- Author: Reka Vasicsek
- Author: Carolyn Rider
Local Health Departments are improving their CFHL programs using the Nutrition Policy Institute's LEAP awards. Three hundred thirty-three schools and programs were recognized across California for making strides on health and wellness practices.
The Issue
Establishing healthy eating and physical activity practices during childhood has become a priority in education and policy. Promoting nutrition and physical activity best practices in school and childcare programs is key to ensuring the next generation of Californians grows into healthy, active adults.
How UC Delivers
The University of California's Nutrition Policy Institute (NPI), in collaboration with the California Department of Public Health's CalFresh Healthy Living (CFHL) program, coordinates evaluation in schools, early care and education centers, and out-of-school time programs to assess nutrition and physical activity policies and practices. NPI's Site-Level Assessment Questionnaires (SLAQs) are used to assess programs and support plans for program development and improvement. CFHL programs target schools and childcare programs in low-income communities to create health-promoting environments for children.
“Thank you for sharing this! I am meeting with my team next week to discuss our school approach for FY24 and this will be super helpful to help identify new/expanded areas for working with the schools.”
- Local Health Department CFHL Project Director
NPI launched the Leaders in Eating and Activity Practices (LEAP) program in 2023, recognizing 131 schools, 124 early care and education programs, and 78 out-of-school time programs across California for achieving best practices in healthy eating and active living. All 333 sites received recognition in one or more specific areas: nutrition, physical activity, gardens, or breastfeeding support. Additionally, 38 sites were awarded gold, silver, or bronze for comprehensive achievement of overall nutrition and physical activity practices.To receive a LEAP award, sites reported wellness practices on a SLAQ and partnered with their Local Health Department's CFHL program to plan and implement health promotion projects. These projects target a range of children's nutrition and physical activity behaviors by changing policies, systems, and the environment at schools and childcare programs. NPI provided LEAP winners with personalized certificates and a digital promotions package to help them promote their achievement through social media, newsletters, or other media.
“Oh how exciting! Especially since we may be working more closely with middle schools in FY24-26 and this recognition might just encourage them join on for more PSE [policy, systems, and environmental change] focused work.”
- Local Health Department CFHL Project Director
The Impact
LEAP recognition of successful wellness programs can invigorate partnerships and inspire more impactful work. LEAP aims to motivate schools and childcare programs to implement comprehensive, evidence-based strategies to improve child health outcomes. The program also encourages Local Health Departments and their partners to promote their wellness efforts among families and community members, building community awareness of and support for CFHL. Within six months of launching the program, two-thirds of surveyed Local Health Departments reported utilizing the LEAP digital promotions package to promote their partners' healthy eating and physical activity interventions and 22% reported utilizing the LEAP award criteria to inform intervention planning at their partner sites. LEAP awardees and LHD partners have been featured on social media and in community newsletters, newspaper articles, and press releases, enhancing public awareness of CalFresh Healthy Living and UC's Nutrition Policy Institute.
Testimonials from Local Health Department CFHL Project Directors:
“I'm thrilled for our schools and extra excited for the Gold Award!! I can't wait to celebrate ourschools and the fabulous work they are doing. THANK YOU so much for this.”
This family childcare home gained LEAP recognition with a Gold Award and all four badges (Nutrition, Physical Activity, Gardens, and Breastfeeding Support).
“I never thought I would be serving asparagus to the kids. I had a hard time getting them to even eat fruits! After doing all the garden activities, they became more excited and more adventurous to try new foods. They were also very excited to check on their plants every day. They tell me they can't wait to eat the stuff they are growing.”
-Dulce Gaytan, Childcare Provider
A new research brief developed by the Nutrition Policy Institute highlights promising school-based CalFresh Healthy Living—California's SNAP-Ed program—physical activity interventions. The study used latent class analysis to describe the predominant combinations of CFHL physical activity interventions implemented in California public schools in partnership with local health departments. Using Fitnessgram data from over 440,000 students in nearly 4,300 schools, the researchers assessed whether intervention combinations were associated with student cardiorespiratory fitness, as measured by V02 max. The study found that students in schools with CFHL interventions focused on establishing or improving wellness policies and increasing opportunities for physical activity had better cardiorespiratory fitness than students in schools without CFHL interventions or in schools with other types of CFHL intervention combinations. The peer-reviewed study was authored by Sridharshi Hewawitharana, Gail Woodward-Lopez, and Wendi Gosliner from the Nutrition Policy Institute, Punam Ohri-Vachaspati and Francesco Acciai from Arizona State University, and John Pugliese from the California Department of Public Health. The research brief was created by NPI's CalFresh Healthy Living Evaluation Unit, including: Summer Cortez, Reka Vasicsek, Miranda Westfall, and Sridharshi Hewawitharana.
- Author: Michael Hsu
Tehama County students empowered by CalFresh Healthy Living, UCCE educator and teachers
It's not uncommon for high school or college students to speak up and seek to improve their school environment. But at Evergreen Middle School in Tehama County, more than 100 sixth graders led the way to create healthy changes at their school.
