Coordinated school health programs in Southeast Texas School Districts

Texas Senate Bills 19 and 1357 mandated that every school district adopt and implement an elementary school Coordinated School Health Program (CSHP), by 2007. These programs have been found to be effective in addressing overweight and risk for overweight in children. The purpose of this study was to measure the barriers and challenges for CSHP adoption and implementation in 50 Southeast Texas School Districts. A web-based questionnaire was administered to school health-related person who could best represent their school district health policies and procedures. Questionnaire items included assessment of CSHP adoption and implementation barriers, self-efficacy, relative advantage, and other constructs from the Diffusion of Innovation Theory. Survey frequencies and percentages responses were analyzed, construct summary scores were calculated and compared to CSHP adoption status and adopter categories to determine the existence of a relationship. The survey revealed that a majority of the respondents think school health is important, CSHPs are advantageous in terms of children's health and behavior, and feel able to improve school health and provide coordination for the CSHPs. Most respondents perceived the levels of support from students, parents, principals, and the state to be high. Time , resources, and training of personnel were seen as the largest barriers to CSHP adoption and implementation. There were no significant relationships between the summary scores of the constructs and CSHP adoption or adopter category, although the perceived importance of implementing school health and coordination for a CSHP was the construct most closely associated with CSHP adoption and the adopter category.