RESEARCHPROPOSAL
Howcanstudenthealthliteracyinformkeystakeholdersregardingschoolwellnesspolicyimplementation?
L‐8‐Canposequestionsandusemethodsofformalinquirytoanswerquestionsandsolveproblems.
L‐9‐Cananalyzetheeffectivenessofwellnesspolicies
inpublicschools.
AdeniaLinker
DePaulUniversity
10July2012
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I. THEPROBLEMANDIT’SSETTING
A. STATEMENTOFTOPIC:
PubliceducationinAmericahascomeunderincreasedcriticismfollowingtheNoChildLeft
Behind(NCLB)legislationenactedin2002.Thispolicyattemptedtoincreasetheaccountabilityofschool
districtsregardingspecificacademicmeasurements,andrequiredschoolstoadoptstandards‐based
educationaswellasmaintainaggressiveachievementstandards.Impactingbothfailingandsuccessful
schoolsandnearly1000pagesinlength,NCLBrepresentsthefirstsignificantreformsincethe
ElementaryandSecondaryEducationActof1965(Noddings15).Today’sreformmovementrequires
thatallstudentsbeproficientinmathandreadingby2014(Noddings14)andrequiresschoolstooffer
annualtestsinthirdtoeighthgradeandonceinhighschool(Noddings14).
NCLBlegislationdidnotmandateachievementgoalsforphysicaleducationandmanyschool
districtsfocusedtheirattentionandresourcesonacademics.Thishasresultedinasignificantreduction
oreliminationofrecessandphysicaleducation.Consideringthepopulationwidedeclineinphysical
activity,andepidemicratesofjuvenilediabetesandobesity(Benham‐Dealetal81)publichealth
advocatesfoundsomesolacewhenTheReauthorizationActof2004requiredthedevelopmentof
schoolwellnesspoliciesforschoolsreceivingmealassistance(Lambert,MonroeandWolff271;Longley
andSneed95).
Topicscoveredinhealtheducationvarybystateanddistrictandinclude:physicalfitness,safety,
nutrition,asthmaawareness,mentalhealth,aswellaspreventionofalcohol/druguse,foodborne
illness,HIV,STD,pregnancy,suicide,tobacco‐useandviolence.OneCenterforDiseaseControland
Prevention(CDC)studyfoundthat6.4%ofelementaryschoolsrequiredinstructiononall13topics.The
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samestudyfoundcomprehensivehealtheducationat20.6%ofmiddleschoolsand35.8%ofhigh
schools(Facts:LearningforLife1).A2002InstituteofMedicine(IOM)releasedreportidentifiedhealth
literacyasan“important,cross‐cuttingthemetoaddressinanyeffortstoreduceethnicandracial
healthdisparities”(SandersetalS312).TheCDCdevelopedschoolwellnessguidelines(Youngetal42)
andrecommended:
• Establishingpoliciesthatpromotephysicalactivity.
• Providingenvironmentsthatencouragesafeandenjoyablephysicalactivity.
• Implementingquality,dailyphysicalactivityinstructionandcurricula.
• Implementinghealtheducationthatprovidesstudentswithknowledgeandneeded
behavioralskills.
• Providingsufficienttrainingforpersonnelinvolvedinphysicalactivityinstructionor
promotion.
• Providinginclusiveextracurricularapproachesthatmeettheneedsandinterestsofall
students.
B. STATEMENTOFPROBLEM:
Duringthe2011‐2012schoolyear,404,151childrenattendChicagoPublicSchools.Eighty‐seven
percentofthesestudentscomefromlow‐incomefamilies(ChicagoPublicSchools:StatsandFacts1).
TheConsortiumtoLowerObesityinChicagoChildrenfoundthat22%ofChicagochildrenareoverweight
beforeenteringschool,morethandoublethenationalaverage(Vevea1).AccordingtotheCDC,if
obesityratesremainunchanged,30%ofboysand40%ofgirlsbornin2000willbediagnosedwith
diabetes(HealthEducationinSchools2),astatisticthatclearlyarguestheimportanceofhealthliteracy
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forCPSstudentsbeyondjust“threemostimportantpreventativemeasures:notsmoking,maintaininga
healthyweight,andexercisingregularly”(HealthEducationinSchools1).
ExpertsnowrefertotheAmericanlifestyleasan“obesogenic”environment,onethatpromotes
weightgainthroughfactorssuchasthedecreaseinhomecookingandbreakfastconsumption,portion
distortion,advertisingandgreaterfoodavailability(StrideInstitute4).Nearlytwo‐thirdsoftheU.S.
adultpopulationisoverweightorobese(HealthEducationinSchools1)andthenumberofAmericans
withdiabeteshasdoubledinthelast15yearsto14.6millionin2005(Colemanetal23).Additional
researchfindsoneinthreeAmericanadultshaslimitedhealthliteracy(SandersetalS307).Obesogenic
behaviorsaresogreatthattheDepartmentofPublicHealthnowrequirespreschoolanddaycare
centerstolimitscreentime(televisionandcomputer)tolessthan60minutesaday,andreiteratesthe
needforaminimumof60minutesofphysicalactivity(Vevea1).TheHealthLiteracyreportpublishedby
the(IOM)highlightsthesignificantroleanddirectinfluencethatschoolshaveinroutineliteracyandthe
importanceofenhancinghealthliteracyasagoalwithinliteracyskills(Manganello842).
