title: Recent changes in school-based policies on physical activity and nutrition in Spain.
abstract: BACKGROUND
  This study evaluates the changes in Spain between 2006 and 2012, of school-based policies encouraging healthy eating and the undertaking of physical activity (PA).
  
  
  METHODS
  A longitudinal study was undertaken comprising 277 representative schools from all the regions of Spain. The questionnaires were completed by the school management board. An indicator for school policies on PA was constructed (score 0-4) from the following indicators: (i) participation in PA programmes, (ii) existence of written PA guidelines, (iii) training of teachers about PA and (iv) organization of extracurricular PA activities. For nutrition, indicators similar to the first three for PA were evaluated, together with access to healthy foods (score 0-4). In addition to comparing the scores for 2006 and 2012, multivariate linear regression was used to study the association between the characteristics of the schools and the changes in the scores.
  
  
  RESULTS
  The indicators for school-based policies on nutrition and PA improved between 2006 and 2012: the average score for PA increased from 1.33 to 1.79 (P < 0.001) and that for nutrition from 1.28 to 1.92 (P < 0.001). The greatest changes were seen regarding the written guidelines for action and participation in PA and nutrition programmes as well as the training of teachers about nutrition. The schools with the least number of students had the highest changes in scores for policies on nutrition (P < 0.05).
  
  
  CONCLUSIONS
  There has been an increase of school-based policies on PA and nutrition, although there is still room for improvement.
authors.affiliation: 1 Centro Nacional de Epidemiología. Instituto de Salud Carlos III [National Centre for Epidemiology, Carlos III Institute of Health], Madrid, Spain pgallego@isciii.es.
authors.forename: Pilar
authors.initials: P
authors.lastname: Gallego
authors.affiliation: 1 Centro Nacional de Epidemiología. Instituto de Salud Carlos III [National Centre for Epidemiology, Carlos III Institute of Health], Madrid, Spain 2 Departamento de Medicina Preventiva y Salud Pública. Facultad de Medicina. Universidad Autónoma de Madrid [Department of Preventive Medicine and Public Health, Faculty of Medicine, Autonomous University of Madrid], Madrid, Spain.
authors.forename: Iñaki
authors.initials: I
authors.lastname: Galán
authors.affiliation: 1 Centro Nacional de Epidemiología. Instituto de Salud Carlos III [National Centre for Epidemiology, Carlos III Institute of Health], Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: José Medrano
authors.affiliation: 3 Departamento de Psicología Evolutiva y de la Educación. Facultad de Psicología. Universidad de Sevilla [Department of Developmental and Educational Psychology, Faculty of Psychology, University of Seville], Seville, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Ramos
authors.affiliation: 4 Departamento de Psicología Clínica, Social y Experimental. Facultad de Psicología. Universidad de Huelva [Department of Clinical, Social and Experimental Psychology, Faculty of Psychology, University of Huelva], Huelva, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Rivera
authors.affiliation: 3 Departamento de Psicología Evolutiva y de la Educación. Facultad de Psicología. Universidad de Sevilla [Department of Developmental and Educational Psychology, Faculty of Psychology, University of Seville], Seville, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Moreno
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009043:Motor Activity; D018673:Nutrition Policy; D012574:Schools; D013030:Spain; D011795:Surveys and Questionnaires