Development and application of tools to assess elementary school wellness environments and readiness for wellness change
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ABSTRACT
Schools play a key role in protecting the health of youth and promoting healthy behaviors. There are many factors that influence the state of wellness within schools, but wellness environments and the ability to implement wellness initiatives are commonly cited as influencers of student behaviors and schools’ engagement in wellness initiatives. Related to this, the United States Department of Agriculture (USDA) mandates that school evaluate their wellness environments and practices and implement efforts to promote wellness to students. Therefore, there is a need for more resources that help schools evaluate their current settings and practices and that also facilitate and guide schools on future planning. The purposes of this dissertation were 1) to understand the utility of school wellness leaders to report information on wellness environments, 2) to develop a school wellness environment audit tool for use in practice, and 3) to examine if school Readiness is associated with implementation of school wellness programming.
The first study provided support for the utility of having school wellness leaders report on school wellness environments based on the level of agreement (percent agreement and Kappa Statistics) with direct observation protocol. Overall, agreement was good (> 70% agreement) but results demonstrated that physical activity items were reported more accurately than nutrition items. The second study used a comprehensive process to develop and refine a tool to evaluate school wellness environments and assess compliance with the USDA school wellness requirements. A preliminary set of items was established based on best practices in school wellness (guided by the Comprehensive School Physical Activity Program national framework and Smarter Lunchroom Movement), then revised by academic experts using a two-round Delphi Technique, and finally, refined by a group of school wellness practitioners. This comprehensive approach ensured the tool would translate well to real-world settings and established content validity. The third study demonstrated that Organizational Readiness for Change (Readiness), which assesses organizational, individual, structural and psychological school factors, was associated with school implementation of wellness programming. A unique finding of this study was that Readiness was associated with program implementation regardless of school socio-economic status.
This dissertation adds to the existing literature on assessing school wellness environment and on factors that are associated with school wellness program implementation. The results have established a tool, (the School Wellness Environment Profile [SWEP]) that schools can adopt and employ to be compliant with USDA school wellness evaluation requirements and to better understand the wellness needs that exists in their school. Additionally, this dissertation provides insight into the utility of Readiness as a barrier or facilitator of implementing school wellness initiatives. Future research is needed to examine the utility of the SWEP tool in practice and to further examine the influence of Readiness on the implementation of school wellness initiatives.