessons and can support attending to the academic and social emotional needs of students in their return to school.
Impacts
What was accomplished under these goals?
The overview session introduced the three online PD sessions, reviewed program goals, provided brand new teacher kits with freshly stocked supplies for all lessons, and presented year 2 (E1) and year 1 (E2) data to the teachers. Unfortunately, due to the timing of the pandemic with only three months of the school year remaining and all the logistical and technological challenges this presented to each school, only one teacher reported having completed PD training sessions and teaching the corresponding lessons on MyPlate, Nutrients, and Sometimes Foods to students. Teacher post-survey data would have been collected at schools E1, E2, C1, and C2 in late May/early June 2020. However, based on communication with participating schools between April and May 2020, the program team did not feel the post-survey responses would be readily received by teachers already very busy with all the adaptations. In the 2020-21 school year, monthly outreach attempts were made to school contacts and discussions of possible creative approaches to support teacher well-being were posed with school leadership. We also held a meeting with our Board of Advisors on 9/23/20 to get feedback on possible strategies for modifying teacher PD opportunities during remote learning. However, the uncertain nature of the pandemic and expectations around school re-openings led to very tentative commitments that were not feasible to implement (at the schools' wishes). School E1 has an enrollment of 347 students, 90% of whom are Black and 10% Hispanic/Latino. The 2018-19 standardized tests show that 23% of the students tested met or exceeded expectations in Math and 11% met or exceeded expectations in ELA. School E2 has an enrollment of 286 students, 98% of whom are Black and 2% Hispanic/Latino. The 2018-19 standardized tests show that 13% of the students tested met or exceeded expectations in Math and 12% met or exceeded expectations in ELA. School C1 has an enrollment of 506 students, 98% of whom are Black and 2% Hispanic/Latino. The 2018-19 standardized tests show that 24% of the students tested met or exceeded expectations in Math and 10% met or exceeded expectations in ELA. School C2 has an enrollment of 274 students, 94% of whom are Black, 4% Hispanic/Latino, and 1% multiple races. The 2018-19 standardized tests show that 10% of the students tested met or exceeded expectations in Math and 8% met or exceeded expectations in ELA. For 11 months of this reporting period (Apr 2020-Feb 2021), all DC Public Schools have served students in a strictly online/distance learning format due to the impacts of COVID-19. In consideration of all the challenges school administrations, teachers, staff and students have been faced with throughout the pandemic, the program team felt it was best to preserve our relationship with the participating schools for future implementation efforts and therefore did not actively expect lessons to be taught. Due to the COVID-19 pandemic, DC Public School students received all education virtually beginning in March 2020 through the June 2021; therefore, post-data collection activities in Y3 were suspended, as well as pre/post data collection activities in Y4. However, in-depth data analysis activities were conducted on available data to examine the implementation of the PD course to increase nutrition lessons across intervention years. Teachers are nested with in schools (2 intervention/2 comparison) and students nested within classrooms. Several new variables were created to account for the multiple levels and for the staggered enrollment of schools; Program Year= year of the Healthy Schoolhouse 2.0 Program (1, 2 or 3); Teacher Year = year of teacher involvement (1, 2 or 3), Student Year= individual student year of involvement (1, 2, or 3), and Test Exposure = beginning at 0 and increasing by one as students retook the student nutrition literacy survey. Teachers who implement at least 3 lessons are defined as having delivered the intervention. Therefore, we also created a new variable for lessons received (< 3 lessons, exactly 3 lessons, > 3 lessons). There is a large proportion of missing data so imputation was necessary. Mean imputation is the replacement of a missing observation with the mean of the non-missing observations for that variable. Mean imputation was performed using the mice package in r. First, we examined the interaction of the teacher scores (self-efficacy) on the students' knowledge percent scores. We hypothesized that the knowledge scores are influenced by number of professional development (PD) sessions the teachers attended and number of lessons the students received. While there was no correlation between teacher pre-test self-efficacy scores and PD sessions attended (p=.98, df = 17, t = .025, r = .006), there was a significant a statistically significant correlation between number of PD sessions attended and number of lessons implemented (p <0.01, df = 40, r = .54). We examined student data for all students who participated in one year of the program, regardless of Healthy Schoolhouse 2.0 program year. There were no significant differences between pre knowledge scores between intervention and comparison schools (p=.2, df = 1091, n = 1001). There is a significant difference between student post knowledge scores between intervention and comparison schools (p = < 0.01 , n= 659). There is also a significant difference between knowledge percent score changes between school type (p < 0.01, n= 659). In student Y1, students in the intervention schools had higher mean and median post knowledge score and knowledge percent score changes. We used the non-parametric Wilcoxon Ranked Sum test and the Kruskal-Wallis Test to compare the differences between groups given the knowledge scores were not normally distributed. Students who received the intervention (3 or more lessons) had knowledge scores that were on average 10% higher than those fewer lessons (0-2 lessons received) (p < .001, df = 2, F = 9.66). Students who received more than 3 lessons had scores that were 8% higher on average than those who received fewer lessons (0-2) (p < .01). We used ordinal logistic regression (OLR) to determine the relationship between random and fixed variables to predict student knowledge scores. We hypothesized that there is a statistical difference between knowledge scores of students who received the intervention (3 or more lessons) and those who did not receive the intervention (2 or less lessons) across the length of the Healthy Schoolhouse 2.0 program to date. In the final OLR model there was significant findings with the following variables: the intervention of lessons implemented is significant, with the intervention of three or more lessons received resulting in a .95 increase in the odds ratio (p = .00017, Estimate = .94, SE = .25, Z value = 3.75) for knowledge scores. Test Exposure is significant, with each one unit increase in test exposure resulting in a 1.2 increase in the odds ratio (p = 1.0e-6, Estimate = 1.2, Z = 4.89) for knowledge scores. There is a significant effect in Program Year, with each one unit increase in program year resulting in .39 increase in the odds ratio (p = .0005) for knowledge scores. There is also significance test time (p-value = <0.01) with an increase in the odds ratio for knowledge scores from Pre to Post test. There is also significance in the students' gender (p-value < 0.002), girls having a .34 increase in the odds ratio for knowledge scores. The interaction of test exposure and program year, and the interaction of test exposure and test were also significant (p-value < 0.01, p-value = <0.05, respectively).