WritingintheJournalofSchoolHealth,Kolbestates“today,themajorcausesofdeath,
disability,injury,andillnessamongyoungpeople…resultfromafewpatternsofbehaviorthatbecome
establishedduringschool‐ageyears”(226).Althoughhealthliteracymayseemofconcernonlyforthose
inpublichealth,thesepreventablebehaviors(e.g.alcoholanddrugabuse,sexualbehaviors,tobacco
use,unhealthydiets,andphysicalinactivity)areasKolbecontinues“taxingourhealthcare,health
insurance,andunderlyingeconomicsystemstothebreakingpoint”(226)andwarrantearlyintervention
andpreventionmeasures(Manganello840).AccordingtotheCDC’sHealthyYouthinitiative,theschool
dayprovides54millionAmericanstudentstheopportunitytolearntheskillsthatsupporthealthy
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lifestylesandbehaviors(HealthEducationinSchools1),however,asNoddingsimplores“thecurrencyof
accountabilityineducationisstandardizedtesting“(41).
Publicschoolwellnesseducationappearstobeinadequatelyandunequallyprovidednationally.
Thefocusonacademictestingishavinganegativeimpactonwellnesseducationinpublicschools.One
studyfoundthatonly5.9%ofthirdgradersattendphysicaleducationclassesdaily,andthosestudents
onlyaveraged4.8minutesofvigorousactivity(Barrosoetal313)whileanextensivestudyofseventh
andeighthgradersfoundolderstudentsdonotmoveduringrecess(StrideInstitute8).Anotherconcern
accordingtotheStrideInstitute,“inlargePEclasses,60%oftimeisspentdoingnoactivityatall”(8).
Whilestatestandardsvary,it’shighlylikelythatCPSstudentsareexperiencingsimilarlimitedPE
programs.
In2010theU.S.DepartmentofHealthandHumanServicesadded“improvedconsumerhealth
literacy”toitsobjectives.Healthliteracyisdefinedas:"thedegreetowhichindividualshavethe
capacitytoobtain,process,andunderstandbasichealthinformationandservicesneededtomake
appropriatehealthdecisions"(Brown,TeufelandBirch8);essentialskillsforthegrowingpopulationof
youthsufferingfromchronicasthma,diabetes,cysticfibrosisandmentalillness(Manganello841).
Consideringnootherinstitutionhasasmuchcontactwithchildren(Haire‐Joshuetal2)schoolsmust
fosterhealthliteracyintheclassroomforchildrenwhodependonpublicschoolstobuildtheseskills
(Brey,ClarkandWantz640).
Thepublicschool,asNoddingspointsout,“shouldbeaplacewherechildrenlearntomake
intelligent,well‐informedchoices”(75);however,thecaseofa15‐yearoldHispanicintheBronxwho
compareddiabetestoacold,showshowstudent’shealthliteracyneedsmightbemetthrougha
“popularscience”classtolearnaboutdisease,diet,exercise,calculatingcalories,interpretingblood
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pressure/sugar(Noddings36).TheInstituteofMedicinerecommendshealthprogramsbedesignedto
improvehealthliteracy,healthbehaviorsandhealthoutcomes,academicachievement,andsocial
outcome(Kolbe227).Onesuchexample,developedbyBrey,ClarkandWantz,recognizedthestrength
ofthemedia’sinfluenceonadolescent’sasahealthresourceandutilizedthatdevelopmentalinterestto
motivatethelearningexperience(641).Anotherstudyfoundthatpeereducatormodelswere“oneof
themosteffectivestrategiesfordisseminatingpreventioninformation”(Colemanetal23).Theseare
bothexamplesof“well‐designed,well‐deliveredschool‐basedhealthinterventions”designedtoinform
andenablestudentstopreventdiseaseandinjury”(HealthEducationinSchools3).
While“someschoolsystemsarebeginningtorecommendorrequirehealthliteracyasa
componentforgraduation,”(SandersetalS310)mostofferonlyonesemesterinhealth(Noddings48),
andIamunawareofanyrequirementforCPSstudents.Giventhecurrenteconomicclimateandschool
budgetcuts,whatisneededaresignificantsystemswhere“theeasierordefaultchoiceisthehealthy
choice”atnocosttotheschool(StrideInstitute4).Dr.StephanieWhyte,therecentlyannouncedChief
HealthOfficerforChicagoPublicSchools,willcertainlybeconsideringsuchchallenges.Her
appointment,whichreportstoboththeChicagoPublicSchoolsandtheChicagoDepartmentofPublic
Health,representsacriticalpartnershipnecessaryforcommunitywidehealthliteracy(“NewChief
HealthOfficer”).
