Building Healthy Communities program aims to surround Michigan school children with healthy living

During the last nine years, more than 260 elementary schools across Michigan have participated in the Building Healthy Communities to prevent and reduce childhood obesity, prevent chronic health conditions, and improve academic achievement. Positive results are pouring in.
Angelia Coleman observes children on a daily basis and has begun to notice a shift in the way they play. "Children don't play games like we used to," the Principal at Timberland Charter Academy in Muskegon says. "When they get into unstructured play time, they become physical. They tackle and crash into each other. We've seen incident reports and injuries during recess rise."

When Coleman saw the application for the Building Healthy Communities (BHC): Engaging Elementary Schools Through Partnership program cross her desk last year, she jumped at the opportunity to apply. BHC helps children to "be physically active, eat healthier, and learn about health-enhancing nutrition and physical behaviors throughout the school day," and Coleman was excited that these goals aligned with other wellness initiatives currently running at Timberland.

Angelia Coleman

Research reveals that play helps children build important emotional and social skills, so Coleman knew that her students would benefit from BHC on multiple levels. "If we're not addressing the socioemotional component, we're not addressing the achievement gap," she says.

Like many urban schools in Michigan, Timberland is grappling with lower than average test scores and a high need student population. A charter school, Timberland serves almost 700 students, grades K-8. According to MI School Data, in 2016-2017, 13 percent of Timberland students received proficient scores on state tests, compared to 36 percent average statewide.

Coleman also felt Timberland was a great fit for BHC because the school is located in Muskegon county, where rates of childhood obesity are among the highest in the nation. Like educators nationwide who are working with increasingly sedentary youth growing up with technology like tablets, her staff also noticed that some children were resistant to recess and physical education.

Healthy lunches and breakfasts at school are strategies for addressing childhood obesity.

Emily Ward, achievement and behavior support specialist, says that some children did not want to go out to recess because they didn't think it was "fun." In addition, the games that were typically offered were competitive, which turned some students off. Ward, who serves as recess guide, says BHC helped the school to find ways to offer more options for students, including indoor or outdoor activities, as well as non competitive games such as Simon Says, Red Light, Green Light, and even dancing.

In order to implement these new games, Timberland needed supplies. Coleman was "thrilled" when she learned they received the grant, which provided the school with a cart stocked with multiple balls, hula hoops ,and jump ropes. But beyond tangible supplies, Coleman says that BHC is helping the school to get the entire staff on the same page.

"We know success will come from a combination of having the resources and shifting the mindset of the staff to support the program," Coleman says. "Mindset is possibly the most important piece."

Comprehensive physical education helps kids avoid being sedentary, making healthier children.

Surrounding kids with opportunities to be active and eat healthy

During the last nine years, more than 260 elementary schools across Michigan have participated in the Building Healthy Communities (BHC). These schools have undergone “Healthy School Transformations” in an effort to prevent and reduce childhood obesity, prevent chronic health conditions, and improve academic achievement.

Kristen Kaszeta, manager of BHC at Wayne State University, shares reasons why Building Healthy Communities is essential in Michigan. According to the 2012 National Survey of Children's Health, 32.6 percent of children in Michigan are overweight or obese, less than 27 percent of children met the recommended amount of daily physical activity. The Center for Disease Control (CDC) recommends 60 minutes or more of physical activity per day. Further, the survey showed that 87.8 percent of children reported an hour or more of screen time per day. And while it is resoundingly clear that nutrition and exercise are important, Kaszeta shares what research reveals: when students eat healthy and are active, it has a huge impact on a school environment, including fewer sick days, fewer disciplinary issues, and fewer unexcused absences.

BHC is part of a partnership of statewide organizations, including Blue Cross Blue Shield of Michigan, the Michigan Department of Health and Human Services, the Michigan Fitness Foundation, and the United Dairy Industry of Michigan. Led by the Wayne State University Center for Health and Community Impact, the program is composed of six elements focusing on physical activity and nutrition: principal engagement, classroom education on healthy eating and physical activity, quality physical education, active recess, student leadership teams, and healthy kids’ clubs.

Improved reading is an important component of the BHC program.

To date, research on the program has identified increases in student academic achievement and health improvements. Specifically, students at participating schools have shown increases in physical activity, improved eating habits, a decreased risk for obesity and other chronic conditions, and improved academic achievement in reading and math. The research is even impacting national conversations, as it is being shared at conferences and published in prominent journals such as the Journal of Preventive Medicine.

