title: Changes in local school policies and practices in Washington State after an unfunded physical activity and nutrition mandate.
abstract: BACKGROUND
  Policies and practices in schools may create environments that encourage and reinforce healthy behaviors and are thus a means for stemming the rising rates of childhood obesity.  We assessed the effect of a 2005 statewide school physical activity and nutrition mandate on policies and practices in middle and high schools in Washington State.
  
  
  METHODS
  We used 2002, 2004, and 2006 statewide School Health Profiles survey data from Washington, with Oregon as a comparison group, to create longitudinal linear regression models to describe changes in relevant school policies after the Washington statewide mandate. Policy area composite measures were generated by principal component factor analysis from survey questions about multiple binary measure policy and practice.
  
  
  RESULTS
  Relative to expected trends without the mandate, we found significant percentage-point increases in various policies, including restricted access to competitive foods in middle and high schools (increased by 18.8-20.0 percentage points); school food practices (increased by 10.4 percentage points in middle schools); and eliminating exemptions from physical education (PE) for sports (16.6 percentage-point increase for middle schools), exemptions from PE for community activities (12.8 and 14.4 percentage-point increases for middle and high schools, respectively) and exemptions from PE for academics (18.1 percentage-point increase for middle schools).
  
  
  CONCLUSIONS
  Our results suggest that a statewide mandate had a modest effect on increasing physical activity and nutrition policies and practices in schools. Government policy is potentially an effective tool for addressing the childhood obesity epidemic through improvements in school physical activity and nutrition environments.
authors: Program Design and Evaluation Services, Multnomah County Health Department and Oregon Public Health Division, 827 NE Oregon St, Ste 250, Portland, OR 97232, USA. myde.boles@state.or.us
authors: Myde
authors: M
authors: Boles
authors: Julia A
authors: JA
authors: Dilley
authors: Clyde
authors: C
authors: Dent
authors: Miriam R
authors: MR
authors: Elman
authors: Susan C
authors: SC
authors: Duncan
authors: Donna B
authors: DB
authors: Johnson
mesh_terms: D000293:Adolescent; D002648:Child; D002664:Child Nutritional Physiological Phenomena / Q000502:physiology*; D005260:Female; D015438:Health Behavior; D006291:Health Policy; D006293:Health Promotion; D006801:Humans; D015994:Incidence; D008297:Male; D009043:Motor Activity; D018673:Nutrition Policy; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology* / Q000503:physiopathology; D009922:Oregon / Q000453:epidemiology; D012189:Retrospective Studies; D012572:School Health Services / Q000592:standards*; D012574:Schools; D014861:Washington / Q000453:epidemiology; D055815:Young Adult