STATEMENTOFQUESTION:
Inthisstudy,Irecommendresearchingthequestion:HowcanCPSstudents’healthliteracydata
informkeystakeholdersregardingtheeffectivenessoftheirschoolwellnesspolicyimplementation?
STATEMENTOFHYPOTHESIS:
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Iproposetotestthefollowinghypothesis:CPSstudents’healthliteracydatacaninformkey
stakeholdersregardingtheeffectivenessoftheirschoolwellnesspolicy(SWP).
Delimitations
ThisstudywillnotincludetheChicagosuburbsnoranyotherareasthatarenotservedby
ChicagoPublicSchools.Nostudentswhohavetransferredfromanotherschoolsystemduringtheschool
yearwillbeincluded.Thisstudywillexcludegrades1‐2,4‐7,and9‐11.
Definitions
Forthepurposeofthisstudy,keytermswillbedefinedasfollows:
Healthliteracy:thedegreetowhichindividualshavethecapacitytoobtain,process,and
understandbasichealthinformationandservicesneededtomakeappropriatehealthdecisions;
healthknowledge,attitudes,andskills(Brown,TeufelandBirch8;Manganello1).
Keystakeholder:atermborrowedfrombusinessacumenindicatingapartywhocanaffectorbe
affectedbytheoutcomeofaneventorinthiscase,byaschoolwellnesspolicy(e.g.school
boardofeducationmembers,physicaleducationdepartmentspecialists,statepublichealth
nutritiondirectors,healtheducationteachers,schoolfoodservicedirectors,schoolnurses,
socialworkers,andcounselors,schoolwellnessadvocates;andteacher,parentandstudent
representatives).
Effectiveness:PhysicalEducationandHealthstandardsexistwithgoalsformovementskills,
physicalfitness,teambuilding,healthpromotion,preventionandtreatment,humanbody
systems,andcommunicationanddecision‐making(“ILSGoals”).Thesegoalsaredocumentedin
20assessmentrubricscoveringallgradelevels(“ILSAssessments”).
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Schoolwellnesspolicy(SWP)includes:
o Nutrition:healthyeating,whichisassociatedwithreducedriskofmanydiseases,
includingthethreeleadingcausesofdeath–heartdisease,cancerandstroke–andis
importantinchildhoodandadolescenceforpropergrowthanddevelopmentandcan
preventobesity,dentalcaries,irondeficiencyanemia,andotherhealthproblems
(ChicagoPublicSchoolWellnessPolicy1).
o NutritionEducation:planned,sequential,K‐12curriculumorsupplementaleducation
programthataddressesthephysical,mental,emotional,andsocialdimensionsofhealth
relatedtonutrition.(ChicagoPublicSchoolWellnessPolicy1)andisalignedwithNHES
andIllinoisLearningStandards(ChicagoPublicSchoolWellnessPolicy2).
o PhysicalEducation:(PE):plannedsequentialK‐12curriculumthatprovidescognitive
contentandlearningexperienceinavarietyofactivityareas(ChicagoPublicSchool
WellnessPolicy2).
o PhysicalActivity:(PA):movementthatreducestheriskofprematuremortalityin
generalandofcoronaryheartdisease,hypertension,coloncanceranddiabetesin
particular(ChicagoPublicSchoolWellnessPolicy1);enablesstudentstoremainactive
andmaintainhighlevelofpersonalfitness,emphasizesself‐managementandis
consistentwithIllinoisLearningStandards(ChicagoPublicSchoolWellnessPolicy4).
Assumptions
Forthepurposeofthisresearch,Iassumethat:
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Publicschoolswillcontinuetoberequiredtoprovidemealandfoodservices,andwellness
educationtotheirstudents.Schoolswillneedtosupplementwhatmightbeconsideredthefamily’s
responsibilitiesinsomearease.g.healthyeating.
HealthliteracyneedswillcontinuetoincreaseasmoreAmericanchildrenarediagnosedwith
chronicillnesses.
II. REVIEWOFTHERELATEDLITERATURE
A. MAJORISSUESEXPLOREDBYSCHOLARSWHOHAVERESEARCHEDTHISTOPICAND
PROBLEM
Significantresearchexistsidentifyingthebarriersthatpreventtheproperadministrationof
high‐qualityschoolwellnesspolicies.Mostscholarsidentifythetopissuesfacingschooldistrictsand
systemstodayas:lackoftimeandfunding,competingpriorities,andlackofkeystakeholdersupport
(Agronetal533;Barrosoetal316;Hammerschmidtetal63;Lambert,MonroeandWolff271;Longley
andSneed100;Noddings2;andYoungetal45).ThesebarrierscanbecorrelatedtotheNCLBmandates
thatplacedacademicachievementaboveallotherlearning;it’smostdamagingimpactthroughits
corruptinginfluencetomanipulatedata,seekloopholes,triggercheatinganddrainfinancialresources
(Noddings7).
