State Wellness Policy Requirement Laws Matter for District Wellness Policy Comprehensiveness and Wellness Policy Implementation in the United States
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data and Design
2.2. Measures
2.2.1. SFA Director Survey Measures
2.2.2. State Wellness Policy Requirements and District LWP Data
2.2.3. SFA and District Controls
2.3. Analysis Methods
3. Results
3.1. Sample Characteristics
3.2. Relationship between State Law, District LWP Comprehensiveness, and SFA LWP Implementation
4. Discussion
Study Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | Overall SFA Sample | SFA Sample in States with WP Requirement Laws | SFA Sample in States without WP Requirement Laws |
---|---|---|---|
% or Mean (95% CI or SD) | |||
SFA Wellness Policy Full Implementation Scale (0–11) (Mean) | 5.28 (SD: 3.87) | 6.45 (SD: 3.99) | 4.93 (SD: 3.77) |
District LWP Comprehensiveness | |||
Tertile 1 (0.00–46.97) | 37.79 (31.76, 44.23) | 24.89 (16.90, 35.06) | 41.75 (34.30, 49.60) |
Tertile 2 (>46.97–64.65) | 36.35 (29.75, 43.51) | 42.05 (29.00, 56.31) | 34.61 (27.20, 42.85) |
Tertile 3 (>64.65–91.29) | 25.85 (20.34, 32.25) | 33.07 (20.33, 48.88) | 23.64 (17.89, 30.55) |
State Wellness Policy Requirement Law | 22.97 (18.06, 28.75) | ||
District Race/Ethnicity | |||
≥50% White | 76.03 (70.91, 80.51) | 81.31 (69.05, 89.45) | 74.46 (68.71, 79.47) |
≥50% Black | 7.04 (4.34, 11.23) | 7.94 (2.58, 21.95) | 6.77 (4.02, 11.17) |
≥50% Hispanic | 8.82 (6.27, 12.28) | 3.49 (1.28, 9.14) | 10.41 (7.27, 14.69) |
Other | 8.11 (5.74, 11.34) | 7.27 (3.65, 13.96) | 8.36 (5.61, 12.28) |
District Child Poverty Rate | |||
<20% | 58.99 (53.38, 64.37) | 63.25 (50.26, 74.57) | 57.72 (51.54, 63.66) |
≥20% | 41.01 (35.63, 46.62) | 36.75 (25.43, 49.74) | 42.28 (36.34, 48.46) |
District Locale | |||
Large to mid-size city | 13.54 (10.09, 17.93) | 8.95 (3.57, 20.69) | 14.91 (10.95, 19.97) |
Suburban | 20.50 (16.90, 24.64) | 33.65 (23.58, 45.46) | 16.58 (12.98, 20.93) |
Rural | 45.19 (38.78, 51.77) | 36.59 (23.78, 51.63) | 47.76 (40.38, 55.23) |
Township | 20.77 (15.49, 27.28) | 20.81 (11.28, 35.20) | 20.76 (14.74, 28.42) |
SFA Size | |||
Fewer than 1000 students | 49.57 (44.23, 54.92) | 30.59 (19.21, 44.97) | 55.23 (49.42, 60.90) |
1000–5000 students | 37.12 (31.92, 42.63) | 53.65 (40.15, 66.64) | 32.18 (26.87, 38.00) |
More than 5000 students | 13.32 (11.09, 15.91) | 15.75 (10.48, 23.00) | 12.59 (10.10, 15.58) |
Region | |||
West | 17.49 (12.92, 23.24) | 12.63 (7.18, 21.28) | 18.93 (13.39, 26.09) |
Midwest | 39.79 (33.29, 46.67) | 16.97 (9.18, 29.26) | 46.60 (39.10, 54.25) |
South | 24.79 (19.95, 30.36) | 39.01 (26.45, 53.21) | 20.55 (16.27, 25.60) |
Northeast | 17.94 (13.30, 23.75) | 31.39 (21.08, 43.93) | 13.92 (9.05, 20.82) |
Predictor or Control Variable | Outcome Variables | |
---|---|---|
District LWP Comprehensiveness | SFA Wellness Policy Full Implementation | |
Coefficient (95% CI) | Coefficient (95% CI) | |
State Wellness Policy Requirement Law | 0.463 ** (0.123, 0.803) | 1.392 * (0.299, 2.485) |
District LWP Comprehensiveness | 0.562 * (0.072, 1.053) | |
District Race/Ethnicity | ||
≥50% White | Referent | Referent |
≥50% Black | 0.426 (−0.109, 0.962) | −0.510 (−2.231, 1.210) |
≥50% Hispanic | 0.440 (−0.042, 0.923) | 0.295 (−1.422, 2.011) |
