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Persons using assistive technology might not be able to fully access information in this file. For assistance, please send e-mail to: mmwrq@cdc.gov. Type 508 Accommodation and the title of the report in the subject line of e-mail. Appendix: Guidelines for School Health Programs to Promote Lifelong Healthy EatingAPPENDIX A: NUTRITION EDUCATION RESOURCE LIST Nutrition education curricula and print, audiovisual, and computer-based materials are available from government agencies, voluntary organizations, corporations, and commodity organizations. State Nutrition Education and Training Program coordinators can help schools identify the most appropriate nutrition education curricula and materials. National clearinghouses that can help schools identify a wide range of nutrition education and school food service resources are sponsored by the U.S. Department of Agriculture's Food and Nutrition Information Center and the National Food Service Management Institute; the former also serves as a lending library. Food and Nutrition Information Center National Agricultural Library U.S. Department of Agriculture 10301 Baltimore Blvd., Room 304 Beltsville, MD 20705 301-504-5719 National Food Service Management Institute P.O. Box 188 University of Mississippi University, MS 38677 800-321-3054 At the local and state levels, educational materials or curricula may be available from affiliates of voluntary health promotion organizations (e.g., the American Cancer Society or the American Heart Association), commodity organizations or national boards for specific food industries, county cooperative extension services, local and state health departments, school districts, state education agencies, and universities. At the national level, nutrition education materials can also be obtained from the following voluntary organizations and federal government agencies: American Cancer Society 1599 Clifton Road, NE Atlanta, GA 30328 800-ACS-2345 (800-227-2345) American Dietetic Association National Center for Nutrition and Dietetics 216 W. Jackson Blvd., Suite 800 Chicago, IL 60606-6995 800-745-0775 ext. 5000 American Heart Association 7272 Greenville Ave. Dallas, TX 75231-4596 800-AHA-USA1 (800-242-8721) American School Food Service Association 1600 Duke St., 7th Floor Alexandria, VA 22314 800-877-8822 ext. 116 Consumer Information Center Pueblo, CO 81009 719-948-4000 (call for catalog) International Food Information Council 1100 Connecticut Ave., NW, Suite 430 Washington, DC 20036 202-296-6540 National Cancer Institute Office of Cancer Communications Building 31, Room 10A16 31 Center Drive MSC-2580 Bethesda, MD 20892-2580 800-4-CANCER (800-422-6237) National Heart, Lung, and Blood Institute Information Center P.O. Box 30105 Bethesda, MD 20824-0105 301-251-1222 Team Nutrition U.S. Department of Agriculture 3101 Park Center Drive, Room 802 Alexandria, VA 22302 703-305-1624 APPENDIX B: YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM AND SCHOOL HEALTH POLICIES AND PROGRAMS STUDY In 1990, CDC established the Youth Risk Behavior Surveillance System to help monitor progress in attaining national health and education objectives by periodically measuring the prevalence of behaviors in six health risk categories. These behaviors, which are usually established during youth, contribute to the leading causes of death and disease in the United States. Dietary behaviors are one of the six health risk categories. CDC conducts the Youth Risk Behavior Survey (YRBS) biennially in a national probability sample of high school students and enables interested state and local education agencies to conduct the survey in comparable probability samples in states and cities (127). The specific dietary behaviors and attitudes monitored by the YRBS include consumption of fruits and vegetables, consumption of foods high in fat, perceptions of body weight, and attempted weight loss and weight-loss techniques used. The YRBS also obtains information about specific physical activity behaviors. In 1994, CDC conducted the School Health Policies and Programs Study (SHPPS), which is a national study of school policies and programs at the school, district, and state levels that support comprehensive school health programs. The study also provides baseline data on national health and education objectives that can be attained through school health and physical education, school food service, and school health services and policies (229). SHPPS included a mail survey of local and state education agencies' policies related to school health in grades kindergarten through 12. The survey was conducted in all states and in a nationally representative sample of districts. The study also included on-site, structured interviews with school principals, health education teachers, physical education teachers, school food service directors, school nurses, counselors, and other personnel in a nationally representative sample of middle schools and high schools. The questionnaire included the following: school nutrition education requirements for students; the content of nutrition education curricula; training and joint activities of food service staff and teachers responsible for nutrition education; school policies related to foods sold in vending machines and for fundraising; food service practices related to purchasing and preparing food; involvement of parents, staff, and students in planning food service meals; and involvement of fast-food or food service management companies in school meals. Single copies of YRBS and SHPPS reports are available from CDC's Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Mailstop K-33, 4770 Buford Highway, NE, Atlanta, GA 30341-3724; telephone: (770) 488-5330. APPENDIX C: SELECTED SCHOOL-BASED STRATEGIES TO PROMOTE HEALTHY EATING Different, developmentally appropriate activities are listed for lower elementary school, upper elementary school, and middle and high school students (194). This list is not intended to be comprehensive. However, it does include many of the concepts critical to improving the diet and health of young persons in this country. Schools should review these educational activities in relation to their students' needs and abilities to determine which activities are appropriate at each grade level. Interventions that promote healthy changes in eating behaviors need to target three interacting spheres of influence: (a) the environment, which influences the likelihood that healthy eating behaviors will be adopted through social norms, influential role models, cues to action, reinforcements, and opportunities for action; (b) personal characteristics (e.g., knowledge, attitudes, beliefs, values, confidence in one's ability to change eating behaviors, and expectations about the consequences of making those changes); and (c) behavioral skills and experience, which are related to selecting or preparing specific foods, dietary self-assessment, and decision-making (186, 194,203,204). The strategies listed here require the involvement of teachers, administrators, food service personnel, other school staff, and parents (194). Classroom teachers play the lead role in most of these activities, but many activities would be most effective if they were reinforced by other persons; all adults in the school community can help by serving as role models. Each school or district should determine the policies it needs to guide its nutrition-related activities and who is responsible for the tasks. For lower elementary students Strategies to make the food environment more health-enhancing
Strategies to enhance personal characteristics that will support healthy eating
Strategies to enhance behavioral capabilities that will support healthy eating
For upper elementary students Strategies to make the food environment more health-enhancing
Strategies to enhance personal characteristics that will support healthy eating
Strategies to enhance behavioral capabilities that will support healthy eating
For middle and high school students Strategies to make the food environment more health-enhancing
Strategies to enhance personal characteristics that will support healthy eating
Strategies to enhance behavioral capabilities that will support healthy eating
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