Lackoftimeisobviouswhenyouconsideronly5.9%ofTexan3rdgradershadPEfivetimesa
week(Barrosoetal313),and84%ofelementaryschoolscomplainofinsufficienttimeforPE
(Hammerschmidtetal66).Assuringdailyphysicaleducationisimportantbecause“children[are]more
activeafterschoolondaysthatthey[have]PEthanondaystheydidnot(Benham‐Dealetal84)and
researchfindsthatbothhealthyandunhealthybehaviorsestablishedbysixthgradewillremainintact
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throughouthighschool(Bauer,YangandAustin36).Adolescents,asManganellodeclares,“areata
crucialstageofdevelopment,learningskillsthatwillcarrywiththemintoadulthood”(840),andphysical
educationclassescanbeoptimalinestablishinghealthylifelonghabits(Barrosoetal313).
Allocationoffinancialresourcestoacademicsubjectsleaveslittlefundingforwellness
programming.Adequatefundingwasthenumberonebarriertoeffectiveschoolwellnesspolicy
development,implementation,andmonitoringcitedina2010nationalsurvey(Agronetal533).Lackof
fundinginterfereswithnutritioneducationat67%ofelementaryand45%ofhighschools
(Hammerschmidtetal66)while39%ofelementaryschoolsand41%ofhighschoolslackthefundingto
facilitatephysicalactivity(Hammerschmidtetal67).Somearguethatphysicaleducationprograms
wouldreceivemorefundingandattentioniftheywereconsidered“essential”informaleducation
(Barrosoetal316),anopinionvoicedbymanybeyondjustphysicaleducationspecialists(Youngetal
45).
ObtainingsufficientfacilitiesandPEequipmentisobviouslycriticalandamajorbarrierfor53%
ofmiddleschools(Youngetal45).Student’sperceptionofproperfacilitiesandadequateresources
shouldalsobeconsideredandsuchinvestmentsshouldbe,asNoddingsinsists,“providedasamatterof
decency”(2).Environmentalfactorssuchaslargeclasssizepreventhigh‐qualityphysicaleducation
experiences(Barrosoetal315),andcompetitionforthelimitedslotsonorganizedteamsisnegatively
impactedbyalackofsufficientcoaches,playingspaceandequipment(Bauer,YangandAustin39).Dr.
JohnRatey,authorofSPARK:TheRevolutionaryNewScienceofExerciseandtheBrain,findsthatless
than3%ofAmericansparticipateinteamsportsbeyondage24(17),remindingusthatcompetitive
sportsinterestdonotresultinlifelongphysicalactivity.Studentsreportedstaffmakingnegative
commentsregardingathleticabilityofsomestudents,whileotherobservationssuggestedopengym
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programmingfavoredboyssportsandactivities.Anothercriticalreflectioninvolvedthelimitednumber
ofcoaches,equipmentandspotsonsportsteamsresultinginagreatdealofcompetitionforthe
covetedteampositions(Bauer38‐39).Whensurveyingmiddleandhighschoolsstudentsregardingtheir
motivationwhether,ornot,toparticipate,studentsdemonstratedahighawarenessthatphysical
activitypromoteshealthwithover70%ofresponsesnoting“Itmakesmehealthier”(Couturier,Chepko
andCoughlin3).Whenaskedabouttheirexperiencewiththevarietyofactivitiesoffered,amajority,
over75%wantedtochoosetheiractivities,while45%“donotlikedoingthesameactivitieseveryyear”
(Couturier,ChepkoandCoughlin3).Additionally64%ofrespondentsdisliked“goingtomynextclassall
sweaty”while53%disliked“nothavingenoughtimetochangeandshower”(Couturier,Chepkoand
Coughlin3).
Anotherdominantbarrierisconflictingpriorities(Agronetal533,Benham‐Dealetal89,
Hammerschmidtetal63,LongleyandSneed100,Youngetal45).Whenschoolsdiverttheirresources
andfocustoacademicsinpreparationforstandardizedtesting,itpreventsimplementationofhigh
qualitydailyphysicaleducation(Agronetal533,Benham‐Dealetal90;Hammerschmidtetal66).
Thirty‐twopercentofhighschoolsalsoreport“toomuchfocusonstate‐mandatedtestingtohavetime
tofocusonnutritioneducation”(Hammerschmidtetal66).AccordingtotheCenterforUrban
Education,studentsinCPSaretakingstandardizedtestseveryfiveweeks(Vevea2).