Publications
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Progress 04/01/19 to 03/31/20
Outputs
Target Audience:For the 2019-20 school year, four schools are enrolled in Healthy Schoolhouse 2.0: Experimental School 1 (E1), Experimental School 2 (E2), Control School 1 (C1), and Control School 2 (C2). For both schools E1 and E2, this is a "booster" year. This is the third year for E1 and second year for E2. However, based on engagement last year, the program team felt it was necessary to increase the dose and provide more professional development exposure this year. This change to the study design was approved by the program officer. Teachers at both schools E1 and E2 participated in the in-person professional development (PD) overview session during which the three online sessions were introduced. An average of 15 teachers attended the overview sessions (range of 15-16). During this session we reviewed program goals, provided brand new teacher kits with freshly stocked supplies for all lessons, and presented year 2 (E1) and year 1 (E2) data to the teachers. In October and November, teacher baseline survey data was collected at schools E1 (n=18), E2 (n=15), C1 (n=26) and C2 (n=27). It is anticipated that post data will be collected from teachers again in late May/early June at all four schools. Changes/Problems:We have, in consultation with the program officer, shifted to providing a higher dose of the intervention to our two experimental schools. Therefore we have not added two new schools but we are working with our existing schools to provide a stronger does of the intervention to engage teachers to teach nutrition education principles to elementary school children. Further, our in person professional development program was shifted to an online format so teachers can do this at their convenience. What opportunities for training and professional development has the project provided?What opportunities for training and professional development have been provided? The PD overview sessions were delivered to Schools E1 on January 17, 2020 and E2 on February 25, 2020. New this year, the program team decided to change the format for delivering the professional development content to online, on-demand 15-20-minute training videos. Feedback from our experimental schools emphasized the demands on their out of class time and the numerous other required PD sessions. The on-demand training videos mirror the content of the USDA's Serving up MyPlate: A Yummy Curriculum written materials, covering MyPlate, Nutrients, and Sometimes Foods. We will still provide all the hard copy materials in the teacher kits, but the program team felt expanding to an electronic format was an important supplement and mechanism for reducing barriers to implementation. The three training videos can be viewed here https://www.american.edu/cas/healthyschools/professional-development.cfm In addition, we have worked with the Office of the State Superintendent (OSSE) to verify that viewing the training video, preparing the lesson, and teaching the lesson earns one continuing education unit. Each time a teacher records a taught lesson, we will provide a certificate of completion they can use toward meeting the CEU requirements for their teaching certificate. How have the results been disseminated to communities of interest?How have the results been disseminated to communities of interest? Information about the Healthy Schoolhouse 2.0 continues to be presented at a variety of meetings with stakeholders. The Healthy Schoolhouse 2.0 Board of Advisors is being kept up to date with two newsletters per year, in addition to our biannual meetings. They have provided additional suggestions on where to disseminate our results. On a national level we presented our findings from year one at two conferences, the Society for Nutrition and Behavior (SNEB) in July 2018 and the Food and Nutrition Conference & Expo (FNCE) in October 2018. Also at SNEB in 2018, we participated in the annual Project Director events and met other NIFA awardees. We have submitted a poster presentation for July 2019 at SNEB. Also, we presented to the Nutrition and Obesity Network: Policy, Research and Evaluation, School Working Group (December 2018). Preliminary findings were shared with new outlets, including Education Dive and The Conversation. We have prepared two manuscripts for submission to JNEB for April 15th--deadline for a special edition on learning and teaching. One manuscript will describe the methodology we are using and the second is a validation paper on the student nutrition knowledge survey instrument. What do you plan to do during the next reporting period to accomplish the goals?What do you plan to do during the next reporting period to accomplish the goals? In the current environment of school closures due to COVID-19, we are thinking creatively as to how we can support teachers in incorporating this content during distance learning. We will maintain the two experimental and control schools currently participating for the duration of this project. It has become clear that maintaining strong relationships and communication each of our partner schools is critical. Even with the continuity of working with the same experimental schools this year, each new school year represents staffing and administration changes that impact successful program execution. The program team is actively working to strengthen and support our school partners each month with proactive outreach and incentives for teachers to make wellness a personal priority as well as a classroom concept. Our partnership with Martha's Table continues to be a program highlight. The monthly Joyful Food Markets allow us to interact with students and their families, as well as teachers and school leaders outside of the classroom. We plan to continue focusing on these activities to further extend the learning to real world scenarios and contexts.