Other | −0.233 (−0.655, 0.189) | −0.088 (−1.569, 1.393) |
District Child Poverty Rate | ||
<20% | Referent | Referent |
≥20% | −0.089 (−0.428, 0.250) | −0.107 (−1.085, 0.871) |
District Locale | ||
Large to mid-size city | Referent | Referent |
Suburban | 0.297 (−0.128, 0.722) | −1.142 (−2.827, 0.543) |
Rural | 0.388 (−0.062, 0.839) | −1.690 (−3.419, 0.039) |
Township | 0.346 (−0.194, 0.885) | −0.332 (−2.140, 1.477) |
SFA Size | ||
Fewer than 1000 students | 0.054 (−0.315, 0.424) | 1.761 * (0.389, 3.132) |
1000–5000 students | 0.032 (−0.297, 0.360) | 0.898 (−0.243, 2.038) |
More than 5000 students | Referent | Referent |
Region | ||
West | Referent | Referent |
Midwest | −0.173 (−0.568, 0.222) | −0.755 (−2.357, 0.846) |
South | −0.215 (−0.634, 0.204) | 0.403 (−1.029, 1.835) |
Northeast | −0.539 * (−1.014, −0.064) | −0.644 (−2.368, 1.081) |
Intercept/ Thresholds | −0.078 (−0.576, 0.420), 0.921 *** (0.413, 1.428) | 5.054 *** (3.125, 6.983) |
Residual Variances | 13.305 *** (9.331, 17.280) | |
Indirect association between state requiring district wellness policy and SFA wellness policy full implementation | 0.261 (−0.053, 0.574) |
Variable | Coefficient (95% CI) |
---|---|
State Wellness Policy Requirement Law | 0.62 ** (0.18, 1.07) |
District Race/Ethnicity | |
≥50% White | Referent |
≥50% Black | −0.09 (−0.92, 0.74) |
≥50% Hispanic | 0.21 (−0.44, 0.86) |
Other | −0.08 (−0.64, 0.47) |
District Child Poverty Rate | |
<20% | Referent |
≥20% | −0.06 (−0.46, 0.34) |
District Locale | |
Large to mid-size city | Referent |
Suburban | −0.37 (−0.92, 0.19) |
Rural | −0.55 (−1.12, 0.02) |
Township | −0.04 (−0.73, 0.65) |
SFA Size | |
Fewer than 1000 students | 0.68 ** (0.19, 1.16) |
1000–5000 students | 0.35 (−0.10, 0.79) |
More than 5000 students | Referent |
Region | |
West | Referent |
Midwest | −0.32 (−0.92, 0.27) |
South | 0.11 (−0.47, 0.69) |
Northeast | −0.36 (−0.93, 0.22) |
Adjusted Mean | |
With state wellness policy requirement | 59.56% |
Without state wellness policy requirement | 44.57% |
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Chriqui, J.F.; Leider, J.; Turner, L.; Piekarz-Porter, E.; Schwartz, M.B. State Wellness Policy Requirement Laws Matter for District Wellness Policy Comprehensiveness and Wellness Policy Implementation in the United States. Nutrients 2021, 13, 188. https://doi.org/10.3390/nu13010188
Chriqui JF, Leider J, Turner L, Piekarz-Porter E, Schwartz MB. State Wellness Policy Requirement Laws Matter for District Wellness Policy Comprehensiveness and Wellness Policy Implementation in the United States. Nutrients. 2021; 13(1):188. https://doi.org/10.3390/nu13010188
Chicago/Turabian StyleChriqui, Jamie F., Julien Leider, Lindsey Turner, Elizabeth Piekarz-Porter, and Marlene B. Schwartz. 2021. "State Wellness Policy Requirement Laws Matter for District Wellness Policy Comprehensiveness and Wellness Policy Implementation in the United States" Nutrients 13, no. 1: 188. https://doi.org/10.3390/nu13010188
APA StyleChriqui, J. F., Leider, J., Turner, L., Piekarz-Porter, E., & Schwartz, M. B. (2021). State Wellness Policy Requirement Laws Matter for District Wellness Policy Comprehensiveness and Wellness Policy Implementation in the United States. Nutrients, 13(1), 188. https://doi.org/10.3390/nu13010188