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RESEARCH

erspectives in Practice

tatewide Assessment of Local Wellness Policiesn Pennsylvania Public School Districts

LAUDIA PROBART, PhD, RD; ELAINE MCDONNELL, MS, RD; J. ELAINE WEIRICH, MEd; LISA SCHILLING, MS; VONDA FEKETE, MS, RD

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BSTRACTith the passage of the Child Nutrition and Women,

nfants, and Children Reauthorization Act of 2004,chools that sponsor school meals programs are requiredo establish local wellness policies to address childhoodbesity. Little is known about how school districts willespond to this mandate, the nature of local wellnessolicies, and their compliance with this mandate. Thebjectives of this cross-sectional descriptive study, con-ucted in early 2007, were to assess local wellness poli-ies established by Pennsylvania public school districts,ompare these policies to local wellness policy mandateequirements, and provide information about local well-ess policy development and implementation. Local well-ess policies were collected from all Pennsylvania publicchool districts that sponsor school meals programsN�499). School district representatives also completednd submitted a local wellness policy checklist, providingnformation about local wellness policy development andmplementation. Policy goal data were abstracted andntered into a Microsoft Access database along with localellness policy data. Frequencies were calculated. All

equired public school districts (N�499) submitted localellness policies. Most school district local wellness pol-

cies (85.6%-100%) met each mandate requirement (eg,ncluded goals for nutrition education, physical activity,tc.). The most common policy goals were general anday be difficult to measure, suggesting school staff mayeed assistance developing action plans and measuringolicy implementation. Most respondents identified theuperintendent (n�377; 75.6%) and school foodserviceirector (n�301; 60.3%) as responsible for ensuring local

. Probart is an associate professor, E. McDonnell is aroject coordinator, and J. E. Weirich is a project man-ger, Department of Nutritional Sciences, Penn Stateniversity, University Park, PA. L. Schilling is associ-te director, Chartwell Education Group LLC, Cen-reville, VA. V. Fekete is state director of child nutritionrograms, Division of Food and Nutrition, Pennsylvaniaepartment of Education, Harrisburg.Address correspondence to: Elaine McDonnell, MS,D, Department of Nutritional Sciences, Penn Stateniversity, 5 Henderson Bldg, University Park, PA6802. E-mail: etm101@psu.eduManuscript accepted: January 7, 2008.Copyright © 2008 by the American Dietetic

ssociation.0002-8223/08/10809-0009$34.00/0

pdoi: 10.1016/j.jada.2008.06.429

2008 by the American Dietetic Association

ellness policy implementation. Questions remain abouteasibility of these district-level personnel to ensure pol-cy implementation at the school level. The ability of localellness policies to impact childhood obesity will depend

n efforts at both the school and district levels to imple-ent and enforce local wellness policies.

Am Diet Assoc. 2008;108:1497-1502.

he establishment of school wellness policies to ad-dress childhood obesity has long been recommendedby government agencies and educators (1-3). This

ecommendation became a mandate with the passage ofhe Child Nutrition and Women, Infants, and ChildrenWIC) Reauthorization Act of 2004 (Public Law 108-265).his law required each local education agency that spon-ors a school meal program(s) to establish a local wellnessolicy by July 1, 2006 to address childhood obesity. Theseolicies were required to include goals for nutrition edu-ation, physical activity, and other school-based activitiesesigned to promote student wellness; include nutritionuidelines for all foods available on the school campusuring the school day; provide an assurance that guide-ines for reimbursable meals meet US Department ofgriculture regulations; establish a plan for measuringolicy implementation, including designation of one orore people responsible for ensuring that the schooleets the local wellness policy; and involve parents, stu-

ents, representatives of the school food authority, schooldministrators, and the public in the development of theocal wellness policy.

Research conducted prior to the passage of this Actndicated that few school districts had wellness policies inlace (4-8). In particular, comprehensive policies and pol-cies addressing nutrition guidelines for competitive foodsere lacking (4,7). A 2003 survey of Pennsylvania school

oodservice directors found that only 18% reported exis-ence and enforcement of policies related to setting nutri-ional standards for a la carte foods in their high schools.ven fewer (5% to 12%; varied by competitive food venue)chool foodservice directors reported existence of policiesetting nutrition standards for foods offered throughther competitive food venues such as vending machinesnd student stores (7). Differences were found betweenchool foodservice directors’ and principals’ perceptions ofxistence and enforcement of policies related to competi-ive foods. Research also suggested lack of involvement ofchool foodservice directors in policy development andossible weaknesses in communication about and en-orcement of policies (6,7).

