Information for Action: School Policies to Prevent Childhood Obesity

An RWJF National Program

Dates of Program: February 2004 through February 2014.

Description: Information for Action took advantage of Arkansas Act 1220 of 2003 to Combat Childhood Obesity by supporting two activities that promoted understanding of the effectiveness of school-based initiatives in reducing childhood obesity:

  • The development and analysis of a database of body mass index (BMI) data collected, per the Act’s mandate, from all Arkansas public school students
  • An evaluation of the effects of Act 1220 on children, families, and schools

Key Results of the Arkansas BMI Database Project:

  • In year 10 of BMI testing (2012–13) the percentage of students classified as either overweight or obese was 37.5, the lowest percentage of the 10-year period. In year 1 of testing (2003–04), 38.1 percent of students were classified as either overweight or obese.
  • Some 31.1 percent of children entering kindergarten were classified as either overweight or obese.
  • Hispanic males had higher rates of overweight and obesity than all other ethnic groups of males or females and at all grade levels tested. Almost half (49.7%) of Hispanic males were classified as overweight or obese.
  • Among females, Hispanic girls had the highest rates of overweight or obesity, with 44.8 percent in those categories, followed by African-American females, with 44.1 percent classified as overweight or obese.
  • A child’s likelihood of obesity appears to be more influenced by his/her family unit than by his/her school, school district, community, or county.
  • Children and youth in grades 3 through 8 in classes with a high proportion of obese students performed significantly worse on math and literacy standardized tests than students in classes with a lower percentage of obese students.

Key Lessons from Nine Years of Findings from the Act 1220 Evaluation:

  • School environments, policies, and practices changed after the passage of Act 1220. School districts implemented required policy changes and also implemented many voluntary changes.
  • Policy change is not necessarily permanent change. Evaluators observed four patterns of school policy change: gradual change over time, early adoption and maintenance of the policy change, early adoption and return to baseline status, and no change or an inconsistent pattern of change over time.

“If you don’t keep the messages fresh and current and keep people reminded about why this is important, then they tend to drift.”—Evaluator Martha M. Phillips

  • Changing school environments was associated with only specific and modest changes in family behavior. Parents made only limited changes to the diets and exercise of their families.
  • It takes changes in both nutrition and physical activity to make changes in BMI at the school level. Schools that adopted a greater number of new nutrition AND new physical activity policies did see a reduction in student weight status compared with schools that made fewer changes, while those that did one or the other did not.

“BMI measurement alone is not going to create a whole lot of behavior change. It’s a constellation of multiple changes within the two broad categories of nutrition and physical activity that really accounts for the greatest change.”—Evaluator James M. Raczynski

Selected Citations

Ryan KW, Card-Higginson P, McCarthy SG, Justus MB, Thompson JW. “Arkansas Fights Fat: Translating Research Into Policy to Combat Childhood and Adolescent Obesity.” Health Affairs, 25(4): 992–1004, 2006. Available online.

Thompson JW, Card-Higginson P. “Arkansas’ Experience: Statewide Surveillance and Parental Information on the Child Obesity Epidemic.” Pediatrics, 124(Suppl. 1): S73–82, 2009. Available online.

Craig RL, Felix HC, Walker JF, Phillips MM. “Public Health Professionals as Policy Entrepreneurs: Arkansas’s Childhood Obesity Policy Experience.” American Journal of Public Health, 100(11): 2047–2052, 2010. Abstract available online.

Krukowski RA, Perez AP, Bursac Z, Goodell M, Raczynski JM, West DS, Phillips MM. “Development and Evaluation of the School Cafeteria Nutrition Assessment (SCNA) Measures.” Journal of School Health, 81(8): 431–436, 2011. Abstract available online.

Phillips MM, Goodell M, Raczynski JM, Perez AP. “Creating and Using Index Scores in the Analysis of School Policy Implementation and Impact.” Journal of School Health, 82(6): 253–61, 2012. Abstract available online.

Phillips MM, Raczynski JM, West DS, Pulley L, Bursac Z, Gauss CH, Walker JF. “Changes in School Environments With Implementation of Arkansas Act 1220 of 2003.” Obesity, 18(Suppl. 1): S54–61, 2010. Available online.

Phillips MM, Ryan K, Raczynski JM. “Public Policy Versus Individual Rights in Childhood Obesity Interventions: Perspectives From the Arkansas Experience With Act 1220 of 2003.” Preventing Chronic Disease, 8(5): A96, 2011. Available online.

Raczynski JM, Thompson JW, Phillips MM, Ryan KW, Cleveland HW. “Arkansas Act 1220 of 2003 to Reduce Childhood Obesity: Its Implementation and Impact on Child and Adolescent Body Mass Index.” Journal of Public Health Policy, 30(Suppl.): S124–140, 2009. Available online.