affecting food and beverage choices, physical activity levels, or other relevant behavioral changes. Evaluating a range of outcomes of school-based programs and interventions appears to be occurring only on a limited basis, at least in part because of the lack of emphasis on evaluation and limited time and resources.

Although the committee could explore only a small subset of the ongoing efforts by states, localities, school districts, and schools in implementing and evaluating obesity prevention policies and interventions, it is apparent that throughout the country there are wide differences in the resources available, the level of evaluation activity, and the extent of commitment to improving the school environment to promote healthy lifestyles. Some schools have implemented extensive changes, with wellness policies in place and improvements occurring in the foods and beverages they offer, the relevant curricula that they present, and the opportunities for physical activity that they provide. Other schools have not yet made changes or are focused on only one aspect of the school environment. Often, the first area of change is in the food and beverage choices made available to students.

The committee urges continued efforts to promote a healthy school environment that encompasses a breadth of changes relevant to nutrition and physical activity and extensive evaluation, as suggested in the Health in the Balance report (IOM, 2005). Additionally, emphasis must be placed on evaluating nutrition and physical activity in child-care, after-school, and preschool settings.

Each of the committee’s four recommendations is directly relevant to improving the efforts to evaluate school-based interventions, policies, and initiatives. The following section highlights the specific implementation actions needed.

Promote Leadership and Collaboration

Given the multiple competing priorities that schools are asked to address—priorities that cover an array of academic, social, and health concerns—there has been a tendency until recently to pay less attention to efforts related to nutrition and physical activity. Leadership is needed at the federal, state, school district, and school levels to:

  • recognize childhood obesity as a serious health concern;

  • implement and prioritize the changes needed to improve nutrition and increase physical activity;

  • establish the expectation and the tracking mechanisms to ensure that standards are followed; and

  • foster creativity and student and parent involvement in developing,



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