Work conducted since passage of the local wellness

olicy mandate suggests concerns about local wellness

Journal of the AMERICAN DIETETIC ASSOCIATION 1497

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olicy implementation related to cost, time, stakeholderuy-in, and enforcement (9,10). The School Nutrition As-ociation and Action for Healthy Kids have reported onnalyses of local wellness policies from 100 to 256 schoolistricts from several states, documenting the number ofistricts that meet the minimum requirements of the law,he number that include key wellness goals (eg, recessequirement, staff qualifications), and competitive foodenues covered by the districts’ nutrition guidelines11,12). A Virginia report provides information aboutteps and procedures taken by school districts in thattate to prepare for establishment of local wellness poli-ies and districts’ proposed goals (13). Specific areas ofoncern noted in these reports include the omission ofutrition guidelines for foods offered as fundraisers; dur-

ng classroom parties; and as rewards, and weaknesses inlans for policy evaluation (11-13).As of fall 2007, no reports have been found describing

ublic school districts’ responses to the 2004 legislationelated to the local wellness policy development process,ndividuals identified as responsible for overseeing policymplementation, and policy goals identified by school dis-ricts on a statewide basis. This report is an examinationf Pennsylvania public school district local wellness pol-cies and provides information about the local wellnessolicy development process, specific goals identified, andompliance with the local wellness policy mandate.

ENNSYLVANIA-SPECIFIC RESOURCEShe Pennsylvania School Boards Association, in collabo-ation with the Pennsylvania Department of Education,eveloped a local wellness policy template and made itvailable to local education agencies to assist in localellness policy development (14). This template includedultiple goals within each required local wellness policy

omponent. The local education agency personnel had theption to use all or selected goals from the template,odify goals, use other templates, or develop their own

oals.The Pennsylvania Department of Education developed

oluntary state nutrition standards for competitive foods15). A 27-item Local Wellness Policy Checklist was alsoeveloped by the Pennsylvania Department of Education16). The Local Wellness Policy Checklist contained 14uestions to be completed by a representative of eachocal education agency and included questions about theocal wellness policy development process, individual(s)esponsible for ensuring the local wellness policy is im-lemented, and nutrition guidelines for competitive foodshe local education agency policy development team hashosen to implement. The mandatory Local Wellness Pol-cy Checklists were to be signed by the person with leadesponsibility for local wellness policy implementationnd the district superintendent. Upon receipt of eachocal wellness policy and Local Wellness Policy Checklisty Pennsylvania Department of Education, copies wereade and sent to the research group. Public school dis-

ricts represent the majority of local education agenciesn Pennsylvania (n�499). They are a homogenous groupn terms of structure, governance, and requirements to

eet state standards. Based on these factors, as well asheir similarities to public school districts in other states,

his report focuses on data collected from all Pennsylva- p

498 September 2008 Volume 108 Number 9

ia public school districts that sponsor school meals pro-rams. This project was approved by the Institutionaleview Board of The Pennsylvania State University.

olicy Data Abstractionhis is a cross-sectional descriptive study abstractingennsylvania public school district local wellness poli-ies. Upon initial review of school districts’ policies, aecision was made to use the Pennsylvania School Boardsssociation template as the basis for a policy abstraction

ool because it was recommended to local education agen-ies by Pennsylvania Department of Education and usedy most school districts (n�480 [96.2%]). A table was setp listing each of the goals from the Pennsylvania Schooloards Association template using Microsoft Office Ac-ess (2003, Microsoft Corp, Redmond, WA). Each policyas reviewed against this template and the presence orbsence of each template goal for each policy was re-orded in the table. Another Microsoft Access table waset up to compile data from the Local Wellness Policyhecklists. Five research assistants were trained in as-ects of the local wellness policy and an abstraction sys-em to designate local wellness policy goals’ correspon-ence to the goals in the Pennsylvania School Boardsssociation template. One research assistant served as

