Background: Obesity is a complex health problem affecting more than one-third of school-aged youth. The increasing obesity rates in Kansas and Missouri has been particularly concerning, with efforts being made to improve student health through the implementation of school wellness policies (SWPs). The primary purpose of this study was to conduct a…

Background: Out-of-school time (OST) programs are an important setting for supporting student health and academic achievement. This study describes the prevalence and characteristics of school-based OST programs, which can inform efforts to promote healthy behaviors in this setting. Methods: A nationally representative sample of public elementary…

Background: The school environment has the potential to influence student body mass index (BMI) through programs and policies. Our objective was to examine the effect of modifying obesity-related school policies and programs on youths' BMI trajectories. Methods: Obesity-related school policies and programs related to physical activity and healthy…

Background: Poor mental health outcomes persist among adolescent youth. Secondary schools play a critical role in fostering positive mental health by implementing policies and practices grounded in evidence. The factors associated with implementation, however, are unclear. This study examines which school- and state-level factors are associated…

Background: Our objective was to examine the association between school wellness committees and implementation of nutrition wellness policies and children's weight status and obesity-related dietary outcomes. Methods: A cross-sectional study was conducted of 4790 children aged 4-15 years recruited from 130 communities in the Healthy Communities…

Background: In this case study, multiple participants in a large urban school district used the Whole School, Whole Community, Whole Child (WSCC) model to guide development of a district wellness policy. The model's health education component is highlighted, focusing on concerns for special needs students and ones speaking English as a New…

Background: In recent decades, the alignment of health and education has been at the forefront of school reform. Whereas the establishment of national in-school physical activity (ISPA) recommendations and state-level mandates demonstrates success, there has been less achievement in areas that address health disparities. The purpose of this…

Background: The purpose is to determine if altering school breakfast policies and the school breakfast environment will positively impact adolescent beliefs of the barriers and benefits of eating breakfast. Methods: There were 904 adolescents from 16 rural high schools, Minnesota, in the BreakFAST Study who reported eating breakfast fewer than 4…

Background: Schools have increasing responsibility to address healthy eating, but physical barriers influence their ability to adopt and sustain recommended strategies. We took advantage of a natural experiment to investigate the role of the physical environment in shaping healthy eating attitudes and practices among school staff members. Methods:…

Background: Written local wellness policies (LWPs) are mandated in school systems to enhance opportunities for healthy eating/activity. LWP effectiveness relies on school-level implementation. We examined factors associated with school-level LWP implementation. Hypothesized associations included system support for school-level implementation and…

Background: School policies and practices, such as the sharing of school facilities with the surrounding community, support physical activity among students and community members, but are often underutilized. This study examined variations in shared use practices, and associations with perceived barriers. Methods: Surveys were completed by a…

Background: In this study, we describe state agency strategies to support weight-related policy implementation in schools, and examine the association among state support, obesity prevalence, and strength of state policies governing school nutrition and physical education. Methods: The 2012 School Health Policies and Practices Study describes…

Background: Steroid use among adolescents is an increasing health concern. Literature examining factors related to steroid use is limited. Methods: We investigated steroid use among 9th through 12th grade adolescents in the Greater Cincinnati area. A total of 38,414 adolescents completed the PRIDE Questionnaire. Associations between demographics,…

Background: Mental health conditions among youth are a major concern. Schools can play an important role in supporting students affected by these conditions. This study examined district-level school health policies related to mental health and social services to determine if they varied by district demographic characteristics. Methods: The School…

Background: School Health Profiles (Profiles) results help states understand how they compare to each other on specific school health policies and practices. The purpose of this study was to develop composite measures of critical Profiles results and use them to rate each state on their overall performance. Methods: Using data from state Profiles…