Severalschoolsreportedthatotheractivities“preventqualityprogrammingandsuggestthat
physicaleducationissimplynothighlyvaluedwithintheschool,”afeelingconfirmedby20of36
PhysicalEducationdepartmentheads(Youngetal45).Asmanyas25%ofPEclassesareshortenedor
cancelledinfavorofotheractivities(Youngetal46)suchaspicturedaysandsciencefairs.A2005study
suggestedthatphysicaleducationbeintegratedmorefully“intoschoolpoliciesandevaluation,suchas
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acomponentoftheacademicassessmentscoresofschools”(Barroso316).Unfortunately,astudyof
low‐incomeschoolsalsofoundnutritionhadnopriorityat54%ofhighschoolsand33%ofelementary
schoolssurveyed(Hammerschmidtetal66).WhenGrevesandRivarareviewedthelargestschool
districtsinthenation,responsibleforacollectiveof5.9millionchildrenor11%ofstudents(3),they
foundnodistrictthatmettheIOM’srecommendationsforpreventingobesity(9).
Researchfindsthatnationalenrollmentinphysicaleducationbeginstodeclineinhighschool,
howeveronestudyfoundthisdeclinewasstartinginjuniorhighinWyoming(Benham‐Dealetal84).In
1995,91%ofelementaryand93%ofsecondaryschoolsinWyomingreportedhavingawrittenschool
physicaleducationcurriculum.However,whenthoseschoolswererevisitedadecadelater,only78%of
elementaryand73%ofsecondaryschoolshadawrittencurriculuminplacerepresentingaconsiderate
decline.ThisisparticularlyinterestingconsideringWyominghasalwaysseenphysicaleducationasa
corecurriculumsubject,andschoolshavebeenrequiredtoprovidestandardsbasedphysicaleducation
aswellmeasuretheirachievements(Benham‐Dealetal81).Exposingthedeclininguseofcurriculum,
illuminatesthevulnerabilitynearlyeveryschooldistrictinthenationfeelswhenbalancingtheirstudents
healthneedswithacademicsdemands.
Dependenceonfundraisingwithnon‐nutritiousfoodsconflictswithupholdingnutrition
guidelinessupportingBolesandcolleaguesfindingsthat“eveninthepresenceofnutritioneducation
policies,foodofminimalnutritionalvalueremainsavailable”(5).Inadequatefundingoffieldtripsfor
example,oftenpromptsschoolstoresortonsalesofsnacksandsodasthatdismissthemessages
encouragedbynutritioneducation(Bauer,YangandAustin41).Today’sschoolsoftenutilizenon‐
nutritionalfoodforfundraisingandcontractwithjunkfoodvendorstosponsortheirsportsteams.
Thesebrandedfastfoodandbeveragecontracts,coupledwithsodavendingin61%ofmiddleschools
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and75%ofhighschools(GrevesandRivara7)sendconflictingmessagesthatundermineindividual
studenthealthbehaviors.TheuseoffastfoodsuchasPizzaHut™andMcDonalds™isalsoemployed
evenwhilethosefoodsdonotmeetnutritionrequirements(GrevesandRivara4)whileanother
challengingbarrierwasthepresenceofunhealthyfoodoncampuseitherbroughtfromhomeorusedas
aclassroomreward(StrideInstitute13).Inanationalstudy,63%offoodservicedirectorsfoundthatthe
foodinfundraisingisabarrier(LongleyandSneed100).Accordingtoassessmentofthenation’s51
largestschooldistricts,noschooldistricts“includedafter‐schoolfundraisingorconcessionsalesaspart
oftheirpolicies(GrevesandRivara4).Anotherstudyfound31‐45%ofSWPomittedfoodsusedas
fundraising,partiesandclassroomrewards(Probartetal1499).
A2004studyofstudentsandstafffoundthepoorqualityandpalatabilityoffoodservedinthe
cafeteriatobeasignificantbarriertohealthynutrition.Staffatthesemiddleschoolsalsofeltthat
eliminatingthejunkfoodaroundcampuswouldbedifficultbecausethefundswerenecessaryto
supportacademicactivitiesforlow‐incomefamilies.(Bauer,YangandAustin41).ACPSteachersecretly
bloggedaphotogalleryanddetailsofherexperiencewithschoollunchesservedatherschoolwhere
90%ofthestudentsqualifiedforfreeandreducedmeals.Mealsofmysterymeat,heavilyprocessed
chicken,andhotdogscoveredinsoggydougharesomeofthefoodsdocumentsduringher162meal
blog‐basedjournal,thesamemealherstudentsdependedon.Almost32millionkidsareservedlunchat
schooldaily,andmostschoolsarestrugglingtofindmealsthatkidswillenjoythatincludeenoughfruit
andvegetables(Hellmich2).
Today’syoutharevulnerabletobothtraditionalmorbidityissueslikecommunicablediseases
and“newmorbidities”suchaseatingdisorders,sedentarylifestyleandobesity,thesoontobenumber
onepreventablekillerintheUS(StrideInstitute36).Someteachingstaffvoicestheconcern“wecannot
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havecupcakesorcookiesonholidays”(Lambert,MonroeandWolff274)and“whenIwasinschoolwe
didn’thavea[schoolwellnessplan],andIstillmadeit,”(StrideInstitute36)highlightingthattoday’s
teachersmaynotfullyappreciatehowthesenewmorbiditiesimpacttheirclassroomandstudents.