he primary abstractor. At five time points throughouthe process, another research assistant abstracted seveno 12 randomly selected policies. Their results were com-ared to those of the primary abstractor. The researcheam met to discuss discrepancies, decide on the correctbstraction, and document decisions. Corrections wereade to previously abstracted policies based on these

ecisions when needed. One research assistant took pri-ary responsibility for entry of data from the Local Well-

ess Policy Checklist. Two other research assistants wereesponsible for inspecting the accuracy of this data entryy comparing printouts of completed data entry forms for0 Local Wellness Policy Checklists with the actual Localellness Policy Checklists. The accuracy rate was deter-ined to be 99.7%. Upon completion of data entry for

oth policy goals and Local Wellness Policy Checklists,ata clean-up procedures were instituted to identify andorrect data anomalies before analyses were conducted.requencies were calculated using Microsoft Access.

ESULTSocal Wellness Policy Developmenthe majority of Local Wellness Policy Checklist respon-ents (n�432; 86.6%) indicated that they conducted anssessment of the school environment prior to developinghe local wellness policy. The most commonly used as-essment forms were Keystone Healthy Zone (n�309;1.9%), an on-line assessment form developed by Penn-ylvania Advocates for Nutrition and Activity, and theenters for Disease Control and Prevention’s Schoolealth Index (n�90; 18%). Fewer school districts indi-

ated using the US Department of Agriculture’s Schoolmprovement Checklist (n�49; 9.8%) and “other” assess-ent forms (n�79; 15.8%).Groups who were represented on the local wellness

olicy development team in each school district are rep-

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esented in Table 1. According to the local wellness policyandate, the first six of these groups (administrators

hrough public) were required to be represented. Slightlyore than three-quarters (n�380; 76.2%) of school dis-

ricts indicated that each of these groups was repre-ented.

ocal Wellness Policy Compliance and Contents a result of the local wellness policy mandate, 100%

n�499) of Pennsylvania public school districts that spon-or school meals programs have established local well-ess policies. Other than the team membership require-ent discussed here, almost all school districts (85.6% to

00%) met each of the other requirements of the localellness policy mandate as represented in Table 2. The

equirement met by the fewest number of school districtsas establishment of a plan for measuring local wellnessolicy implementation.Policy goal areas addressed by Pennsylvania public

chool districts related to nutrition education, physicalctivity, physical education, and other school-based well-ess activities are presented in Table 3. The top selectedoals in each category were general; the least selectedere more specific. Goals extending the content outside of

he classroom were also least selected. Although goalselated to physical education were not required by theocal wellness policy mandate, these goals are presentedecause a large number of school districts included them.The majority of Local Wellness Policy Checklist respon-

ents (n�299; 59.9%) indicated they implemented theutrition standards for competitive foods developed byhe Pennsylvania Department of Education without mod-fication. These standards provide guidelines for foodsnd beverages offered as a la carte items, in vendingachines, in school stores, as fundraisers, at classroom

arties/celebrations, as rewards, brought from home, andn faculty lounges. Approximately one third (n�164;2.9%) indicated they used the Pennsylvania Departmentf Education nutrition standards with “minor” modifica-ions. Forty school districts (8.0%) indicated they imple-ented substantially modified versions of the Penn-

ylvania Department of Education standards or theyeveloped their own. (Total number of schools districtsdds up to �499 because respondents could check more

Table 1. Groups who participated in local wellness policy devel-opment in each Pennsylvania public school district (N�499)

Group n %

School administrator(s) 497 99.6School food authority 492 98.6Parents 485 97.2School board representative(s) 466 93.4Students 444 89.0Public representative(s) 429 86.0Teachers 139 27.9Nurses 135 27.1Other 105 21.1

han one response, possibly indicating plans to imple- t

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ent different versions of the standards in differentrade levels.)

ocal Wellness Policy Implementationost respondents (n�377; 75.6%) indicated the superin-

endent has lead responsibility for ensuring that the localellness policy is implemented. This response was fol-

owed by school foodservice directors (n�301; 60.3%).maller percentages of respondents selected school nurse

n�171; 34.3%), assistant superintendent (n�128; 25.7%),rincipal/assistant principal (n�128; 19.8%), teachern�90; 18.0%), business manager (n�84; 16.6%), and cur-iculum coordinator (n�78; 15.6%).

