Healthy School Food Guide for Implementation - FY2014-15 - Minnesota Department of Health Statewide Health Improvement Program
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Minnesota Department of Health Statewide Health Improvement Program Healthy School Food Guide for Implementation FY2014-15
Healthy School Food – last updated 6/2013 Contents Description of Strategy ....................................................................................................... 3 Priority Populations ............................................................................................................ 3 Scope of Strategy ................................................................................................................ 4 Outputs ........................................................................................................................... 6 Outcomes ........................................................................................................................ 6 Indicators ........................................................................................................................ 7 Requirements ...................................................................................................................... 7 Recommended Partners ..................................................................................................... 8 Training and Technical Assistance ...................................................................................... 8 Appendices.......................................................................................................................... 8 A: Dietary and School Food Guidelines: Information and Resources ....................... 10 B: Local Wellness Policy Requirements and Planning for Sustainability .................. 12 C: School Health Councils.......................................................................................... 15 D: Action Plan Template – Sample for School Teams ............................................... 18 E: Healthy School Food Work Plan............................................................................ 19 F: Farm to School Guide to Implementation ............................................................ 21 G: Healthy School Food Options: Outside of the USDA Reimbursable Meal Program Guide to Implementation ......................................................................................... 27 References ........................................................................................................................ 33 2|Page
Healthy School Food – last updated 6/2013 Description of Strategy Today, more than 23 million children and adolescents in the United States, nearly one in three young people, are overweight or obese. With the obesity epidemic comes an increased risk of a variety of chronic health problems, impacting young peoples’ lives and straining the healthcare system.1 Since approximately 95 percent of youth in the United States attend school, schools are an important setting in which to model healthy eating. On average, students consume 35 percent to 50 percent of their daily total calories at school.2 However, within the school setting youth are often given access to junk foods and sugary drinks that offer little nutritional value. Some of this access is through competitive foods. Competitive foods and beverages include all items served or sold in schools outside of the federally reimbursable meal programs. Typically, these competitive products are sold in vending machines, a la carte lines within cafeterias, school stores, and snack bars. Recent studies show that approximately 40 percent of students buy and eat one or more snacks at school and 68 percent buy and consume at least one sugary drink.3 Several studies have linked competitive foods and beverages with excess calorie consumption and obesity among school-age children. In 2010, the Healthy, Hunger-Free Kids Act (HHFKA) was passed with the goal of providing healthier foods and beverages in schools.4 This was the first time in over thirty years that nutrition standards for school foods were updated. The HHFKA required that the USDA update nutrition standards for the School Breakfast Program and National School Lunch Program, and update nutritional standards for snack foods and beverages that are available on school campuses during the school day. The final rule was published for the School Breakfast Program and National School Lunch Program in 2012, and proposed standards for all snacks were released in February of 2013. Prior to this time, nutritional standards for all foods available on school campuses were determined at the local level as Minnesota has no established competitive food guidelines at the state level. Research shows that standards must be comprehensive in scope to improve children’s diets and help prevent obesity. It is the goal of this strategy, Healthy School Food Options, to increase fruit and vegetables and decrease sodium, saturated fat, and added sugars in foods available during the school day on school campuses. Evidence-based strategies to reach these goals include Farm to Fork, nutrition literacy components, establishing and implementing standards for all foods sold on school grounds within the school wellness policy, and more.5 6 Priority Populations Schools that have a high percentage of free and reduced meal eligibility should be targeted, concentrating on schools that have 50 percent eligibility or greater. To access 3|Page
Healthy School Food – last updated 6/2013 data on individual school eligibility information (not the whole district) visit: http://education.state.mn.us/MDE/SchSup/FNS/SFSP/Elig/index.html. The document is titled, Public School List with Percentage of Free and Reduced-Price Lunch Students Used for Eligibility Determinations. Scope of Strategy The scope of the Healthy School Food Options strategy includes creating sustainable policy, systems, and environmental change by increasing access to healthier options and decreasing access to unhealthy options, enhancing health literacy to school decision makers (providing professional and skill development trainings leading to practice change), and by changing policy at the local level. All healthy eating initiatives should focus on the following four goals: increasing access to fruits and vegetables, decreasing access to foods high in sodium, saturated fat, and added sugars. The work of the Physical Activity and Nutrition Unit (PAN) at the Minnesota Department of Health is depicted in the graphic on the following page. 4|Page
Healthy School Food – last updated 6/2013 Figure 1: PAN Commitment Infographic 5|Page
