(P28-008-25) Adoption of Nutrition Policy Elements in School Wellness Policies: Insights From the Healthy Living Program

Objectives: School wellness policies can help create lasting change by embedding best practices into school environments. However, the effectiveness of programs aimed at strengthening policy adoption and implementation is understudied. This study evaluated the impact of the Tobacco Settlement Endowment Trust Healthy Living Program (HLP) on policy adoption.

Methods: HLP grantees provide technical assistance to help school districts adopt strong policies and support implementation at school sites across Oklahoma. Data were collected from schools incorporating nutrition elements during 12/2020-12/2024. Analysts systematically reviewed district policies to evaluate adoption of federal/state requirements (n=16), evidence-based, high-impact (n=41), and other policy elements (n=19) at baseline and reassessment. Documentation of implementation (e.g. training materials, newsletters, photos, etc.) for specified elements was reviewed. Schools were categorized as high, medium, or low risk based on census tract data (life expectancy, Child Opportunity Index, and Area Deprivation Index). Descriptive statistics, t-tests, and ANOVA were used to analyze element adoption.

Results: Among 56 districts and 31 schools within those districts, 87.5% of districts represented all grade levels and 39.3% were high-risk. Median reach was 756 students and employees per district. Significantly more elements were included at reassessment (49.4±21.9) than baseline (31.5±19.5, p< 0.001). Required (48.0%) and high-impact (34.0%) elements were most likely to be adopted by reassessment. There were no differences by risk tier. Elements most adopted included: limiting the use of food as a reward or punishment (60.0%), regular policy compliance assessment (56.3%), and including stakeholders in the policy review process (52.8%). Least incorporated elements included meeting USDA standards for on-campus fundraisers (10.8%), foods served at staff events (11.8%), and alternative breakfast service (16.3%).

Conclusions: HLP improved adoption of nutrition elements into school wellness policies during the study period. Required and high-impact elements showed greater change, suggesting that targeted support may facilitate implementation.

Funding Sources: Oklahoma Tobacco Settlement Endowment Trust