ISCUSSIONhe Child Nutrition and WIC Reauthorization Act of004 included a requirement for all local education agen-ies to establish local wellness policies focused on reduc-ng childhood obesity. This report is an examination ofocal wellness policies submitted by Pennsylvania publicchool districts sponsoring school meals programs, in-luding the development process, key players involved,pecific goals identified, compliance with the local well-ess policy mandate, and lead people responsible for im-lementation. Limitations of this study include the facthat it involves only Pennsylvania public school districtsnd, therefore, results and conclusions may not be gen-ralizable beyond this audience. These data reflect a one-ime assessment.

Although earlier research found the existence of fewchool nutrition policies, now all Pennsylvania school dis-ricts that sponsor school meals programs have policies inlace (4-8). In a 2003 survey, only 18% of Pennsylvaniachool foodservice directors indicated the existence of aolicy at their high school related to the nutritional qual-ty of a la carte foods (7). Policies related to nutritiontandards for other sources of competitive foods wereven less common (7). In their examination of local well-ess policies, the School Nutrition Association foundome weaknesses in the reach of school districts’ nutri-ion guidelines (11). Thirty-one percent to 45% of schoolistricts omitted nutrition guidelines for foods offered asundraisers, during classroom parties, or as rewards inhe classroom. In the current study, virtually all (99.8%)ennsylvania public school districts included nutritionuidelines for competitive foods in their local wellnessolicies, with 92% of them using the voluntary Pennsyl-ania Department of Education nutrition guidelines forompetitive foods, with no or only minor modifications.hese guidelines cover all of the venues mentioned here.his finding suggests a reliance on state nutrition guide-

ines and provides opportunities for school foodserviceersonnel to work together with the food industry toevelop and test new foods that meet the guidelines andre acceptable to students.An earlier report about local wellness policy develop-ent in Virginia indicated that only 34.1% of school dis-

ricts included the required people on their policy devel-pment team, compared to �75% in the current study13). The required groups that were least represented in

he current study were students and members of the

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ublic. Lack of involvement of these groups may impacthe ability of school districts to gain support and buy-inor policy goals. However, while these were the leastepresented of the required groups, students and theublic were still represented on the large majority ofolicy development teams.Other than the team membership requirement, each of

he requirements of the local wellness policy presented inable 2 was met by almost all (85.6% to 100%) of Penn-ylvania public school districts. In their analysis of 256ocal wellness policies from several states, Action forealthy Kids also reported high levels of compliance with

hese requirements, although not as high as in the cur-ent study (12). Several Pennsylvania-based organiza-ions and associations offered training on local wellnessolicies and/or provided information on local wellnessolicy requirements in newsletters and mailings. Theennsylvania Department of Education presented a man-atory training session for all National School Lunchrogram sponsors on the Child Nutrition and WIC Reau-horization Act of 2004, including the local wellness pol-cy requirement. These training opportunities, promo-ional efforts, and availability of resources to aid in policyevelopment, coupled with state-level collection and re-iew of local wellness policies may account for the highumber of school districts meeting local wellness policyequirements.

Previous research has suggested weaknesses in therea of local wellness policy measurement and evaluationnd has documented school districts’ need for assistancen these areas (12,13). The findings in the current studyre in line with these previous findings and suggest aeed for assistance in developing and implementinglans for local wellness policy measurement and evalua-ion.

While 100% of school districts established local well-ess policies as required and most met the specific re-uirements, some school districts included qualifiers inheir policy language to suggest ambiguity in their com-itment to certain goals. For example, some policies

tated that a goal is “recommended” or that they willstrive to comply.” The rigor of the policy statementsncluded with local wellness policies is an area in need ofurther research.