Healthy School Food – last updated 6/2013 Outputs Phase 1 – Partnerships and Planning Required – Review literature and resources on dietary guidelines - see Appendix A for Dietary Guidelines Required – Review literature and resources on Local Wellness Policy Requirements – see Appendix B for Local Wellness Policy Requirements Required – Attend or convene a school health council meeting-see Appendix C for more information and guidance on School Health Councils Required – Review existing nutrition policies and practices for school(s)/district Required – Conduct an initial school food environment assessment (tool to be completed by MDH Evaluation) Review action plan as identified in the RFP for Healthy School Food Work Plan – see Appendix E for Healthy School Food Work Plan Required – Action plan outlined- see Appendix D for sample Action Plan Define common goals, identify key stakeholders, and assign roles/responsibilities Review existing implementation guides for strategies that school health councils would like to pursue, if applicable – see Appendix F for Farm to School Guide and Appendix G for Healthy School Food Options Outside of the USDA Reimbursable Meal Program Phase 2 – Growth Required – Implement action plan – see Appendix D for sample Action Plan Engage key stakeholders and decision makers in implementation Identify professional development and skill training needs Conduct or arrange for trainings Enhance practices with health literacy (educational components) of healthy eating strategies Phase 3 – Innovation and Promising Practices Grantee will determine and provide lessons learned to other grantees Outcomes Short-Term, Mid-Term, and Long-Term Outcomes Short-Term Outcomes: Relationship is established and strengthened between local public health and school partners Knowledge of policies, practices, and attitudes regarding healthy eating are discussed 6|Page
Healthy School Food – last updated 6/2013 School decision makers are informed of key findings and are engaged in action plan development Mid-Term Outcomes: Healthy eating practices within the school are implemented Healthy eating policies are implemented and/or enforced Access to fruits and vegetables is increased Intake of foods high in sodium, saturated fat, and added sugar is decreased Health literacy (educational components) has increased Long-Term Outcomes: Students and staff eat more fruits and vegetables Students and staff eat decreased amounts of sodium, saturated fat, and added sugars Indicators MDH Evaluation to make final determinations--information forthcoming Requirements Review Dietary Guidelines- see Appendix A for more information on Dietary Guidelines Review Local Wellness Policies for school(s)/district sites – see Appendix B for more information on Local Wellness Policy Requirements Attend or convene a School Health Council meeting – see Appendix C for more information on School Health Councils Complete an initial school-wide needs assessment with aid from the School Health Council *Recommended tool – School Health Index (SHI) The School Health Index is a self-assessment and planning tool that enables schools to identify the strengths and weaknesses of the school’s policies and programs that promote health and safety. The SHI has an Elementary and Middle/High School version. Both versions are available free of charge, online and in print form. The SHI consists of eight self-assessment modules and a planning for improvement process. The assessment process involves members of the school community, parents, students, tribal council and the community to improve school policies, programs and services. The SHI is a nationally recognized, researched-based assessment tool recommended by the CDC. Many schools are familiar with this tool. Training for the proper use of the SHI will be available through the MN Department of Education upon request. http://www.cdc.gov/healthyyouth/SHI/index.htm 7|Page
Healthy School Food – last updated 6/2013 Conduct a baseline school food environment assessment (tool is forthcoming) Action plan outlined addressing all four goal areas of increasing fruits and vegetables, decreasing sodium, saturated fat, and added sugar. See Appendix D for sample action plan template and planning calendar. Continue to modify and update Healthy School Food Work Plan and communicate with assigned Community Specialist at MDH – see Appendix E for Healthy School Food Work Plan Recommended Partners A best practice for working in schools is to convene a school health council/team. Having a broad base of internal stakeholders will move the work along more quickly and efficiently. The school health council should include various professionals and decision makers, including, but not limited to: administrators, physical education teachers, health teachers, classroom teachers, school support staff, food service staff, school nurse, parents, students, and community members. Training and Technical Assistance All trainings will be posted on the Basecamp calendar and in SHIP’s weekly newsletter, Making It Better: Minnesota’s Health Improvement Log. More information will be forthcoming. Please refer to the SHIP 3 Guide to Training and Technical Assistance for an overview of all training and TA. Required – A two-hour virtual training kick-off for school setting strategies planned for local public health. Topics include engaging schools, required assessments, clarifying what technical assistance is available, setting up sharing networks, and outlining resources. Two options tentatively planned for fall of 2013. Regional workshop (approximately one per year) School Health Index training on request Monthly strategy specific phone call/webinars (topics/dates to be released on September 1, 2013) Timely resources shared via Making It Better: Minnesota’s Health Improvement Log Appendices A. Dietary and School Food Guidelines: Information and Resources B. Local School Wellness Policies: Background Information and Resources C. School Health Councils: Information and Resources D. Action Plan Template- sample for school use E. Healthy School Food Work Plan- for local public health use F. Farm to School - Guide to Implementation and Resources 8|Page
Healthy School Food – last updated 6/2013 G. Healthier School Food Options Guide - Guide to Implementation and Resources 9|Page
Healthy School Food – last updated 6/2013 Appendix A A: Dietary and School Food Guidelines: Information and Resources Background: Competitive Foods Competitive foods are defined by the USDA as foods and beverages, regardless of nutritional value, sold at school separate from the USDA school meals program. These foods are typically available in school stores, vending machines, and a la carte lines. Currently, in Minnesota there is no standard for competitive food guidelines. However, the Healthy, Hunger-Free Kids Act requires the USDA to issue healthy nutrition standards for all foods sold in schools with the goal of eliminating unhealthy foods. These standards were proposed in February of 2013; however, the final rule for this federal legislation has not yet been released. For more information, please see the literature and resources below. Districts can have nutrition standards that exceed the federal rules, both before and after new rules are implemented. Schools are encouraged to stay abreast of the new USDA rules and requirements. Literature and Resources 2010 Dietary Guidelines for Americans http://www.health.gov/dietaryguidelines/2010.asp Also, check out ChooseMyPlate educational resources that align with the dietary guidelines http://www.choosemyplate.gov/. USDA