Coordinated school health programs (CSHPs) provide an organizational framework for school health practice by combining health education, health promotion, disease prevention, and access to health services in an integrated, systemic manner. This project examined the effects of a regional 2-year training program to increase local school districts' CSHP infrastructure as measured by the establishment of four structures essential to the CSHP model. These structures include a (a) school health advisory council, (b) school health coordinator, (c) school-based health teams, and (d) school board policy. Nine participating school districts were compared to seven nonparticipating districts. The nine participating districts demonstrated a significant increase in school health services and their infrastructure for CSHP as measured by the establishment of the four essential structures. Academic and physical fitness gains were noted for both the participating and nonparticipating districts. These results suggest that an intervention to increase school districts' infrastructure for CSHP show promise and provide an impetus for continued efforts at national, regional, and local levels. (Contains 1 table.)