Department of Food Science and Human Nutrition, Iowa State University, 1104 HNSB, Ames, IA 50011, USA.
Child Obes. 2012 Aug;8(4):331-8. doi: 10.1089/chi.2012.0047.
Congress sought to address escalating rates of childhood obesity by mandating local wellness policies (LWP) (Child Nutrition and WIC Reauthorization Act of 2004). Previous research has examined LWP content and quality; however, data relative to LWP implementation is limited, and none has examined the relationship between LWP quality and implementation. The purpose of this study was to examine the influence of LWP strength on perceived implementation of LWP components.
Data collected from school districts in California, Iowa, and Pennsylvania included district LWPs and online surveys at the district (n = 23) and school levels (n = 76). LWPs were scored using a standardized coding tool. Binary and multinomial regression models were used to examine the predictive ability of covariates and independent factors on perceived implementation of reimbursable school meals and nutrition guidelines for competitive foods sold and offered.
Overall LWP strength score did not predict perceived implementation of reimbursable school meals or nutrition guidelines for competitive foods. LWP component strength scores for reimbursable meals and nutrition guidelines did not consistently predict perceived implementation of those components. State and urban-centric locale did predict perceived implementation of some LWP components, particularly nutrition guidelines for competitive foods sold and offered. State was a particularly influential factor in the implementation of LWPs in this study, likely due to differences in state policies and laws.
Overall LWP, reimbursable school meals, and nutrition guidelines for competitive foods strength scores do not predict perceived implementation of reimbursable school meals and nutrition guidelines for competitive foods.
国会试图通过强制推行地方健康政策（LWP）（2004 年儿童营养和 WIC 授权法案）来解决儿童肥胖率不断上升的问题。之前的研究已经检查了 LWP 的内容和质量；然而，与 LWP 实施相关的数据有限，并且没有研究 LWP 质量与实施之间的关系。本研究的目的是检查 LWP 强度对 LWP 组件感知实施的影响。
从加利福尼亚州、爱荷华州和宾夕法尼亚州的学区收集的数据包括地区 LWP 和地区（n = 23）和学校层面（n = 76）的在线调查。使用标准化编码工具对 LWP 进行评分。使用二项和多项回归模型检查协变量和独立因素对可报销学校膳食和销售和提供的竞争食品营养指南的感知实施的预测能力。
总体 LWP 强度得分不能预测可报销学校膳食或销售和提供的竞争食品营养指南的感知实施。可报销膳食和营养指南的 LWP 组件强度得分并不总是预测这些组件的感知实施。州和以城市为中心的位置确实预测了某些 LWP 组件的感知实施，特别是销售和提供的竞争食品的营养指南。在这项研究中，州是 LWP 实施的一个特别有影响力的因素，这可能是由于州政策和法律的差异。
总体 LWP、可报销学校膳食和销售及提供的竞争食品营养指南的强度得分不能预测可报销学校膳食和销售及提供的竞争食品营养指南的感知实施。