Healthy, Hunger-Free Kids Act “Nutrition Standards for All Foods Sold in School” has not been released at time of press; however, the proposed rule was released in February of 2013 and final rule should be forthcoming. http://www.fns.usda.gov/cnd/Governance/Legislation/CNR_2010.htm Institute of Medicine Review the following document to establish baseline knowledge of developing guidelines for a healthy school food environment: Nutrition Standards for Foods in Schools: Leading the Way to Healthier Youth, Institute of Medicine Report 2007. http://www.iom.edu/Reports/2007/Nutrition-Standards-for-Foods-in-Schools- Leading-the-Way-toward-Healthier-Youth.aspx CDC Competitive Foods in Schools Webpage Review the compiled resources on implementing nutrition standards in schools. Listed case studies, resources, references, and fact sheets will aid in the health literacy component of advancing support for strong nutrition standards for foods and beverages in schools. http://www.cdc.gov/healthyyouth/nutrition/standards.htm USDA Team Nutrition & Healthier US School Challenge The goal of the Challenge is to improve the health of the nation’s children by creating healthier school environments and encouraging those improvements through awards. http://teamnutrition.usda.gov/HealthierUS/index.html 10 | P a g e
Healthy School Food – last updated 6/2013 Alliance for a Healthier Generation Includes School Beverage and Competitive Food Guidelines that help students make healthier food and beverage choices in the school environment. The guidelines cover foods and beverages offered outside of the USDA reimbursable meal program and were taken into account when the USDA drafted their proposal, including products sold in school vending machines, a la carte lines, snack bars, fundraisers, and school stores. This resource offers numerous tools and free resources after enrollment on the website. For available resources and tools as well as success stories and future learning opportunities, visit https://schools.healthiergeneration.org/resources__tools/ Two commonly used tools include: Product Navigator (an online searchable database) and the Product Calculator which determines if a product meets the established Guidelines after nutritional information is submitted. https://schools.healthiergeneration.org/wellness_categories/healthy_vending/ 11 | P a g e
Healthy School Food – last updated 6/2013 Appendix B B: Local Wellness Policy Requirements and Planning for Sustainability Background The Child Nutrition and Women, Infants, and Children (WIC) Reauthorization Act of 2004 (P.L. 108-265, Section 204) required school districts participating in the National School Lunch Program, School Breakfast Program or other child nutrition programs to adopt and implement a wellness policy by the 2006-2007 school year. The law required that district wellness policies include: Goals for nutrition education, physical activity and other school-based activities An assurance that school meal nutrition guidelines meet the minimum federal school meal standards Guidelines for foods and beverages served or sold outside of school meal programs (“competitive foods”) Implementation plans Healthy, Hunger-Free Kids Act of 2010 is a federal law that has renewed focus on the importance of school wellness policies and strengthens existing requirements. The law requires additional changes as follows: Permitting parents, students, school food personnel, school board members, administration and the public to participate in the development of wellness policies. Expands the purpose of the team to include the implementation of the local wellness policy with periodic review and updates. Requires local school districts to inform and update the public (including parents, students and others in the community) about the content, implementation and progress of school wellness policies and compare them to model school wellness policies. Requires the school district to designate at least one or more persons (within the district or at each school) to ensure compliance with the local wellness policy. Updates nutrition guidelines to meet new U.S. Department of Agriculture (USDA) nutrition standards and apply the standards to all foods sold for school breakfast and lunch programs AND to all foods sold on school grounds during the school day, including a la carte, vending machines, school stores, and school-sponsored fundraisers. Current Legislation The Healthy, Hunger-Free Kids Act of 2010 was effective as of October 1, 2010. USDA advised school districts to begin reviewing their local wellness policies during school year 2011-2012, and to the extent practicable, begin moving forward on implementing the new requirements. 12 | P a g e
Healthy School Food – last updated 6/2013 Resources Food and Nutrition Services (FNS). A comprehensive USDA website with updated materials to help schools adhere to the new HHFKA requirements. http://www.fns.usda.gov/tn/healthy/wellnesspolicy.html Centers for Disease Control and Prevention (CDC). A wide array of resources to assist in designing, implementing, and promoting elements of local wellness policies. http://www.cdc.gov/healthyyouth/npao/wellness.htm School Health Guidelines to Promote Healthy Eating and Physical Activity (CDC). Current guidelines that synthesize the scientific evidence and best practices from 1995-2009 and combine healthy eating and physical activity into one set of evidence-based guidelines for schools serving students in kindergarten through 12th grade. Other educational programs within schools might also apply these guidelines to their settings. This document, released in September 2011, contains substantial literature reviews and analysis for schools responding to the childhood obesity epidemic. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6005a1.htm?s_cid=rr6005a1 _x USDA Local Wellness Policy Requirements. USDA is due to release the proposed rule of wellness policy requirements in summer of 2013 from FNS and their partners at the Department of Health and Human Services/CDC and the Department of Education. These three agencies will provide a draft plan that will provide an overview of local wellness policies, outline technical assistance outcomes, services, and activities on current resources related to the Healthy, Hunger-Free Kids Act. For the full 5 year technical assistance and guidance plan, visit: http://www.fns.usda.gov/tn/Healthy/lwp5yrplan.pdf In the interim, refer to the guidance memo USDA released, http://www.fns.usda.gov/cnd/Governance/Policy-Memos/2011/SP42- 2011_os.pdf USDA Team Nutrition. A website set up by the USDA and Food and Nutrition Service that provides many resources. Links provide sample legislation, outlined local wellness policy requirements, discussions of the components of a wellness policy and sample wellness policies established in various states. The site also provides step-by-step procedures for developing a local wellness policy, funding a wellness policy, topic- specific resources, organizations, programs, curricula, research and a section of frequently asked questions. http://teamnutrition.usda.gov/Healthy/wellnesspolicy.html Action for Healthy Kids -- Wellness Policy Tool. 13 | P a g e
