title: Factors influencing the implementation of school wellness policies in the United States, 2009.
abstract: BACKGROUND
  The quality of school wellness policy implementation varies among schools in the United States. The objective of this study was to characterize the school wellness policy environment nationally and identify factors influencing the quality and effectiveness of policy implementation.
  
  
  METHODS
  We invited school administrators from 300 high schools to complete a questionnaire; 112 administrators responded. We performed a 2-step cluster analysis to help identify factors influencing the implementation of school wellness policies.
  
  
  RESULTS
  Eighty-two percent of schools reported making staff aware of policy requirements; 77% established a wellness committee or task force, 73% developed administrative procedures, and 56% trained staff for policy implementation. Most commonly reported challenges to implementation were lack of time or coordination of policy team (37% of respondents) and lack of monetary resources (33%). The core domains least likely to be implemented were communication and promotion (63% of respondents) and evaluation (54%). Cluster 1, represented mostly by schools that have taken action toward implementing policies, had higher implementation and effectiveness ratings than Cluster 2, which was defined by taking fewer actions toward policy implementation. In Cluster 1, accountability was also associated with high ratings of implementation quality and effectiveness.
  
  
  CONCLUSIONS
  The development of organizational capacity may be critical to ensuring an environment that promotes high-quality policy implementation. Assessing, preventing, and addressing challenges; establishing clear definitions and goals; and requiring accountability for enacting policy across all core domains are critical to ensuring high-quality implementation.
authors: George Warren Brown School of Social Work, Washington University in St. Louis, Campus Box 1196, One Brookings Dr, St. Louis, MO 63130, USA. ebudd@wustl.edu
authors: Elizabeth L
authors: EL
authors: Budd
authors: Cynthia
authors: C
authors: Schwarz
authors: Byron W
authors: BW
authors: Yount
authors: Debra
authors: D
authors: Haire-Joshu
mesh_terms: D000288:Administrative Personnel; D026683:Advisory Committees; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D016000:Cluster Analysis; D017598:Efficiency, Organizational; D005522:Food Services / Q000331:legislation & jurisprudence*; D006284:Health Plan Implementation; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006293:Health Promotion / Q000331:legislation & jurisprudence*; D006801:Humans; D007400:Interprofessional Relations; D018673:Nutrition Policy; D052756:Nutritional Sciences / Q000193:education; D009937:Organizational Objectives; D016134:Organizational Policy; D010043:Outcome and Process Assessment, Health Care; D012572:School Health Services / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D017749:Total Quality Management; D014481:United States