Implementation of legislative mandates to address childhood obesity: Challenges for schools

Background: The WV Healthy Lifestyles Act (HB 2816) targeted childhood obesity through school-based mandates addressing physical education, health education and assessment, fitness assessment, BMI measurement, and vended beverages. Purpose: To describe West Virginia's progress and challenges in implementing the legislation. Significance: States are increasingly legislating changes in school environments to reduce childhood obesity. Examining implementation is essential in understanding the outcomes of these legislative efforts. Methods: Two annual statewide evaluations of HB2816 have been conducted with support from the Robert Wood Johnson Foundation. The evaluations included interviews with a stratified random sample of 1500 parents and 420 students each year, and surveys of superintendents, principals, PE and health teachers, and school nurses. Results: Survey response rates for school personnel were high (range = 57% for PE teachers in Year 1 to 95% for superintendents in Years 1 and 2). Principals reported substantial implementation difficulties, with approximately 40% of schools lacking the resources to implement 1 or more mandates each year. PE minutes were not met by 31% of elementary schools due to inadequate staffing (56%), inadequate facilities (5%), or both (39%); nutrition and physical activity health education standards were met by only 37% and 30% of teachers, respectively. Conclusions: Efforts to address childhood obesity through public policy and environmental change are underway across the country, and schools are an important focus of these efforts. Policy makers should consider the resources needed by schools to implement changes, and assess the extent of implementation when these efforts are evaluated.