Impacts
What was accomplished under these goals?
?Goal R1: Measure the effects of the implementation of the PD course to increase nutrition lessons within elementary sch oolsLesson Implementation: Participating teachers in E1 and E2 schools are asked to implement a minimum of three nutrition lessons over the course of the school year and to log the implementation of each lesson in an online Qualtrics form. Teachers can also provide feedback on the lessons and curriculum in the form. Lesson Study and Teacher Observations of Lessons: The project team is determining how lesson observations will be conducted given the COVID-19 closures to ensure program fidelity may take place in the current environment. Teacher Baseline Surveys Year 3: A total of 86 teachers completed teachers completed baseline surveys. All survey data were entered, cleaned and double-checked by a different data coder for entry errors before statistical analysis. Statistical analyses of baseline survey data were performed using IBM SPSS Statistics software (Version 26.0). There were no significant demographic differences in the analysis of the baseline responses between the four schools. Teacher health education belief scores at the beginning of year 3 averaged 4.26 +/- 0.87 and 4.33 +/- 0.42 for schools E1 and E2, respectively. The average health education belief score at school C1 was 4.33 +/- 0.11, and at school C2 4.22 +/- 0 .42. Self-efficacy scores were 3.95 +/- 0.11 at school E1, 4.01 +/- 0.80 at school E2, 3.97 ± 0.104 at school C1 and 4.04 +/- 0.45 at school C2. There were no statistically significant baseline differences between teachers at each school for health education beliefs or self-efficacy as determined by one-way ANOVA (F(3,77)= 0.427, p > 0.05andF(3,77)= 0.191, p > 0.05). The teacher overall health score captured teacher's current self-reported health behaviors (such as physical activity and nutrition), stress levels and attitudes towards teaching health-related topics to students. The score had a possible range between 0 and 100. Teachers averaged a score of 63.19 +/- 7.78 at school E1, 69.36 +/- 10.44 at school E2, 69.39 +/- 13.15 at school C1, and 62.45 +/- 10.43 at school C2. The highest score recorded was 87.19 and the lowest score recorded was 34.012 Teachers Surveys Pre-Post Year 2: Teacher health education beliefs and self-efficacy were each captured as a score between 0 and 5. The average paired score for teacher health education beliefs in year 2 increased from 4.02 +/- 0.45 to 4.36 +/- 0.52 at school E1, this was a statistically significant score change (t(10)=2.39, p < 0.05). For school E2, the average paired score for teacher health education beliefs in year 2 increased from 4.46 +/- 0.45 to 4.6 +/- 0.31, this was not a statistically significant score change (t(10)= 0.323, p >0.05). The average paired score for school C1 also increased from 4.37 +/- 0.52 at the beginning of the school year to 4.4 +/-0.54 at the end of the school year and was also not a significant change (t(12)=0.845, p>0.05). Teacher self-efficacy paired scores in year 2 increased at school E1 from 3.99 +/- 0.59 to 4.08 +/-0.58 with no significant change (t(11)= 0.49, p>0.05). Teacher self-efficacy paired scores at school E2 did not change in year 2 4.075 +/- 0.77 (at baseline) and +/-0.56 at the end of the year, with no significant change (t(10)= 000, p>0.05). Paired scores at C1 followed the same pattern, increasing from 4.12 +/- 0.77 to 4.21 +/- 0.43 over the course of the school year, but the score increase was not statistically significant (t(13)=4.35, p>0.05). Goal R2: Measure the effects of targeted nutrition lessons in elementary school classrooms on student knowledge, attitudes, and behaviors. Student Baseline Surveys Year 3: A total of 760 students completed the year 3 baseline survey. The average student nutrition knowledge score was 67.61% (n=151) at school E1, 65.74% (n=138) at school E2, 66.01% (n=158) at school C1 and 63.47% (n=317) at school C2. Student nutrition knowledge and student attitudes and beliefs were each captured as scores between 0 and 100. There was no statistically significant difference in nutrition knowledge scores or attitude scores between students by school at year 3 baseline, as determined by one-way ANOVA (F(3,758)=1.789, p>0.05) and (F(3,755)=0.7, p>0.05), respectively. Student Surveys Pre-Post Year 2: During Year 2 of the intervention, nutrition knowledge paired scores significantly increased among students at the intervention schools, from 67.06% to 73.34% correct at E1 (t(127) = 2.926, p < 0.001) and from 57.63% to 73.9% correct at school E2 (t(121) = 8.174, p < 0.001). At the comparison school (C1), nutrition knowledge paired scores also increased significantly from 65.41% to 70.2% (t(103) = 2.419, p<0.05). During Year 2 of the intervention, student attitude paired scores decreased among students at the intervention schools, from 87.58% to 87.35% correct at E1 (t(118) = 0.102, p > 0.05), from 82.25 % to 81.77% correct at school E2 (t(110) = 0.216, p > 0.05). At the comparison school (C1), nutrition knowledge paired scores also decreased from 90.15% to 89.8% (t(97) = 2.419, p>0.05). None of the student attitude score changes were statistically significant. ? Fruit and Vegetable Consumption and Plate Waste Year 2 Pre-Post: On average, the percent of students consuming an entire serving of fruit during lunch in year 2 of the study was 47.74% for school E1, 46.41% for school C1, and 57.74% for school E2. There was a statistically significant difference in overall fruit consumption between students at the different schools in year 2 as determined by one-way ANOVA (F(2,2371)=31.501 ,p<0.001). A Tukey post hoc test revealed that overall fruit consumption was significantly different among the schools. Overall fruit consumption for students at school E1 (51.41 +/- 45.06) was significantly lower than students at school E2 (64.9 +/- 43.95, p<0.001) and significantly lower than fruit consumption of students at school C1 (68.14+/- 41.06,p<0.001). Students consuming an entire serving of vegetables during year 2 was 18.06% of students at school E1, 17.67% of students at C1, and 29.01% of students at school E2. There was a statistically significant difference in overall vegetable consumption between students at the different schools in year 2 as determined by one-way ANOVA (F(2,2686)=5.700,p<0.05). A Tukey post hoc test revealed that overall vegetable consumption was significantly different among the schools. Overall vegetable consumption for students