Theoretical Background and research questions/hypothesis: Type 2 diabetes is an increasing concern for youth. What was once considered an adult onset disease is now impacting younger generations, especially Native American youth. The Eagle Adventure Program was developed in collaboration with the Chickasaw Nation Get Fresh! program and Oklahoma State University around the Centers for Disease Control and Prevention’s Eagle book series. The program is implemented in Grades 1-3 and was designed to address multiple levels of influence using the socioecological model as a framework. Because youth spend the majority of their day at school, the current project aimed to explore policy, system and environmental factors influencing healthy school environments, foods offered at school and school fund raising policies. The goal of this research was to improve and expand the Eagle Adventure program to have influence at additional levels of the socioecological model so that we can work in coordination with schools to expand the levels of influence necessary to prevent type 2 diabetes and other chronic conditions in Indian Country and beyond. To achieve this goal, a qualitative study was designed with the following research objectives:
- Determine teacher perspectives of nutrition, health and school policies that affect student health.
- Determine school administrator perspectives of nutrition, health and school policies that effect student health.
- To identify feasible school policy changes based on expressed needs and concerns.
Methods: The sample population for this study included teachers and school administrators at an elementary school in the Chickasaw Nation’s jurisdictional boundaries with intent to include the Eagle Adventure program in the upcoming school year. All school teachers and administrators were invited to participate in a group discussion, dyad or individual interview. The semi-structured script was developed by senior team members and reviewed by additional team members prior to use. The members who reviewed the script had extensive experience with the subject matter, population, and school settings. The reviewers made suggestions related to flow and clarity of questions to address face validity. Discussions, interviews and dyads were audio-recorded and transcribed verbatim. Transcripts were analyzed using content analysis. The Chickasaw Nation and Oklahoma State University IRBs approved this research.
Results: Overall, limited knowledge of current school wellness policies was expressed. The primary concern related to foods offered in the school environment was related to addressing hunger. The need to address food insecurity/hunger superceded healthy school food offerings. There was an overall consensus recommending the need for more kid friendly food options and snacks; more widely implemented wellness policy; and the need to address school funding shortages.
Conclusions: Increased communication related to awareness and adaptation of school policies is needed. Funding shortage was identified as a major factor impeding the adoption of healthy school policies related to fundraising and demands attention of policy makers who have influence in funding recommendations.
Implications for research and/or practice: This results from this study cannot be generalized due the limited sample size and geographic representation. Additional studies at the local level are recommended to identify factors influencing the adaptation and utilization of school policies.