High School Physical Activity and Nutrition Policy: Summarizing Changes Over Time Using Latent Class Analysis.

Area of Science:

• Public Health
• Health Policy
• Education Policy

Background:

• School physical activity and nutrition policies significantly influence student health behaviors and outcomes.
• Understanding local-level policy changes is crucial for public health and legislative efforts.
• Previous research has not fully captured the evolution of school policy environments.

Purpose of the Study:

• To identify distinct classes of physical activity and nutrition policy environments in school districts.
• To analyze changes in the prevalence of these policy environments from 2000 to 2016.
• To explore associations between policy environments, time, and urbanicity.

Main Methods:

• Latent class analysis of data from the School Health Policies and Practices Study (2000, 2006, 2012, 2016).
• Identification and description of policy environment subgroups.
• Logistic regression to assess associations with year and urbanicity.

Main Results:

• Five distinct latent classes were identified for both physical activity and nutrition policies.
• Physical activity policies improved initially then plateaued; nutrition policies showed consistent improvement (2000-2016).
• Urban-rural disparities in policies narrowed over time, especially for physical activity.

Conclusions:

• The proportion of school districts with satisfactory policy environments increased, likely due to advocacy.
• Persistent unsatisfactory policy classes indicate areas for targeted future interventions and research.
• Continued efforts are needed to ensure all school districts meet policy recommendations.