Michigan’s Upper Peninsula (UP), which contains only 3% of the state’s population, uses the long-distance model of Project Healthy Schools, while schools participating in PHS within 100 miles of Ann Arbor use the local model. With the local model, PHS staff visit schools at least once per month to provide assistance with wellness initiatives and participate in meetings at the school. In contrast, schools utilizing the long-distance model are visit-ed by PHS staff twice per year for training in the fall and a wrap-up in the spring. All other staff assistance and guidance is telecommunicated, approximately once per month. All schools, local and long-distance, are provided access to the PHS Portal, which contains the PHS health curriculum, resources for wellness champions and school staff, and open discussion forums.
To evaluate the effectiveness of the long-distance model, the PHS research team compared the demographics and health behaviors pre- and post-intervention of UP and local students participating in PHS since 2014. Of 21,459 students, 695 (3.2%) were from the UP and utilizing the long-distance model. UP students were less racially diverse (82.1% white v. 64.1%, p=0.001) and more likely to be from low (39.4% v. 31.1%, p<0.001) or middle (60.6% v. 35.0%, p<0.001) socioeconomic status (SES) communities than local students.
Despite the larger proportion of low SES students, at baseline, UP students appeared to have better health behaviors than local students (i.e. more fruits and vegetables, more moderate exercise, and less screen time). Following the PHS intervention, health behaviors improved in both groups; no significant differences were seen in health behavior improvement between UP and local students (see Figure 1). This suggests that the local and long-distance delivery models are equally effective in influencing health behaviors and adds support for utilizing long-distance models to implement school-based wellness interventions in remote communities.