Healthy School Food – last updated 6/2013 This tool is intended to help anyone involved in developing, implementing and evaluating wellness policies by providing practical guidance and how-to information about the wellness policy process. http://actionforhealthykids.org/school-programs/our-programs/wellness-policy- tool/ Public Health Law Center. Provides publications on many topics, with a sample of resources below: o Healthy, Hunger-Free Kids Act of 2010: A Summary o Healthy, Hunger-Free Kids Act of 2010: School Wellness Policies o Promoting School Wellness in Minnesota Schools: Creating and Sustaining a School Health Council o Liability for Minnesota School Districts Implementing Policies to Promote Active Living and Healthy Eating o Checklist for Improving Your School Wellness Policy o Sample School Wellness Policy Language: School Gardens o Sample School Wellness Policy Language: No Food as a Reward/Punishment o Sample School Wellness Policy Language: Farm to School o Sample School Wellness Policy Language: Healthy Classroom o Sample School Wellness Policy Language: Healthy Concessions o Sample School Wellness Policy Language: Healthy Fundraising o Legal Issues Impacting Farm to School and School Garden Programs in Minnesota http://publichealthlawcenter.org/topics/special-collections/ship- publications-and-resources-collection. Wellness School Assessment Tool (WellSAT). Education and public health professionals can use this effective tool for evaluating the quality of existing school wellness policies. http://wellsat.org/default.aspx The Wellness Impact: Enhancing Academic Success Through Healthy School Environments. Provides evidence, resources, and next steps in making the connection between wellness policy implementation and education success indicators. http://www.genyouthfoundation.org/wp- content/uploads/2013/02/The_Wellness_Impact_Report.pdf 14 | P a g e
Healthy School Food – last updated 6/2013 Appendix C C: School Health Councils School Health Councils: Overview 1. Form a new or revitalize an existing School Health Council/Team (SHC), often referred to as a “wellness committee.” 2. SHCs complete an initial assessment of their school health environment and select strategies based on data collected. Focus on changes that target disparate populations and are considered high priority, high impact, and have a high level of support within the school and community. 3. SHCs should obtain administrative support early and often SHCs should identify one contact person per site for communication with SHIP grantee and Minnesota Department of Health (MDH). 4. SHCs should have an understanding of SHIP goals; policy, systems, and environmental (PSE) change; and sustainability planning. 5. SHCs will network with other SHIP partners, see Figure 1 below. Figure 1 - Networking Organization Chart for School SHIP Strategies MDH SHIP grantee SHIP grantee SHIP grantee SHIP School Coordinator SHIP School Coordinator SHIP School Coordinator Wellness Wellness Wellness Wellness Champion Champion Champion Champion SHC SHC SHC SHC Figure 1 illustrates how networking will be applied to facilitate ongoing dialogue and support to SHIP grantees across the state. Tapping into this network will allow for the sharing of ideas, identifying common barriers, and highlighting resources because many successful practices have already been implemented and many policies have already been adopted. The sharing of these successes across the network is essential to maintaining SHIP support and building capacity to further advance SHIP work across Minnesota. 15 | P a g e
Healthy School Food – last updated 6/2013 School Health Councils: Action Steps 1. Form a Committee. A. School health teams should have a member representative on the district wide school health council. B. Invite key stakeholders, including: a. Administration b. Classroom teachers (including PE/health specialists) c. School food nutrition staff d. School health services staff e. Parents f. Students g. Community partners C. Regular meeting times should be established. Best practice suggests a minimum frequency of quarterly meetings. D. Recommended staff knowledge, skills, and abilities include: a. Knowledge of policy, systems, and environment (PSE) b. Ability to work collaboratively with representatives from schools c. Knowledge of nutrition and school wellness policies d. Ability to work with and organize volunteers e. Effective communication with administration, staff, and students E. Identify a lead to facilitate meetings (this could be the “wellness champion”). 2. Secure administrative support. A. Get approval early and often. B. Best practice suggests having an administrator on the school health council. C. Keep administrative office informed on action plan updates. 3. Recruit/select a “wellness champion” and key contact person. A. A committee contact person should be identified to SHIP grantee & MDH, most likely the “champion”. This person will get updated SHIP school information related to resources, trainings, and networking opportunities. B. Have a back-up person or “co-champion” in case of staff changes. C. Set up initial SHC meeting and define roles/responsibilities. 4. Select a tool to assess the school health environment. 5. Develop an action plan. A. Using the scores on the assessment tool, select strategies from the SHIP menu. B. Develop short-term goals identifying the time frame, person responsible and additional resources needed. C. Purposefully plan for sustainability. D. Access training calendar on SHIP website to identify workshops that meet group needs. E. Keep administration and staff updated on action plan goals. 6. Meet regularly. A. Update action plans as needed. 16 | P a g e
Healthy School Food – last updated 6/2013 B. Report updated action plans to SHIP grantee quarterly. C. Continue to invite key stakeholders to join the council/team. D. Maintain a record of agenda items and notes. 7. Provide support to staff and students as needed. A. Engage students and staff in the process of implementation. B. Network with other schools implementing similar strategies. C. Communicate with parents. Resources Public Health Law Center. Promoting School Wellness in Minnesota Schools: Creating and Sustaining a School Health Council (2011). This document defines school health councils and the current federal and state laws that surround this topic. In addition, a sample policy to add in School Health Councils to the Minnesota School Board Association model policy is included. http://publichealthlawcenter.org/sites/default/files/resources/Creating%20and %20Sustaining%20a%20School%20Health%20Council.pdf NrgBalance (“energy balance”). A health promotion brand developed by the Center for Nutrition and Activity Promotion at Penn State Hershey Children’s Hospital created a school health council resource guide. http://www.nrgbalance.org/documents/School-Health-Council- ResourceGuide.pdf American Cancer Society. Improving School Health. A Guide to School Health Councils (2003). A thorough guide assisting school districts in developing new school health councils, strengthening existing school health councils and maintaining them as effective entities that support and guide school health practices, programs, and policies. http://www.rmc.org/CSH/Docs/Ntl_Guide_to_SHAC.pdf 17 | P a g e
