School-based physical education (PE) and physical activity (PA) policies can improve PA levels of students and promote health. Studies of policy implementation, communication, monitoring, enforcement, and evaluation are lacking. To describe how states implement, communicate, monitor, enforce, and evaluate key school-based PE and PA policies, researchers interviewed 24 key informants from state-level organizations in 9 states, including representatives from state departments of health and education, state boards of education, and advocacy/professional organizations. These states educate 27% of the US student population. Key informants described their organizations' roles in addressing 14 school-based PE and PA state laws and regulations identified by the Bridging the Gap research program and the National Cancer Institute's Classification of Laws Associated with School Students (C.L.A.S.S.) system. On average, states had 4 of 14 school-based PE and PA laws and regulations, and more than one-half of respondents reported different policies in practice besides the “on the books” laws. Respondents more often reported roles implementing and communicating policies compared with monitoring, enforcing, and evaluating them. Implementation and communication strategies used included training, technical assistance, and written communication of policy to local education agency administrators and teachers. State-level organizations have varying roles in addressing school-based PE and PA policies. Opportunities exist to focus state-level efforts on compliance with existing laws and regulations and evaluation of their impact.
This study describes themes related to the processes and activities that state agencies and relevant partner organizations use to implement, communicate, monitor, enforce, and evaluate key state physical education and physical activity policy components.
Harvard Prevention Research Center, Harvard School of Public Health, Boston, Massachusetts (Dr Cradock and Ms Barrett); Prevention Research Center, Washington University in St Louis, St Louis, Missouri (Ms Carnoske); Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois (Dr Chriqui); Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–-Chapel Hill, Chapel Hill, North Carolina (Dr Evenson); Department of Epidemiology, Prevention Research Center, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana (Dr Gustat and Ms Healy); Department of Kinesiology, Kansas State University, Manhattan, Kansas (Dr Heinrich); Worcester County Prevention Research Center, University of Massachusetts Medical School, Worcester, Massachusetts (Dr Lemon); Prevention Research Center, West Virginia University, Morgantown, West Virginia (Dr Tompkins); Department of Environmental Health, Colorado School of Public Health, Aurora, Colorado (Ms Reed); and Department of Kinesiology, San Francisco State University, San Francisco, California (Dr Zieff).
Correspondence: Angie L. Cradock, ScD, Harvard School of Public Health, 677 Huntington Ave, 7th Floor, Boston, MA 02115 (email: firstname.lastname@example.org).
This study was funded by the Centers for Disease Control and Prevention (CDC) Cooperative Agreement Numbers U48/DP001903, U48/DP001946, U48/DP001933, U48/DP001948, and 5U48DP001938-02 from the CDC, Prevention Research Centers Program, Special Interest Projects 9-09 and 9-10, and Physical Activity Policy Research Network. The content is solely the responsibility of the authors and does not necessarily represent the official views of CDC. The authors thank Sara Satinsky and Kate Lolley for their support in data collection, and Taisy Conk for her support in data coding and entry.
All authors have contributed to the manuscript as collaborators of the Physical Activity Policy Research Network (PAPRN) and have provided critical review and revision of the manuscript for important intellectual content. In addition, ALC, JFC, KRE, JG, SCL, NOT, HR, and SGZ contributed to the conception and design of the project; and ALC, KRE, JG, IBH, and NOT supported the conceptualization of the manuscript. ALC, JLB, KMH, SCL, NOT, HR, and SGZ contributed to acquisition of the data. ALC, JLB, CC, KRE, JG, IBH, KMH, NOT, HR, and SGZ contributed to analysis and interpretation of the data. ALC, JLB, and SGZ supported the writing of the initial draft of the manuscript. JLB provided statistical analysis and administrative, technical, or material support; ALC obtained funding; and JG provided supervision.
Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (www.JPHMP.com).
The authors declare no conflicts of interest.