Formative Work and Advocacy Process
In 2004-2005, the West Virginia Nutrition Advisory Council (NAC), with guidance from the Child Nutrition Executive Director, convened to determine how West Virginia could meet the new nutrition requirements of the 2004 Child Nutrition Reauthorization. At that same time, Barbara Fish, a West Virginia State Board of Education member, was serving on the Institute of Medicine (IOM) committee that issued recommendations for nutrition standards for all foods in schools.1 Ms. Fish worked closely with the Child Nutrition Executive Director to encourage the NAC to draft statewide nutrition standards based on the IOM recommendations.
The West Virginia Board of Education Wellness Committee then approved the draft policy and referred it to the full board. The board posted the new standards for a 30-day public comment period, during which stakeholders responded with 132 pages of comments. The Board voted on the individual provisions of the policy separately and revised certain provisions of the policy, specifically the beverage recommendations (see description below). The revised policy passed on January 10, 2008 and went into effect July 1, 2008, making West Virginia the first state to enact statewide nutrition standards based on the IOM recommendations.
The IOM beverage recommendations, which do not allow soft drinks, were a controversial provision because they conflict with existing West Virginia state law. West Virginia Code §18-2-6a expressly allows sale of soft drinks in high school. Since West Virginia State Board of Education policy cannot conflict with state legislation, the policy's provision addressing soft drinks was revised to prohibit caffeinated drinks, which would categorically disallow many soft drinks. However, since some soft drinks are caffeine-free or have uncaffeinated versions, the West Virginia Department of Education's Office of Child Nutrition (OCN) worked with West Virginia First Lady Gayle Manchin to develop a program that publicly recognized and provided financial incentive for county school systems that voluntarily removed all soft drinksâ€”both caffeinated and uncaffeinatedâ€”from their high schools. The program was very successful and resulted in 53 of the 55 county school systems in the state removing soft drinks from all of their high schools during the school day.
Implementation of the nutrition standards involves a variety of components including:
- Education and training for state- and county-level school staff as well as other key groups;
- A marketing campaign targeting parents, students, and schools through a branded website and a variety of informational materials; and
- Resources and tools to help schools and parents implement the policy and advocate for healthier foods in schools.
Education and Training
Training and guidance for state- and county-level staff is critical to ensuring the policy is implemented as intended. Training and guidance materials could include:
Implementation guidance memos: In West Virginia, guidance memos are developed and distributed by the OCN to key state- and county-level school staff on an ongoing basis and are posted to the OCN website. The memos clarify and operationalize specific provisions of the policy.
In-person trainings for state- and county-level school staff: Following passage of the West Virginia nutrition standards, the Child Nutrition Director conducted in-person internal trainings with state OCN staff. State-level staff then held in-person training for county food service directors, superintendants, principals, school business staff, and school nurses in all 55 counties in the state. Presentations were also delivered to county boards of education, the West Virginia School Nutrition Association, the West Virginia Healthy Lifestyles Coalition, the U.S. Department of Agriculture, and other state and national audiences. Training and education efforts are ongoing with both county- and state-level staff and policymakers, as well as national groups and federal agencies.
General informational/educational materials: The OCN developed various factsheets for general dissemination and public education. These factsheets provide general information about the policy and also cover specific topics such as flavored milk and school meals.
Press kit: After passage of the nutrition standards, the OCN developed a press kit that was made available to county school system staff and administration to supply to media outlets in their county.
Marketing and Promotion
Marketing and promotion of the nutrition standards increases awareness of and support for the policy after it has passed.
In West Virginia, the OCN hired a communications and marketing firm to develop a branding and marketing campaign for the policy. The campaign involved:
- Designing an OCN logo, which is used on all materials related to the policy.
- Developing a website: In West Virginia, the website (www.wvsmartfoods.com) is the centerpiece of the implementation strategy. The site provides information about the policy and includes a toolkit to help parents and schools advocate for and implement various provisions of policy including healthy fundraising, school celebrations, healthy rewards, and healthy snacks. The website also includes success stories, recipes that meet the policy's nutrition guidelines, a nutrition calculator, and media contacts.
- Creating a variety of other marketing and educational materials: West Virginia developed these materialsâ€”including the factsheets mentioned aboveâ€”for schools, parents, and the community. (These materials can be accessed through the website or in the Intervention Materials section of this template)
Revise Tools and Resources
In addition to creating new tools and resources, it is important to revise existing resources to support policy implementation.
