Novel Approaches to Qualitative Studies with Youth Regarding Wellness Changes In a Large Urban School District

Background: Districts are required to implement nutrition and physical activity policies to help prevent childhood obesity. Most districts do not fully implement policies due to academic priorities, budgetary constraints and the social-cultural milieu. Schools also report a lack of student buy-in can prevent or mitigate potential benefits from changes. Usually adults generate programs aimed at changing the nutrition and activity environments. There is ample evidence from school reform to violence prevention programs that student involvement positively affects outcomes. For sustainable school wellness practices, shifts in social norms to support and reinforce new patterns will be necessary.

Program background: A private public partnership was formed between Fuel Up to Play 60 (FUTP60 is a national initiative of National Dairy Council and the National Football League), Houston Independent School District (HISD), government, community and business organizations to pilot a whole-systems approach to improving nutrition and physical activity district-wide. Students were engaged in the development and implementation of program activities aimed at improving school nutrition and physical activity practices.  

Evaluation Methods and Results:  During 2009-2010, formative and process evaluation methods were conducted with participation from students, community members, industry and school stakeholders. Student involvement in the effort included pre-Summit on-line discussion board, participation in Summit, development of communications, nutrition and physical activity strategies. Other methods used to gather student views were video stories and group interviews, in-class focus groups, mini-workshops and on-line surveys. Over 2500 students from 45 schools participated in the FUTP60 initiative. Data was collected with an iterative process using development-stage dependent methods. Information gathered included possible motivations for changing eating habits, reasons for not eating school meals, motivations for being active, incentives for participating in wellness activities, best methods of communicating to peers about school wellness and resonance of nutrition and physical activity messages. Students’ vision for a healthy school included being active throughout the day, more choices in activities, restriction of “junk foods” and improving taste, choice and healthfulness of school meals. Students were emphatic about inclusion in wellness changes; sentiments best represented in the student-developed slogan “No Fixation Without Representation”. After five weeks of implementation, over 1500 students completed an on-line questionnaire. The majority of students reported learning new information about importance of food groups, eating more healthful options at school and the intention to eat healthful options in the future.

Conclusions: Broader student representation and deeper insights on school wellness were gleaned by using a “multiple modes, iterative process” approach. An added benefit to the approach was involvement of students district-wide with student dispersion contributing to high awareness at an early stage.

Implications for research and/or practice: Shifting norms will require involvement of a large numbers of students, not just student-leaders. Using a variety of qualitative methods in an iterative process allows more students to participate in a developmentally appropriate, and comfortable, manner.