Good Health Key to Student Learning

Last fall, school nurse Sheryl Lapp had to rush out of her office to help a student having a seizure in a classroom.

"Most seizures last about five minutes," says Lapp, who is based at John F. Kennedy Elementary School in South Plainfield, New Jersey. "This one went on for almost 15."

Fortunately, the classroom staff knew to remain calm, begin tracking the time and length of the seizure, monitor the student's breathing, and protect the student's head until Lapp arrived and activated emergency medical services.

"Our secretary knew who to call … our maintenance staff were on standby to help with whatever was needed," Lapp recalls. "Fortunately, everyone has been trained on how to assist. We are very lucky that our school administration recognizes the importance of having a full-time nurse in the building."

Lapp is also grateful that there is a Local Wellness Policy (LWP) in place at Kennedy, which lets her focus on students' overall health and well-being.

"Wellness impacts not only the physical but also the emotional and social health of children and adolescents," says Lapp. "Wellness policies focusing on the reduction of overweight and obesity among children and adolescents reduces risk for other heath conditions."

According to Lapp, wellness policies help to address the following health conditions:

• cardiovascular disease
• respiratory problems
• diabetes
• gastrointestinal issues
• psychological problems including anxiety and depression
• joint and musculoskeletal disorders
• cancer

"Other important benefits of a successful wellness policy are improved self-esteem, enhanced quality of life, and diminished social problems such as bullying," Lapp adds.

Wellness Plans Needed in Every School

The link between health and learning in school is well established: healthy kids learn better. With more and more districts embracing the idea of supporting the whole student, LWPs are becoming more popular as a vital link to the various elements required to support a holistic approach to keeping students healthy and more attentive in class.

Registered professional school nurses play an important role in contributing to the success of school wellness programs. With their unique understanding and knowledge of nutrition and the standards for healthy weight and exercise, school nurses use their skills and provide cost-effective, sustainable interventions.

"These interventions address the complex needs of children and adolescents which include physical as well as social needs," says Lapp.

Many school nurses are guided by standards of practice found in, "Framework for 21st Century School Nurse Practice," published by the National Association of School Nurses in 2015.

Other education support professionals (ESP) as well as specialized instructional support personnel (SISP) play a role in the success of LWPs as well. For example, according to Lapp, food service workers contribute to nutrition promotion by obtaining student input on menu choices.

"By surveying the student population, they ensure that new food items are enjoyed and likely to be chosen by students for school meals," Lapp says. "They also can place healthier food items in the food service line where they are more visible and thus more likely to be selected by students."

The student who suffered the seizure received efficient care and was back in class within several days. The successful resolution of this medical incident, says Lapp, is an example of the high level of collaboration and commitment to the health and safety of students at Kennedy. Even district-level administrators are supportive, says Lapp, by budgeting for sufficient medical supplies, health care apparatus, and crisis care training for teachers, ESP, and SISP.

"Collaboration is key for students not only with actual health problems but also for those with undiagnosed, potential health issues," Lapp says.

At the heart of successful LWPs in schools across the nation are ESP and other educators working as paraeducators, custodial and maintenance workers, in food services and as health and student service members (nurses, health aides and technicians, family and parent services aides and other community welfare service workers).

Educators Call for More Research

At the 2017 NEA Representative Assembly in Boston, Massachusetts, delegates called for a report on LWPs. The following passages are excerpted from "Local Wellness Policies," by Nora Howley.

To see Howley's full report, visit nea.org/Howleyreport.

What are LWPs?

As a requirement of the Healthy, Hunger-Free Kids Act of 2010, which authorizes and regulates breakfast and lunch programs, participating school districts are required to have a LWP, which is a written document that directs the district's actions to establish environments in schools that promote students' health, well-being, and ability to learn.

The law places the responsibility for developing, implementing, and evaluating the policy with the local district. The goal is to have policies developed to meet the unique requirements of that district, while still meeting basic requirements and complying with the federal regulations of the school food program. The state agency that manages school meal programs (usually the state education agency) is responsible for oversight. This agency, in turn, reports to the U.S. Department of Agriculture (USDA). It is important to note that this oversight allows the state agency to look at areas that are normally not covered by USDA meal program regulations. According to the USDA, state agencies can "assess how areas of the local educational agency (school district), other than the school food service, implement their local school wellness policy responsibilities, as applicable."

Why are LWPs Needed?

The requirements for LWP originated in the early 2000s in response to the growing concern over obesity among children and adults. In 2001, the Office of the U.S. Surgeon General (OSG) identified schools as one of the most important social sectors for fostering good health in young people. In "Call to Action to Prevent and Decrease Overweight and Obesity," the OSG reported that it was at the local level that specific policies and practices should be decided. Following that report, LWP requirement were included in the 2004 Child Nutrition Act, and districts enacted their first policies by the beginning of the 2006 school year. And while the 2010 Healthy, Hunger-Free Kids Act expanded some of the required content areas, the responsibility of crafting wellness policies still rests with school districts.

What else can the policy cover?

In addition to the required areas (which are listed in the full report, see link below), school districts should consider incorporating other requirements that can promote health, well-being, and the ability to learn. This can include mental health and wellness programs, school safety, restorative justice, expanded meal program participation, green cleaning, and/or expanding student health services. Some districts may also choose to include opportunities for staff wellness in their policy. Regardless of the specific issues addressed, LWP programs should also address staff professional development, family and community engagement as needed to implement the policy.

Who is responsible for the Local Wellness Policy?

Each district must identify one or more officials with its authority to ensure that all schools comply with the policy. Because the policy crosses different departments, as well as covering all schools in the district, it is important that the person filling this role understand its collaborative nature. The staff member will need to have the authority to bring people together across departments and to be an active advocate for the policy. While some districts have assigned this responsibility to the district food service director (because of the USDA oversight), many other districts have identified a high-level administrator with cross-cutting responsibilities. Other districts include this in the responsibilities for a school health coordinator or someone with similar responsibilities.

At the building level, principals have the overarching responsibility for assuring that the policy is implemented in their building. Each department whose work is addressed by the policy has a role in the program's implementation. Schools can also organize a school health or wellness committee to help support this work.