In West Virginia, existing resources that were revised to support the new nutrition standards and provision in the policy include:
Let's Party: School Party Ideas (April 2010), a booklet to help schools and parents host safe, healthy, active school celebrations. The booklet includes tips, recipes, and ideas for activities, decorations, and creative themes. Originally published in 1993, the booklet was revised in 2010 to include more physical activity and support the new, revised nutrition standards. (This resource can be accessed in the Intervention Materials section of this template)
Mountain MealTimes Newsletter: The Mountain MealTimes Newsletter is the OCN's quarterly newsletter. After passage of the new nutrition standards, the newsletter included information about and promotional messaging for the policy. (This resource can be accessed in the Intervention Materials section of this template)
Policy Monitoring and Evaluation
Monitoring activities determine the extent to which county school systems are in compliance with the policy, and evaluation examines the impact of the policy on environmental and behavioral outcomes. In West Virginia, the OCN conducts two key activities to measure progress on implementing the policy and improving the school food environment:
Monitoring: West Virginia incorporates monitoring activities into existing tools and systems. Monitoring occurs through both formal and informal methods. Informally, the OCN receives feedback from parents and independent auditors about policy violations observed in county school systems. Formally, the OCN modified its annual Monitoring of Accountability form, a mandatory reporting tool that tracks compliance with the National School Lunch Program standards and is completed annually by county food service directors for each school in their school system. The form was modified to incorporate questions tracking compliance with the nutrition standards. County school system funding for school meals is contingent upon compliance with the nutrition standards policy. (The Monitoring of Accountability form may be accessed in the Intervention Materials section of this template)
Evaluation: The OCN contracts with the West Virginia University Health Sciences Center to conduct an annual evaluation. The Year One Evaluation surveyed parents, students, and key school staff (food service directors, county school superintendents, principals, and school nurses) about their perceptions of the policy, as well as the extent to which the policy is being implemented. The evaluation also reported changes in student food and beverage consumption. The Year Two Evaluation is expected soon and will examine additional measures and policy outcomes. (The Year One Evaluation may be accessed in the Intervention Materials section of this template)
Keys to Success
- Gain student acceptance of new foods. Various counties conducted taste testing of some new food items, along with meetings to educate the students about some of the new changes and the reasons for the change. Many counties used student councils and student advisory groups as well as the students involved in the USDA Team Nutrition grants West Virginia received. These students were peer advocates and were able to lead the change in some counties.
- Be flexible and creative in implementing challenging policy provisions. In West Virginia, changes to foods offered in the cafeteria as part of school meals included identifying and purchasing more whole grain products. Most schools had already offered some whole grains but expanded from offering only whole wheat bread to including brown rice and whole wheat pastas. Schools also added more fresh fruits and vegetables. There was some concern that costs would significantly increase, and while there was an initial increase, planning healthier options and food preparation methodsâ€”such as preparing more meals from scratchâ€”allowed the costs of other food products to decrease. Milk distributors have been reformulating some of their products to meet the new standards. For example, low fat dairy products were already available prior to the new policy, but distributors are now reducing the amount of sugar in flavored milk and are providing nonfat flavored milk as well.
- Address fundraising concerns by providing alternatives. In West Virginia, concerns about fundraising were addressed by OCN staff and county child nutrition directors by providing alternative ideas for fundraising through the www.wvsmartfoods.comwebsite. The OCN and county child nutrition directors also monitor schools for compliance on marketing healthier items.
- Address professional development requirements. In West Virginia, there were no major concerns about the policy provision requiring that all county child nutrition directors hold a bachelors degree with a minimum of six hours of foods and nutrition related course work. Every current child nutrition director was grandfathered in with a "permanent authorization." All new child nutrition directors were given a "temporary authorization" that is renewed annually, and is contingent upon the annual completion of 15 clock hours of staff development related to Child Nutrition Programs and offered or granted prior approval by the state agency.
Barriers to Implementation
Opposition from various stakeholders to specific provisions during policy development and enactment. West Virginia experienced opposition during policy development to certain policy provisions such as eliminating soft drinks during the school day. This barrier was addressed by creating a recognition program for schools that voluntarily removed soft drinks (see page 4 for a detailed explanation).
Resistance from parents, principals, and other school staff in implementing various aspects of the nutrition standards. In West Virginia, parents and schools were not initially receptive to certain policy provisions such as disallowing unhealthy foods in school/classroom celebrations, and no longer using food as a reward. Providing guidance memos and training to school staff, as well as educational materials for parents such as the "Let's Party" booklet and the online parent toolkit helped increase buy-in. Tracking compliance through the annual monitoring forms and tying compliance to funding further helped ensure the policy's implementation.
1 Institute of Medicine, Nutrition Standards for Foods in Schools: Leading the Way toward Healthier Youth, 2007