title: Facilitators to promoting health in schools: is school health climate the key?
abstract: BACKGROUND
  Schools can promote healthy eating in adolescents. This study used a qualitative approach to examine barriers and facilitators to healthy eating in schools.
  
  
  METHODS
  Case studies were conducted with 8 low-income Michigan middle schools. Interviews were conducted with 1 administrator, the food service director, and 1 member of the coordinated school health team at each school.
  
  
  RESULTS
  Barriers included budgetary constraints leading to low prioritization of health initiatives; availability of unhealthy competitive foods; and perceptions that students would not eat healthy foods. Schools had made improvements to foods and increased nutrition education. Support from administrators, teamwork among staff, and acknowledging student preferences facilitated positive changes. Schools with a key set of characteristics, (presence of a coordinated school health team, nutrition policies, and a school health champion) made more improvements.
  
  
  CONCLUSIONS
  The set of key characteristics identified in successful schools may represent a school's health climate. While models of school climate have been utilized in the educational field in relation to academic outcomes, a health-specific model of school climate would be useful in guiding school health practitioners and researchers and may improve the effectiveness of interventions aimed at improving student dietary intake and other health behaviors.
authors.affiliation: Assistant Professor, (lucarell@oakland.edu), School of Health Sciences, Oakland University, 2200 N. Squirrel Road, Rochester, MI 48309.
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Lucarelli
authors.forename: Katherine
authors.initials: K
authors.lastname: Alaimo
authors.forename: Ellen
authors.initials: E
authors.lastname: Mang
authors.forename: Caroline
authors.initials: C
authors.lastname: Martin
authors.forename: Richard
authors.initials: R
authors.lastname: Miles
authors.forename: Deborah
authors.initials: D
authors.lastname: Bailey
authors.forename: Deanne K
authors.initials: DK
authors.lastname: Kelleher
authors.forename: Nicholas B
authors.initials: NB
authors.lastname: Drzal
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D002648:Child; D053198:Child Nutrition Sciences / Q000458:organization & administration*; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008824:Michigan; D019982:Organizational Case Studies; D015279:Organizational Culture; D012424:Rural Population; D012572:School Health Services / Q000458:organization & administration*; D013334:Students / Q000523:psychology*; D014505:Urban Population
keywords: nutrition; school policy; wellness policies
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