How U-M's Project Healthy Schools is spreading better nutrition through education

Google image search "school lunch" and prepare for a pleasant surprise. If you're a parent, the well-balanced meals arrayed before you may not fall in line with your memories of greasy rectangular pizza, suspect burgers, decadent Choco Tacos, and doughy cookies.

Less-than-healthy cafeteria options were at the root of a very real problem that plagued American lunch programs for decades: the struggle between filling stomachs and providing adequate nutrition for growing bodies. But Dr. Kim A. Eagle, the University of Michigan's (U-M) Albion Walter Hewlett professor of internal medicine, says there's a much broader problem than what's filling cafeteria trays.

"We're a culture that has embraced fast food," says Eagle, who is also the director of U-M's Samuel and Jean Frankel Cardiovascular Center. "We've embraced video games over physical games. We have limited sports activities for the more elite, sports-minded students. For the average person, not much is there."

So in 2004, distressed by spiking childhood obesity levels and the prevalence of preventable cardiovascular risk factors among youth, Eagle decided to take a stand by intervening in Michigan schools firsthand. Eagle co-founded Project Healthy Schools (PHS), a program that works to connect principals, teachers, and parents concerned that convenience culture is having a detrimental effect on youth at a critical time in their development. The program is now used in 70 Michigan middle schools.

"We were concerned that the students in our school system weren't being exposed to a health curriculum that would promote both nutrition and activity in a way that would promote both their short-term and long-term health, so we created PHS with the goal of doing that," Eagle says.

Light approach, lofty goals
Conceived in collaboration with U-M, PHS uses additional funding from Blue Cross Blue Shield and the Michigan Department of Health and Human Services to promote healthy eating practices in Michigan middle schoolers. In planning the program, Eagle conferred with a team of social scientists who identified age 12 as the ideal transitional period to establish and maintain healthy lifelong practices.

Eagle and his team designed the PHS curriculum, which debuted at Ann Arbor's Clague Middle School, as a series of interactive 20-minute lessons. The team opted for a fun, interactive approach focusing not on obesity, but simply offering tools to improve health in a judgment-free environment. The lessons are designed to be delivered by a teacher, staff member, or volunteer. The latter category often includes so-called Health Ambassadors – high school students who remember the lessons they learned from PHS as middle schoolers and embrace the opportunity to pay it forward to a new generation.

The PHS curriculum has five main goals: encouraging kids to eat more fruits and vegetables, choose less sugary foods and beverages, eat less fast and fatty foods, be active every day, and spend less time in front of screens. However, some of the biggest hurdles impeding PHS come not from active resistance to altering ingrained habits, but the bureaucratic, behind-the-scenes struggles that teachers understand all too well.

Asked why Washtenaw County schools required the assistance of organizations like PHS in offering healthier choices in the lunchroom and the classroom, program manager Jean DuRussel-Weston cites some less obvious but inhibiting factors. She notes that the low-performing schools designated as "priority schools" (there are four in Washtenaw County, and 221 statewide) are unlikely to prioritize health education.

"There are just so many pressures," DuRussel-Weston says. "You compete with curriculum about bullying – all kinds of critical issues that need to be addressed."

Maintaining momentum
Eagle emphasizes the cyclical nature of the program as a key factor in its continued success, and you're unlikely to find a better example of that than Ann Arbor siblings Bridget and Duncan Kennedy. Inspired by the lessons she learned from PHS in the mid-2000s, when she was a sixth-grader at Ann Arbor's Forsythe Middle School, Bridget Kennedy found her interest in the program reignited while she was a student at Skyline High School. After meeting with Skyline science teacher and PHS educator Jeffrey Bradley, Kennedy returned to her old school as a Health Ambassador, delivering the same curriculum that influenced her as a young girl.

Today Kennedy is a sophomore at U-M, but PHS' influence continues with her younger brother Duncan. Currently a Skyline senior who plans to pursue a career in nursing, Duncan takes great pride in his role as a Health Ambassador.

"It really blows me away, because [students] actually know a ton of stuff compared to me when I was in middle school – things like not falling back on fast food for convenience," Duncan says.

Bradley, who has been involved with PHS virtually from the beginning, recognizes the challenges programs like PHS face when threatened by budget cuts and curriculum changes. Even so, he remains optimistic about the future of PHS and other school health education programming.

Bradley cites the creation of SkyWell, a wellness club focusing on fundraising for wellness walks and water bottle refill stations at Skyline, as an encouraging example of the way schools can use PHS as a springboard to launching their own initiatives. Bradley also established Skyline's Science of Wellness course partly to accommodate growing demand for the PHS program.

"It's more than just PHS at that point," Bradley says. "It gets right into the science of it – the science of obesity and the concept that we are what we eat, but sometimes it's the genetics."

Meanwhile, PHS continues to expand its reach. The program has begun sending team members to introduce PHS curriculum into schools in the Upper Peninsula, as well as teaching courses online in some schools. Eagle notes that the program is still only reaching "a small fraction" of Michigan's 950 middle schools, but he aspires to improve kids' health statewide.

"I'm very pleased that we've been able to grow and I think we're going to reach 50,000 kids this year," he says. "It's really exciting to see the support of our state – major insurers, major health systems, major leaders – who embrace the notion that we've got to do something for these kids."

Jason Buchanan is a writer, father, and film fanatic living and working in Ann Arbor.

All photos by Doug Coombe.
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