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Title: A qualitative investigation of factors that influence school employee health behaviors: implications for wellness programming

Author
item SCHULTZ, NICOLE - Friedman School Of Nutrition
item CHUI, KENNETH - Tufts University
item ECONOMOS, CHRISTINA - Friedman School Of Nutrition
item LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item VOLPE, STELLA - Drexel University
item SACHECK, JENNIFER - Friedman School Of Nutrition

Submitted to: Journal of School Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/11/2019
Publication Date: 9/8/2019
Citation: Schultz, N.S., Chui, K., Economos, C.D., Lichtenstein, A.H., Volpe, S.L., Sacheck, J.M. 2019. A qualitative investigation of factors that influence school employee health behaviors: implications for wellness programming. Journal of School Health. 89(11):890-898. https://doi.org/10.1111/josh.12831.
DOI: https://doi.org/10.1111/josh.12831

Interpretive Summary: Employee health promotion in the elementary school setting can support optimal cardiometabolic risk factors in students' health and academic success. The overall objective of this study was to identify factors that influence school employee health behaviors to inform subsequent development of successful staff wellness programs. Focus groups were conducted with school employees, and key informant interviews were conducted with the staff members most involved with school employee wellness initiatives. Participants were recruited from schools in socioeconomically disadvantaged and racially diverse school districts in Massachusetts. A socioecological framework was used to identify multi-level factors that influence school staff health behaviors. Factors were characterized as supports or barriers to health-promoting behaviors and were further analyzed according to Health Belief Model constructs. Emergent themes highlighted the importance of an organizational culture of wellness to develop and sustain successful staff wellness programming. Participants expressed a general desire to adopt healthy behaviors and a universal concern about their health and that of their students' nutrition and physical activity behaviors. These findings suggest that this population would be receptive to staff health promotion programming. Promising strategies include targeting the school environment, identifying and supporting a dedicated wellness champion, and creating recognizable top down wellness support for school staff.

Technical Abstract: BACKGROUND: Employee health promotion in the elementary school setting can support students' health and academic success. School employees serve as role models for students, yet existing evidence suggests poor health and high perceived stress among this population. The overall objective of this study was to identify factors that influence school employee health behaviors to inform subsequent development of successful staff wellness programs. METHODS: Focus groups (N=10) were conducted with school employees and key informant interviews (N=5) were conducted with staff members most involved with school employee wellness initiatives. Participants were recruited from schools in socioeconomically disadvantaged, racially diverse school districts in Massachusetts. A socioecological framework was used to identify multi-level factors that influence school staff health behaviors. Factors were characterized as supports (+) or barriers (-) to health-promoting behaviors, and further analyzed according to Health Belief Model constructs. RESULTS: Eight emergent themes highlighted the importance of an organizational culture of wellness to develop and sustain successful staff wellness programming. Intrapersonal themes reported by staff included: High Perceived Stress (+/-), Inherent Desire to Adopt Healthy Behaviors (+), and Sufficient Health Knowledge (+). Interpersonal themes included: Presence of a Strong Social Network (+) and a Desire to Role Model for Students (+). Organizational themes included: Demanding Nature of the Job (-), Lack of Wellness Culture (-), and Availability of Unhealthy Food in the School Setting (-). Participants expressed a general desire to adopt healthy behaviors and a universal concern about their students' physical activity and nutrition behaviors. CONCLUSIONS: Our findings suggest that this population would be receptive to staff health promotion programming. Promising strategies include targeting the school environment, identifying and supporting a dedicated wellness champion, and creating recognizable top down wellness support for school staff.