at school E1 (26.47 +/- 39.08) was significantly lower than students at school E2 (33.12 +/- 44.8, p<0.05). Goal X1: Extend the formal classroom instruction to families through school-wide events with local partners focused on food access and education ?To extend the formal learning, the Healthy Schoolhouse 2.0 has partnered with Martha's Table Joyful Food Markets, a local nonprofit that runs a monthly, free after-school market in over 50 schools in DC, including E1, E2, C1, and C2. The goal of the market is to provide access to fresh fruit and vegetables, as well as pantry staples to families with children in schools located in low-income areas. The Healthy Schoolhouse 2.0 Team has continued their adoption of the market at E2, and AU's School of Education has also continued their adoption of the market at E1, giving us the ability to provide both schools with nearly identical extra monthly activities. These activities include a focus on both physical activity and nutrition activities. This is done through hop-scotch style games and nutrition-related jumping contests, interactive MyPlate quizzes and hands on learning through creating snacks with foods from different food groups. The average attendance of the first six markets in school year 2019-2020 is 163 at E1 and 79 at E2.
Publications
- Type:
Journal Articles
Status:
Published
Year Published:
2019
Citation:
Design and Implementation of a 5-Year School-Based Nutrition Education Intervention
Melissa Hawkins PhD,Erin WattsMPH, Sarah IrvineBelsonPhD2 AnastasiaSnellingPhD,
https://doi.org/10.1016/j.jneb.2019.12.005
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Progress 04/01/18 to 03/31/19
Outputs
Target Audience:The target audience we reached are the following: Teachers are both the experiemental school 1 and experimental school 2. This is approximately 60 teachers, administrators, and support staff. The number of students we reached is about 600 students. And through the Joyful food markets we reach about 200 families each month. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided?Three of the five professional development sessions have been provided to School E2, September 2018 (Healthy Schoolhouse 2.0 Preview), October 2018 (MyPlate Curriculum & Teacher Kits), and March 2019 (Nutrition Lessons and Lesson Study). While these have been primarily focused on the implementation of nutrition education sessions with students, we also attend to the physical and emotional health needs of the teachers. In the pre-survey, of the 24 teachers who completed the survey, 19 noted they were interested in learning about mindfulness, and 20 teachers stated they were interested in stress management. At the March session, we distributed yoga mats to the teachers, as well as a handout with tips on managing stress and the ABCs of yoga. Seventeen teachers indicated interest in physical activity; in January we organized a pedometer challenge for the teachers at Schools E1 and E2 to focus on physical health. These are examples of tailoring to the interests and needs of the teachers and customizing the professional development sessions to topics that are applicable. In addition, we conducted a booster session at School E1 in November 2018 and 15 teachers attended. During this session, there was great discussion and enthusiasm for contiuation of the program. How have the results been disseminated to communities of interest?Information about the Healthy Schoolhouse 2.0 has been presented at a variety of meetings with stakeholders, including at a workshop for the American University School of Education faculty in March 2019, and presentations to the following groups: DC Foodservice Committee (August 2018), the Deputy Chancellor's Innovation and Systems Improvement Advisory Board meeting (February 2019), DC School Food Advisory Meeting (March 2019), and to the DC Cardiovascular Health and Obesity Collaborative (March 2019). We presented the year 1 findings at school E1 during a booster session in November 2018 and to the Healthy Schoolhouse 2.0 Board of Advisors in October 2018. The Board of Advisors is also kept up to date with two newsletters per year, in addition to our biannual meetings. On a national level we presented our findings from year one at two conferences, the Society for Nutrition and Behavior (SNEB) in July 2018 and the Food and Nutrition Conference & Expo (FNCE) in October 2018. Also at SNEB in 2018, we participated in the annual Project Director events and met other NIFA awardees. We have submitted a poster presentation for July 2019 at SNEB. Also, we presented to the Nutrition and Obesity Network: Policy, Research and Evaluation, School Working Group (December 2018). Preliminary findings were shared with new outlets, including Education Dive and The Conversation. We have prepared two manuscripts for submission to JNEB for April 15th--deadline for a special edition on learning and teaching. One manuscript will describe the methodology we are using and the second is a validation paper on the student nutrition knowledge survey instrument. Finally, we have created a website (www.american.edu/cas/healthyschools) where we feature our work that prominently promotes the Healthy Schoolhouse 2.0. What do you plan to do during the next reporting period to accomplish the goals?For the next reporting period, we will implement the program at another experimental and add another control school (E3 and C2). We will then be managing programming at 3 intervention schools and two control schools. Though we will repeat our process from years one and two, we are continually tweaking our approach and strengthening the program. We plan to begin recruitment in early summer for the next two schools. This early planning and meeting with the school leadership is essential to building a working collaborative relationship that allows us to execute the program. We are learning that building those relationships with school leadership and teachers is essential for them to own the curriculum and then teach it to the students. We continue to seek new ways to build and strengthen these relationships each year. In addition, we have developed and implemented a more robust set of activities for students at the Joyful Food Markets in year two than in year one, and we plan to continue to improve upon those during the next reporting period. These activities can be informal learning opportunities for the students, faculty, and the families at the school and help increase attend to healthy eating to the program participants. ?
