School Employee Wellness: Understanding Health Behaviors and Identifying Opportunities for Student and Staff Health Promotion
Schultz, Nicole.
2018
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Abstract: BACKGROUND: Despite the growth of workplace wellness nationwide, schools lag behind other employers in the promotion of employee health and the provision of employee wellness programming. School employees, however, serve as role models for students, and are called upon to deliver student health-related programs, including physical activity (PA) programs. Employee wellness can increase pr... read moreoductivity, boost morale, save money, and, in the school setting, potentially enhance student program implementation and academic success. However, evidence suggests poor health among school employees. The primary objectives of this research were to provide evidence to support the need for and value of school employee wellness, particularly in underserved school districts, and to inform employee wellness efforts in the school setting. METHODS: Employees were recruited from lower-income Massachusetts schools participating in the Fueling Learning Through Exercise (FLEX) Study, a group randomized-controlled trial evaluating two school-based PA programs. Focus groups were conducted to identify barriers and facilitators to healthy behaviors. Employees participated in Wellness Assessments, including measured height, weight, and lipids [total (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C)]. Surveys were used to collect demographic, perceived stress, PA and 24-hour food intake data. Linear regression was used to examine the relationship among health behaviors (PA and diet), stress and cardiometabolic health. An interaction between stress and health behaviors was explored. Lastly, intervention implementation, PA environment (PAE) scores, student demographics and objectively measured student school-time moderate-to-vigorous physical activity (MVPA) were collected from FLEX. Linear regression was used to examine the relationship between employee MVPA and (1) intervention implementation, accounting for stress, and (2) student school-time MVPA. The impact of the PAE on the relationship between employee MVPA and intervention implementation was explored. RESULTS: Findings from the focus groups (10 sessions, N=62) highlighted the importance of an organizational culture of wellness. Barriers included High Stress, Demanding Job, Lack of Wellness Culture, and Unhealthy Food. Facilitators included a Desire to Adopt Healthy Behaviors and Role Model, Sufficient Health Knowledge, and a Strong Social Network. Seventy-four employees (66% teachers) participated in Wellness Assessments. Overweight/obesity, high TC and LDL-C were observed in 47% (mean BMI: 25.6 kg/m2), 4%, and 34%, respectively, and MVPA was low (median: 17 min/day). Significant positive associations were identified between MVPA and cardiometabolic health. The relationship between MVPA and BMI was modified by stress (p-for-interaction=0.001), with higher levels of stress associated with a diminished protective association between MVPA and BMI. Higher stress was also associated with lower implementation (p<0.0001). Contrary to our hypothesis, higher employee MVPA was associated with lower student school-time MVPA (p=0.0002) and lower implementation (p<0.0001), with a stronger negative relationship in schools with higher PAE scores (p-for-interaction <0.0001). CONCLUSION: Our findings demonstrate physical inactivity and high stress among school employees, and suggest that this population would be receptive to wellness programming if barriers were minimized. Promising approaches to employee health promotion include wellness champions, accountability, and convenience. Observed relationships between employee PA and both implementation and student PA, which were contrary to our hypotheses, warrant further investigation as our analysis was limited by school-level employee PA data. Future studies should measure individual-level PA of teachers and champions delivering programming. This work provides a foundation for future research examining the impact of school employee wellness on both employee and student health, as well as on the implementation of school-based student PA programs.
Thesis (Ph.D.)--Tufts University, 2018.
Submitted to the Dept. of Biochemical and Molecular Nutrition.
Advisor: Jennifer Sacheck.
Committee: Kenneth Chui, Christina Economos, Alice Lichtenstein, and Stella Volpe.
Keywords: Nutrition, and Health education.read less - ID:
- 3n204902q
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