title: Creating and using index scores in the analysis of school policy implementation and impact.
abstract: BACKGROUND
  Epidemic increases in childhood obesity and associated health risks are resulting in efforts to implement school policies related to nutrition and physical activity (NPA). With multicomponent policy efforts, challenges exist in characterizing the extent of policy change across the breadth of NPA policies.
  
  
  METHODS
  Aggregated policy indices were created to characterize NPA policy implementation in Arkansas public schools from 2004 through 2009. Index scores are presented by year, domain, and school level.
  
  
  RESULTS
  Both mean and median index scores increased over time, with greater changes seen in nutrition than in physical activity policy scores. The composite index score was heavily dependent on the nutrition index score and, thus, is relatively less useful for the purposes of our evaluation. Policy index scores varied by school level, rurality, enrollment size, and percentage of students eligible for federal meal programs.
  
  
  CONCLUSIONS
  The policy index approach facilitates the consideration of the effect of school policy change in a holistic, aggregated way. School characteristics influence policy adoption, and thus, should be taken into consideration in the promotion of policy change.
authors.affiliation: Department of Epidemiology, Fay W. Boozman College of Public Health and Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St. # 820, Little Rock, AR 72205, USA. mmphillips@uams.edu
authors.forename: Martha M
authors.initials: MM
authors.lastname: Phillips
authors.forename: Melanie
authors.initials: M
authors.lastname: Goodell
authors.forename: James M
authors.initials: JM
authors.lastname: Raczynski
authors.forename: Amanda G
authors.initials: AG
authors.lastname: Philyaw Perez
mesh_terms: D001131:Arkansas / Q000453:epidemiology; D005069:Evaluation Studies as Topic; D006293:Health Promotion / Q000379:methods; D006306:Health Surveys; D006801:Humans; D009043:Motor Activity; D009749:Nutrition Surveys / Q000379:methods; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology / Q000451:nursing / Q000517:prevention & control*; D016134:Organizational Policy; D011446:Prospective Studies; D012572:School Health Services / Q000331:legislation & jurisprudence; D012573:School Nursing / Q000331:legislation & jurisprudence / Q000379:methods* / Q000639:trends; D040241:Social Marketing