Nate McCaughtry, Ph.D., center director and assistant dean of the Division of Kinesiology, Health and Sports Studies, is one of the researchers who played a key role in steering the program. McCaughtry is also involved in ongoing analysis and dissemination of a large data set surrounding BHC. McCaughtry explains that from its inception, BHC was innovative. While many other programs focus primarily on either exercise or diet, BHC focuses on the two primary components of childhood obesity: a lack physical activity and poor nutrition.

In addition, unlike other programs that might introduce a program in the classroom, BHC focuses on including all personnel in the school in the transformation, from recess supervisors to principals. This whole school approach “surrounds kids with opportunities to be active,” says McCaughtry. “As soon as they arrive at school, they are getting opportunities everywhere they go. It sounds simple, but it is very powerful.”

First, because their participation yields results for kids, BHC focuses on involving one of the busiest people in a school: the principal. As Kaszeta explains, "the principal’s support in any form (watching students take part in physical activity, talking about physical activity with students, doing physical activity with students, and encouraging students to do physical activity) was most consistently associated with higher levels of in-school physical activity among children, and this mattered even more than the support provided by parents."

With healthy consistent diet and exercise, students perform better in the classroom.

Like principals, Kaszeta explains that teachers want to lead health discussions, but research has shown that teachers often lack training. Therefore, Kaszeta shares that BHC is "a capacity development model." A key part of this model is the BHC healthy school coordinator, who visits the school multiple times per month. In addition to reminding the school of the program priorities, Kazeta explains that the coordinator makes an effort to help the staff think about restructuring policies so the changes are sustainable, such as those for indoor recess. The coordinator also teaches four of the eight classroom lessons, which is important help for busy classroom teachers.

Beyond the classroom, while the word recess might bring to mind lots of running, jump roping, and dodge ball, Kaszeta explains children don't tend to move as much during recess anymore. While the Center for Disease Control (CDC) recommends that children get at least 60 minutes of cardiovascular strength and endurance training, muscular and bone strength training and flexibility exercises, many children aren't getting this activity during recess.

This lack of activity partially stems from a lack of equipment, Kaszeta explains. Federal programs tie their dollars to either funding classroom lessons or physical activity, and even when funding is dedicated to physical activity, money is not allocated to supplies. That's why some schools struggle to help students have an active recess, as they don't have balls or jump ropes. According to Kaszeta, BHC provides $2,000 for a storage room of physical education equipment, as well as the dedicated instruction time to teach play.

Another reason children aren't moving as much during recess is that children are not as versed in childhood games as they were in the past, Kaszeta explains. This lack stems from everything from more time playing on tablets to budget cuts. When schools tighten their budgets, art and physical education curriculum are the first to go, Kaszeta explains. That's why BHC focuses on helping school by making current recess sessions more active, while also helping schools to add more recess sessions throughout the day, as well as making indoor recess active.

While many components of BHC are more traditional in that they are adult-led, Kaszeta explains that BHC also incorporates student-led components, including The Student Leadership Team (SLT), which is "a group of six 10 students in a school who investigate, plan, and carry out their own ideas for making the school environment healthier a place." Students are assigned an advisor, who guides students and helps to foster leadership experiences. "Research from previous years of this program has shown that membership on Student Leadership Teams improved leadership skills, self confidence and student reported health behaviors," Kaszeta says.

Jodi Brems, academic specialist at Timberland, serves as the advisor of the Student Leadership Team at Timberland and has observed many benefits of the program, including students enjoying working with students from other grades and being good examples for each other. "They're getting better at encouraging each other, even in terms of healthy snacks," Brems says.

Jodi Brems

BHC also aims to go beyond the school day, and offers the opportunity for students to join a Healthy Kids Club, where they can "participate in positive examples of lifelong physical activities while interacting in fun ways with their peers." Emily Ward serves as coordinator for Healthy Kids Club at Timberland, where forty kindergarten through fourth grade students signed up to attend the club before school.

Ward shares that a typical day with the club might include challenging kids to complete as many laps as they can in 20 minutes, learning a health tip and sharing a healthy snack, such as celery with peanut butter and raisins, or 'ants on a log.' Ward says some kids didn't know about this snack and enjoyed eating it. But beyond the fun, Ward has watched their understanding of nutrition blossom, as she takes time to teach them how food affects the body as well as about portion control.

Ward says that the club has been eye-opening for many children, including one boy who regularly snacked on Cheetos. First, the club challenged him to snack on other orange foods at home, such as mandarins and carrots. Then, they upped the ante and asked him to eat other colors and Ward watched his knowledge of nutrition expand.

