State Wellness Policy Requirement Laws Matter for District Wellness Policy Comprehensiveness and Wellness Policy Implementation in the United States

Evaluation of School Wellness Policies in Low-Income California Districts After the 2016 USDA Final Rule

BACKGROUND

Districts with federal nutrition programs must have an updated local school wellness policy (LSWP) to promote nutrition, physical activity, and student wellness. This study evaluates factors associated with LSWP quality among low-income districts.

METHODS

In 2018, we collected LSWPs from websites of 200 randomly selected, county-stratified, low-income-serving California public districts. Multivariable linear regression assessed associations between district characteristics, model LSWP use (national, state, none), and adoption date on policy quality.

RESULTS

On the WellSAT 3.0 scale of 0-100, mean (95% CI) comprehensiveness was 65.0 (63.2-66.7) and strength was 37.3 (35.3-39.2). Nearly verbatim adoption of model LSWPs was high (68.5% state model, 13.0% a national model). Half were adopted before mandated updates. District size (≥1000 students) and national model LSWP adoption were associated with higher comprehensive scores. National model LSWP adoption was associated with higher strength scores in updated policies compared with those not updated.

IMPLICATIONS

LSWPs have improved school food and activity environments, but district engagement in LSWP is low. Integration into education frameworks that reduce learning barriers could provide synergy for re-engagement.

CONCLUSIONS

High adoption of model policies and low update compliance indicate little district engagement in LSWP. Mixed methods studies of districts with high-quality LSWP are needed.

"Competitive" food and beverage policies and weight status: A systematic review of the evidence among sociodemographic subgroups

Prior studies identified variable associations between competitive food and beverage policies (CF&B) and youth obesity, potentially due to differences across population subgroups. This review summarizes the evidence on associations between CF&B policies and childhood obesity within gender, grade level/ age, race/ethnicity, and/or socioeconomic levels. PubMed, EMBASE, CINAHL, and ERIC database searches identified studies published in English in Canada and the United States between January 1, 2000, and February 28, 2022. Of the 18 selected studies, six were cross-sectional, two correlational, nine were before/after designs, and one study utilized both a cross-sectional and pre-post design. Twelve studies reported findings stratified by a single sociodemographic factor, with grade level/age as the most frequently reported. Although the evidence varied, greater consistency in direction of associations and strengths of evidence were seen among middle school students. Six studies reported findings jointly by multiple sociodemographic subgroups with evidence suggesting CF&B associations with slower rate of increase or plateaus or declines in obesity among multiple subgroups, though the strengths of evidence varied. Over the past two decades, there have been relatively limited subgroup analyses on studies about CF&B policies and childhood obesity. Studies are needed with stronger designs and analyses disaggregated, particularly by race/ethnicities and socioeconomic factors, across places and time.

Embracing policy implementation science to ensure translation of evidence to cancer control policy

Although health-related policies are abundant, efforts to understand how to ensure that these policies serve as an effective vehicle for translating scientific evidence are relatively sparse. This paper explores how policy-focused implementation science (IS) may contribute to understanding the translation of scientific evidence to health-related policy in governmental and nongovernmental sectors. Expanding the focus of implementation science in cancer control could systematically address policy to both increase the use of scientific evidence in general and to address health equity. In this Commentary, we look to relevant work outside of IS that could be informative, most notably from the field of political science. We propose several ideas for future research that could help move the field of policy implementation science in cancer control in the USA forward. Although most efforts to increase uptake of the scientific evidence base reference translation to "practice and policy," there has been relatively little emphasis in the USA on implementation at the policy level, especially related to cancer control. If we are to achieve the full benefits of scientific discovery on population and public health, we will need to consider policy as a critical mechanism by which evidence can be translated to practice. We have a robust set of methods within implementation science that are increasing the pace of adoption and maintenance of evidence-based programs in a variety of settings. Building on these efforts, the time is right to expand our focus to include policy implementation.