Healthy School Food – last updated 6/2013 Appendix D D: Action Plan Template – Sample for School Teams Agenda: (Send this to council members in advance of next meeting) Purpose of next meeting: Meeting date: Location: Start and end times: Meeting leader: Contact info: Time Action Item Council Member Disposition (information, discussion, or frame Responsible decision) Adapted from Collaboration Handbook. Creating, Sustaining, and Enjoying the Journey, by Michael Winer and Karen Ray (St. Paul: Amherst H. Wilder Foundation, 1994.) 18 | P a g e
Appendix E E: Healthy School Food Work Plan Healthy School Food Specific Activities Proposed Timeframe The specific activities that will lead to the Staff person(s) Month in which activity Reportable Milestone achievement of the reportable milestone in the Responsible starts to month in which timeframe activity ends School Health Council is formed School Health Council has conducted a needs assessment Existing school nutrition practices have been reviewed Assessment done of current school nutrition environment Action plan, including a policy component, is written School staff, teachers and other community partners have received training Action plan, including a policy component is presented to stakeholders Action plan, including a policy
Healthy School Food – last updated 6/2013 component is implemented Efforts are sustained For each of your potential partner sites, please indicate where you expect them to be in the spectrum of this strategy over the course of the grant cycle: Partner At start of grant cycle After 6 months After 12 months At end of grant cycle Partner #1 Choose an item. Choose an item. Choose an item. Choose an item. Partner #2 Choose an item. Choose an item. Choose an item. Choose an item. Partner #3 Choose an item. Choose an item. Choose an item. Choose an item. Partner #4 Choose an item. Choose an item. Choose an item. Choose an item. 20 | P a g e
Appendix F F: Farm to School Guide to Implementation Farm to School Implement Farm to School practices and policies which may include school gardens, orchards, and harvest bars. Description of Strategy Students who eat well learn better. Farm to School strategies aim to increase the number of fruits and vegetables children eat during the school day while also lowering their intake of sodium, saturated fat and added sugar. Farm to School encompasses changes within the classroom, curriculum and community. Children have increased access to minimally processed, local food and an environment conducive to learning about how food is grown and good nutrition is created. Some operationalized strategies of Farm to School include cafeteria menu changes with local sourcing, harvest bar implementation, school gardens and/or orchards, on-site greenhouses or hoop houses as well as incorporation of these elements into the school curriculum such as FACS or FFA classes. Scope of Strategy Creating sustainable policy, systems, and environmental change by increasing access to healthier options and decreasing access to unhealthy options, enhancing health literacy to school decision makers (providing professional and skill development trainings leading to practice change), or by changing policy at the local level. All healthy eating initiatives should focus on the following four goals: increasing fruits and vegetables and decreasing sodium, fat, and added sugars. Outcomes Outcomes include implementing Farm to School practices and adopting a related policy. The ultimate goal of the Farm to School strategy is to improve overall health status of students through the increased consumption of fresh fruits and vegetables produced from gardens on school premises or local farms. Research has shown that both Farm to School salad bar initiatives increase fruit and vegetable consumption by at least one serving per day and often those habits are brought home with the student. Indicators MDH Evaluation to make final determinations, information forthcoming Requirements Review Dietary Guidelines- see Appendix A for more information on Dietary Guidelines Review Local Wellness Policies for school(s)/district sites – see Appendix B for more information on Local Wellness Policy Requirements
Healthy School Food – last updated 6/2013 Attend or convene a School Health Council meeting – see Appendix C for more information on School Health Councils Complete an initial school wide needs assessment with aid from the School Health Council *Recommended tool - School Health Index (SHI) The School Health Index is a self-assessment and planning tool that enables schools to identify the strengths and weaknesses of the school’s policies and programs that promote health and safety. The SHI has an Elementary and Middle/High School version. Both versions are available free of charge, online and in print form. The SHI consists of eight self-assessment modules and a planning for improvement process. The assessment process involves members of the school community, parents, students, tribal council and the community to improve school policies, programs and services. The SHI is a nationally recognized, researched-based assessment tool recommended by the CDC. Many schools are familiar with this tool. Training for the proper use of the SHI will be available through the MN Department of Education upon request. http://www.cdc.gov/healthyyouth/SHI/index.htm Conduct a baseline school food environment assessment – will be forthcoming Action plan outlined addressing all four goal areas of increasing fruits and vegetables, decreasing sodium, saturated fat, and added sugar – see Appendix D for sample action plan template and planning calendar Continue to modify and update Healthy School Food work plan and communicate with assigned Community Specialist at MDH – see Appendix E for Healthy School Food Work Plan Planning and Assessment School Health Council is formed School Health Council has conducted a needs assessment Existing school nutrition policies are reviewed Connect with MDH on specific strategy selection so that networking can start occurring on relevant topics. To better understand the constraints of the food service operation, become familiar with the food service regulations and standards ( http://www.ruddspark.org/get_started.aspx is a helpful resource). Be mindful that the slightest change in a school food service operation can have significant positive or negative impacts on compliance, vendor contracts, food preparation, equipment labor hours and financial solvency. In addition, begin to understand the access points for local foods in your area. A place to start is the MN Grown Wholesale database at http://www3.mda.state.mn.us/whlsale/. Become familiar with the School Day Just Got Healthier resources, which includes a toolkit on the federally mandated changes that are occurring with school meals. http://www.fns.usda.gov/cnd/healthierschoolday/ If your target work may include additional environmental changes such as school gardens or salad bars, be sure to investigate planning strategies such as the 22 | P a g e