Impacts
What was accomplished under these goals?
Three schools are enrolled in the Healthy Schoolhouse 2.0: Experimental School 1 (E1), (E2), and Control School 1 (C1). E2 has 22 classroom teachers (1 SPED), and an enrollment of 401 students. Teachers at school E2 have received three of the five professional development sessions this school year, in September 2018 (Healthy Schoolhouse 2.0 Preview), November 2018 (MyPlate Curriculum & Teacher Kits), and March 2019 (Nutrition Lessons and Lesson Study); the remaining two sessions will be delivered in April and May of 2019. An average of 20 teachers have attended the first three professional development sessions (range of 17-23). School E1 was the Year 1 experimental school. We conducted one booster session in fall November 2018, during which time we reviewed the program goals, restocked teacher kits, and presented year 1 data to the teachers and staff. Another booster will be conducted in spring 2019. School E2 has an enrollment of 401 students in PreK3 - fifth grade, 99% of whom are Black and 1% are Hispanic/Latino. The 2017-2018 standardized tests show that 4% of the tested students met or exceeded expectations in Math and 7% met or exceeded expectations in ELA. School E1 has an enrollment of 387 students, 92% of whom are Black, 7% Hispanic/Latino, and 1% multiple races. The 2017-2018 standardized tests show that 28% are met or exceeded expectations in Math and 12% met or exceeded expectations in ELA. School C1 has an enrollment of 269 students, 96% of whom are Black, 3% Hispanic/Latino, and 1% White. Of the tested students, 14% met or exceeded expectations in Math and ELA. Teacher Baseline Surveys Year 2: Teachers completed 33 and 24 baseline surveys from schools E1 and E2, respectively, and 34 teachers from C1 completed the baseline survey. All survey data were entered, cleaned and a double-checked by a different data coder for entry errors before statistical analysis. Statistical analyses of baseline survey data was performed using IBM SPSS Statistics software (Version 23.0). There were no significant demographic differences in the analysis of the baseline responses between the three schools. Teacher health education belief scores at the beginning of year 2 averaged 4.2 ± 0.78 and 4.33 ± 0.47 for schools E1 and E2, respectively. Scores for teachers at C1 averaged 4.29 ± 0.55. Self-efficacy scores were 3.99 ± 0.87 at E1, 3.99 ± 0.91 at E2 and 4.02 ± 0.75 at C1. There were no statistically significant baseline differences between teachers at each school for health education beliefs or self-efficacy as determined by one-way ANOVA (F(2,82) = 0.328,p> 0.05 andF(2,83) = 0.010,p> 0.05). The teacher overall health score captured teacher's current self-reported health behaviors (such as physical activity and nutrition), stress levels and attitudes towards teaching health-related topics to students. The score had a possible range between 0 and 100. Teachers averaged a score of 63.61 ± 15.24 at E1, 66.47 ± 10.44 at E2, and 63.52 ± 10.55 at C1. The highest score recorded was 92.91, and the lowest score recorded was 26.02. Teachers Surveys Pre-Post Year 1: Teacher health education beliefs and self-efficacy were each captured as a score between 0 and 5. The average paired score for teacher health education beliefs in year 1 decreased from 4.41 ± 0.38 to 4.32 ± 0.52 for school E1, however this was not a significant change (t(14)=0.83, p>0.05). The average paired score for school C1 also decreased from 4.33 ± 0.59 at the beginning of the school year to 4.26 ± 0.52 at the end of the school year and was also not a significant change (t(9)=0.44, p>0.05). Similarly, teacher self-efficacy paired scores in year 1 decreased at school E1 from 4.30 ± 0.47 to 4.16 ± 0.59 with no significant change (t(14)=1.03, p>0.05). Paired scores at C1 demonstrated a similar but insignificant pattern, decreasing from 4.2 ± 0.53 to 3.93 ± 0.50 over the course of the school year (t(9)=0.86, p>0.05). Student Baseline Surveys Year 2: Prior to Year 2 of the intervention, nutrition knowledge scores at the E1 and E2 schools averaged 67.61% (n=184) and 56.28% (n=161), respectively. The average score at the C1 school was 56.28% (n=142). Student nutrition knowledge and student attitudes and beliefs were each captured as scores between 0 and 100. There was a statistically significant difference in nutrition knowledge scores between students at schools in year 2 as determined by one-way ANOVA (F(2,484) = 12.095,p< 0.001). A Tukey post hoc test revealed that the nutrition knowledge scores were statistically significantly higher for students at school E1 (67.61 ± 22.43,p< 0.001) and C1 (63.71 ± 18.55,p<0.01) compared to the average score for students at E2 (56.28 ± 22.87). There was no statistically significant difference between the average scores for students at E1 and C1 schools (p> 0.05). There was also a statistically significant difference in attitude and belief scores between students at schools in year 2 as determined by one-way ANOVA (F(2,449) = 7.89,p< 0.001). A Tukey post hoc test revealed that the attitude and belief scores were statistically significantly higher