Teachersmaynotrecognizethevalueandneedforclassroomnutritioncompetenciesthatsupportthe
SWP(Lambert,MonroeandWolff275).
TheNationalHealthEducationStandards(NHES)recommendthatalleducationaldisciplines
(math,readingandsocialstudiescurricula)incorporatehealthliteracycompetencies(Sandersetal
S310),however,onestudyofelementaryschoolteachersfoundonly30%includenutritioncompetences
intotheirlessons,andanalarming75%ofteacherswerenotconfidentthattheywouldhavetimeto
attendprofessiondevelopmentwereitavailable(Lambert,MonroeandWolff274).Thisspeakstothe
currentlowprioritySWPhavewithkeystakeholders,asonly10%ofthoseinterviewedfeltadequately
recognizedfortheirefforts(Lambert,MonroeandWolff274).AccountabilitytoNCLBtieskey
stakeholderstostudentacademicsuccessdiscouragingallocationofresourcesandtimetonon‐
academicmaterial.FoodservicedirectorsalsonotedlackofsupportandfeltNCLBwasabarrierfor
teachersandprincipals(LongleyandSneed100).
Interviewsfromkeyinformantsemphasizethatawellnesscoordinatorordedicatedpersonto
guidewellnessinitiatives,alongwithlong‐termtop‐levelcommitmentformadministratorsandschool
boardswouldsignificantlyimprovecurrentefforts(Agronetal533).Agron’steamfoundthat
administratorsarelimitedintheircapacitytotrainfororimplementwellnesswithintheirschool
environment(533)andoften,differingopinionsregardingwhichwellnesspolicytoolstoutilizehinders
decision‐making(533).Schoolboardmembersaremoreoptimisticregardingeffectivelyimplementing
andmonitoringthepolicywhencomparedtothoseactuallyexpectedtocarryoutthoseactivities,
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suggestingalackofunderstandingaboutwhatisactuallyinvolvedincarryingoutwellnessgoals(Agron
etal534).
Supportandresourcesnecessarytoreducethefinancialandtimebarrierseducatorsfacewill
likelybeslowandinadequate,thereforekeystakeholdersmustconsideradditionalmeanstoimprove
theirstudent’shealthliteracy.Student’sindividualandcollectiveperceptionandawarenessofphysical
educationandnutritiongoalscanprovidekeystakeholderswithcriticalinformationthatmaynot
previouslyhavebeenconsideredwhenplanningandimplementingacomprehensiveSWP.
B. METHODOLOGIESUTILIZEDBYSCHOLARSTORESEARCHTHISTOPICANDPROBLEM
Thescholarlyresearchstudiesandotherarticlesidentifiedusedavarietyofresearch
methodologies,includingfocusgroupsandinterviews;however,themajoritydependedonweb‐based
surveysanddata.Severalofthesestudieswereannounced,administeredandfollowedupon
exclusivelyviawebinteraction.Administratorsandeducationstakeholdersweremorelikelytobe
surveyed,withfewstudiesseekinginputfromstudents,confirmingtheneedforadditionalresearchon
earlyadolescenthealthliteracy(Brown,TeufelandBirch8;Manganello840).
Youngandherteam,forexample,selected36schoolsfromapre‐establishedfieldtrialgroup,
andconductedagroupofphenomenologicalinterviews.Interviewswithschoolprincipals,physical
educationandhealtheducationdepartmentheads,andschool‐basedphysicalactivityprogramleaders
involvedquestionsrangedfrompolicytocurriculumandincludedfrequencyandparticipant’sgender.
Thisstudyfocusedonthebarriersforadolescentgirls,however,didnotinterviewthemwhich
significantlylimitstheresultingdata.Anotherextensivestudythatdidnotincludestudentsdirectlywas
anwide‐rangingtwo‐yearstudyconductedbytheStrideInstituteevaluatingthewellnesspolicesofa
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largecounty.Itincludedfiveinterviewswithkeyinformants,directobservationofphysicalactivity,a
platewastestudyandphotodocumentary,andmodifiedschoolhealthindexscorecardsanalysis.While
anextensivecollectionofdata,itdidnotincludeanystudents’perspective,andthequalitativedatawas
limitedtoasingleschool.