While the Child Nutrition and WIC Reauthorization

Table 2. Pennsylvania public school districts meeting each local we

Requirements for the local wellness policy as mandated by TheReauthorization Act of 2004

Include at least one goal for nutrition educationInclude at least one goal for physical activityInclude at least one goal for other school-based activities designedInclude nutrition guidelines for all foods available on the school camProvide an assurance that reimbursable meals meet US DepartmentEstablish a plan for measuring implementation of the local wellnessDesignate one or more person responsible for ensuring that the sch

ct of 2004 required that school districts develop policies a

500 September 2008 Volume 108 Number 9

hat include goals in specific areas (eg, nutrition educa-ion), it did not mandate specific goals in these areas. Theost commonly chosen goals in the current report were

airly broad and general and the least often chosen goalsere more specific and measurable. This may reflect

chool districts’ discomfort with committing to specificoals because of concerns that they may not be able tochieve those goals or a philosophy that policy goalshould be broad and general, with the specific detailsescribed in Administrative Guidelines. Detailed proce-ures or Administrative Guidelines will be necessary forchool districts to measure policy implementation andvaluate effectiveness of the local wellness policies. Stan-ardized forms for assessment and reporting may aidchools in these processes.Among the least-often selected nutrition education

oals are goals that extend nutrition education beyondhe classroom environment to engage families, providepportunities for community nutrition projects, and linkith school foodservice. These goals represent strategies

or reinforcing classroom nutrition education and provid-ng opportunities for skill-building related to nutritionhat have been recommended by US Department of Ag-iculture’s Team Nutrition program (17). Schools mayenefit from examples of successful strategies for extend-ng nutrition education beyond the classroom to connectith the cafeteria and the community.Integrating nutrition education into other subject areas

as been advocated as a strategy for providing nutritionducation, given the limited time available within thechool day (2). The current finding that 59.3% of schoolistricts included a goal related to integrating nutritionnto other subject areas is in line with findings from anarlier report (12).In the current study, many of the “other school-based

ctivities” goals relate to school meals with the top threeoals in this area addressing the school meal environ-ent and time allocated for school meals. This may be

eflective of the fact that almost all of the school districts98.6%) indicated that a representative of the school fooduthority was on the policy development team.Previous local wellness policy research has shown that

1% to 58.7% of school districts’ policies addressed pro-essional development for staff responsible for providingutrition education (12,13). Findings in the current study

s policy requirement (N�499)

Nutrition and WIC

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499 100498 99.8

mote student wellness 499 100uring the school day 498 99.8riculture regulations 494 99.0

y 427 85.6eets the local wellness policy 499 100

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urrent findings suggest room for improvement and sug-est opportunities for professional organizations to pro-ide continuing education related to school-based nutri-ion education strategies.

In previous research, school foodservice directors ex-ressed discomfort with being identified as responsibleor local wellness policy enforcement because of the reachf the local wellness policies into a variety of areas in thechool environment unrelated to the school meals pro-rams and the time required to monitor compliance withhe local wellness policies (9). In the current study, schoolistrict representatives most often identified superinten-ents as having lead responsibility for policy implemen-ation, followed by school foodservice directors. Althoughupport and leadership from the superintendent is impor-ant, it is questionable whether a district-level admini-trator can feasibly oversee the day-to-day implementa-ion of and compliance with the local wellness policy athe school level. In addition, while it is appropriate for thechool foodservice director to oversee policy implementa-ion related to school meals, it is doubtful that he or sheould have the time or authority to oversee implementa-

ion of other policy areas. School district personnel mayeed to consider identification of school level personnel toversee policy implementation, division of oversight re-ponsibilities, and/or identification of district wellnessoordinators to oversee implementation of local wellnessolicies.

ONCLUSIONSn the current study, all required public school districts inennsylvania established a local wellness policy, and theajority met the specific requirements of the local well-

Table 3. Local wellness policy goal areas addressed by Pennsyl-vania public school districts (N�499) (continued)

Goal area n %

Time to eat school meals 355 71.1Access to handwashing 347 69.5Availability of drinking water 338 67.7Availability of nutrition content of school meals 337 67.5Nutrition qualifications of school foodservice

administrator(s) 310 62.1Training for staff about local wellness policy 308 61.7Communication about diet and physical activity

with parents 307 61.5Professional development for district nutrition staff 304 60.9Appropriate scheduling of meal periods 297 59.5Limits access to foodservice operation 288 57.7Encourage positive role-modeling 287 57.5Consideration of local wellness policy goals in

school activities 286 57.3Safe routes to school 283 56.7Utilization of funding to enhance student wellness 281 56.3Fundraising projects supportive of student

wellness 241 48.3Involve of parents/guardians in menu selections 226 45.3Addresses use of food as reward or punishment 223 44.7

