Passing a school health policy bill is not enough. Ongoing program refinements, monitoring and accountability measures, as well as supportive communitywide efforts, may be necessary to achieve the legislation's goals, according to this study assessing the implementation of a bill which mandates physical education time and a comprehensive school health program. This paper is part of a supplement to the Journal of Public Health Policy, reporting on the 2008 Active Living Research Conference.
The rate of childhood obesity in Texas is higher than the national average, especially among its economically disadvantaged populations. Passed in 2001, Texas Senate Bill 19 requires elementary school children to participate in 30 minutes of physical activity daily, or 135 minutes weekly. In addition, the bill required the state to recommend comprehensive coordinated health programs and for schools to adopt and receive implementation training in these "approved" programs by 2007. The bill's requirements were unfunded and no monitoring or accountability mechanisms were created.
This study has two purposes: First, to assess awareness and adherence to this bill throughout the state by interviewing key staff at 169 sample schools; and second, to evaluate progress in two economically disadvantaged regions—Regions 10 and 11—along the Texas-Mexico border. The study was conducted from 2005–2007.
- Schools were very aware of the mandates for a coordinated school health program and minimum physical activity (96% and 97%, respectively), but significantly less informed about components required in the program, such as parent involvement.
- Physical education minutes averaged 179 per week statewide, well above the minimum, and were even higher in Regions 10 and 11.
- Schools reported fairly low compliance with coordination requirements, such as the creation of school or district-level health committees. One year before the 2007 deadline, only 43 percent had adopted an "approved" coordinated school health program.
- Childhood obesity rates in border schools were high but Region 10's rate was one- third lower than that of Region 11. On almost every measure of compliance with Bill 19, Region 10 was doing better.
Although schools knew of Bill 19's requirements, implementation was mixed. Differences between the border regions indicate the legislation's mandates are not being equally addressed throughout the state. The authors also note Region 10 had a large-scale community health program in place until 2005. Since its discontinuation, the region's obesity rate has started to rise. This may indicate the importance of multicomponent, sustained and funded school and community interventions, in addition to legislation. The authors conclude passing school health policy legislation is not enough. Continued refinements, monitoring and accountability measures, as well as supportive communitywide health efforts, are necessary to achieve the legislation's goals.
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