Severalstudiesthatincludedfocusgroups,alsoutilizedonlinesurveysaswell.Hammerschmidt
andhercolleaguessurveyed69keystakeholdersincludingclassroom,healthandPEteachers,school
nurses,foodservicesandparentsviaonlinesurveys,andsupplementedtheirresearchwith56
contributionsviasevenfocusgroupsmadeofteachers,administrators,foodservice,andhealth
coordinators.Amuchlargerqualitativestudy,byAgronandhercolleagueswasconductedbasedonan
onlinesurveyrepresentingall50statesbywayof2350respondents(1296schooldistricts)with37
schoolboardmembersparticipatedinfocusgroups,representing17statesaswell.Fourseparateonline
surveysweredesignedforeachfocusgroup:stateschoolboardmembers,stateschoolboard
associationleaders,statepublichealthnutritiondirectors,andschoolwellnessadvocates,however
therewerenoteachersorstudentsincludedinthisstudy.Onevaluablefindingofthisstudy,the
recommendationforschoolstohavededicatedwellnesscoordinatorspromptsseveralquestionsformy
proposedstudy.
Anothergroupofkeystakeholderswhohavehadlimitedvoicesintheresearcharethephysical
educationteachers.Benham‐Dealandhercolleaguesdesignedastudy,basedonquestionnaires
distributedin1995and2005viamailandemailexclusivelytophysicaleducationteachersineach
elementaryandsecondaryschoolinallofWyoming’s48schooldistricts.Resultsoftheself‐reporting45
open‐endedandclosedquestionsdemonstratethevalueoflongitudinaldata,however,islimitedto
quantitativeanalysiscomparedtolargerstudies.Anothercrosssectionalstudybasedonphysical
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educationspecialists’surveyswasconductedbyBarrosoetal.Approximately150respondentsself
reportedbarriersallowingfortrendanalysisoverthelastfouryears.Thisdatawasinvaluablein
developingquestionsformystudy,especiallywhenconsideringastudyofweb‐basedSWPresearchthat
foundpoliciesretrievedviathewebweresubstantivelydifferentthanon‐site.Supplementaldatafrom
sitevisitsremainsignificantwhencollectingSWPdata(Chriquietal8‐9).
Finallycollectingthevoiceofstudentstakeholders,Bauer,YangandAustinconducteda
phenomenologicalstudyusingtwosuburbanpublicmiddleschoolswithethnicandsocioeconomic
factorsrepresentativeofthesurroundingcommunity.Thestudyparticipantswerederivedfroman80%
whitestudentbodywherelessthan10%ofstudentswereeligibleforfreeorreducedmeals.Forty‐nine
focusgroupsincluded26studentsand23facultywereconductedincludingseventhandeighthgrade
students.Individualinterviewswereconductedwithkeyinformantsincludingcafeteriamanagers,PE
directors,schoolnursesandguidancecounselors.ThediscussiontopicsarerelevantasIdesignmy
study,however,ethnicandeconomicfactorsofthesubjectsarenotconsistentwiththeurban
populationthatintereststhisresearcher.Couturier,ChepkoandCoughlinconductedanotherstudyof
studentstakeholdersbysurveyingmiddleandhighschools.Over5,300urbanschoolstudents
completedthesurvey,offeredinbothSpanishandEnglish,intheirphysicaleducationclass.The
questionspertainedtoreasonsforparticipatingornotparticipatinginphysicaleducation,andwhilenot
includinghabits,establishedthevalueofstudent’svoices.Brownandcolleaguesattest“adolescentsin
theUSandelsewherecanvalidlyandreliablyself‐reporttheirownemotional,behavioral,psychological,
andsomatichealth“(9).Student’sanswerscanpredictinterestinlearningandmotivationtofollow
whatislearned(Brown,TeufelandBirch13),andthereforeinformcurriculadevelopersandprogram
providers.
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III. PROPOSEDRESEARCHMETHODOLOGY
A. DATAOREVIDENCETOBECOLLECTED
Recognizingthat“studentsthemselvescouldberesourcesforaddressingsomeoftheobstacles”
(Couturierp6),IplantoconductfieldresearchonthehealthliteracyofKindergarten,third,eighthand
twelfthgradestudents.Iwillcollectdataregardingindividualnutrition,andphysicalactivityand
educationtodeterminehowschoolwellnesspoliciesareimpactinghealthliteracy.Iwillalsocollectdata
regardingcurrentSWPimplementationandthestudent’sperceptionsofSWPimplementation.
1. DESCRIPTIONOFTHEDATA
Thestudentquestionnairewillexplorehealthtermsandconcepts,snackandbeverage
frequency,andphysicalactivity.Responseswilldemonstratehealthknowledge,attitudeandskillsas
wellascriticalthinking.SurveyingearlyadolescentsusingquestionsbasedonNHESprovidesdatathat
canbeusedtoimprovethedeliveryofhealtheducationandultimatelytoincreasehealthliteracy
(Brown,TeufelandBirch8).Focusgroupsinvolvingstudentsandwellnesscommitteemembersaswell
ason‐sitedatacollectionregardingtoSWPimplementationwillalsobesought.
2. WHERETHEDATAARELOCATED
AllofCPS’s474elementaryschools,106highschools,87chartercampusesandeightcontract
schools(“ChicagoPublicSchools:StatsandFacts”1)willbeconsidered.StudentsingradesKindergarten,
third,eighthandtwelfthgradeswillbesurveyedandincludedintherandomizedfocusgroups.
