title: Healthier fundraising in U. S. elementary schools: associations between policies at the state, district, and school levels.
abstract: OBJECTIVE
  We examined whether state laws and district policies pertaining to nutritional restrictions on school fundraisers were associated with school policies as reported by administrators in a nationally-representative sample of United States public elementary schools.
  
  
  METHODS
  We gathered data on school-level fundraising policies via a mail-back survey during the 2009-10 and 2010-11 school years. Surveys were received from 1,278 public elementary schools (response rate = 60.9%). Data were also gathered on corresponding school district policies and state laws. After removing cases with missing data, the sample size for analysis was 1,215 schools.
  
  
  RESULTS
  After controlling for school characteristics, school policies were consistently associated with state laws and district policies, both those pertaining to fundraising generally, as well as specific restrictions on the sale of candy and soda in fundraisers (all Odds Ratios >2.0 and Ps<.05). However, even where district policies and state laws required fundraising restrictions, school policies were not uniformly present; school policies were also in place at only 55.8% of these schools, but were more common at schools in the West (77.1%) and at majority-Latino schools (71.4%), indicating uneven school-level implementation of district policy and state law.
  
  
  CONCLUSIONS
  District policies and state laws were associated with a higher prevalence of elementary school-level fundraising policies, but many schools that were subject to district policies and state laws did not have school-level restrictions in place, suggesting the need for further attention to factors hindering policy implementation in schools.
authors.affiliation: Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois, United States of America. lindseyt@uic.edu
authors.forename: Lindsey
authors.initials: L
authors.lastname: Turner
authors.forename: Jamie F
authors.initials: JF
authors.lastname: Chriqui
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Chaloupka
mesh_terms: D002648:Child; D002664:Child Nutritional Physiological Phenomena; D005653:Fund Raising / Q000331:legislation & jurisprudence*; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D018673:Nutrition Policy; D016017:Odds Ratio; D012574:Schools / Q000191:economics*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States