Introduction

In response to the inter-related epidemics of poor nutrition, physical inactivity and obesity, and their relationship to academic performance, U.S. Senator Harkin introduced a provision into the 2004 Child Nutrition and Reauthorization Act requiring that all school districts adopt a comprehensive wellness policy by the 2006-7 school year. This local wellness policy mandate was a milestone in the federal government's efforts to address childhood obesity through school environments. The requirement to develop a policy reportedly resulted in a high level of compliance among those schools required to do so. However questions remain regarding the level of implementation of these policies, factors influencing successful implementation, critical steps for sustaining implementation, and the impact on student food purchases and school finances. In order to answer these questions the United States Department of Agriculture funded The School Wellness Policy Demonstration Project in three states (California, Iowa and Pennsylvania). During the project these three states experienced three distinct levels of regulation for competitive foods in schools: California had legislatively mandated nutrition standards without monetary incentive, Pennsylvania had voluntary standards with a monetary incentive, and Iowa had voluntary standards. Therefore this study provides a unique opportunity to assess the impact of these different approaches to regulation. The study design was pre-post with comparison group and the methodologies included surveys and interviews with school and district personnel, records of meal participation and food/beverage sales, systematic observations of the nutrition environment, and reports from project schools. Eighty-four schools (elementary, middle, and high) from 31 districts participated.