for students at school E1 (87.64 ± 19.83,p< 0.001) and C1 (89.85 ± 18.64,p<0.01) compared to the average score for students at E2 (80.84 ± 21.35). There was no statistically significant difference between the average scores for students at E1 and C1 schools (p> 0.05). Student Surveys Pre-Post Year 1: In Year 1 nutrition knowledge scores significantly increased among students at the intervention school from 61.23% to 74.92% correct (t(124) = 7.1, p<0.001). At the comparison school, nutrition knowledge scores also increased significantly but at a lower magnitude, from 61.34% to 64.28% (t(124) = 3.06, p<0.01). There was a significant difference in scores between the schools after the intervention (t(318) = 4.242, p<0.001). Changes in attitudes and beliefs of nutrition and health were negligible after the intervention. Year 1 information does not include the taco question, due to the changes made between administration of the pre and post surveys. Fruit and Vegetable Consumption and Plate Waste Year 1 and 2: All three schools participate in the Community Eligibility Program; thus, 100% of students are eligible for free breakfast and lunch meals. On average, the percent of students consuming an entire serving of fruit during lunch in year 1 of the study was 24.83% for E1 and 33.45% for C1, a significant difference (z(622) = 4.328, p<0.0001). Students consuming an entire serving of vegetables during year 1 was similar between the two schools, with 31.99% of students at E1 and 32.45% of students at C1. Breakfast Participation: Current breakfast participation rates among students in the E1 school is 85.21%, and 78.80% in school E2. Participation among students in the C1 school is 78.28%. To extend the formal learning, the Healthy Schoolhouse 2.0 has partnered with Martha's Table Joyful Food Markets, a local nonprofit that runs a monthly, free after-school market, including E1, E2, and C1. The market is to provide access to fresh fruit and vegetables, as well as pantry staples to families with children in schools located in low-income areas. The Healthy Schoolhouse 2.0 Team adopted the market at E2, and the American University School of Education adopted the market at E1, giving us the ability to provide both schools with nearly identical extra monthly activities. The average attendance of the first six markets in school year 2018-2019 is 130 at E1 and 111 at E2. Our community partner DC Greens continues to serve on our Board of Advisors; however, they have shifted their mission towards advocacy and food justice so are no longer collaborating directly with schools.
Publications
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Progress 04/01/17 to 03/31/18
Outputs
Target Audience:We had three target audiences for this project: 1. The school teachers and administration; we reached in the Experiemental school with a 5 hour professional development program that incorporated nutrition lessons into their personal lives and into their classroom lessons. 2. The students at the experimental school. The students received close to 56 additional nutrition lessons as a result of this program. 3. The families: through our extension partner, Martha's Table, we provided monthly family activiites at a pop-up food market. Changes/Problems:There were no major changes or problems in the approach we had proposed in our proposal, Healthy Schoolhouse 2.0. We learned from the teachers, principal, and students how to modify the program to enhance learning and improve the process. For example, changing the order of the lessons in the professional development program. We note in the previous question the changes we propose to make to improve the program. What opportunities for training and professional development has the project provided?The program team developed a five-session course tailored to the needs of the teachers at school E1. The goal of the PD sessions was to empower teachers with health knowledge and included information on the link between health and education, strategies for integrating health into the classroom curriculum, and becoming an agent of change, as well as lessons and materials needed to conduct lessons. The program utilized the USDA's Serving up My Plate: A Yummy Curriculum materials, available in Level 1 (grades 1 and 2), Level 2 (grades 3 and 4), and Level 3 (grades 5 and 6). In addition, given the number of PK and Kindergarten classrooms, we offered these teachers support to use of the Discover My Plate curriculum. The team desiged a curriculum kit for each grade level of teachers. Each of these kits included a Curriculum booklet for the level (grade) for each of the classroom teaches, Parent Handouts, a My Plate poster, and other instructional materials including lesson reproducibles, food group signs, crayons, scissors, stickers, and glue sticks. Each session occurred during a time set aside for professional development, at the school location. Each session focused on teacher needs including stress management, nutrition for the teachers, and celebrations. Our prior research has shown that by making nutrition and health topics personal to teachers, we increase their commitment