Approaches to Enhancing Wellness Policy Implementation in Schools to Prevent Obesity: Protocol and Measures Development

Abstract

To describe development of key outcome measures for a 5-year NIFA/USDA school-based obesity prevention study and protocol for Wellness Champions for Change-Students (WCC-S), a 5th and 8th grade student leadership/advocacy/health literacy training wherein students promote Local Wellness Policy implementation (school system documents outlining food/physical activity/health education policies) to create a health-promoting school environment. Three key outcome measures were developed for students: in-school food access and consumption survey, school wellness policies and practices perceptions survey, and real-time healthy eating/physical activity access/accessibility via ecological momentary assessment (EMA). WCC-S intervention protocol was developed through focus groups with 5th, 7th, and 8th graders, stakeholder interviews, and compilation of evidence-based content and materials. Measures were developed and/or modified from existing instruments. To assess wording, comprehension, and timing, cognitive pre-testing was conducted with 3rd (n=4), 6th (n=4), and 9th (n=3) grade students. To assess feasibility, reliability, and validity, a separate cohort of 3rd (n=20), 6th (n=20), and 9th (n=20) grade students participated in a 2-week validation study. Surveys were administered twice, one week apart, to evaluate reliability. The EMA questionnaire was administered via smartphone, after school, over five days to evaluate feasibility. The in-school food access and consumption survey was validated against daily report over a 5-day period, using a smartphone survey. Data analysis is in process. WCC-S will be evaluated for feasibility and acceptance through pilot-tested with 5th and 8th graders in an elementary school and during a summer camp during spring/summer 2017. The first year of a 5-year project included the systematic development of intervention measures and protocols, which will be incorporated into the randomized trial.