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B. TECHNIQUESFORCOLLECTIONOFDATA
Myresearchwillemploybothquantitativeandqualitativemethodsofdatacollection.Iwill
conductasurveyusingfourstandardizedquestionnaires,oneforeachgradelevelbeingsurveyed.
QuestionnaireswillbedistributedandcollectedduringasinglePEclass,whichwillensureahigh
completionrateresultinginasignificantclustersamplingfromeachschool.
Similarly,Iwillconductastratifiedsampleschoolcampuses(e.g.neighborhood,selective
enrollment,charterandcontract),conductingface‐to‐facequalitativeinterviewswithstudentsin
preferredgradelevelsandthewellnesscommitteemembers.Iwilluseacombinationofopen‐ended
andmultiple‐choicequestionsduringtheseinterviews.Casefilesforallrespondentswillbedeveloped,
consistingofdatesofcontactandinformationcollectedduringthatvisit.Allsessionswillberecorded
andtranscribed.
Finally,anauditofSWPimplementationwillbedoneatthesameschoolswherethefocus
groupsareconducted.Dataforthepreferredgradelevelswillinclude:contacthoursofnutrition
educationandactivities;minutesofphysicaleducation;andmeasuringmoderatevs.vigorousactivityin
recess.Datafortheschoolwillinclude:verificationofplanned,sequential,curriculumforK‐12physical
education;numberofattendeestocommunityprograms,afterschoolprogramsandrecess
participation;useoflossofrecessasapunishmentoroffoodasclassroomreward;andmeasuring
wellnesscommitteeconductsuchasincludingstudents,andparentsinmembership,andannual
evaluationsasperpolicy.
C. METHODSOFANALYSIS
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Thequestionnairewillcontainbothclosedandopen‐endedquestions,requiringtwodifferent
formsofanalysis.Numericaldatawillbecalculatedbasedonquantitativeresponses,whilequalitative
responseswillbecategorizedaccordingtoemergingthemes.Schoolwellnesspolicyimplementation
andhealthdemographics,willbetriangulatedwiththestudentquestionnaireandfocusgroup
qualitativethemes.
1. HOWTHEDATAWILLBEEXAMINEDFORITSMEANING
Datawillbeexaminedforinteractionandindirecteffects,andthefinalanalysiswilldetermine:
o Abaselineofhealthliteracyatstudiesgradelevels.
o RelationshipbetweenstudenthealthandenvironmentduetoSWPimplementation.
o Whatfactorscankeystakeholdersutilizetoimprovewellnessprogramming.
2. HOWDATAWILLBEPRESENTED
Thisobservationalresearchwillgeneratealargecross‐sectionaldatacollectiononhealth
literacyandschoolwellness.Anareamapwillidentifyparticipatingschools,whilepiechartsandgraphs
willpresentboththeschoolwellnesspolicyimplementationdataandtheordinaldatafromthe
questionnaire.Aqualitativecontentanalysiswillprovideanarrativereportofthedominantthemes
identifiedinthefocusgroups.Additionally,transcriptionoffocusgroupinterviewsandfieldnoteswill
beincluded.
IV. OUTLINEOFTHEFINALREPORT
Afinalreportwillbedesignedtoincludethefollowing:
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Titlepage
Acknowledgements
TableofContents
ListofTables
ListofFigures
Chapters
TheProblemanditsSetting
ReviewofRelatedLiterature
ResearchMethodology
TheResults
Appendixes
V. EXPECTEDOUTCOMES
Educationalstakeholdersareresponsibleforthewholechild:intellectual,social,emotionaland
physical.ResearchregardingthehealthofAmericanpublicschoolstudentsisextremelyimportantfor
theeducation,publichealthandgovernmentpartnerswhosemissionincludesimprovinghealth
outcomesinouryouth.Suchpartnersincludenot‐for‐profitsliketheAmericanDiabetesAssociation,
publichealthsystemssuchastheChicagoPublicHealthDepartment,professionalorganizations
includingtheNationalSchoolBoardsAssociation,andphilanthropistsliketheRobertWoodJohnson
Foundation.
ThisresearchwillservepublichealthprofessionalsinthebothChicagoandthenationby
providingarichassessmentofpublicschoolwellnessandtheimpactsofwellnesspoliciesontheir
healthliteracy.Individualschoolsandthedistrictasawholecanbuildlongitudinallybyrepeatingthis
AdeniaLinker ResearchSeminar EllenBenjamin
23
studyinthefuture.Thisresearchandadditionalstudiesthatwillfollowilluminatethestudent’sworld
forthosekeystakeholderswhoimpactschoolwellnesspolicesandfunding.
Lastly,thisresearchcanbeusedbyeducationkeystakeholdersandreformadvocatestotarget
improvementeffortsregardingpolicyimplementation,andreactwithevidence‐basedpracticesand
programming.
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