to the project and assist them with being role models of healthy behaviors. We surveyed the teachers on their personal health and explored what topics they were interested in learning and included these in each PD. During the five PD sessions, the team focused on the following topics: Healthy Schoolhouse 2.0: Overview of the Healthy Schoolhouse project, introduction to the socio-ecological approach to nutrition education, Training on the Serving up My Plate: A Yummy Curriculum. My Plate Curriculum and Teachers Kits: Relaxation using Yoga, Advanced Serving up My Plate: A Yummy Curriculum with model lessons. Nutriiton Lessions from the My Place Curriculum: A focus on Mindfulness, Presentation of prelimary school data, Fidelity Training on the curriculum. Food Myths & Facts: An introduction Nutrition Myths and A Guide to Portion Size Feedback and Wrap-up: Wrap up sesssion, Smoothies In addition to the PD program, the intervention also provided a Pedometer challenge to teachers and reminded teachers to log their lessons. Technical support for each teacher was provided in-person and online. As we move to new schools, we will be sure to include activities to increase lesson implementation as well as programming designed to engage teachers as agents of change by creating a culture of health within their classrooms and in the school. How have the results been disseminated to communities of interest?The outcomes of this first year will guide ongoing programming for the project and ultimately inform the USDA curriculum. We will present our findings at two upcoming conferences, including the Society for Nutrition and Behavior (SNEB) and the Food and NutritionConference& Expo (FNCE) conferences this year. Information about the project was presented in the summer of 2017 at a workshop for American University's Center for Behavioral Neuroscience. We also have presented the preliminary results of student and teacher pre-test data to the teachers and administrators at our first experimental school as part of the professional development program. Finally, we presented findings to the Healthy Schoolhouse Board of Advisors. Further, the Board of Advisors have recommended we present to the DC Food School Council and consider submitting an abstract for the School Nutrition Association. We plan to use the results of the first year of implementation in a paper to be submitted to a referred journal. Key results will be posted on the Department of Health Studies' website as part of the American University site. What do you plan to do during the next reporting period to accomplish the goals?For the next reporting period, we will include another experimental and another control school (E2 and C2). Though we will repeat our process from year one, we are planning some changes that will strengthen our approach. During the final professional development session, we asked the teachers for feedback on the program. We plan to respond to the feedback in the survey, as well as making small changes to our approach that we noted throughout this first year. Primarily, we plan to prioritize the lessons for next year. While the design of the curriculum lends itself to selecting lessons somewhat at random, we realized that teachers may be missing providing students with baseline knowledge in order to ensure that later lessons are conducted with success. By prioritizing lessons, teachers will better build baseline understanding with students rather than selecting a lesson that solely fits with a certain amount of time they have in their schedules. In addition, we observed that some lessons seemed very challenging for the population, despite the fact that they are grade-appropriate. For example, in Level 2 First Course, students are to create and describe a healthy meal using food from all food groups. We observed that this was very difficult for students; rather than putting together a meal, they simply selected foods from each food group, not considering the aspect of putting together components the complement each other. In addition, we plan to make small improvements, such as setting up a computer at the professional development sessions to ensure teachers can easily log their lessons and access their incentives upon eligibility. We conducted a pedometer challenge in February with weekly prizes; this proved to be motivating and engaging for the 14 staff who particiapted. We plan to move that to earlier in the school year to promote teacher/staff wellness and get more buy-in and visibility at the start of the program. In addition, we did not focus on breakfast as planned in year 1. Next year, we plan to include breakfast in the professional development sessions and encourage teachers to promote breakfast with students. We also plan to move the teacher surveys to an online platform. Though we have not yet conducted booster sessions, we realized through our partnership with E1 that they will require slightly more support than we had planned. We plan to ensure that American University continues to partner with E1's Joyful Food Market to maintain a consistent presence.
Impacts
What was accomplished under these goals?