As part of their health classes during the 2022-23 school year, the students researched the availability of spaces for physical activity, developed a survey gauging their peers' health awareness and needs, analyzed the results and data, and made recommendations for improvements.
“We learned that there's not a lot of places – except for Evergreen Middle School and some other parks around [our community of] Cottonwood – that have many physical activity places that you can easily get to or have access to,” said Bailey, one of the students.
They were guided by Mario Monroy-Olivas, a nutrition educator with CalFresh Healthy Living, University of California Cooperative Extension in Tehama, Shasta and Trinity counties. Locally administered by UC Agriculture and Natural Resources, CFHL, UCCE is one of the agencies in California that teaches nutrition to people eligible for SNAP (Supplemental Nutrition Assistance Program) – referred to as CalFresh Food in California.
Working alongside Evergreen teachers Roxanne Akers and Albert Estrada, Monroy-Olivas challenged the sixth graders to tackle a “Youth Participatory Action Research” project – a yearlong, multi-step undertaking typically designed for older teens.
“The fact that we're doing it with these younger kids, starting a lot sooner, I think it's super impactful for them to know that, together, collectively they can make huge changes that will create positive outcomes – not just for themselves but for an entire community,” Monroy-Olivas said.
Middle school students speak up at school board meeting
In February 2023, eight class representatives presented their findings to the Evergreen Union School District Board of Education. Speaking before the five-member board for 20 minutes, the young people were naturally a bit nervous.
“It was a little nerve-wracking at first, but it wasn't that bad, once we got up there and got it over with,” said Lilah, one of the presenters. “Me and a couple of my friends were doing pep talks and practicing what we were going to say.”
The students showed a composite map that they drew from their classes' investigation of spaces for physical activity in the area, and shared a brochure that outlined their research and survey results. In a survey of more than 80 of their peers, 92% of respondents said they needed more access to physical activity equipment during class breaks, recess and lunch.
“The board members were super impressed with the students, coming to the school board and doing this,” Monroy-Olivas said. “They said they haven't had students doing this kind of advocacy work; for them, it was a really big deal.”
In the end, the young people made a strong case for more water-bottle refilling stations, badminton equipment and balls for other sports, and stencils for schoolyard activities like hopscotch, four square and snail (a type of hopscotch game).
“We got almost everything we asked for, and the project we're working on now is to help put in the things we asked for,” said Lilah, adding that, during this current school year, the students (now in seventh grade) are working on acquiring the stencils and paint.
More than just equipment, students gain skills and confidence
While the promise of new gear is exciting for the youth, they are acquiring something even more valuable and enduring – a sense that they are empowered to make a difference in their community, according to Janessa Hartmann, UC Cooperative Extension community nutrition and health advisor for Tehama, Shasta and Trinity counties.
“Yes, it's important to want to do stencils and hydration stations and have more equipment,” Hartmann said, “but the bigger impact for the students is that they think: ‘Now I know that my health is important, now I know how to advocate for myself, and now I know that I can do that.'”
Monroy-Olivas said he observed tremendous growth in all the students, and especially in the self-confidence of the class representatives.
“I grew as a leader because I used to be really shy and hated talking in front of people, but through this project we're doing, this has really helped me be able to talk in front of crowds – and listen to others,” Lilah explained.
In a survey at the end of the sixth-grade project, the percentage of youth who answered “Yes, most definitely” to the statement “I want to make a difference in making my school/community healthier” jumped from 19% before the project to 44% after. And that percentage of “Yes, most definitely” replies jumped from 6% to 31% for the statement “I can use research results to come up with solutions or recommendations for making my school/community a healthier place.”
“We learned to promote what we want and try to get it as much as we can, so we can get more physical activities and more people can be included,” said Brian, another student working on the project.
“It's important so when we get older, we know how to voice our opinions and let people know what we're thinking,” added classmate Brooklynn.
Wishing that he had such an opportunity when he was growing up, Monroy-Olivas said he feels the students now know the power of their voice.
“I wholeheartedly believe that's the biggest win out of this whole project, that they're learning how to advocate for their own voice and change,” he said.
/h3>/h3>/h3>- Author: Michael Hsu
New law mandates at least 30 minutes of recess for K-8 public school students
Last year, while working on a bill that would require California public schools to provide at least 30 minutes of recess, State Sen. Josh Newman sought the latest research on youth physical activity. Newman, whose district encompasses parts of Los Angeles, Orange and San Bernardino counties, traveled to the Bay Area to see one of the leading experts in the field.
During several visits with Newman, Hannah Thompson – a Nutrition Policy Institute senior epidemiologist and an assistant research professor in the University of California, Berkeley School of Public Health – shared the most recent science.
Both the American Academy of Pediatrics and Centers for Disease Control and Prevention recommend that children have 20 minutes or more of daily recess. But, when asked about the current “state of recess” across California, Thompson said she only knew of anecdotal evidence at the state level.
