Words or Reality: Are School District Wellness Policies Implemented? A Systematic Review of the Literature

摘要

Background: The 2004 Child Nutrition Reauthorization Act (CNRA) instructs school districts to develop nutrition and physical activity policies, and the 2010 CNRA includes language aimed to further this initiative. Policy approaches are part of the national response to prevention of child and adolescent obesity; information on the effectiveness of this initiative is needed.Methods: A systematic review of the literature was conducted to establish whether school wellness policies are written and implemented as a result of the 2004 CNRA and for evidence that implementation of the policies influences school nutrition and physical activity practices, student behavior or body mass index. Studies were limited to those reporting on district policies established in response to the 2004 legislation and were not limited by study design.Results: School districts comply with the written requirement of the wellness policy legislation despite its weak accountability measures. There is limited but promising evidence that school district policy predicts a decrease in the availability and consumption of low nutrient density foods at school. Studies examining physical education and physical activity in response to district policy are minimal but suggest little change, and studies examining student behavior and weight as a result of policy implementation are lacking.Conclusion: Information gained from early efforts will assist policy makers, educators, health professionals and community advocates in strengthening school policy implementation. Further research is necessary to determine if policy language translates to school practices and subsequent improvements in the eating patterns, physical activity and body mass index of children and adolescents.