To recruit an experimental school (E1) and control school (C1), we needed to coordinate with our community partners, due to the fact that Martha's Table was operating their school-based food access program only in select schools. Once the schools were identified, we then created a marketing email to school principals to market the program. Two schools responded and the principal investigators visited the school and met with the principals, and then assigned Nalle Elementary School as the experimental (E1) and Houston Elementary School (C1) as the control school. Kits included all materials needed for teachers to teach the lesson and then were assembled and placed into a plastic container with the teacher's name and grade on it. School E1 had 21 classroom teachers, and School C1 had 16 classroom teachers.The professional development program was a five-hour program with the goal to empower teachers with health knowledge on the link between health and education, strategies for integrating health into the classroom curriculum, as well as lessons and materials needed to conduct lessons. We have a Board of Advisors, made up of government officials, community leaders, and organizations invested in nutrition and child health. We have held two meetings, September 2017 and June 2018. In addition, we created a Healthy Schoolhouse 2.0 newsletter to keep Board members up to date on the Healthy Schoolhouse 2.0. One Board member volunteered with us at the Joyful Food Market. School E1 has 391 students in grades PreK - fifth grade. Although the program is targeted for students in grades 1-5, we included PreK 3, Pre K 4, and Kindergarten in the PD program and provided kits to all teachers. Students in grades 1 - 5 were assessed on nutrition knowledge or eating behaviors. The PD program laid the foundation for teachers to have the necessary knowledge and materials to deliver the Curriculum. Teachers recorded each lesson through a google form; once they delivered three lessons, they were eligible for the financial incentive. All students in grades 1-5 enrolled in schools E1 and C1 completed the nutrition quiz . The quiz was based on the previously validated "Fit Kids 'r' Health Kids' survey. Forty-two (42) teachers/staff attended one or more PD sessions; the highest participation (n=35) was the first introductory PD session. Participating teachers attended a mean of 3 PD sessions.There is a significant positive correlation between the number of PD sessions teachers attended and the number of lessons taught (r2=0.328, p<0.05). Teachers were asked to implement a minimum of three lessons; teachers logged the implementation of each nutrition lesson. Fifty-four percent (54%) of teachers implemented at least one nutrition lesson. In total, 15 teachers implemented 56 nutrition lessons. Among teachers who implemented lessons, the average (mean) number of lessons taught was 3.7, with a range of 1 to 12 lessons implemented. Approximately 220 students received nutrition lessons in grades PreK3 through 5th at E1. Teachers had the opportunity to provide detailed feedback on the lessons. Positive feedback included: high student engagement with the lessons, songs and nutrition cards; teacher kits are helpful. Challenges to the curriculum included: length of time to implement lessons, confusion with the portion lessons, and recommendation for videos for younger children. Twenty-one E1 teachers and 20 C1 teachers (n=41) completed the previously validated teacher survey which includes 44-items regarding personal health habits, beliefs about health and education, and self-efficacy as it relates to implementing health-related content in the classroom. The pre-survey was administered at the beginning of the academic year and a post-survey at the end. All responses were confidential and did not include identifying information. Responses for the health beliefs and self-efficacy are on a five-point Likert scale with "1" strongly disagree or very little to "5" strongly agree or very much. There were no significant demographic differences between E1 and C1 participants in the analysis of the pre-survey responses. The majority of participants were African-American (66%) and female (90%). The mean age of teachers was 41 years. The were no significant differences between mean teacher scores on the 14 health education belief questions. The overall mean score for E1 teachers was 61 and for C1 teachers the mean overall score was 58 out of a max score of 70. In the pre-surveys, there was a significant difference in mean self-efficacy scores between teachers at E1 and teachers at C1 (t36.29=2.714, p<0.05). The mean cumulative score for teachers at E1 was 25.89 +/- 3.05 and 22.95 +/- 3.71 at C1. For both schools, the question with the lowest mean reported self-efficacy was "How much can you do to improve the health status of a student who is engaging in unhealthy behaviors?" (E1 = 4.11, C1 = 3.50). For both schools, the question with the highest mean reported self-efficacy was "How much can you do to get students to believe they can engage in health habits?" (E1 = 4.53, C1 = 4.10). Baseline data collection for students included the administration of the previously validated "Fit Kids 'r' Health Kids' survey (Gower et al 2010) which was adapted for the MyPlate curriculum. There are 2 versions of the survey: Level 1 for students in grades 1-2 and Level 2 for grades 3-5. The instrument contains 15 multiple choice questions which assess nutrition knowledge, attitudes, perceptions and intent. Questions were read aloud by teachers for students in grades 1-2. Student name, class and gender was also collected to assess changes pre-post assessments at the individual level, although data were coded and de-identified during data entry. There were 326 students who completed the pre-survey (n=180 at E1 and n=146 at C1). The demographic characteristics of the students are detailed in Table 3 below. There were no significant differences in gender or grade participation between students in E1 and C1 in the pre-survey analyses. There were no significant differences in nutrition knowledge between E1 and C1, except for in 5th grade where C1 students had a significantly higher knowledge score than E1 students (see Figure below). Overall, nutrition knowledge scores were higher among Level 2 than Level 1. There were no significant differences in nutrition beliefs and attitudes between students at E1 and C1 at any grade level. It is interesting to note that majority of students (80%) responded yes to the statement "I like to try new foods." For the first day of consumption data collection, there were significant differences in the percent of sweet potato fries and collard greens eaten between students at the E1 and C1 (sweet potato fries:??2= 43.9, df = 3, p<0.001; collard greens:??2= 84.3, df = 3, p<0.001). There were no differences in the percent of whole pears eaten between the two schools. For the second day of consumption, students were served a kale salad and a choice of whole fruit (apples, bananas or pears). There were significant differences in the percent of the kale salad and whole fruit eaten betweenstudents at E1 and C1 (kale salad:??2= 43.5, df = 3, p<0.001; fruit:??2= 15.821, df = 3, p<0.01). To extend formal classroom instruction to families through school-wide events, Healthy Schoolhouse 2.0 collaborated with a local community partner focused on food access and education. The monthly pop-up markets set up in school cafeterias, gymnasiums or outdoor areas immediately after students are released at the end of the school day. To promote the visibility of the Healthy Schoolhouse 2.0 and connect the classroom curriculum to the extension activities, canvas bags with the Healthy Schoolhouse 2.0 logo were distributed to each family, and raffles were done in November and December. Each month a special activity was hosted to extend the learning.
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