“I said, ‘You know what? I don't actually know what is going on in California,'” Thompson recalled. “I contacted a couple of colleagues who had done more national-level work on recess that included samples of California schools – but no one was really able to disaggregate what was happening in California.”
She brought up the bill during a meeting with her fellow researchers at NPI, an institute under UC Agriculture and Natural Resources.
And it turned out that Janice Kao, an NPI academic coordinator, had exactly what she needed.
CalFresh Healthy Living evaluation team provides key recess data
Kao leads a project team that evaluates local health departments' programs of CalFresh Healthy Living – California's version of the educational arm of SNAP (the federally supported Supplemental Nutrition Assistance Program).
As part of that evaluation process, Kao's team coordinates questionnaire administration at SNAP-Ed-eligible schools that are partnering with local health departments on CalFresh Healthy Living interventions, ranging from nutrition programs to physical activity initiatives. The survey asks school administrators about their current policies, environments and practices – including the provisioning of recess.
“It was just really good luck that everything was in the right place at the right time to be able to work together,” Thompson said.
At Thompson's request, Kao and her colleagues processed and cleaned that crucial piece of data, comprising responses from 153 low-income elementary schools in the 2021-22 school year.
“Just 56% of schools reported providing more than 20 minutes of recess daily,” Kao said. “So this was a situation where the data showed, ‘OK, there is some room for improvement, perhaps at that state policy level.'”
Thompson and Rebecca London, a sociologist at UC Santa Cruz, wrote a research brief detailing their analysis of the data. They describe disparities in recess time based on school size and income level of families, with students in larger, less affluent schools generally receiving less daily recess.
Thompson said those disparities are related to funding and academic inequities, as the imperative to boost test scores forced schools to increase certain classroom hours at the expense of recess time.
“We did all this work engineering physical activity out of the school day despite the tremendous body of evidence that shows physically active kids not only are healthier but can concentrate better; they have better academic performance, fewer disruptions, better classroom behavior,” explained Thompson, a former physical education teacher in Oakland. “In trying to address that academic gap, we ended up exacerbating a lot of these public health disparities.”
Virtual learning during the pandemic showed educators and parents – firsthand – the harmful effects of children staying sedentary in front of computer screens for hours. But the resulting momentum for restoring recess and time for physical activity was soon stalled as schools tried to make up for “lost time” in returning to classrooms, Thompson said.
NPI resources, expertise invaluable to lawmakers
Newman's bill, SB 291, was an attempt to lock in those recess minutes that are crucial for student health, development and scholastic performance. Both Thompson and London testified before the Senate Education Committee in April 2023, providing the senators with science-based information and context to guide their policymaking.
“Crafting policies rooted in science is critical for legislators to ensure our policies are impactful,” Newman said. “The work of Dr. Thompson and her colleagues at UC provided clear and useful guidance on the benefits of unstructured play and how to improve health and educational outcomes in California schools.”
Gov. Gavin Newsom signed SB 291 into law last October. Starting this coming school year, public elementary and middle schools across California will be required to give at least 30 minutes of recess to K-5 students – and prohibited from withholding recess as punishment.
Kao said her team was excited that their CalFresh Healthy Living evaluation data was useful for lawmakers, illustrating NPI's important role in informing evidence-based policy.
“I'm hopeful that we can use this same data set to also provide key pieces of information on other types of legislation that's in the works, or newly passed legislation,” Kao said.
Thompson said the challenge now will be ensuring schools have the resources and funding to provide quality time for young people.
“If you only have one schoolyard, and it's already dedicated to PE, what do you do now, if you have to increase your time for recess and you don't have that space?” she said.
Thompson added that she is currently applying for a grant to study how schools across California are adjusting to meet the new requirements.
/h3>/h3>/h3>A recent study finds that comprehensive school-based Supplemental Nutrition Assistance Program-Education, also known as SNAP-Ed, interventions focused on improving wellness policies and increasing physical activity opportunities are associated with better student fitness. Researchers identified predominant combinations of school-based, physical activity-focused SNAP-Ed interventions and then looked at how they affected student fitness. Study data included over 442,000 fifth and seventh-grade students attending nearly 4,300 public schools in California communities with low-income in 2016-2017. Students in schools with SNAP-Ed interventions combining policy changes and improved physical activity opportunities had better cardiorespiratory fitness, as measured by VO2 max. On average, these students had 1.17 mL/kg/min greater VO2max than students at schools without interventions. They also had greater VO2 max compared to students in schools with any other type of intervention combination. This study suggests that focusing on both wellness policy changes and increased physical activity opportunities may have a synergistic effect and may warrant prioritization in SNAP-Ed program planning and implementation. The study, published in Preventive Medicine, was conducted by Nutrition Policy Institute researchers Sridharshi Hewawitharana, Gail Woodward-Lopez, Hannah Thompson, and Wendi Gosliner; Arizona State University researchers Punam Ohri-Vachaspati and Francesco Acciai; and California Department of Public Health researcher John Pugliese.