Table 3. Local wellness policy goal areas addressed by Pennsyl-vania public school districts (N�499)

Goal area n %

Nutrition educationAlign with state curriculum regulations and

academic standards 435 87.2Teach, encourage, and support healthy eating 427 85.6Age appropriate lessons 329 65.9Consistent nutrition messages 315 63.1Knowledge and skills to lead healthful lives 314 62.9Link with physical activity 299 59.9Integrate into other subjects 296 59.3Professional development for staff 275 55.1Engage and involve families 250 50.1Opportunities for community nutrition projects for

students 233 46.7Behavior-focused curriculum 193 38.7Link with school foodservice 165 33.1Physical activityDevelopmentally appropriate 373 74.7Age-appropriate activities 366 73.3Environment encourages safe and enjoyable

activity 337 67.5Access to facilities outside school hours 295 59.1Partner with parents and community to institute

physical activity programs 276 55.3Addresses use of physical activity as punishment 270 54.1Classroom physical activity breaks for elementary

students 228 45.7Provide physical activity through after-school

programs 206 41.3Discourages extended periods of student

inactivity 186 37.3Contribute to effort to provide students with 60

minutes of daily physical activity, includingoutside of school 218 43.7

Daily physical activity to achieve health, wellness,fitness, and performance benefits 201 40.3

Physical education (PE)Quality PE to promote lifelong physical activity 387 77.6Taught by certified health/PE teachers 367 73.5Alignment with state curriculum regulations and

academic standards 375 75.2Safe and adequate equipment, facilities, and

resources 346 69.3Provide means for students to learn, practice and

be assessed on skills and knowledge forlifelong physical activity 298 59.7

Professional development for PE staff 282 56.5Addresses level of physical activity during PE 329 65.9Provide skills, knowledge, and confidence 252 50.5Varied and comprehensive curriculum 218 43.7Planned instruction to meet proficient level for

academic standards 222 44.5Require local assessment system 168 33.7Address teacher-to-student ratio 156 31.3Other school-based wellness activitiesClean and safe meal environment 398 79.8Space for eating and serving school meals 372 74.5

ess policy mandate. Considering that research in 2003

eptember 2008 ● Journal of the AMERICAN DIETETIC ASSOCIATION 1501

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ocumented that few school nutrition policies existed inennsylvania public high schools, current findings sug-est the effectiveness of the combination of federal legis-ation, state-level oversight, and availability of resourceso impact policy change at the local level (7).

Applications suggested for the following sectors include:

pplications for Policy-Makers

A federal mandate, coupled with state review and en-forcement, was very successful in prompting Pennsyl-vania school districts to establish local wellness policiesrelated to reducing childhood obesity.Because school district staff relied heavily on centrallydeveloped resources to meet the mandate require-ments, additional resources should be developed to as-sist school district staff in development of implementa-tion plans.Implementation and enforcement of the local wellnesspolicy will require delegation of both authority andresponsibilities or appointment of a dedicated and qual-ified individual to coordinate this process, as well as theestablishment of a plan for communicating implemen-tation and enforcement plans.

pplications for Researchers

The rigor of the policy statements included in localwellness policies is an area in need of additional anal-ysis.The extents to which policy goals are implemented andbarriers associated with implementation are areas inneed of follow-up research.The success of local wellness policies to change schoolenvironments, student behavior, and ultimately, ratesof childhood obesity should be documented.

pplications for Food and Nutrition Professionals

Local wellness policies provide an opportunity for foodand nutrition professionals to become involved in pre-vention of childhood obesity. Food and nutrition profes-sionals should learn about the local wellness policy intheir local school districts and become members ofschool districts’ wellness committees.Food and nutrition professionals can play a role in offer-ing professional services to assist implementation of ex-isting local wellness policies as well as working withinschool districts to adopt additional nutrition goals in sub-sequent revisions of local wellness policies. Areas in par-ticular need of professional assistance are those identifiedin this report as being least likely to be adopted. Theseinclude behavioral approaches and approaches that ex-tend the nutrition education beyond the classroom, im-portant goals to solve the problem of childhood obesity.Food and nutrition professionals can become involvedin local wellness policies success by assisting in devel-opment of tools and strategies to measure local well-ness policy implementation and effectiveness.

