title: Local wellness policy strength and perceived implementation of school nutrition standards across three states.
abstract: BACKGROUND
  Congress sought to address escalating rates of childhood obesity by mandating local wellness policies (LWP) (Child Nutrition and WIC Reauthorization Act of 2004). Previous research has examined LWP content and quality; however, data relative to LWP implementation is limited, and none has examined the relationship between LWP quality and implementation. The purpose of this study was to examine the influence of LWP strength on perceived implementation of LWP components.
  
  
  METHODS
  Data collected from school districts in California, Iowa, and Pennsylvania included district LWPs and online surveys at the district (n = 23) and school levels (n = 76). LWPs were scored using a standardized coding tool. Binary and multinomial regression models were used to examine the predictive ability of covariates and independent factors on perceived implementation of reimbursable school meals and nutrition guidelines for competitive foods sold and offered.
  
  
  RESULTS
  Overall LWP strength score did not predict perceived implementation of reimbursable school meals or nutrition guidelines for competitive foods. LWP component strength scores for reimbursable meals and nutrition guidelines did not consistently predict perceived implementation of those components. State and urban-centric locale did predict perceived implementation of some LWP components, particularly nutrition guidelines for competitive foods sold and offered. State was a particularly influential factor in the implementation of LWPs in this study, likely due to differences in state policies and laws.
  
  
  CONCLUSIONS
  Overall LWP, reimbursable school meals, and nutrition guidelines for competitive foods strength scores do not predict perceived implementation of reimbursable school meals and nutrition guidelines for competitive foods.
authors.affiliation: Department of Food Science and Human Nutrition, Iowa State University, 1104 HNSB, Ames, IA 50011, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Wall
authors.forename: Ruth
authors.initials: R
authors.lastname: Litchfield
authors.forename: Alicia
authors.initials: A
authors.lastname: Carriquiry
authors.forename: Elaine T
authors.initials: ET
authors.lastname: McDonnell
authors.forename: Gail M
authors.initials: GM
authors.lastname: Woodward-Lopez
mesh_terms: D002140:California; D002648:Child; D005509:Food Dispensers, Automatic; D005522:Food Services / Q000592:standards*; D006293:Health Promotion; D006801:Humans; D007484:Iowa; D018673:Nutrition Policy; D010414:Pennsylvania; D012574:Schools