Healthy School Food – last updated 6/2013 Creating and Growing Edible Schoolyards Manual or the Salad Bars to Schools information found at www.health.state.mn.us/fts. Assemble a team of key stakeholders. Choose diverse partners that best serve your situation. Engage your team in a discussion of Farm to School and the opportunities for this strategy within your school. You may need to begin your discussions individually but eventually you will want all partners to meet together. Begin with sustainability in mind. o Refer to the Farm to School Primer to understand the basic steps to getting started. To access online visit: http://www.extension.umn.edu/farm-to-school/getting- started/docs/MDE-primer.pdf and/or the “Farm to School: So Fresh, So Easy” on-line training video http://www.extension.umn.edu/farm-to- school/online-trainings o Determine your goals based on the three C’s of Farm to School: Cafeteria, Curriculum and Community. Be sure to create goals that include all three elements. If you are just beginning, keep these goals simple to ensure some early wins. This will energize your team to continue. Develop an action plan designed to implement Farm to School strategy components. Prioritize the plan based on feasibility, cost, resources, and sustainability. o See the Farm to School Annual Planning Tool for assistance. To access online visit: http://www.health.state.mn.us/divs/hpcd/chp/cdrr/nutrition/docsandpd f/FarmtoSchoolannualplanningtool.pdf o Be sure to include plans to assess and potentially change policies related to Farm to School. Develop your evaluation plan before you begin implementing Farm to School strategies. Set realistic expectations, work towards achieving these expectations and determine what’s working and what’s not working. o See Farm to School Evaluation Toolkit from the National Farm to School Network. To access online visit: http://www.farmtoschool.org/files/publications_385.pdf Work with school staff, teachers, and other community partners to attend trainings and other opportunities based on the needs that are identified in the prioritized action plan. o Refer to the Basecamp calendar for technical assistance opportunities that MDH might be able to provide on selected strategy components. o Educate school staff, students, parents, and the community on Farm to School strategy components. Network with other SHIP grantees Plan your educational outreach and promotion activities. Get the word out about your program! Engage students and community partners in the promotion of selected Farm to School practices. There are many great ideas and resources you 23 | P a g e
Healthy School Food – last updated 6/2013 can use. To access online visit: http://www.health.state.mn.us/fts or www.mn- farmtoschool.umn.edu Implementation and Growth Action plan, including a policy component, is presented to stakeholders Determine the roles of the various partners involved in implementing the plans. Provide support to partners as needed, such as assisting with gathering the information and resources they need to complete their tasks. Ensure ongoing communication between partners during the implementation phase. Be sure to deliver on your commitments made in your plan. Meet with your team of school partners and community members responsible for school wellness, food and nutrition, and administration to review the initial action plan and the progress being made. o Continue to gather additional input from key stakeholders. o Review progress, setbacks, obstacles and unforeseen opportunities. o Finalize action plan so next steps are clearly identified. Action plans should clearly identify goals, steps, responsible party, timeline, budget, resources, outcome measures and plans for sustainability. Present action plan and progress to school administration, school board, and other community elected officials, key decision makers, and community groups. Hold follow-up meeting with school and community stakeholders to review action plan, priorities, identify next steps and discuss existing barriers. Sustain Action plan, including a policy component, is implemented Farm to School initiatives promoted to all school partners, included community partners. Modifications to work plans for this strategy can be made in consultation with your assigned Community Specialist. Please refer to the training and technical assistance below for resources you can use to help you identify possible courses of action. Training and Technical Assistance Refer to the Basecamp calendar for technical assistance that MDH might be able to provide on selected strategy components. Additional Resources Resources for Planning and Assessment Farm to School Self-Assessment http://www.health.state.mn.us/divs/hpcd/chp/cdrr/nutrition/docsandpdf/se lf_assessment.pdf Legal Issues Impacting Farm to School and School Garden Programs in MN 24 | P a g e
Healthy School Food – last updated 6/2013 http://www.publichealthlawcenter.org/sites/default/files/resources/ship- f2s-school%20garden%20legal%20issues-2011.pdf Serving Locally Grown Produce in Food Facilities A MDH, MDA, University of MN authored factsheet with basic statute information. http://www.health.state.mn.us/healthreform/ship/techassistance/locally_gr ownfactsheet.pdf On-farm Food Safety Information for K-12 Food Service Personnel http://safety.cfans.umn.edu/documents/F2s%20OnFarm%20FoodSafety%20 Qs.pdf Existing Program/Support Resources Local Technical Assistance Identify people in your area that are available to provide support and assistance. http://www.health.state.mn.us/divs/hpcd/chp/cdrr/nutrition/docsandpdf/T hisTeamisReadytoHelp.pdf Minnesota Farm to School Programs Learn what other schools in Minnesota are doing to bring fresh, local produce to their students. http://www.farmtoschool.org/mn/programs.htm National Farm to School Network Learn about Farm to School programs across the nation. http://www.farmtoschool.org/index.php Action Plan Resources Resource list A list of resources from getting started to formal adoption of local wellness policies. http://www.health.state.mn.us/divs/hpcd/chp/cdrr/nutrition/FTS/resources. html MN Farm to School The most updated MN resource with information on food service, farmers, parents, teachers and school gardens. http://www.extension.umn.edu/farm-to-school/ Review the online trainings and the resource lists for a wealth of information. http://www.extension.umn.edu/farm-to-school/online-trainings/ Let’s Move Salad Bars to Schools This MN website offers templates, best practices and a variety of resources that can be used in any school to obtain, implement or enhance school salad bars. http://www.health.state.mn.us/divs/hpcd/chp/cdrr/nutrition/FTS/saladbars. html 25 | P a g e