unding for this project was provided by both the US

epartment of Agriculture administered through the

502 September 2008 Volume 108 Number 9

ennsylvania Department of Education, Division of Foodnd Nutrition and the Robert Wood Johnson Foundation,ealthy Eating Research program.

eferences1. US Department of Agriculture, Food and Nutrition Service. Healthy

school nutrition environment Web site. http://www.fns.usda.gov/tn/Healthy/hsne.html. Accessed December 18, 2007.

2. Centers for Disease Control and Prevention. Guidelines for school healthprograms to promote lifelong healthy eating. Morb Mortal Wkly Rep.1996;45:1-37. MMWR Web site. http://www.cdc.gov/mmwr/preview/mmwrhtml/00042446.htm. Published September 19, 1998. AccessedDecember 18, 2007.

3. Bogden J. Fit, Healthy, and Ready to Learn: A School Health PolicyGuide. Alexandria, VA: National Association of State Boards of Educa-tion; 2000.

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8. Wechsler H, Brener ND, Kuester S, Miller C. Food service and foodsand beverages available at school: Results from the School HealthPolicies and Programs Study 2000. J Sch Health. 2001;71:313-324.

9. McDonnell E, Probart CK, Weirich, JE. School foodservice directorsperceptions and concerns about local wellness policy development, im-plementation, and enforcement. J Child Nutr Manage. [serial online].2006;1: http://docs.schoolnutrition.org/newsroom/jcnm/06spring/mcdonnell/index.asp. Accessed December 18, 2007.

0. Probart CK, Snow-Telfer H, McDonnell E. Use of stakeholder theoryto examine groups salient in decisions related to a la carte offerings.J Child Nutr Manage. [serial online]. 2006;2. http://docs.schoolnutri-tion.org/newsroom/jcnm/06fall/probart/index.asp. Accessed December18, 2007.

1. School Nutrition Association. A foundation for the future II: Analysisof local wellness policies from 140 school districts in 49 states.http://www.asfsa.org/uploadedFiles/SchoolNutrition.org/News_&_Publications/School_Foodservice_News/New_Folder/Regional%20LWP%20Report.pdf. Published December 2006. Accessed December18, 2007.

2. Howley N. Local wellness policies: A national snapshot. Presented atWellness and Academic Success: From Policy to Action conference,State College, PA, April 30-May 1, 2007.

3. Serrano E, Kowakeska A, Hosig K, Fuller C, Fellin L, Wigand V.Status and goals of local school wellness policies in Virginia: A re-sponse to the Child Nutrition and WIC Reauthorization Act of 2004.J Nutr Educ Behav. 2007;39:95-100.

4. Pennsylvania School Boards Association. PSBA Local Wellness PolicyTemplate. Pennsylvania Department of Education: PennsylvaniaSchool Boards Association (PSBA) Resources Web site. http://www.pde.state.pa.us/food_nutrition/cwp/view.asp?a�5&q�119997. Ac-cessed July 14, 2008.

5. Pennsylvania Department of Education, Division of Food and Nutrition.Nutrition Standards for Competitive Foods in Pennsylvania Schools.School Nutrition Incentive Program Web Site. http://www.pde.state.pa.us/food_nutrition/cwp/view.asp?Q�125996&A�5. Published July 27,2007. Accessed December 18, 2007.

6. Pennsylvania Department of Education, Division of Food and Nutrition.Local Wellness Policy Checklist. Local Wellness Policy Web site. http://www.pde.state.pa.us/food_nutrition/cwp/view.asp?Q�117239&A�5.Accessed December 18, 2007.

7. United States Department of Agriculture, Food and Nutrition Ser-

vice. Team Nutrition Web Site. http://www.fns.usda.gov/tn/. AccessedDecember 18, 2007.