Abstract
ObjectivesTo examine high school personnel's perceptions of the school environment, its impact on obesity, and the potential impact of legislation regulating schools' food/beverage offerings.MethodsSemi-structured interviews were conducted with the principal (n = 8) and dietitian/food service manager (n = 7) at 8 schools (4 rural, 4 suburban) participating in a larger study examining the relationship between the school environment and adolescent health behavior patterns.ResultsPrincipal themes included: 1) Obesity is a problem in general, but not at their school, 2) Schools have been unfairly targeted above more salient factors (e.g., community and home environment), 3) Attempts at change should start before high school, 4) Student health is one priority area among multiple competing demands; academic achievement is the top priority, 5) Legislation should be informed by educators and better incorporate the school's perspective. Food service themes included: 1) Obesity is not a problem at their school; school food service is not the cause, 2) Food offerings are based largely on the importance of preparing students for the real world by providing choice and the need to maintain high participation rates; both healthy and unhealthy options are available, 3) A la carte keeps lunch participation high and prices low but should be used as a supplement, not a replacement, to the main meal, 4) Vending provides school's additional revenue; vending is not part of food service and is appropriate if it does not interfere with the lunch program.ConclusionDiscrepancies exist between government/public health officials and school personnel that may inhibit collaborative efforts to address obesity through modifications to the school environment. Future policy initiatives may be enhanced by seeking the input of school personnel, providing recommendations firmly grounded in evidence-based practice, framing initiatives in terms of their potential impact on the issues of most concern to schools (e.g., academic achievement, finances/revenue), and minimizing barriers by providing schools adequate resources to carry out and evaluate the effectiveness of their efforts.
Highlights
The prevalence of overweight among US children and adolescents (6–19 years of age) has reached epidemic proportions [1]
Obesity Principals agreed that obesity is a problem among high school students, in general; most did not feel that obesity was a problem at their school
Our findings suggest a number of consistent themes among high school principals and food service personnel regarding the school environment and its impact on obesity
Summary
The prevalence of overweight among US children and adolescents (6–19 years of age) has reached epidemic proportions [1]. Escalating obesity rates threaten the health of our nation and the social, emotional, and physical well-being of our youth. Poor diet and physical inactivity account for approximately 365,000 deaths per year, ranking second only to tobacco as the leading cause of preventable death [2] and cost our nation an estimated $110 to $129 billion annually in direct and indirect health-care costs [3]. Overweight youth are more likely to become obese adults [4] and to experience significant obesity-related health concerns even as normal weight adults [5]. Overweight children are more likely than their normal weight peers to experience lower self-esteem, depressed mood, body dissatisfaction, discrimination, negative stereotyping, and social marginalization [6]
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