Healthy School Food – last updated 6/2013 Cultivating Childhood Wellness Through Gardening This free online video series produced in Wisconsin provides relevant information for schools and childcare settings incorporating schoolyard gardens. https://connect.wisconsin.gov/dhsgotdirt1 USDA Team Nutrition In addition to numerous resources and helpful information, Team Nutrition has recently released two new curriculums, The Great Garden Detective Adventure and Dig In, offering interactive and exploratory lessons to connect school gardens with health literacy messages. http://teamnutrition.usda.gov/ Agriculture in the Classroom The Minnesota Department of Agriculture is due to release a statewide garden curriculum linked to standards that schools may wish to implement. Piloting of the curriculum began in spring 2013. http://www.mda.state.mn.us/kids.aspx Evaluation Resources Farm to School Evaluation Toolkit The Farm to School Evaluation Toolkit is an evaluation tool from the National Farm to School Network and is useful for measuring program impact on fruit and vegetable consumption among students. This toolkit includes three main evaluation tools: School Lunch Recall, Fruit and Vegetable Neophobia Scales, and Interview Guides to facilitate discussions with stakeholders. http://www.farmtoschool.org/files/publications_385.pdf Farm to School and School Garden Research Consortium The Consortium was created to coordinate research & evaluation efforts to strengthen farm to school and garden-based education programs, practices, and policies. Create an account to join the Farm to School listserv. http://datadorksunite.ning.com/ Resources for Sustaining Long-Term Farm to School Changes Delivering More: Scaling Up Farm to School Programs https://www.foodsecurity.org/pub/Delivering_More- Scaling_up_Farm_to_School.pdf Public Health Law Center Sample School Wellness Policy: Farm to School http://www.publichealthlawcenter.org/sites/default/files/resources/ship- fs2-schoolwellnesssamplepolicylanguage-2011FarmtoSchool.pdf Michigan Farm to School Wellness Policy http://www.mifarmtoschool.msu.edu/assets/farmToSchool/docs/STEP2_Sa mple_FTSLanguage_WellnessPrograms.pdf Model Farm to School Wellness Policy http://www.foodsecurity.org/F2Cwellness.html 26 | P a g e
Healthy School Food – last updated 6/2013 Appendix G G: Healthy School Food Options: Outside of the USDA Reimbursable Meal Program Guide to Implementation Healthy School Food Options Healthy School Food Options involves implementation of policies and practices that increase access to healthy snacks and beverages and limit unhealthy snack and beverage choices through lowering sodium, saturated fat, and added sugar while increasing fruit and vegetables within the school environment but outside of the USDA reimbursable meal program; such as snack carts, a la carte, vending, concessions, school store, food rewards, fundraising, and celebration/parties. Description of Strategy This strategy supports increased fruit and vegetable intake and decreased sodium, saturated fat, and added sugars in Competitive Foods. Competitive Foods are defined by the USDA as foods and beverages, regardless of nutritional value, that are sold separately from the USDA school meals program. Due to the Healthy, Hunger-Free Kids Act the USDA is required to issue nutrition standards for all foods sold in schools with the goal of eliminating unhealthy foods in vending machines, snack bars, a la carte, and other foods sold outside of the federally-reimbursed school meal program. Adopting Smart Snacks in Schools (as currently termed) guidelines will be a federal requirement for participation in the federal school meal programs; however, the final rule is yet to be released. To view the proposed rule that was released early in 2012, visit: http://www.fns.usda.gov/pressrelease/2013/001913. Improving the nutritional content/value of snacks available in schools may also directly impact student’s eating behaviors, as research shows that over 40 percent of young people have a snack at school7. Until the USDA releases the final federal rule, schools can work towards this strategy by implementing competitive food guidelines at the local level to get a jump on adopting the federal competitive food guidelines that are forthcoming. Specifically, schools can restrict the availability of less healthy foods by adopting standards for the foods sold; restricting access to vending machines, banning food as rewards in the classroom; or by prohibiting food sales at certain times of the school day.8 The Institute of Medicine recommends that competitive foods be limited to nutritious foods, including fruits and vegetables.9 Implementation of this strategy will be unique to each school due to differing results of school environment assessments. All strategies can be tailored to accommodate age and developmental differences. Scope of Strategy The scope of this strategy includes creating sustainable policy, systems, and environmental change by increasing access to healthier options and decreasing access to unhealthy options, enhancing health literacy to school decision makers (providing 27 | P a g e
Healthy School Food – last updated 6/2013 professional and skill development trainings leading to practice change), or by changing policy at the local level. All healthy eating initiatives should focus on the following four goals: increasing fruits and vegetables and decreasing sodium, saturated fat, and added sugars. Outcomes Outcomes include implementing Smart Snacks in School practices and policies. The ultimate goal of the Healthier School Food Options strategy is to improve overall health status of students through the increased consumption of fresh fruits and vegetables and a reduction in sodium, saturated fat, and added sugar intake at school. Indicators MDH Evaluation to make final determinations, information forthcoming Requirements Review Dietary Guidelines- see Appendix A for more information on Dietary Guidelines Review Local Wellness Policies for school(s)/district sites – see Appendix B for more information on Local Wellness Policy Requirements Attend or convene a School Health Council meeting – see Appendix C for more information on School Health Councils Complete an initial school wide needs assessment with aid from the School Health Council *Recommended tool: School Health Index (SHI) The School Health Index is a self-assessment and planning tool that enables schools to identify the strengths and weaknesses of the school’s policies and programs that promote health and safety. The SHI has an Elementary and Middle/High School version. Both versions are available free of charge, online and in print form. The SHI consists of eight self-assessment modules and a planning for improvement process. The assessment process involves members of the school community, parents, students, tribal council and the community to improve school policies, programs and services. The SHI is a nationally recognized, researched-based assessment tool recommended by the CDC. Many schools are familiar with this tool. Training for the proper use of the SHI will be available through the MN Department of Education upon request. http://www.cdc.gov/healthyyouth/SHI/index.htm Conduct a baseline school food environment assessment – will be forthcoming Action plan outlined addressing all four goal areas of increasing fruits and vegetables, decreasing sodium, saturated fat, and added sugar -- see Appendix D for sample school action plan template and planning calendar Continue to modify and update Healthy School Food Work Plan and communicate with assigned Community Specialist at MDH -- see Appendix E for Healthy School Food Work Plan for local public health use 28 | P a g e
