Association between Written School Nutrition Wellness Policies and the Observed Nutrition Environment within the Elementary Schools

Background: Studies have demonstrated that written school wellness policies (SWPs) exist, but policies lack comprehensiveness and vary widely in strength of the language used to address mandated components. SWPs should support creating a healthy nutrition environment, however, it is unclear the extent to which they do. The aim of this study was to examine the association between overall quality (strength and comprehensiveness) of written SWPs and the observed physical, situational and policy nutrition environment and specific areas of interest within Midwestern elementary schools. Methods: Twenty-six schools were visited during the 2017-2018 academic year. At each school, SPAN-ET was used to assess the physical, situational and policy environment within the school. Schools were categorized as ‘poor’, ‘fair’, ‘good’ and ‘best’ in each nutrition environment section based on the number of criteria met within specific areas of interest. Written SWPs were scored by two trained researchers, using WellSAT 2.0, prior to the onsite school visit, and strength and comprehensiveness of written SWPs were determined. Results: Strength scores for the nutrition standards section of written SWPs were positively correlated with scores for the observed garden features area of interest (r = .55, p<.01) and comprehensiveness scores for the nutrition education section of written SWPs were negatively correlated with scores for the observed school meals area of interest (r = -.53, p<.05). Mean written SWP nutrition section scores did not vary across observed physical, situational or policy nutrition environment scores, or overall observed nutrition environment score. Conclusion: Examining written SWPs together with the observed school environment can help to identify gaps between how policies are written and how they are being implemented within schools. This information has the potential to shape policy development, implementation and in turn, the school nutrition environment.