Experiences like these are in high demand in Michigan’s schools. Each January, BHC advertises to all Michigan schools, and interviews all applicants to decide good fits for the program. BHC receives nearly 100 applications per year and is charged with narrowing to fill 40 slots. Kaszeta explains that schools are asked questions that evaluate their readiness for the transformation, such as: do they have physical education regularly and a dedicated recess place?

Kaszeta explains that it's also important for BHC to educate the schools on the components of the program, so that the school can gauge whether they have the resources to commit. Since schools are busy places, some schools realize they can't undertake another initiative and self select to leave the interview process. BHC then narrows schools down in terms of geography: BHC aims to spread their services throughout the state and gives priority to areas where they haven't served recently. Of the schools selected, Kaszeta says that diversity tends to happen naturally in terms of the socioeconomic class and race of those selected: in the past, BHC has taken place on Native American reservations in the U.P., private Christian schools and large urban schools.

While McCaughtry explains that BHC serves students of a variety of socioeconomic levels, students with lower income brackets especially struggle with less access to healthy food and less exposure to exercise. That’s why he feels a school-based program is such a promising solution. “It presents this eight-hour window of time where we are able to counterbalance their life outside of school,” he says.

But BHC doesn’t want to ignore the influence of home life on the health of children. McCaughtry says that the program works to extend the school program to home life, through family fitness nights, homework that emphasizes healthy living and information exchange with parents and guardians.

While Michigan has seen recent cuts to mental health funding, McCaughtry says its safe to say that BHC will continue indefinitely, as funding has been stable for 10 years. He is involved in an effort to continually review and improve the program on a yearly basis, and with the demand, he is confident that BHC is serving an urgent need.

'It challenges us to be creative': Transitioning out of the program

As Timberland nears the end of ‘17-’18 school year, staff reflects on the success of BHC and how they will continue the momentum. Each recipient of the grant receives funding and support for one year, which means that soon, Timberland will no longer receive visits and lessons taught by a coordinator. The stipends for teachers to serve as coordinators will also be off the table.

"It sort of feels like it's all hands off the wheel next year," says Jodi Brems, coordinator of Student Leadership Team and academic specialist. "We appreciated the support but there's a few things that we need still need support and reminders about going forward."

Emily Ward, achievement and behavior support specialist, believes that an ideal approach to help sustain success would be a "gradual release of resources, which also helps us to gather data over multiple years."

Principal Coleman says she is grateful for anything that supports urban schools, and believes that sustainable change will take time. Yet she is mindful with the demands placed on her staff and wants to be careful not to increase their workload as they transition out of the grant. Coleman says it was especially helpful to have coordinators to help teach classroom lessons, as teachers have so much on their plates.

Ward recalls the many experiences this year, including an apple tasting, which aimed to make healthy eating fun. BHC provided nearly 700 apples and all students bit into an apple at the exact same time. While it was a simple experience, Ward knows how complex it will be to execute such plans in a busy school without support. "It is challenging for us to make sure our kids have these experiences," she says. "But it challenges us to be creative."

Kristen Kaszeta, manager of BHC at Wayne State University, has seen such creativity firsthand. Because BHC was conceived as a way to kick start and build capacity in schools, she says, ideally schools experience a synergy that lasts beyond the first year. She has watched schools seek out local businesses for funding or launch after school programs such as walking club that eventually turned into a 5K.

While Kaszeta admits that in a perfect world, a two or three-year program would be ideal, the current funding only provides for one year. She hopes that with new research published this year that shows reductions in obesity and increases in achievement among BHC participants, new avenues of funding will open up. In the meantime, Wayne State University remains in touch with all former participants through regular newsletters that provide new research and tips.

Kaszeta also continues to hear about the small but powerful ways schools have been impacted, including a school where students used to have a weekly bagel sale as a fundraiser. After participating in BHC, students decided that the bagels were not a healthy enough option and decided to sell yogurt parfaits instead.

"Little things can make a long term impact, and sometimes they have no cost."

This article is part of Michigan Nightlight, a series of stories about the programs and people that positively impact the lives of Michigan kids. It is made possible with funding from the W.K. Kellogg Foundation. Read more in the series here.

Natalie Tomlin is a freelance writer based in Grand Rapids. Her recent work appears in Midwestern Gothic, New Pages, Literary Mama, Cultured.GR, and elsewhere. A former public school teacher, she has taught writing for over a decade, most recently at DePaul University in Chicago.

Photos by Adam Bird of Bird + Bird Studio.
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