Healthy School Food – last updated 6/2013 Planning and Assessment School Health Council is formed School Health Council has conducted a needs assessment Review Dietary Guidelines information and resources- see Appendix A Existing school nutrition policies are reviewed Connect with MDH on specific strategy selection so that networking can begin on relevant topics. Assemble a team of key stakeholders. Choose diverse partners that best serve your situation. Check out current legislation on Smart Snacks in Schools for the final rule release, http://www.fns.usda.gov/pressrelease/2013/001913 Review applicable additional resources in the final section of this document Develop an action plan designed to implement Healthy School Food Options strategy components. Prioritize the plan based on feasibility, cost, resources, and sustainability. o Be sure to include plans to assess and potentially change policies related to foods available and sold. Develop your evaluation plan before you begin implementing Healthy School Food Options strategies. Set realistic expectations, work towards achieving these expectations and determine what’s working and what’s not working. Work with school staff, teachers, and other community partners to attend trainings and other opportunities based on the needs that are identified in the prioritized action plan. o Refer to Basecamp calendar for technical assistance opportunities that MDH might be able to provide on selected strategy components. Educate school staff, students, parents, and the community on strategy components. o Generate excitement over selected SHIP strategy components. Network with other SHIP grantees Plan your educational outreach and promotion activities. Get the word out about your program! Engage students and community partners in the promotion of Healthy School Food Options. There are many great ideas and resources you can use, see the Additional Resources section. Implementation and Growth Action plan, including a policy component, is presented to stakeholders Determine the roles of the various partners involved in the implementation plan. Provide support to partners as needed, such as assisting with gathering the information and resources they need to complete their tasks. Ensure ongoing communication between partners during the implementation phase. 29 | P a g e
Healthy School Food – last updated 6/2013 Be sure to deliver on your commitments made in your plan. Meet with your team of school partners and community members (perhaps food distributors) responsible for school wellness, food and nutrition, and administration to review the initial action plan and discuss progress. o Continue to gather additional input from key stakeholders, including students. o Review progress, setbacks, obstacles and unforeseen opportunities. o Finalize the action plan so that next steps are clearly identified. Action plans should clearly identify goals, steps, responsible party, timeline, budget, resources, outcome measures and plans for sustainability. Present the action plan and progress to school administration, school board, and other community elected officials, and key decision makers. Hold a follow-up meeting with school and community stakeholders to review action plan and priorities and to identify next steps and existing barriers. Sustain Action plan, including a policy component, is implemented- see Appendix B for Local Wellness Policy Requirements and sustainability Healthy School Food Options promoted to all school partners, including community partners. Modifications to work plans for this strategy can be made in consultation with your assigned Community Specialist. Please refer to the training and technical assistance noted below for resources you can use to identify possible courses of action. Training and Technical Assistance Refer to the Basecamp calendar for technical assistance that MDH might be able to provide on selected strategy components. Plan for future learning opportunities that the Alliance for a Healthier Generation offers. https://schools.healthiergeneration.org/resources__tools/learning_opportunitie s/ Additional Resources Center for Preventing Childhood Obesity/Robert Wood Johnson Foundation Making Schools the Model for Healthier Environments Toolkit Includes an extensive list of resources related to making improvements to the school food environment. http://www.reversechildhoodobesity.org/webfm_send/207 Food Research and Action Center Improving the School Food Environment: Making Competitive Foods Healthier http://org2.democracyinaction.org/o/5118/p/salsa/web/common/public/conten t?content_item_KEY=8793 30 | P a g e
Healthy School Food – last updated 6/2013 Center for Science in the Public Interest Review the School Foods Tool Kit for sample goals, fact sheets, model policies, surveys and more that will assist you in the development of an action plan. Please note, however, that this toolkit was developed in 2003 and will not incorporate new federal legislation. http://www.cspinet.org/schoolfoodkit/ Public Health Law Center- School Food Policies Informational fact sheets and sample policies http://phlc.stylefish.com/topics/healthy-eating/school-food-policies Tactic Specific Resources (this is not an exhaustive list) Classroom Snacks/Snack Carts/School Stores Eat Right – The American Dietetic Association put together this list of 25 healthy snacks for kids. This could be used as a parent information piece. http://www.eatright.org A thorough spreadsheet of snacks that meet IOM nutritional standards. http://www.dakmed.org/cass/healthy-snack-list/ Starting a School Store. A site that utilizes classroom building skills and incorporates them into the running of a school store. http://www.raymondgeddes.com/school-store-academy.html Vending Machines/Concessions National Policy and Legal Analysis Network to Prevent Childhood Obesity. District Policy Establishing a Healthy Vending Program. This model will help school districts develop a vending program that fits within any established wellness policy by making sure products meet the policy’s nutritional standards. Model policies of healthy vending agreements are also available on the site. http://www.nplanonline.org/nplan/products/district-policy-establishing-healthy- vending-program Eat Well Work Well. A wide array of resources and tools specific to vending, including: vending machine assessment tools, sample vending policies, and sample letters to vendors. http://www.eatwellworkwell.org/education-tools.htm#vending A La Carte Competitive Foods Calculator. USDA’s Healthier US School Challenge. http://healthymeals.nal.usda.gov/hsmrs/HUSSC/calculator.html Meeting the Competitive Foods Criteria for the Healthier US School Challenge (HUSSC). Provides objectives, lessons plans, and handouts specific to the HUSSC program. http://www.fns.usda.gov/tn/HealthierUS/NFSMI/lesson5.pdf 31 | P a g e
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